Why is there so much opposition to safer nicotine products, including from the WHO?

There is continuing debate within tobacco control and public health about the role of safer nicotine products in reducing smoking-related harm.

Organisations including the World Health Organization (WHO) have raised concerns about youth uptake, nicotine dependence, marketing to non-smokers, uncertainty about long-term health effects and the involvement of the tobacco industry in the manufacture and promotion of newer nicotine products. The WHO argues that these concerns justify strong regulation and, in some circumstances, restrictions on their availability.

Other public health organisations and experts take a different approach. They argue that, for adults who smoke, switching completely from combustible cigarettes to lower-risk nicotine products can substantially reduce exposure to the toxic substances produced by burning tobacco. For example, the UK Royal College of Physicians concluded in its 2024 evidence review that e-cigarettes remain an important tool for reducing the death, disability and inequalities caused by tobacco use.

The disagreement therefore concerns not only the relative risks of different nicotine products, but also how their potential benefits for people who smoke should be balanced against risks such as uptake by young people and non-smokers. Different assessments of this balance have led to very different policy approaches around the world.