Published in The Spokesman-Review
By Dr. Paul Racicot, Opinion
April 19, 2025
A proposal by Washington lawmakers to impose new taxes on tobacco-free nicotine products would endanger some of the state’s most at-risk individuals and hurt broader public health efforts designed to curb cigarette smoking.
At issue is the tax treatment of nicotine pouches, a product that many adult smokers have used to successfully stop smoking. Unlike cigarettes, nicotine pouches give users a small nicotine fix without the need to inhale the toxic smoke responsible for the lung disease and cancer that often plague smokers.
While public policy debates over nicotine pouches are sometimes well-intentioned, they are also often replete with misinformation about the product, its users and the impact on young people.
As a licensed physician certified in the field of Smoking Cessation, I have more than 40 years of experience in treating people struggling with a variety of addictions, including narcotics, alcohol and nicotine. Of those with nicotine addictions, the vast majority are trying to quit smoking cigarettes.
Most public health experts, including the federal Food and Drug Administration, recognize that nicotine and tobacco products exist on a “continuum of risk” with cigarettes being by far the most harmful. While nicotine is highly addictive, the toxic chemicals in cigarette smoke are what do the real damage to smokers. Therefore, moving smokers toward smoke-free nicotine products like pouches can help bring substantial benefits to their health.
Along these lines, the FDA recently authorized the marketing of ZYN nicotine pouches, concluding that “due to substantially lower amounts of harmful constituents than cigarettes” these nicotine pouches “pose lower risk of cancer and other serious health conditions.”
Lawmakers should be making it easier for adult smokers to access lower-risk products. Imposing new taxes would do the opposite. This is especially dangerous because we know there is an inverse relationship between smoking and income brackets. Households with less income are more likely to have smokers and thus are less likely to be able to purchase higher-priced, reduced-risk products.
In Washington and other states, some proponents of these taxes argue that smokers should only quit smoking through the use of nicotine cessation products like gum, patches or lozenges. But my experience has been that these methods have extremely low rates of success. Even prescription medications like Chantix work in less than 10% of the people who use them and can have side effects like psychosis and suicidal ideation.
Tax proponents also argue that it is necessary to raise the price of nicotine pouches to reduce youth usage. But when it comes to youth and tobacco use, there is actually good news that doesn’t get shared enough.
Since the national age to purchase tobacco increased to 21 five years ago, youth tobacco use has sunk to its lowest recorded levels in history. Last year’s National Youth Tobacco Survey also found that only 1.8% of young people reported using a nicotine pouch in the previous month.
When it comes to addressing the societal impact of smoking, our concerns should be on the thousands of adult smokers who need more and better options to overcome their
addiction to cigarettes. Unfortunately, this is a glaring blind spot in the policies – like new taxes on nicotine pouches – being sought by many organizations pushing for greater tobacco control.
These groups ignore the significant health benefits that could be achieved by switching smokers to nicotine products with substantially less risk. This approach would keep cancer-causing chemicals out of people’s lungs, improve health care outcomes and lower government health care costs.
As the state of Washington looks for ways to generate more income, it should avoid imposing new taxes that would derail meaningful public health efforts and result in more Washington smokers continuing to smoke cigarettes.
Dr. Paul Racicot, MD, resides in Laconia, Hew Hampshire. He has more than 40 years of experience in addiction treatment, helps manage six convenient care centers in New England, is the co-founder of a New Hampshire recovery clinic.
