Advocacy group warns EU heart plan risks undermining harm reduction

Global nicotine pouch advocacy group Considerate Pouchers has criticised the European Commission’s newly unveiled Safe Hearts Plan, arguing that it fails to properly distinguish between combustible tobacco and smoke-free nicotine products such as pouches.

The Safe Hearts Plan, launched on 16 December as part of a wider EU health package, is the bloc’s first coordinated approach to tackling cardiovascular disease. However, Considerate Pouchers says the prevention chapter groups nicotine pouches together with cigarettes, heated tobacco and e-cigarettes, linking them to potential future taxation under a revised Tobacco Taxation Directive.

According to the group, this approach ignores the fundamental driver of smoking-related cardiovascular disease: combustion. Cigarettes expose users to carbon monoxide, fine particulates and thousands of toxic by-products created by burning tobacco, which are strongly linked to heart disease and stroke. Nicotine pouches, by contrast, do not burn, produce no smoke and do not expose users to these cardiovascular toxins.

“If the goal is to reduce heart disease, the science is clear. Combustion causes cardiovascular harm. Nicotine pouches do not involve combustion. Treating them like cigarettes may be administratively simple, but it ignores evidence, real-world data, and basic public health logic,” said Juan Rafael Taborcía, global spokesperson for Considerate Pouchers.

The group points to comparative risk assessments that place cigarettes at the highest end of the harm scale, while nicotine pouches are estimated to carry around a 99.9 per cent lower health risk relative to smoking. The group also highlights Sweden as a real-world example of risk-proportionate regulation delivering public health gains. Sweden, where smoke-free oral nicotine products are widely available, has the lowest smoking rate in the EU at 5.3 per cent, alongside tobacco-related mortality rates 44 per cent lower than the EU average and the lowest lung cancer incidence in Europe.

“These results were achieved through risk-proportionate regulation, not bans or punitive taxation,” the organisation said, warning that equal taxation of unequal products could reduce incentives for smokers to switch away from cigarettes, keep smoking rates higher and increase the risk of illicit trade.

The group has called on the European Commission and Member States to ensure future tobacco and nicotine policy under the Safe Hearts Plan clearly differentiates between combustible and smoke-free products, with taxation aligned to relative risk.