Beyond Combustion: The Science Behind Lower-Risk Profile Nicotine Alternatives

Summer Hanna, Head of Toxicology at BAT, discusses the evidence behind smokeless nicotine products, the importance of risk-proportionate regulation, and how science can help inform better public health outcomes while helping prevent underage access to such products.

Question: Smokeless nicotine products are gaining attention in some markets. What are the key scientific principles behind these reduced risk profile products compared to conventional cigarettes?

Summer Hanna: Scientific research has demonstrated that Smokeless Products, such as heated tobacco, vapour and nicotine pouches, expose consumers to fewer and lower levels of harmful chemicals compared to cigarettes. Combustion is the main source of toxicants in cigarette smoke, and for products that do not require combustion, emission toxicant levels are substantially lower.

Because nicotine pouches are used orally without burning, they eliminate exposure to toxicants produced by combustion. However, like all nicotine products, they are not risk free and are addictive. But based on the weight of the available evidence and assuming a complete switch from cigarette smoking, they present a lower risk profile than continued smoking of combustible cigarettes.

Question: How do you evaluate the risk profile of smokeless products like electronic cigarettes compared to cigarettes?

Summer: Absent robust epidemiology, there is no single test that can compare all products, so our scientists use a weight of evidence approach, which combines multiple streams of research:

• Chemical analyses – to examine and compare toxicant levels.
• Toxicology assessments – rigorous review of relevant scientific literature and analyses of biological responses in cells and animal systems.
• Clinical studies – to measure relevant Biomarkers of Exposure and Biomarkers of Potential Harm in consumers when they completely switch from cigarettes to smokeless products.

When these streams of evidence are considered together, a clearer comparison of risk profiles emerges between conventional cigarettes and smokeless alternatives such as vapour products, heated tobacco, and nicotine pouches, which have been shown to have lower exposure to harmful chemicals.

Question: Can you share some success stories of countries where smokeless products have been associated with reduced smoking prevalence?

Summer: Oral pouch products have contributed to the decline in smoking prevalence in markets such as Sweden, where smokeless alternatives have been available for years. Sweden’s model, often cited internationally as a vanguard example of Tobacco Harm Reduction, shows that when lower risk products like snus are accessible, adult smokers shift away from cigarettes, leading to notable reductions in smoking prevalence and related health indicators.

Other countries in a similar manner to Sweden have demonstrated that regulated access to Smokeless Products can support public health objectives. Even so, clearer policy recognition of tobacco harm reduction could unlock even better outcomes. Countries such as Bangladesh may consider international experiences from countries like Sweden to further advance the concept of Tobacco Harm Reduction.

Question: You have been working in the scientific engagement team for many years now, in your experience how do you think science can support to shape regulations for smokeless products?

Summer: Science plays a critical role in shaping regulations for Smokeless Products by providing robust evidence to guide policy decisions. Regulators rely on scientific research to determine how these products compare with traditional cigarettes, drawing on chemical analyses, toxicology studies, and clinical data to build a clear picture of their risk profile. This evidence‑based approach helps ensure that decisions are informed by evidence rather than assumptions, and a proportional view of risk allows authorities to avoid treating all nicotine products the same, particularly when some may expose users to fewer harmful substances.

Regulatory standards related to product quality and safety are another area where science provides direction. Research can inform standards that ensure these products are manufactured responsibly, deliver nicotine in a consistent way, and use flavors intended for adults rather than appealing to the underaged.
By drawing on rigorous scientific evidence, policymakers can develop a regulatory framework that recognizes the reduced‑risk potential of smokeless products compared with cigarettes, while prioritizing product quality, consumer protection, and public health.

Question: One of the biggest criticisms against reduced risk profile products include their appeal to underaged consumers, what has BAT done globally to counter this narrative?

Summer: At BAT, we apply strict standards to the way we communicate about our products. Our marketing is directed only to adult tobacco and nicotine consumers, and we have firm rules in place to prevent any form of underage targeting. We name flavours to keep everything factual and straightforward, and we don’t offer any youth-orientated flavours, such as candy, desserts or soft drinks.

