A group of European scientists has warned the European Commission that public statements about the risks of smoke-free nicotine products may be misleading and could undermine efforts to reduce smoking across Europe. The experts sent an open letter to the EC President Ursula von der Leyen, criticising official statements about the risks of smoke-free products, calling them “false and misleading”.
The academics specialising in medicine, toxicology, epidemiology and addiction science argue that recent claims suggesting alternatives such as e-cigarettes, heated tobacco products and nicotine pouches may be as harmful as cigarettes contradict established scientific evidence. Notable members of the scientific community, including Professor Riccardo Polosa of the University of Catania (IT), Professor David Nutt of the Imperial College London (UK) and Dr Anders Milton, Former President of World Medical Association (SW) are among the signatories.
The letter was published on the website of Clive Bates, a British policy expert on tobacco and harm reduction. It aims to address and correct several statements made by European Commissioner Olivér Várhelyi, Commissioner for Health and Animal Welfare, which the authors believe contradict current scientific evidence.
According to the scientists, the real concern isn’t whether these products are entirely safe—a claim made by very few—but whether policymakers are clearly communicating how the risks of these products compare to those of combustible tobacco. “There is no scientific basis for claiming that smoke-free nicotine products have risks comparable to cigarettes,” the letter states. “Policies based on such misinformation could discourage smokers from switching away from the most dangerous form of nicotine consumption.” Smoking remains the leading cause of preventable death in the European Union, responsible for nearly 700,000 deaths every year.
The harm-reduction debate
The main issue in this debate is tobacco harm reduction. Many public health researchers believe that although nicotine products are not completely safe, how nicotine is consumed makes a big difference. Cigarettes burn tobacco and create thousands of toxic chemicals that cause most smoking-related diseases. In contrast, smoke-free products—such as vapes, heated tobacco, and nicotine pouches—provide nicotine without combustion.
Dr Konstantinos Farsalinos, a cardiologist and researcher specialising in tobacco harm reduction, said public messaging should clearly distinguish between these risks. “Claiming that the harm caused by smokeless nicotine products is comparable to conventional cigarettes is in disagreement with scientific evidence and common sense,” he said. “Public health communication should encourage smokers to move away from combustible tobacco.” Advocates of harm reduction argue that policies should recognise these differences and encourage smokers who cannot quit nicotine entirely to switch to lower-risk alternatives.
Evidence from other countries
Supporters of the approach frequently point to countries where smoking has declined rapidly alongside the availability of alternative nicotine products. Sweden is often cited as a leading example. Thanks largely to widespread use of snus and nicotine pouches, Sweden is close to becoming the first country in Europe to achieve “smoke-free” status, defined as fewer than 5% of adults smoking.
Cancer rates associated with smoking are also significantly lower than the European average.
The United Kingdom has taken a similarly pragmatic approach to vaping, with public health authorities acknowledging that e-cigarettes are substantially less harmful than smoking. Government-backed campaigns encouraging smokers to switch have contributed to a sharp fall in smoking prevalence over the past decade. Professor Gerry Stimson, a British public health researcher and pioneer of harm-reduction policy, has described vaping as: “A consumer-led market solution to a health problem.” Countries including New Zealand have also seen substantial reductions in smoking rates as vaping has become more widespread.
EU policy under review
The scientists’ letter comes at a crucial moment for tobacco regulation in Europe.
Brussels is currently reviewing several major policy frameworks, including:
- the Tobacco Products Directive (TPD)
- the Tobacco Excise Directive (TED)
- measures linked to the Europe’s Beating Cancer Plan
The EU’s long-term goal is to create a “tobacco-free generation” by 2040, meaning fewer than 5% of Europeans using tobacco products. Some proposals under discussion could introduce higher taxes and stricter regulations on emerging nicotine products. Critics argue that treating lower-risk alternatives the same as cigarettes could unintentionally slow progress in reducing smoking.
The scientists warn that excessive taxation or restrictive regulation may remove incentives for smokers to switch away from combustible tobacco. “Fiscal and regulatory provisions that discourage the switch from smoking to less risky alternatives are unethical and protect the cigarette trade,” the letter states.
Concerns about youth use
However, many public health authorities remain cautious about the rapid growth of nicotine alternatives. Health ministers from several EU countries have urged stronger regulation of vaping and other products, citing concerns about youth uptake and marketing practices.
International health organisations have also warned that flavoured nicotine products could attract younger users who might not otherwise smoke. This tension reflects a broader global divide in tobacco policy. One side argues that harm-reduction technologies offer the fastest way to reduce smoking-related deaths. The other emphasises precaution, warning that widespread nicotine availability could create new public-health challenges.
Science and policy
The scientists behind the letter say their aim is not to promote nicotine use but to ensure that policymaking remains grounded in scientific evidence. “Europe’s public health policies must be guided by science,” the letter concludes.
With more than 100 million nicotine users across the European Union, the stakes for policymakers remain high. As Brussels prepares the next generation of tobacco legislation, the debate over harm reduction versus precaution is likely to intensify.
The letter was signed by 23 experts in public health, addiction science and tobacco control, including researchers from institutions such as Imperial College London, the University of Nottingham, the University of Catania, the Norwegian Institute of Public Health and the University of Michigan.
The letter has also been supported or endorsed by several organisations involved in tobacco harm-reduction research and policy discussion, including:
- European Tobacco Harm Reduction Advocates (ETHRA)
- International Association for Smoking Control and Harm Reduction (SCOHRE)
- Spanish Medical Platform for Tobacco Harm Reduction (PRDT)
These organisations advocate a risk-proportionate regulatory approach to nicotine products.
