In every gas station and convenience store, a new category of addictive products is flying off shelves. This new thorn in the side of public health advocates is tobacco nicotine pouches. These pouches are made of wood pulp and salt, filled with nicotine, and flavors placed under the upper lip to give the user a buzzing sensation.
What do we make of this new nicotine rush and what it means for society? As our smoking rate declines to an all-time low of just 11 percent, it means we’re in for a paradigm shift in how we view nicotine. And we should welcome it.
On social media and Wall Street, pouches have become a craze. Politicians like Senate Majority Leader Chuck Schumer have deemed them “quiet and dangerous,” asking the FDA to crack down. Health Minister Mark Holland has banned flavored varieties in Canada and restricted their sales to only pharmacies. And nicotine products have become a cultural fixation heralded by GOP members of Congress, broadcaster Tucker Carlson, and the political campaign of Republican vice-presidential nominee JD Vance.
With people more aware of the harmful effects of smoking cigarettes, adult smokers have begun shifting their addictions to products deemed less risky. Entrepreneurs and tobacco firms have delivered on this trend, but public institutions have been less tactful in response.
Alternative nicotine products like vaping devices, gums and pouches have markedly lower risk than cigarettes. They could help save some of the hundreds of thousands of lives lost to smoking illnesses each year. Despite the scientific evidence in favor of alternative nicotine products, the FDA continues to be outdated and obstinate. The FDA regulates vaping devices and pouches as “tobacco products” — even though they do not contain tobacco.
The FDA’s Premarket Tobacco Product Application restricts sales of these new products, forcing firms to endure a byzantine application and review process that is insurmountable for any small business. Of the nearly 27 million applications, just 34 vaping devices or nicotine alternatives have been authorized, all of which are primarily products of tobacco firms that can afford the compliance costs.
And while perceptions across health and political establishments sour on the utility of these products, and make them less available to adults, they’ve also become captive to outright misinformation.
A 2020 study in the Journal of General Internal Medicine revealed that more than 80 percent of U.S. physicians surveyed wrongly believe that “nicotine causes cancer” rather than smoking itself. According to a recent Gallup survey, 79 percent of Americans believe cigarettes are very harmful, and 57 percent say the same about vaping devices. That number dips to 34 percent for nicotine pouches.
Public health institutions have contributed to these false perceptions, buoyed by a vibrant industry of philanthropists who would prefer to outlaw nicotine altogether. While youth access to nicotine products should continue to be of paramount concern to regulators, we should also recognize that technological innovation has delivered a less harmful way for adults to use nicotine once they’re addicted.
It’s time our institutions reflect this reality.
First, the FDA must communicate to adults the truth about nicotine alternatives to traditional tobacco products. Whether it’s pouches or flavored nicotine vaping devices, the risk of using these products would be significantly lower.
Second, governments should tax lower-risk nicotine products less. Pouches and vaping products should not be taxed the same as cigarettes. If sin taxes are here to stay, they should at least be proportionate and nudge consumers toward less risky products.
This has been the approach of countries such as Sweden, which now boasts some of the lowest smoking-related illness rates in the world.
Third, in the private sector, the health and insurance industries must accept the risk profile of the new generation of nicotine products and recalibrate their plans. Many health and life insurance policies still equate smoking cigarettes with using non-tobacco nicotine products. That practice should change to reflect scientific reality and facts.
Misguided public policy forces adult smokers to choose between an arbitrarily limited number of legal options, many of which are decades-old legacy products, the rampant illicit market for illegal disposable vapes and nicotine pouches, or continuing to smoke cigarettes.
When they do switch, our institutions are set up to continue to punish them with higher taxes and insurance policies. This cannot stand. As our culture updates its perception of nicotine, we should make sure our policies do the same. That is the best way to save lives and lower healthcare costs for most people.
Originally published here
