Earlier this month, Iceland’s Office of Health Promotion and Science launched a consultation on a draft law on nicotine products. If passed, the law will introduce age limits for nicotine consumption, ban e-cigarette flavors perceived to appeal to children, and stipulate a permissible maximum nicotine concentration.
Nobody is arguing that children should take up nicotine products, and introducing age restrictions for pouches and gums, among others, is sensible. The current minimum age for buying vapes in Iceland is 18. The proposed bill intends to introduce the same limit for other nicotine products. ID requirements and potential fines for retailers increase compliance rates, as the examples of Germany and Canada show.
However, the other aspects of the proposed law seek to protect children at the expense of adult smokers and vapers—a theme we’ve seen repeated elsewhere in the world. The underlying assumption that nicotine is everyone’s enemy is concerning. A better appreciation of the facts about nicotine and flavors would add impetus to Icelandic efforts to reduce smoking that are already succeeding.
Iceland today has a reported adult smoking rate of just 7 percent—the lowest in Europe apart from Sweden, where smokeless snus has been widely adopted as a replacement for cigarettes. As recently as 2014, Iceland’s reported adult smoking rate was 14 percent; the rise of vaping among tens of thousands of Icelanders has been credited, in part, with smoking’s rapid decline.
Vaping is vastly safer than smoking. Yet nicotine consumption is traditionally associated with smoking, and that association continues to distort perceptions.
The truth is that nicotine is relatively harmless—unlike toxins found in tobacco smoke. According to Yorkshire Cancer Research in England, “Nicotine is not the cause of death from smoking. Nicotine is not a carcinogen; there is no evidence that sustained use of nicotine alone increases cancer risk. Of the three main causes of death from smoking (lung cancer, Chronic Obstructive Pulmonary Disease and cardiovascular disease), none are caused by nicotine. The harm from smoking comes from the thousands of other chemicals in tobacco smoke.”
Nicotine is also used in nicotine-replacement therapy, which speaks for its harmless qualities. Multiple studies have found that it also enhances cognitive function and reduces the risk of Parkinson’s disease.
Giving up on smoking is difficult. And if nicotine is safe, then the goal of tobacco control should be to endorse safer ways of consuming nicotine. Thanks to innovation, there are several ways to do that. Some smokers prefer nicotine pouches and gums, or, as seen in Sweden, forms of smokeless tobacco. For many others—the bulk of 82 million people worldwide at one recent count—e-cigarettes are the best way to quit smoking and the health risks that come with it.
Given all this, how can it be justified to limit the amount of nicotine that vapers may consume? When vapers are overwhelmingly either ex-smokers or smokers in the process of switching, allowing whatever nicotine concentrations best help them to stay off cigarettes is a clear public health imperative.
Vape flavors, which Iceland also proposes to ban, are moreover an essential element in helping many smokers quit. They’re routinely mischaracterized as appealing uniquely to children, but adults prefer them too.
Flavor bans drive vapers—teenagers, too—back to smoking or into the riskier illicit market. A 2020 survey of vapers in Canada, England and the United States found that in response to flavor bans, “28.3% would find a way to get their banned flavor(s), 17.1% would stop vaping and smoke instead.” Does Iceland want to prove the point?
While the architects of the new law may have good intentions, they need a better grasp of these realities. Sensible regulation, including child and consumer protections, can be achieved without removing key options that smokers need to switch. As it stands, the legislation risks counteracting years of Icelandic progress.
Originally published here