How the world’s leading health bureaucracy produced over 100 pages of panic and forgot about smoking
The World Health Organization has released a new report on nicotine pouches titled “Exposing marketing tactics and strategies driving the global growth of nicotine pouches.” Unfortunately, after wading through dozens of pages of bureaucratic alarmism, a simpler title that might have been more accurate is “Everything We Hate About People Using Nicotine.”
The report is a masterpiece of modern public health absurdity. It manages to discuss flavours, fonts, influencers, social media, branding, youth trends, marketing psychology, regulatory loopholes (aka businesses complying with the law), nicotine concentrations, sponsorships, and “lifestyle positioning” while somehow ignoring the central scientific fact that nicotine pouches are orders of magnitude less harmful than smoking cigarettes.
But science seems to have wandered out of the building along with Elvis somewhere around page three.
Instead, readers are treated to a kind of nicotine-themed ghost story in which fruit flavours and sleek packaging threaten to “renormalise nicotine use” and unravel decades of tobacco control progress. You half expect the next WHO briefing to warn that using a nicotine pouch may also summon ancient demons or destabilise the Earth’s magnetic field.
The report’s preferred policy options are as subtle as a brick and as well thought-out as using a sieve to bail out a sinking boat. Governments are encouraged either to ban nicotine pouches outright or regulate them into oblivion through flavour bans, nicotine caps, plain packaging, advertising prohibitions, and restrictions so extensive they would make a third world dictator blush (no offence, Dr Tedros).
Curiously missing is any serious engagement with the growing body of evidence that smoke free nicotine products dramatically reduce harm compared to cigarettes. The WHO does not meaningfully discuss the U.S. Food and Drug Administration authorisations for oral nicotine products. It avoids the inconvenient Swedish experience almost entirely, despite Sweden having the lowest smoking rate and among the lowest smoking-related death rates in Europe thanks largely to oral nicotine use.
That omission is especially comic given that Sweden is precisely the sort of real world public health success story international health agencies are supposed to celebrate. Swedish men have dramatically lower rates of smoking related cancers and cardiovascular disease compared to much of Europe thanks to a permissive policy over oral nicotine, but that doesn’t fit the narrative the WHO is paid to wants to convey.
Instead, the report reads like an instruction manual for how to protect cigarettes from competition. That may sound unfair until you consider the practical outcome of the WHO’s recommendations. Cigarettes remain widely available almost everywhere in the world, sold in supermarkets, gas stations, and convenience stores. Meanwhile, the products that threaten the cigarette trade most effectively are the ones the WHO demands are banned, regulated to extinction, and subject to relentless public misinformation campaigns.
The WHO is beginning to resemble a cartel protection racket for combustible tobacco, which is appropriate seeing as, in many countries, it is criminal gangs who are eagerly filling the void created by WHO-endorsed policymaking (hello, Australia!). The organization insists it is fighting Big Tobacco while systematically undermining innovations that could eradicate cigarette sales.
The report fusses endlessly about nicotine pouch growth in countries such as Germany. The small problem is that nicotine pouches are banned there already. Which means the booming market the WHO cites as evidence of danger has been created despite exactly the kind of policy the WHO endorses. Surely an important detail which should have been picked up when the document was reviewed.
Likewise, countries such as Belgium and the Netherlands have seen burgeoning illegal trade despite prohibitions and restrictions. Police seize quantities of illicit nicotine pouches while shops continue selling them anyway. The WHO observes all this with the confused mentality of someone throwing petrol on a house fire and wondering why the flames keep getting bigger.
Most telling of all is the report’s obsession with “renormalisation” of nicotine use. This word appears so frequently that you wonder if WHO officials have ever looked around them when leaving their offices. Nicotine has been used, normally, for thousands of years. You’d think a global health agency may have noticed.
The tragedy here is that the WHO was once an institution capable of leading genuine public health progress. Today it increasingly resembles an ideological cult suggesting a nicotine purity test where all forms of nicotine are treated as equally sinister regardless of scientific evidence.
The WHO claims it aims to reduce tobacco-related harm. Increasingly, however, its lucratively-funded policy suggestions, as shown in this latest report, are helping to perpetuate it. Nice work if you can get it!