Publications

By Charis Girvalaki, Scientific Director, European Network for Smoking and Tobacco Prevention (ENSP)

The revision of the Tobacco Products Directive (TPD) represents a critical opportunity to strengthen Europe’s cancer prevention agenda. Tobacco use remains the leading preventable cause of cancer in the European Union. A robust and forward-looking TPD must therefore be viewed not merely as a market regulation instrument, but as a central pillar of the EU’s public health and cancer prevention strategy.

The European Code Against Cancer sends a clear and evidence-based message: do not smoke, do not use tobacco in any form and support smoke-free environments. The TPD has already contributed significantly to these goals through measures such as larger health warnings, restrictions on flavourings and enhanced product regulation. However, the rapidly evolving nicotine market now demands a broader and more coherent regulatory response.

The Shift From Tobacco to Modern Nicotine Addiction

One of the most important lessons of recent years is that nicotine addiction itself cannot be separated from the broader public health challenge. New and emerging nicotine products – including e-cigarettes, heated tobacco products, nicotine pouches, and synthetic nicotine products – are increasingly marketed in ways that appeal especially to young people and non-smokers. While these products are often presented as reduced-risk alternatives, growing evidence suggests that they can carry substantial health risks, particularly regarding respiratory, cardiovascular and neurological health, while also sustaining nicotine dependence and increasing the likelihood of long-term use.

In this context, the future TPD should avoid repeating a major missed opportunity: limiting its scope primarily to traditional tobacco products while allowing the nicotine market to evolve faster than regulation. A modernised directive should establish a comprehensive framework covering all non-therapeutic nicotine-containing products, irrespective of whether nicotine is derived from tobacco. Regulation must be based on public health impact rather than product origin.

Several priorities should guide the future revision of the TPD.

1. 1. 1. All nicotine products should be subject to strong marketing and flavour restrictions, particularly flavours that attract children and adolescents.
      2. Health warnings and plain packaging requirements should be expanded consistently across product categories.
      3. Loopholes related to cross-border online sales, social media promotion and nicotine product design must be addressed.
      4. Stronger rules on product taxation and affordability should complement regulatory measures, given the well-established relationship between price and reduced consumption.

Importantly, the revision of the TPD should align closely with Europe’s Beating Cancer Plan initial targets, the Safe Hearts Plan and support implementation of the WHO Framework Convention on Tobacco Control. Europe has the opportunity to remain a global leader in tobacco control by ensuring that regulation keeps pace with industry innovation and prioritises prevention above commercial interests.

If the EU is serious about achieving a tobacco-free generation and reducing the burden of cancer, the next TPD must move beyond a narrow focus on tobacco alone. It should provide a comprehensive, precautionary and future-proof framework capable of protecting current and future generations from the harms of both tobacco and nicotine addiction.