When Conviction Replaces Evidence: EU Claims on Nicotine Pouches Defy Public Health Science

Something unusual just happened in Brussels.

In an interview with Euractiv, EU Health Commissioner Olivér Várhelyi claimed that nicotine pouches are “100% as harmful as cigarettes.”

At the same time, the European Commission acknowledged that it is still waiting for World Health Organization studies on nicotine pouches that are not expected until 2026.

So the conclusion is already in, even though the evidence is not.

That is not how science usually works.

What Actually Causes Smoking-Related Disease

For decades, medical research has established that the primary driver of smoking-related cardiovascular disease, cancer, and respiratory illness is combustion, not nicotine itself.

Burning tobacco produces carbon monoxide, fine particulates, and thousands of toxic by-products that damage blood vessels and significantly increase the risk of heart disease and stroke.

Nicotine pouches do not burn, do not produce smoke, and do not expose users to combustion-related toxins, as Germany’s Federal Institute for Risk Assessment confirms.

This distinction is foundational in toxicology and cardiovascular science.

What Risk Assessments Actually Show

Independent health authorities routinely compare nicotine products based on toxic exposure and disease outcomes.

On a relative harm scale, cigarettes score 100, while nicotine pouches score approximately 0.1.

That represents a 99.9% lower health risk compared to smoking.

These conclusions align with toxicological reviews conducted by the UK Committee on Toxicity and are further reinforced by Germany’s Federal Institute for Risk Assessment.

Lower risk does not mean no risk. It means no comparable risk.

Real-World Outcomes Do Not Support the Claim

If nicotine pouches were truly “100% as harmful as cigarettes,” population-level data would reflect that. It does not.

In Sweden, where smoke-free oral nicotine products are widely available, smoking prevalence has fallen to approximately 5.3 percent.

Eurostat confirms that this is the lowest smoking rate in the European Union.

Sweden also records roughly 44 percent lower tobacco-related mortality than the EU average, reports the lowest lung cancer incidence in Europe, and shows lower rates of cardiovascular disease compared to neighboring countries.

These outcomes were achieved through substitution and risk reduction, not prohibition.

A Reversed Standard of Proof

The Commission has stated that it is still waiting for WHO studies due in 2026. So on what scientific basis can a definitive claim be made today?

In normal science, evidence precedes conclusions. Here, the conclusion arrived first.

Why This Matters

When policymakers treat unequal risks as equal risks, they distort consumer behavior. Research consistently shows that access to lower-risk alternatives increases switching away from smoking and reduces disease burden.

Conversely, overregulation and excessive taxation reduce switching and increase the likelihood of illicit trade. Despite decades of regulation, the EU’s adult smoking rate has stalled at around 24 percent.

The Question Brussels Has Not Answered

Combustion and non-combustion are not the same. Cigarettes and nicotine pouches are not interchangeable. Declaring them “100% equivalent” while admitting the evidence is still pending is not precaution. It is certainty without proof.

And when public health policy stops following evidence, the outcomes are predictable.

Combustion still changes everything.