Building a Smoke-Free Canada is Ottawa Life Magazine’s year-long editorial series examining how Canada is tackling tobacco-related harm. Each article explores policy, innovation, and public health efforts shaping the future of nicotine use.
Canada once led the world in tobacco control. Public education campaigns, graphic warnings, and smoke-free policies drove smoking rates to historic lows. But more than 3.5 million Canadians still smoke, and many of them are struggling to quit.
As other countries embrace harm-reduction strategies to help smokers move away from cigarettes, Canada finds itself at a crossroads. A new generation of smoke-free products, from nicotine pouches to low-risk vapour devices, could accelerate the country’s progress toward its “less than five percent by 2035” target. Yet federal policy has made access to these products more complicated, not less.
Today, nicotine pouches authorized by Health Canada are sold only in pharmacies, under a strict framework that treats them more like prescription drugs than consumer health products. Meanwhile, cigarettes remain available on nearly every corner. The result is a confusing, contradictory system that makes quitting harder, not easier and pushes many smokers toward the very products the government wants them to leave behind.
Health Canada’s policy restricts the sale of nicotine pouches to pharmacies only, and only if each pouch contains 4 milligrams of nicotine or less. This prescription-like model has created barriers for smokers seeking alternatives. Many pharmacies do not stock them and access is limited by geography, hours of operation and public awareness. Meanwhile, cigarettes remain widely available in convenience stores and gas stations across the country.
This contrast has led to criticism from public health advocates and small business groups. Imperial Tobacco Canada’s CEO, Frank Silva, whose company produces ZONNIC, the first nicotine pouch authorized by Health Canada, has publicly argued that the current restrictions are counterproductive. Writing in The Hill Times, Silva said that limiting access to regulated products has “fueled the growth of an illicit market for high-nicotine pouches” and made it harder for adult smokers to transition to safer alternatives. He urged Health Minister Marjorie Michel to review the policy, stating that “Canadians deserve clarity and access to safer options that are approved and controlled by Health Canada.”
Other countries have taken a different approach, and it seems to be working. Sweden, for example, sells the pouches in convenience stores with strict age limits and marketing controls. It now has the lowest smoking and lung cancer rates in Europe, thanks in part to its harm-reduction strategy. In the United Kingdom, nicotine pouches are regulated as consumer products and also sold in convenience stores with clear labelling and age restrictions. Public Health England has even endorsed harm-reduction strategies that include vaping and nicotine pouches.
Meanwhile, the United States has launched a pilot program through the Food and Drug Administration to streamline the approval process for nicotine pouches. Products must meet rigorous standards, but they are not confined to pharmacies.
These models show that it is possible to regulate nicotine pouches responsibly without limiting access to those trying to quit smoking. But Canada faces a unique challenge: health is a shared jurisdiction. While Health Canada sets national policy, provinces and territories control retail access, enforcement, and public health messaging. This creates a patchwork of regulations and enforcement gaps.
One of the most debated aspects of nicotine pouches is the use of flavours and how they may appeal to youth. Health Canada–authorized nicotine pouches are permitted only in mint or menthol flavours, contain a maximum of 4mg of nicotine, and must be sold behind the counter in pharmacies—this applies across all provinces. However, illicit nicotine pouches, which are not authorized by Health Canada, are widely available through unauthorized channels in a range of fruity flavours and often contain much higher nicotine levels.
In Quebec, public health officials have raised concerns about flavoured nicotine products being marketed in ways that resemble candy or gum. In response, the province has proposed amendments to its Tobacco and Vaping Products Act that would ban flavoured nicotine pouches entirely. Other provinces, including Nova Scotia and Prince Edward Island, have already enacted flavour bans for vaping products and are considering similar measures for pouches.
It’s important to note that other nicotine replacement therapies (NRTs), such as gum and lozenges, can be sold in fruity flavours and are available without restriction in most provinces—except in Quebec, where they are sold only over the counter in pharmacies. Additionally, new products containing small amounts of tobacco have entered the market. These fall under the Tobacco and Vapour Products Act, can contain higher nicotine levels, and may be sold in fruity flavours depending on provincial regulations. The broader debate centres on balancing adult access to effective cessation tools with the need to prevent youth uptake.
This fragmentation makes it difficult to implement a unified national strategy. It also complicates efforts to educate the public and monitor usage. Without coordination between federal and provincial governments, policies risk being inconsistent, confusing, or ineffective.
Other countries have already shown what works. In Sweden and the United Kingdom, smoke-free products are sold responsibly in retail stores under strict age controls and clear labelling, helping millions move away from cigarettes. The results speak for themselves: smoking rates are at record lows, and public health outcomes are improving.
Canada could achieve the same but only with a coordinated, evidence-based framework that prioritizes both access and accountability. That means allowing regulated, lower-risk products to compete with cigarettes, investing in education to keep youth away, and enforcing real penalties for those who sell unregulated, high-nicotine products on the black market.
Canada has led before. It can lead again not by banning, restricting, or confusing smokers, but by giving them a fair and safe path to quit.
