WHO Stance Risks Derailing UK’s Progress on Smoking

• WHO continues to take a restrictive stance on nicotine pouches, despite growing evidence of their role in harm reduction.
• The United Kingdom is pursuing an evidence-based strategy, combining strict regulation with access to lower-risk alternatives.
• Research shows that nicotine pouches are primarily used by existing nicotine users and have risk profiles similar to approved nicotine replacement therapies.
• Treating all nicotine products the same risks slowing smoking reduction and may protect cigarettes from competition.

As World No Tobacco Day is marked on 31 May, the message is clear. Fewer smokers and fewer lives are cut short unnecessarily.

Yet while the United Kingdom is making rapid progress towards becoming one of the world’s first smoke-free societies, the WHO is advancing an approach that risks moving in the opposite direction.

In its latest report on nicotine pouches, the WHO repeats a familiar message. Alarm, suspicion, and calls for restrictions are recurring themes.

This reflects a broader challenge. Instead of viewing smoke-free nicotine products as tools to help reduce the harm caused by smoking, the WHO considers them a threat that must be contained.

This is happening at a time when smoking still causes more than eight million deaths globally each year. The question is not whether this is a problem—but why solutions that can reduce harm are met with such scepticism.

In the United Kingdom, the government has chosen a different approach, predominantly through the Tobacco and Vapes Act. This framework that is currently being developed clear product standards, responsible marketing regulations, and strong protections for young people.

A particular priority is age verification. The legislation is expected to further strengthen requirements for online sales and introduce a licensing scheme for tobacco and nicotine sales, in what is already a tightly regulated market.

This demonstrates that it is possible to both protect young people and ensure that adult smokers have access to alternatives.

Importantly, the British Standards Institute has established PAS 8877:2022 which is an industry standard that sets detailed requirements or product quality, ingredients, and consumer safety.

This means there is an existing British pouch standard that manufacturers should adhere to. However, these standards are voluntary and are not part of regulation.

One person who sees these developments as positive is Haypp’s Senior Director of Scientific Affairs, Dr Marina Murphy, who comments:

“This is not an unregulated experiment. It is an example of how modern regulation can work in practice.”

What is happening in the United Kingdom is not unique. In the United States, the Food and Drug Administration has scrutinised nicotine pouches for several years, focusing on toxicology, behavioural data, and youth use before authorising a number of products as “appropriate for the protection of public health”.

In Germany, authorities have relied on assessments from a government agency called the Bundesinstitut für Risikobewertung, with the aim of removing products with excessively high nicotine levels while preserving adult access.

And in Sweden, a long-term harm reduction strategy—providing smokers with access to less harmful alternatives—has resulted in the lowest smoking rates and lowest levels of smoking-related disease in Europe.

These are not isolated examples. They show that governments are already doing the work that the WHO is calling for. It means weighing the evidence, setting proportionate rules, and combining consumer protection with public health goals, says Dr Murphy.

The scientific evidence on nicotine pouches is becoming increasingly clear. Toxicological studies show that modern nicotine pouches have a chemical profile broadly similar to pharmaceutical nicotine replacement therapies.

In other words, consumers are using products that are comparable to products that the WHO itself classifies as essential medicines.

Dr Murphy continues:

“Population studies also show that nicotine pouch users are predominantly current or former users of cigarettes, snus, or e-cigarettes.

This is not about attracting large numbers of nicotine-naïve adults, but about offering alternatives to people who already use nicotine.”

When all nicotine products are treated as equally problematic, critical differences are blurred. Products that cause disease and death are placed on the same level as those that can help people stop smoking.

Dr Murphy explains:

“The consequence risks being counterproductive. If less harmful alternatives are restricted in the same way as cigarettes, the incentive to switch is reduced. In practice, this may mean that cigarettes are protected from competition.

The United Kingdom has chosen a different path. By combining strict regulation with a clear understanding of risk differences, the conditions are in place to continue reducing smoking.

The WHO should support this development, not oppose it.”

The gap between the WHO’s position and the policies being pursued in countries such as the United Kingdom is becoming increasingly clear. While national governments adapt to new evidence and real-world outcomes, the WHO maintains a more restrictive and ideologically driven stance.

If the goal is to reduce smoking globally, it requires a strategy that distinguishes between products that cause harm and products that can reduce it.

Dr Murphy concludes:

“Until the WHO recognises this fundamental principle, its recommendations risk appearing increasingly disconnected from both the science and real-world progress.”

In a world where the goal is to make smoking history, World No Tobacco Day should be about highlighting what actually works—not questioning the tools already helping millions of people move away from cigarettes.