The debate over nicotine's status is about to take centre stage at the United Nations, with a potential global ban looming by 2028. The catalyst for this development is a request from Palau, which has asked the World Health Organization (WHO) to review nicotine's legal standing. At the heart of the issue is whether addiction and dependence on nicotine alone should be classified as harmful, even in cases where other significant health consequences are not apparent.
Against this backdrop, the popularity of tobacco-free nicotine products such as vapes and nicotine pouches has surged globally. While the risks associated with traditional cigarettes are well-documented – according to former WHO head Gro Harlem Brundtland's 2000 statement, 'a cigarette is the only consumer product which when used as directed kills its consumer' – the implications of nicotine itself are less clear-cut.
The argument for a ban centres on the principle that highly addictive substances should be curtailed, even if their long-term consequences are not immediately apparent. However, some experts argue that caution is necessary. Nicotine products have been shown to offer benefits, particularly for smokers trying to quit. A recent Cochrane review found that individuals who switch to vaping are twice as likely to successfully stop smoking.
Despite this, regulators face a complex challenge. Concerns have been raised globally about the rapid emergence of the nicotine product market in a regulatory grey area. The WHO has highlighted that children are nine times more likely to vape than adults, and some e-cigarettes contain harmful ingredients such as heavy metals. Nicotine is also detrimental to adolescent brain development, according to the UK's Royal College of Physicians, which found 'current evidence suggests nicotine itself confers little risk to health'.
A middle ground is being sought. The UK will introduce a new smoking ban next year, including restrictions on e-cigarette displays and advertising, and allows for further limitations on child-friendly flavours. Some are calling for ministers to go further, emulating measures seen in Quebec, Canada, where e-cigarettes have been heavily restricted.