Shrey Madaan, Indian Policy Associate, Consumer Choice Center
In India, the hardest part about quitting smoking isn’t the addiction, it’s the policy. Tools that help smokers quit are being restricted, even as cigarettes remain widely available. The result is a system that keeps the harm within reach while closing off the exit. Recent recommendations from the Drugs Technical Advisory Board (DTAB) seek to remove nicotine lozenges from over-the-counter access. Low-dose nicotine gums may continue to sell under tighter rules, but the bigger picture is clear: access to cessation tools is being tightened, not widened.
This reflects a deeper policy issue. Regulation is focusing on nicotine itself rather than the way it is consumed, ignoring its role in helping smokers quit. The result is counterproductive: tools designed to support cessation are being restricted. The tools that help people quit are being restricted. Nicotine replacement therapies, proven tools for quitting, are becoming harder to access. At the same time, cigarettes remain widely available, even as safer alternatives face tighter controls.
The imbalance is clear, quitting is not a one-time choice, it depends on access, affordability, and sustained effort over time. When cessation tools become harder to obtain, that process breaks down. The choice is no longer between smoking and quitting, it becomes a choice between smoking and trying to quit.
India’s broader approach to nicotine regulation follows the same pattern. E-cigarettes have been banned outright under PECA Act 2019. Other smoke-free alternatives remain tightly restricted. Now, even products specifically designed to support quitting are being drawn into stricter control. When all nicotine products are treated the same, policy stops differentiating between the risk levels. That weakens its effectiveness and leads to a perverse outcome: the most harmful products remain accessible, while safer alternatives become harder to access. The consequences are immediate. Restricting cessation tools does not eliminate demand for nicotine, it makes quitting more difficult. Some smokers delay attempts to quit. Others turn to informal markets, where product quality is uncertain and safeguards are absent.
India has seen this trend before. Crack down on products without offering alternatives, and demand doesn’t vanish, it goes underground. India’s e-cigarette ban proved exactly that. Extending this approach to cessation tools risks turning quitting itself into a harder. Global examples point in a different direction. Sweden has slashed smoking rates by keeping lower-risk alternatives like nicotine pouches and snus accessible. In the United Kingdom, vaping was included in its public health strategy and is linked to higher quit success rates. The evidence shows smoke-free alternatives expose users to far fewer harmful chemicals than cigarettes.
None of this suggests that nicotine products should be unregulated. Safeguards are crucial. Sales to minors must be strictly enforced. Product standards should be clearly defined, and marketing should remain responsible. But regulation should reflect relative risk. Low-dose nicotine therapies are fundamentally different from combustible tobacco. Treating them the same way blurs that distinction and undermines their purpose.
The goal of tobacco policy is not simply to restrict nicotine, it is to reduce smoking-related harm. That requires making the exit easier, not harder. India’s current trajectory risks doing the opposite. By tightening access to tools that help people quit while leaving cigarettes largely untouched, policy is not reducing harm, it is making it harder to escape it.
