CLEMENT: BC will give you drugs for free but makes nicotine pouches hard to get

Just a few months ago a new, legal smoking cessation tool, nicotine pouches, came onto the market in Canada. The emphasis on legal is important, because nicotine pouches were widely available in Canada prior to the launch of legal pouches, they just weren’t sold legally nor were they regulated by Health Canada. In fact, the availability of nicotine pouches before legal products were available was so widespread that Health Canada, more than three years ago, had to issue a health safety information notice about it.For the legal products that are now on the market, they are regulated by Health Canada as a smoking cessation tool and because they don’t have tobacco in them at all, they aren’t regulated like tobacco products.But, as with any new product when it hits the market, especially in the world of tobacco harm reduction, calls for heavy-handed regulations are par for the course. In fact, just this month, BC’s health minister announced that these nicotine pouches will no longer be available at convenience stores and will only be sold through pharmacies.The goal, in the minister’s own words, is to protect children from accessing these products and becoming addicted to nicotine. That is certainly a valid concern. I don’t think anyone, or at least anyone with some sense, wants minors having access to nicotine products.However, the problem with only having these products available at pharmacies is two-fold. First, where do smokers buy cigarettes? Would it not make sense for the reduced-risk products that help smokers quit to be sold alongside cigarettes? In fact, that has been the approach for vaping, which is another tool that when used by smokers is shown to be effective for quitting.It would be a lot easier to simply have nicotine pouches sold from behind the counter at convenience stores so that every time a smoker goes to make their purchase they are offered the choice of a significantly less risky product. The German Federal Institute for Risk Assessment (BfR) published a comprehensive review on nicotine pouches and the results are pretty eye opening. On a harm scale, with 100 representing the risk from smoking, and 0 representing not consuming any product with nicotine, the BfR gave nicotine pouches a score of 1.For minors and the products attracting minors to nicotine, the authors cite evidence that these pouches have very limited appeal (11% to12%) to people who have never consumed tobacco products before. That’s good news.In comparison, for smokers or those who use chewing tobacco, interest in nicotine pouches skyrockets to 75%. This, of course, should be intuitive for policy makers given that most smokers spend much of their lives trying to quit smoking and pouches are a potential off-ramp for them. So, pouches are an exponentially lower risk alternative to smoking, that generates little interest from those who don’t smoke and yet the health minister wants to limit their availability?The second main issue with the new rule is that it is wildly inconsistent with the province’s overall adoption of harm reduction. BC has fully embraced harm reduction, for substances exponentially more harmful than nicotine. At every turn, the province has pushed policies that seek to save lives by removing as much harm as possible from the addictions people suffer with. But when it comes to nicotine, there appears to be a huge blind spot. Calling it hypocritical would be an understatement.If the health minister took a look at what has worked in Sweden, a country where these low-risk alternatives are widespread, he would see how harm reduction actually works in practice. The German BfR researchers clearly point out that Sweden is the only country in Europe where lung cancer isn't at the top of the list for cancer mortality. Lung cancer in Sweden, because of the embrace of tobacco harm reduction, is the lowest in all of Europe’s 40 countries. In Canada, lung cancer is the leading cancer killer, with well over 20,000 Canadians dying annually.And for those worried that pouches may serve as a gateway to smoking, again the evidence from Sweden shows the opposite to be true. The risk assessors highlight that in Sweden nicotine alternatives did not act as a gateway to smoking and that smokers who use these alternatives are often able to quit smoking altogether.The health minister, in trying to protect children, is limiting access for smokers who want, and need, to use low risk alternatives to quit. Having nicotine pouches sold alongside cigarettes, so that smokers can make the switch, would be applying harm reduction in a consistent manner.David Clement is the North American Affairs Manager at the Consumer Choice Center

CLEMENT: BC will give you drugs for free but makes nicotine pouches hard to get

Related Stories