More than one billion people continue to smoke worldwide, and smoking sits in the category of avoidable, high-risk behaviour. In Sri Lanka, where 3.4 million of adults still smoke, it remains a big issue for public health. The question for policymakers, communities, and responsible companies is how smokeless nicotine products can be supplied in ways that reduce the risks associated with smoking-related diseases.
For years, the science has been clear: the health issues from smoking come primarily from combustion of the cigarette that creates the smoke, not nicotine. When you light a cigarette and burn tobacco, it releases thousands of toxic chemicals, and that is the globally accepted, scientifically backed, primary cause of smoking-related diseases. This is why new products based on this non-combustible principle have been developed, for example, vapour products, which heat a liquid into a vapour and oral nicotine pouches which don’t involve tobacco or combustion.
These pouches are a clear example of innovation at work. They’re nicotine pouches that you place in your mouth. There’s no burning and more critically no smoke.
Due to the lack of combustion when using oral nicotine pouches, the levels of 9 key toxicants the World Health Organization recommends reducing in cigarette smoke, are decreased by approximately 99% when compared with the smoke from a scientific standard reference cigarette (approximately 9mg of tar).
But meaningful innovation goes beyond analysing a product. To fully unpack impact, we must also understand if nicotine pouches can have a lasting, positive public health effect. For this, we look to Sweden for a real-world case study. Over the past few decades, a shift toward non-combustible oral tobacco and nicotine products in the market, coincided with some of the lowest smoking prevalence rates and tobacco-related mortality in the European Union. Multiple public health analyses concluded that smokeless alternatives contributed to Swedish men’s lower smoking prevalence and smoking-related diseases, suggesting a population-level benefit when smokers switch completely from combustible products like cigarettes. This stands in stark contrast to Sri Lanka, where 17.7% of adult male population still smoke.
The world is changing, and technology has enabled us to take a substantial leap forward in creating smokeless nicotine alternatives to cigarettes. That said, the public health community rightly urges caution. Some authoritative voices warn that allowing the marketing of smokeless products like vapes and nicotine pouches will cause unintended consequences, like underage access. The marketing of these products must therefore be married with robust regulation: strict age verification, marketing restrictions that prevent underage appeal, product quality standards for ingredients and clear labelling.
So, what should good regulation and industry practice look like? First, regulate smokeless nicotine products, recognising their reduced risk profile compared to smoking. Encourage adult smokers who do not quit, to switch completely, while prioritising measures that keep them out of the hands of the underaged. Second, seek and demand transparent, independent science, appropriate product standards and evidence that substantiates tobacco harm reduction potential. Thirdly, coupling product access with public health information will help ensure that adult smokers who find it hard to quit can be better informed about the reduced‑risk potential of completely switching from smoking to nicotine or smokeless alternatives that have a lower risk profile.
Ultimately, building a smokeless future for Sri Lanka means letting policy be guided by the evidence. By recognising the clear scientific distinctions between smokeless nicotine products and cigarettes, we can give adult smokers who do not wish to quit, potentially less risky options and accelerate our progress toward a smoke-free nation.
By N. Perera