Denmark Public Consultation 3
rd
party activation
New nicotine pouches regulation by Danish MoH will set negative precedent for EU
member countries in achieving 2040 smoke-free goal.
INTRODUCTION
Advanced Centre for Addiction Treatment Advocacy (ACATA) lauded the continuous and tireless
effort by the Danish government to reduce tobacco use in Denmark particularly efforts that focus on
protecting young people and tobacco-naïve persons from initiating tobacco use.
Smoking is the most lethal form of tobacco use and unfortunately it is the most used method of
using tobacco. More than 90% of tobacco use is by smoking and it caused an enormous health,
economic and environmental burden to the world.
Urgent action is warranted to reduce the high prevalence of smokers in Denmark; which stood at
19% in 2022
1
.
The Danish Smoking Habits 2022
shows that 23% of the population use at least one
tobacco or nicotine containing product
1
. Smoking kills more than 13000 people each year in
Denmark
2
and caused various smoking related morbidity.
Although the relatively harmless nicotine
3
is the main addictive ingredient in tobacco, it causes
minimal harm to health. Almost all harms from smoking are caused by hundreds of chemicals in the
smoke produced by the combustion of tobacco
4
.
Quitting tobacco smoking is extremely difficult and the successful quit rate is less than 10%
5
.
Therefore, it is very sensible to deliver the addictive nicotine through the less harmful way and
without combustion rather than smoking to minimize the harmful effect of tobacco use.
NICOTINE POUCH AND SMOKING CESSATION
Nicotine pouch is a new non-combustible nicotine delivery product that does not contain tobacco.
Nicotine pouch deliver adequate nicotine from the pouches to overcome cravings from cigarettes
6
.
The efficacy in reducing withdrawal symptoms and helping smokers reduce or stop combustible
tobacco use is suggested to be similar or better than NR products
7
.
Studies on the safety of nicotine is currently sparse but the absence of tobacco and combustion
strongly suggest nicotine pouch is a less harmful nicotine delivery product. A study comparing 26
harmful and potentially harmful constituents from snus, nicotine replacement therapy products, and
nicotine pouch showed that compared to snus, NPs had lower levels of 10 HPHCs and generally no
difference could be seen between the two Nicotine replacement products and Nicotine Pouch
8
.
Due to the efficacy in delivering nicotine and, the safety of nicotine pouch and its potential of
moving smokers away from smoking, it can be a very efficient smoking cessation product. It is highly
recommended to encourage recalcitrant smokers to use nicotine pouch as an alternative to smoking.
The success of making as many smokers as possible to use nicotine pouch instead of smoking greatly
depends on the availability, accessibility, and appeal of nicotine pouch.