Public health policy often develops through long institutional processes. Regulations are debated, negotiated, and revised through multiple stages of consultation and political review. This is particularly true in the European Union, where legislative frameworks such as the Tobacco Products Directive (TPD) and the Tobacco Excise Directive (TED) shape tobacco and nicotine policy across all Member States.
Because these frameworks evolve gradually, policymaking can sometimes rely heavily on established approaches. Familiar regulatory models offer predictability and administrative stability. However, when public health outcomes are at stake, reliance on precedent alone may not always produce the most effective results.
As Johan Nissinen, former Member of the European Parliament, recently noted in discussions with GINN, this tendency toward familiar approaches often appears in policy discussions.
“In closed meetings, I often heard: ‘This is how we have always done it.’ It is a comforting sentence in politics. It is also a dangerous one in public health.”
The current revision processes for the TPD and TED provide an opportunity to examine how existing policies perform in practice and whether adjustments are needed to improve health outcomes.
The Importance of Evaluating Outcomes
Public health regulation ultimately aims to reduce disease, premature mortality, and healthcare burdens. In the context of tobacco control, this objective is closely linked to reducing smoking prevalence and limiting exposure to harmful substances generated by combustible tobacco products.
Over the past several decades, European tobacco control policies have achieved significant progress through measures such as advertising restrictions, health warnings, smoke-free environments, and excise taxation. These strategies have contributed to measurable declines in smoking rates in many countries.
At the same time, millions of Europeans continue to smoke, and smoking remains a leading cause of preventable disease across the region. For policymakers, this reality raises an important question: how can regulatory frameworks evolve to accelerate further reductions in smoking-related harm?
As Nissinen pointed out in policy discussions surrounding the upcoming revisions:
“TPD and TED revisions are political, of course. But they have practical consequences for how many people keep smoking.”
Answering this question requires careful examination of evidence, including how individuals actually respond to different policy measures.
Evidence and Policy Adaptation
Scientific understanding of nicotine products and consumer behaviour has developed considerably over the past decade. Research increasingly distinguishes between the risks associated with combustible tobacco products and those associated with a range of non-combustible nicotine alternatives.
These distinctions have become part of broader discussions about harm reduction in public health policy. Harm reduction approaches focus on reducing health risks in situations where eliminating risk entirely may not be immediately achievable for all individuals.
In the context of tobacco control, harm reduction discussions often examine how policy frameworks can support individuals who are unable or unwilling to quit nicotine use immediately but may move away from the most harmful forms of consumption.
As Nissinen has emphasised in discussions with GINN, the central question for policymakers should be practical outcomes rather than familiar policy models.
“The argument from GINN is simple: look at what reduces harm in practice, not what feels familiar.”
For regulators, the key challenge is how policies can reflect evolving evidence while maintaining strong safeguards for public health.
Moving Beyond Familiar Frameworks
Policy continuity is often valuable, particularly when regulatory systems have delivered clear public health benefits. However, effective governance also requires the capacity to adapt when new evidence emerges.
Within tobacco control policy, debates sometimes reflect tensions between established regulatory approaches and newer discussions about relative risk and behavioural incentives. These debates are often complex, involving scientific uncertainty, ethical considerations, and differing policy priorities.
Nevertheless, one principle remains widely accepted across public health disciplines: policies should be evaluated based on their measurable outcomes.
As Nissinen explained, the objective of this discussion is not to promote nicotine use but to address existing harm more effectively.
“This is not about being pro-nicotine. It is about being serious about reducing harm where harm already exists.”
If a policy framework contributes to fewer people smoking, fewer smoking-related illnesses, and reduced long-term healthcare costs, those outcomes provide an important basis for assessing its effectiveness.
The Role of the TPD and TED Revisions
The ongoing revision of the Tobacco Products Directive and the Tobacco Excise Directive represents a rare moment when multiple aspects of EU tobacco policy can be reconsidered simultaneously.
The TPD governs product standards, market access, packaging rules, and other regulatory requirements. The TED shapes taxation structures that influence retail prices and consumer purchasing behaviour. Together, these directives form the foundation of the EU’s regulatory approach to tobacco and nicotine products.
Revisions to these frameworks therefore have the potential to influence public health outcomes for many years. Decisions made during the revision process will shape how nicotine products are regulated, how they are priced, and how policy signals are communicated to consumers.
Evidence-Based Public Health Policy
For organisations such as the Global Institute for Novel Nicotine (GINN), the central principle guiding policy discussions is straightforward: public health strategies should be grounded in evidence and evaluated through real-world outcomes.
Evidence-based policymaking focuses on identifying regulatory strategies that reduce harm in measurable ways while maintaining strong protections for young people and non-users.
As Nissinen summarised in discussions around the review process:
“If the evidence points to better outcomes, policy should be brave enough to follow it.”
Looking Forward
Public health policy inevitably operates within political systems, where compromise and negotiation are part of the legislative process. However, the ultimate measure of success remains the same: whether policies improve health outcomes.
As the European Union reviews the TPD and TED, policymakers have an opportunity to assess how existing regulatory frameworks perform and how they might evolve to better support the reduction of smoking-related harm.
Building policy around evidence and outcomes, rather than familiarity alone, may help ensure that future regulatory frameworks remain effective in addressing one of Europe’s most persistent public health challenges.
