Framing Harm Reduction as a Threat: A Critical Response to the Nicotine Pouch Perception Study in Australia

Alan Gore 29 June 2025

https://pubmed.ncbi.nlm.nih.gov/40570643/ Mary-Ellen E Brierley 1, Runze Li 2, Michelle I Jongenelis 

A recently published study examining Australian attitudes toward nicotine pouches offers more insight into academic bias and moral panic than it does into actual public health progress. While the researchers claim to assess risk perceptions of nicotine pouches among young Australians, the undertone throughout the paper is one of subtle alarmism and predetermined conclusions, all of which undermine the potential of safer nicotine alternatives to combat smoking.

Let’s unpack the deeper issues with this study and why it reflects a broader problem in how public health institutions in Australia treat harm reduction.

The Study’s Premise

The researchers surveyed 1,598 Australians aged 16–39, narrowing their analysis to the 1,230 respondents who were aware of nicotine pouches. They sought to assess:

• Perceived harm and addictiveness of pouches vs. cigarettes, smokeless tobacco, and e-cigarettes

• Attitudes towards use

• Influence of peers and advertising exposure

• Demographic and behavioural correlates of these perceptions

They found that many respondents believed pouches were less harmful or similarly harmful compared to cigarettes and other nicotine products. Around 38–40% believed pouches to be equivalent in harm and addictiveness to NRTs like patches and gum. These beliefs were more common among current pouch users, men, and those whose friends or family also used pouches.

Flaws in Framing and Interpretation

1. Suspicion of “favourable” perceptions

Instead of interpreting positive risk perceptions as signs of increased public awareness or accurate harm comprehension, the authors frame them as a cause for concern:

“Favourable perceptions of nicotine pouches appear to be forming in the community.”

This phrasing is loaded. It assumes favourable perceptions are inherently problematic without assessing whether those perceptions are actually correct. This reflects a deep bias in the study, which evaluates harm reduction based not on evidence but on whether it contradicts an abstinence-focused ideology.

2. Weaponising “unknowns” as a rhetorical tool

The conclusion warns of “considerable unknowns” about nicotine pouches. This is misleading. All new products have some unknowns, but nicotine pouches have already been assessed in several jurisdictions, including:

• The German Federal Institute for Risk Assessment (BfR) found that well-manufactured pouches are significantly less harmful than cigarettes or smokeless tobacco.

• The UK Committee on Toxicity, which considers pouches lower risk than smoking or vaping and sees no major health hazard with responsible use.

Citing “unknowns” while ignoring knowns is intellectually dishonest.

3. Guilt by association with the tobacco industry

The authors highlight the “tobacco industry” as the primary threat:

“Regulatory frameworks need to be agile enough to capture new products being developed by the tobacco industry.”

This implies that any product developed or sold by tobacco companies is inherently harmful. This logic ignores two facts:

• Tobacco companies are not monolithic; they now invest heavily in reduced-risk products.

• Nicotine is not the enemy. Combustion is. If a product drastically reduces harm, it should be judged on that merit, not by its manufacturer.

This guilt-by-association tactic is common in Australian public health commentary and derails meaningful discussions on product innovation.

4. No harm reduction context or comparative risk acknowledgment

Nowhere in the study is there serious engagement with the public health benefits of switching from smoking to nicotine pouches. This omission is glaring. Real-world data from Sweden, Norway, and the US show:

• Sweden’s daily smoking rate is 5.3%, largely due to widespread snus and pouch use.

• Norwegian men under 25 now use snus more than they smoke, and youth smoking has plummeted.

• In the US, oral nicotine pouch use is rising as smoking continues to fall, a positive trend.

In contrast, Australia continues to push prohibition and tight regulation, while youth illicit use rises and the black market thrives.

5. Fear-based policy recommendations

The paper calls for tighter controls and pre-emptive regulation without ever demonstrating a clear risk profile of pouches relative to more harmful products. It is more concerned with the perceived emergence of acceptance than with reducing disease and death from smoking.

This signals that Australia’s public health framework remains obsessed with purity, not pragmatism.

What the Study Should Have Said

A better-informed and truly public health-oriented conclusion would be:

“Australians are beginning to correctly perceive nicotine pouches as a significantly less harmful alternative to smoking. These perceptions align with current toxicological evidence. As such, regulatory frameworks should be guided by proportionality, protecting youth from uptake while enabling access for adult smokers looking to quit. Harm reduction is not a threat; it’s an opportunity.”

Final Thoughts

This study isn’t about understanding nicotine pouch perceptions; it’s about policing them. It reflects a worrying trend in Australian public health: dismissing or suppressing positive developments in harm reduction to preserve outdated ideologies.

If we are serious about ending smoking, it’s time to stop treating every safer product as a Trojan horse and start embracing innovation, respecting user experience, and following real-world evidence, not just fear and dogma.

Let science lead. Let people choose. Let harm reduction happen.