On top of that, we continue to invest in new technology that helps limit underage access.

We take underage access very seriously, and we’ve put a great deal of work into ensuring we follow responsible practices to prevent underaged access. In several countries, including Canada, Germany, South Africa and the UK, we’ve introduced vapour products with built in age verification technology designed to make sure only adults can purchase our products, and this should be available globally in due course. Every vapour product we’ve launched since early 2025 also includes features designed to stop activation by someone who isn’t meant to use it.

All of these steps reflect our commitment to ensuring that our products are designed for adult consumers only.

Question: As you are aware in Bangladesh multiple reduced risk profile products like electronic cigarettes are facing massive criticism. Do you think banning such products will be an effective policy?

Summer: At BAT we think it’s important that adult smokers have the ability to choose scientifically substantiated, reduced risk profile alternatives to cigarettes, and restricting access to regulated smokeless alternatives may limit options for adult smokers. When adult smokers are denied access to well-regulated smokeless alternatives, many continue smoking traditional cigarettes, which will have unintended consequences for public health.

Outright bans also can drive demand underground, creating illicit markets where products are completely unregulated and of questionable product quality. We believe it is far better for consumers and more effective for public health to keep these products within a legally regulated and controlled framework.

We’ve seen in some markets that allow responsibly regulated smokeless nicotine products, that smoking prevalence rates decline, particularly when adult smokers are given accurate information on smokeless alternatives. In our view, the most effective tobacco control strategies combine strong underage protection measures with tobacco harm reduction policies that encourage smokers who would otherwise continue to smoke, to switch completely to smokeless alternatives.

A risk proportionate regulatory framework is preferable to blanket prohibitions. This means clearly distinguishing between combustible tobacco and reduced risk profile, non-combustible alternatives such as vapour products, heated tobacco, and nicotine pouches. Establishing strict quality product standards, robust age verification, and clear product labelling can help ensure adult only access while giving smokers access to smokeless alternatives. This can be done by proportionate regulations that differentiate smokeless products from combustible tobacco products. Such a regulatory model could support public health objectives, reduce illicit trade, and contribute to national revenue while maintaining strong protection for those underage and non-users.

Question: Going forward how can policy makers from one country collaborate on Tobacco Harm Reduction (THR) with their counterparts in other countries who have shown success in THR adoption?

Summer: International cooperation is becoming increasingly important in the effort to advance Tobacco Harm Reduction, and several countries are already offering valuable lessons. New Zealand, for example, has seen major declines in smoking prevalence rates after allowing access to smokeless products, and its experience is often highlighted as a model for others. When policymakers from different nations share their regulatory approaches, public health strategies and scientific findings, it helps create a clearer picture of how alternative smokeless nicotine products can support public health objectives when properly regulated. Open dialogue between governments, regulators, health authorities and industry also plays a crucial role, allowing all sides to better understand each other’s priorities and design rules that protect public health while acknowledging the choices adult consumers make.

Such collaboration can be strengthened through supranational institutions and scientific partnerships. These platforms offer opportunities for policymakers to exchange knowledge, coordinate research and address questions about the long term impacts of products like smokeless alternatives. Joint scientific work can help build the evidence base regulators need, while consumer focused policies ensure adults receive accurate information without increasing underage access. By working together, countries can accelerate progress toward reducing tobacco related harm worldwide and learn from each other’s successes rather than tackling the issue in isolation.

This article is intended to contribute to public policy and public health discussions for policymakers, regulators, scientists, and public health stakeholders and is not directed at consumers nor intended to promote or advertise any specific product or brand. While the best option for smokers is to quit, for those who would otherwise continue smoking, switching completely to smokeless alternatives presents a lower risk profile. These smokeless products are not risk-free and contain nicotine, which is addictive. The long-term health effects continue to be studied.