What is the future of European public health policy?

The EU is edging towards a worrying change to the way it taxes tobacco products, but it is not too late to change course. The EU faces a choice of two possible policy directions on tobacco. It could follow the example and instructions, both implicit and explicit, of the World Health Organisation and pursue a tax-and-ban approach, seeking to eliminate tobacco altogether through bold government initiatives. Alternatively, it could put consumers first by adopting an approach based on harm reduction.

The interventionist approach to tobacco policy is rooted in ideology rather than reality and has a consistent track record of failure. Sin taxes don’t work.¹ All they achieve is making smokers a little poorer without helping anyone become healthier, as countless case studies show. For example, in Australia, smoking was falling by a considerable margin each year when the government introduced the highest tobacco taxes in the world, along with other new laws like plain packaging regulations and various bans on smoking in public places. Since 2012, when those changes took effect, the drop in smoking rates in Australia has all but stalled.²

Focusing on elevated taxes as a strategy in tobacco policy would also be a boon for the black market. Illicit trade flourishes when the legal market shrinks and becomes less accessible, which is what happens when taxes are too high. There is a wealth of research, such as this paper from a US university, demonstrating that the illegal tobacco trade funds organised crime gangs and terrorism.³ It even contributes to underage smoking—because the safeguards of the legal market, which ban cigarette sales to children, are not in place in the black market—all while costing governments billions in lost tax revenue.

Smoking is unhealthy. We already know that. Too often, when questioned on their interventionist policies (especially high taxes), proponents of those policies quote statistics on how many people smoking kills and how much it costs healthcare systems. But that doesn’t answer the key question about whether their proposed policy solutions actually work. Europe should learn from the flaws and failures of other regulators around the world and abandon its received wisdom about ever higher taxes being the only way forward on tobacco.

If the EU wants to help accelerate the shift away from cigarettes, cracking down on reduced-harm tobacco products is counterproductive—but that’s exactly what it seems set to do with its current policy direction of rigid, unscientific overregulation of reduced-harm nicotine products like vapes.⁴ There are countless products—e-cigarettes, snus, nicotine pouches, heated tobacco – which are considerably less harmful than cigarettes and are a lifeline for many smokers who want to quit.⁵

These products are part of the solution to traditional smoking, not part of the problem. Lumping them into the same category as ordinary cigarettes and cracking down on all of them with aggressive taxes is shortsighted in the extreme. This purist view of tobacco policy—that voluntary harm reduction isn’t good enough and all tobacco products must be priced out of existence—is directly harmful to smokers who want to quit, not to mention the problems with fuelling the illicit market, worsening the cost of living crisis, and so on.

There is still hope that this harmful plan might be stopped in its tracks. There are some positive signs, such as some member state governments, some members of the European Parliament, and others who stand up for common sense and science when it comes to public health debates and issues of civil liberties.

Unfortunately, there still seems to be a consensus in Brussels and at the top of EU institutions that more interference in domestic health policy and the lives of ordinary people trying to be healthy is necessarily a good thing. That spells disaster for vapers across Europe and for public health more generally.