In the global war against smoking, Action on Smoking and Health (ASH) in the UK is known as one of the fiercest adversaries of the tobacco industry. For decades, they have championed plain packaging, tax hikes, and strict advertising bans. They are, by all accounts, "anti-tobacco" purists.
Yet, in recent years, ASH has taken a stance that might surprise policymakers in the Maldives: they openly support the regulation and availability of smoke-free alternatives, including nicotine pouches, heated tobacco, and e-cigarettes.
Why would an organization dedicated to destroying the tobacco industry support these products?
ASH’s position is based on a simple, uncomfortable truth that many governments ignore: Nicotine causes addiction, but combustion causes cancer.
The British health establishment realized that fighting the "addiction" (nicotine) while ignoring the "killer" (smoke) was a losing strategy. When you light a cigarette, tobacco burns at over 900°C, releasing tar and carbon monoxide. It is this chemical reaction that kills.
By allowing smokers to switch to non-combustible alternatives—products that deliver nicotine without burning tobacco—the UK gave smokers a "fire escape" from cigarettes. The results speak for themselves: The UK has seen smoking rates plummet, not because they banned nicotine, but because they moved users to safer delivery systems.
In the Maldives, we have taken the opposite approach. We have conflated "tobacco control" with "prohibition." By banning or heavily restricting smoke-free alternatives, the government has effectively locked the fire escape, leaving smokers trapped in the burning building of combustible cigarettes.
Critics often argue that alternatives are just a "gateway" for the industry to hook new users. But if that were true, why does ASH—the industry's watchdog—support them? They support them because the data is undeniable: when regulated correctly, these products decimate cigarette sales.
We do not have to like the tobacco industry to accept the science. If the goal of the government is truly to reduce the burden of non-communicable diseases (NCDs), then we must look at what is working globally.
The UK model proves that you can be tough on tobacco and smart on harm reduction simultaneously. You can tax cigarettes into oblivion while keeping safer, smoke-free alternatives—like heated tobacco and pouches—accessible and regulated for adults.
To continue banning these alternatives in the name of "health" is to ignore the very experts who have spent their lives fighting for it.
