Public health has moved on from many things. We no longer think fat is evil. We now know carbohydrates are not the enemy. Even cannabis has gone from criminal to commercial. But nicotine? That is still framed by outdated perceptions, rooted in an era when we had not yet learned to separate the smoke from the science.
The world has changed, science has changed, but nicotine? Not so much — and that is the problem. We continue to regulate and judge nicotine as if it is the same thing as smoking. As if it is still being delivered through a pack of unfiltered cigarettes. But nicotine, on its own, is not the killer here. What kills people is how we consume it: through burning tobacco. That combustion process produces thousands of harmful chemicals — the real villains behind lung cancer, heart disease, and early death.
And here is something most people do not realize, nicotine is not even unique to tobacco. It is a naturally occurring compound found in foods like tomatoes, potatoes, eggplants, and green peppers — the kind of ingredients you would find in any home-cooked meal. The amounts are tiny, of course, but they are enough to challenge the idea that nicotine is some foreign, man-made toxin.
Yet despite decades of data showing that nicotine is not the problem, our laws, attitudes, and policies continue to treat every nicotine product the same — regardless of how it is delivered. We do not distinguish between a combustible cigarette and a smoke-free nicotine pouch. We lump together high-risk behaviors and low-risk alternatives under the same outdated umbrella. Science proves that there are less harmful ways to consume nicotine today in the form of pouches, lozenges, gum, heated tobacco, none of which involve combustion. These alternatives exist because people deserve a way out of smoking that does not rely on cold turkey or shame.
But public perception has not caught up. Regulation has not caught up. We are still fighting the last war with yesterday’s playbook — and people are paying the price for it. It is time we stop acting like we are stuck in the 20th century and start making room for 21st-century solutions. Harm reduction is not a loophole but rather a solution. And if we are serious about saving lives, we need to stop punishing innovation just because it looks like something we used to hate.
