Alarmism Is Ruining Harm Reduction and Lives

Recent data and discussions around oral nicotine products like Zyn and other nicotine pouches call for a nuanced examination of public health policies targeting these alternatives to combustible cigarettes. Despite concerns over youth usage, the evidence suggests that these products do not pose the same level of risk as traditional tobacco products, and restrictive policies may be overlooking their potential benefits.

The Centers for Disease Control and Prevention’s (CDC) 2024 National Youth Tobacco Survey (NYTS) has provided some crucial insights. The survey revealed that while youth vaping rates have significantly declined, the usage of nicotine pouches among U.S. middle and high school students is minimal—only 1.8 percent in 2024, a slight increase from 1.5 percent in 2023. These figures are starkly lower than the 5.9 percent who reported vaping and much less than the 22 percent who reported drinking alcohol. This suggests that nicotine pouches are not as appealing to youth as other substances, a point often overshadowed in public discourse.

Moreover, the public health response, particularly from bodies like the American Lung Association (ALA), seems disproportionately alarmist. Focusing intensely on products like Zyn could detract from broader anti-smoking efforts that aim to reduce the much more significant harms associated with smoking combustible cigarettes. Research indicates that smoke, not nicotine, is the primary cause of tobacco-related health issues. Oral nicotine products, by eliminating smoke, might represent a safer alternative.

This perspective is supported by global experiences. For example, Sweden, where similar products like snus (a type of smokeless tobacco) have been popular for decades, boasts the lowest smoking rates and one of the lowest lung cancer rates in Europe. This suggests that smokeless products can play a role in reducing smoking rates and associated diseases.

It’s important to consider the role of public perception influenced by health campaigns. The “e-cigarette epidemic” narrative in past years led to a spike in e-cigarette use among youth, following intense media and policy focus. This pattern warns against overly aggressive campaigns against nicotine pouches, which might inadvertently heighten interest among the youth, contrary to public health goals.

Policymakers should ensure that nicotine products do not target youth. However, the evidence suggests that nicotine pouches are not being used by youth at concerning levels. Policies aimed at reducing youth exposure to nicotine must be balanced with the needs of adults who seek safer alternatives to smoking. The Food and Drug Administration’s approach to regulating tobacco products, including the expedited approval of harm reduction products like e-cigarettes and nicotine pouches, reflects an understanding of these nuances.

Given the potential of oral nicotine products to serve as harm reduction tools, public health initiatives should focus more on reducing the impact of the most harmful tobacco products rather than imposing stringent restrictions on all nicotine products. A policy framework that acknowledges the varying levels of risk associated with different tobacco and nicotine products will likely be more effective at improving public health outcomes.

While protecting youth from nicotine addiction is paramount, public health policies must also consider the full spectrum of scientific evidence and real-world data. This ensures that adults who are looking to reduce their smoking habits have access to safer alternatives, potentially leading to significant public health benefits.