The UN’s war on nicotine confuses addiction with harm, risking lives by sidelining safer alternatives that could end smoking’s deadly toll.
Later this month, world leaders will gather in New York to adopt the United Nations’ latest political declaration on non-communicable diseases (NCDs). Framed as a bold step toward cutting premature mortality from cancer, cardiovascular disease, COPD, and other chronic conditions by one-third before 2030, the document carries the weight of ambition. Yet hidden within its language is a troubling misstep: the conflation of nicotine itself with smoking, and the framing of all nicotine use as inherently harmful.
For advocates of tobacco harm reduction, this is a dangerous departure from evidence-based policymaking. “The global effort to reduce non-communicable diseases by one-third by 2030 has been hijacked by tobacco control ideologues. It will not end well,” highlighted tobacco harm reduction expert Clive Bates in the opening statement of a blog on the matter. He explained that by placing “tobacco and nicotine control” side by side, the declaration blurs the crucial distinction between high-risk combustible products and low-risk smoke-free alternatives. This is more than a semantic issue. It risks discouraging the very strategies—switching from cigarettes to safer nicotine products—that could save millions of lives.
“The global effort to reduce non-communicable diseases by one-third by 2030 has been hijacked by tobacco control ideologues. It will not end well.”Clive Bates, THR expert
Earlier this year, the Head of the Secretariat of the WHO’s infamous Framework Convention on Tobacco Control (FCTC), Dr. Adriana Blanco Marquizo caused outrage among THR experts, when she passed sweeping comments lumping the tobacco industry and the alternative nicotine industries together. She said that these industries continue to exploit youth through flavours, packaging, and deceptive marketing, fuelling addiction and long-term health risks. And while of course we are all in agreement that some dishonest manufacturers of nicotine products do indeed try to target minors, most are aware that the vast majority are well intentioned, aiming to produce effective nicotine products which would help adult smokers quit.
Attacking nicotine threatens the fight against smoking
The UN insists that loopholes and weak enforcement allow companies to bypass regulations – again true in some cases. However, where it all goes wrong: while the WHO FCTC provides governments with tools to restrict flavours, enforce advertising bans, regulate product design, and prevent industry interference, it also encourages sweeping bans.
Meanwhile, as has been written numerous times, decades of research are unambiguous: the harms of smoking do not come from nicotine, but from the toxic products of combustion. Burning tobacco releases thousands of chemicals, dozens of which are proven carcinogens. By contrast, smoke-free alternatives such as nicotine pouches, snus, vaping, and heated tobacco deliver nicotine without producing the same deadly cocktail of toxins. To treat all nicotine use as equally dangerous is to ignore this evidence—and, worse, to potentially stall progress against smoking-related disease.
The perils of nicotine eradication
Interestingly, highlighted Bates, earlier drafts of the UN’s NCD declaration focused more squarely on smoking and taxation of combustible tobacco. The sudden shift toward “nicotine control” appears to have emerged during later negotiations, reflecting ideological positions within certain tobacco control circles.
This ideological framing matters. By calling for blanket restrictions and higher taxes on nicotine products, the declaration risks penalizing smokers who seek out safer alternatives. Such policies could make it harder, not easier, for them to quit smoking. The result? More people continuing to inhale smoke, and more preventable deaths.
This is a textbook example of letting ideology override science. Harm reduction, whether applied to drugs, alcohol, or sexual health, is about meeting people where they are and offering safer options. In the case of tobacco, that means recognizing that while nicotine is addictive, it is not the killer. Smoke is.
Yet the controversy highlighted a deeper truth: Poland, where tobacco-related illness claims around 67,000 lives each year, could benefit enormously from adopting the harm reduction strategies seen in Sweden or the UK. Instead of demonizing nicotine, policymakers should focus on eliminating the far more deadly act of smoking.
The missed opportunity
The UN has an unparalleled platform to influence global health policy. Its declarations set the tone for national governments, international agencies, and funding priorities. But with this influence comes responsibility. By framing nicotine itself as a central threat, the UN risks repeating the mistakes of prohibitionist policies that have historically backfired.
A smarter, evidence-based approach would differentiate clearly between combustible tobacco and safer nicotine alternatives. It would encourage governments to scale access to lower-risk products, invest in education campaigns for both consumers and healthcare providers, and design tax systems that reflect relative risk rather than punishing all products equally.
The global fight against NCDs requires pragmatism, not ideology. Millions of smokers cannot or will not quit nicotine entirely, but they can quit smoke. Denying them safer alternatives in the name of “nicotine control” is not only unscientific—it is unethical.