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Canada remains one of the only Western countries where nicotine pouches—a smoke-free alternative widely available in other countries in gas stations, supermarkets and online—are treated almost like a controlled substance and only available in pharmacies. To understand why, we spoke with Dr. Pascal Michel, Senior Manager of Scientific Engagement at Rothmans, Benson & Hedges Canada, a subsidiary of PMI Science.

Dr. Michel says Canadians are largely unaware of these reduced-risk products. “People are very poorly informed about the various lower-risk nicotine products available in Canada,” he explains, noting that access to basic information is “very, very, very low.”

Unlike in Europe, where nicotine pouches are commonplace, “in Canada, a user has to stand in front of a pharmacist in order to obtain the product.”

Scientifically, Michel insists that the risk difference between smoking and nicotine pouches is enormous. “When you smoke a cigarette… it is truly dangerous for your health,” he says. In contrast, a nicotine pouch carries “a risk comparable to that of small Nicorette gums.”

The product itself, he explains, is simple: “A small pouch… with pharmaceutical-grade nicotine and a few flavourings.”

So why is Canada lagging behind? Michel is blunt: “Canada is somewhat behind in adopting… smoke-free products.” While other countries regulate pouches as consumer products, Canada treats them strictly as cessation aids, severely limiting choice. As a result, “access… is very limited,” and only one brand, Zonnic, is currently authorized.

International comparisons suggest Canada is missing a major public health opportunity. Michel highlights Sweden, where widespread adoption of smoke-free nicotine products has led to “an incredible reduction” in lung cancer. He calls it evidence that reduced-risk products can help Canada reach the global benchmark of “less than 5% of smokers.”

But progress will require regulatory courage. “We have a lot of work to do,” Michel warns, pointing to both restrictive policies and the rise of illicit markets as major barriers.

Canadians can legally buy cigarettes, alcohol, cannabis and vapes—yet must ask a pharmacist for nicotine pouches. For Michel, the path forward is simple: empower adults with safer choices and align Canada with international science.