For decades, tobacco control policies have helped to reduce smoking rates and save millions of lives. However, while countries strengthened regulations, the tobacco and nicotine industry adapted its strategies. “Today, we are on the brink of a new addiction revolution fuelled by the industry, and tobacco control policies are not up to speed,” says Dr Ghazi Zaatari, Professor and Chair of the Department of Pathology & Laboratory Medicine at the Faculty of Medicine at the American University of Beirut.
On World No Tobacco Day, the public health expert, who is currently chairing the WHO Study Group on Tobacco Product Regulation, warns that a new wave of nicotine and nicotine-like products could fundamentally reshape and expand the addiction market, making it even more accessible for children and young people.
Synthetic nicotine: cheaper and more accessible
The tobacco industry has always relied on one core mechanism: keeping people addicted. Traditionally, this addiction came from nicotine in tobacco leaves, delivered primarily through conventional cigarettes and other tobacco products. But the future of nicotine products may no longer rely solely on the tobacco plant.
“In the last 5 years, the industry increased its reliance on laboratory-synthesized nicotine and its chemical analogues. Lately, these substances have become as cost–efficient as nicotine derived from tobacco leaves. This means that the industry is moving towards a new generation of products that may contain little or no tobacco-derived nicotine, while still targeting the same brain receptors responsible for nicotine dependence,” warns Dr Zaatari.
This shift could trigger a major expansion of novel nicotine products – from e-cigarettes and nicotine pouches to entirely new synthetic formulations designed to deliver nicotine more efficiently, more discreetly and in ways that are harder to regulate.
“These new products are designed to make initiation easier, reinforce repeated use and reduce the perception of risk, especially among adolescents and young adults,” adds Dr Zaatari.
New addiction for new generations
Modern nicotine products are skilfully engineered around addiction science. Nicotine salts allow higher nicotine doses to be inhaled or absorbed more smoothly. Sweet flavours and cooling sensations reduce harshness and make experimentation easier for first-time users. Online marketing techniques increasingly focus on lifestyle, technology and social identity rather than tobacco itself.
At the same time, synthetic nicotine and nicotine analogues are creating new regulatory challenges. Some companies market products as “tobacco-free”, “cleaner”, “more modern” or “less harmful”, even though they trigger the same addiction mechanisms in our brain. Nicotine analogues are being marketed as “zero nicotine”, even though they have strong dependence potential.
Children and adolescents are particularly vulnerable to nicotine addiction. Since the brain continues to develop until the mid-20s, nicotine exposure during this period, when inhibitory impulses are not well developed, can alter neural pathways linked to attention, learning and impulse control. This explains why youth remain the primary target of nicotine marketing.
“Bright packaging, fruit flavours, influencer promotion and discreet product designs are not random innovations – they are mechanisms designed to normalize nicotine use and accelerate addiction among younger generations,” says Dr Zaatari.
Countries urgently need comprehensive laws
He warns that countries cannot afford to wait until the next wave of products becomes fully established and urges them to update tobacco control laws to make them as comprehensive as possible: “Without stronger and more adaptive policies, the world risks entering a new phase of the nicotine epidemic”.
Existing tobacco laws in many countries were not designed to address nicotine analogues, synthetic compounds or hybrid products that blur the boundaries between pharmaceutical, recreational and tobacco categories.
WHO European Region: worrying trends need to change
Each year, tobacco kills 1.2 million people in the WHO European Region alone. Of those, 202 000 die from exposure to second-hand smoke.
Our Region has the highest global rate of tobacco use among adults and is projected to retain this status through 2030. Among adolescents aged 13–15, around 4 million use tobacco and 4.2 million use e-cigarettes. The Region has the highest prevalence of e-cigarette use in this age group globally (14.3% vs 7.2% elsewhere).
According to the latest WHO report on the global tobacco epidemic, only 18 out of the 53 countries of the European Region have comprehensive smoke-free laws covering all public spaces. Just 12 provide national quit lines and cover the cost of cessation services. Comprehensive bans on tobacco advertising and promotion exist in only 13 countries. While more than half of the countries have reached the recommended level of tobacco taxation, cigarette prices are still not rising sufficiently to reduce affordability. Alarmingly, in 19 countries, cigarettes are more affordable today than they were in 2014, underscoring the need for stronger and more sustained price increases through taxation.
The tobacco epidemic can be controlled through evidence-based interventions in line with the WHO Framework Convention on Tobacco Control and MPOWER measures. WHO-recommended policies include:
- strong regulation of all tobacco and nicotine products, including e-cigarettes
- comprehensive advertising bans
- flavour restrictions
- higher taxation
- plain packaging
- youth protection measures
- expanded access to effective and evidence-based cessation support for all.
“In addition, it is very important to treat synthetic nicotine and nicotine analogues according to their biological and addictive effects – not simply according to whether they originate from tobacco leaves,” explains Dr Zaatari.
The challenge facing countries today is no longer only about cigarettes. It is about an industry that continues to redesign addiction itself.
Governments must act now to strengthen policies before a new generation falls victim to nicotine dependence disguised as innovation. Behind the sleek packaging, appealing flavours and technological branding lies the same business model – profits built on addiction and inherent harm.