What the EU Barometer Really Shows About Nicotine Pouches

A new analysis based on the European Commission’s Special Eurobarometer 539 survey is already being framed as a warning about nicotine pouches in Europe. But the same numbers tell a different story: nicotine pouch use remains low, smoking remains high, and the EU is missing one of the clearest harm reduction signals in its own data.

The EU Still Has a Big Smoking Problem

The EU’s biggest nicotine-related public health issue is still cigarettes. Roughly 24% of people aged 15 and older in the EU smoke, and successive Eurobarometer surveys indicate only a 1% decline in smoking prevalence from 2020. Smoking tobacco still causes hundreds of thousands of deaths in Europe every year.

That is the baseline policymakers should use when looking at nicotine pouch data. A category used by 1% of EU citizens should not be treated as the central crisis while smoking remains widespread and stubbornly slow to decline.

What a New EU Nicotine Pouch Study Found

Ktenidis et al. analyzed EU Barometer 2023 responses from more than 26,000 people across all 27 EU member states. They found:

• 1.0% of EU citizens were current nicotine pouch users.
• 43.5% of current nicotine pouch users also smoked cigarettes.
• 18.3% of current nicotine pouch users had never smoked.

In other words, nicotine pouches are not a runaway category next to a 24% smoking rate. The data suggest most EU pouch users smoke, used to smoke, or are experimenting with alternatives to cigarettes.

That is not evidence of a new nicotine epidemic. It looks much more like the start of substitution.

The EU built an instrument to measure a smoking crisis and it is still reading a smoking crisis: 24% and barely moving. Point that same instrument at nicotine pouches and it finds a category one-twentieth the size, made up mostly of smokers and ex-smokers. That is not a broken alarm. That is the alarm doing its job and nobody in Brussels wanting to hear it.

Markus Lindblad, Communications Director at Pouch Patrol

 

Not Smoking Is the Point

The authors call the 18.3% never-smoker figure “particularly concerning.” But there is another way to read it: these are people who, according to the survey, had never smoked tobacco. That matters in a European market where cigarettes remain the dominant public health burden.

If some adults who might otherwise have entered nicotine use through cigarettes are instead using a smoke-free product, that is not a public health failure. It may be the opposite: a sign that non-combustible alternatives are competing with cigarettes before smoking ever starts.

If current nicotine pouch use is 1.0% of the EU population, then never-smoker current pouch use is under two-tenths of one percent of EU citizens aged 15 and older. The study is also cross-sectional, meaning it captures a snapshot in time and cannot prove whether pouches prevented, displaced, or encouraged any later tobacco use.

Sweden Shows the EU a Different Path

Sweden has the lowest smoking rate in the EU. It also has the longest and deepest history of oral nicotine use.

It is also close to where the EU says it wants everyone to go. Europe’s Beating Cancer Plan sets a “tobacco-free generation” target of less than 5% tobacco use by 2040. Sweden is already there.

What Regulators Should Take From This

This study will almost certainly be cited in the process of the forthcoming revision of the Tobacco Products Directive (TPD3). The responsible reading is that nicotine pouch use remains low, and most users are current or former smokers.

If the EU wants to reduce smoking from 24% to below 5%, it should not close off access to alternative products before they have a chance to move smokers away from cigarettes.

TPD2 offers a useful warning here. The EU banned menthol cigarettes in May 2020, but many menthol smokers continued smoking by switching to non-menthol cigarettes or finding ways to recreate menthol. The lesson for TPD3 should not be that every alternative nicotine product must be banned. It should be that bans on cigarettes have limited impact when smokers are not given access to acceptable, regulated, smoke-free alternatives to move to.

The EU set the target. Sweden is already there. Brussels should be studying that route instead of blocking it.