The Pacific island nation of Palau has formally asked the United Nations to place nicotine under international drug control, a move that would task the World Health Organization’s expert committee on drug dependence with reviewing the substance and could lead to a global ban by 2028. The notification, submitted under Article 2 of the 1971 Convention on Psychotropic Substances, requires the WHO Expert Committee on Drug Dependence (WHO-ECDD) to conduct a critical review of nicotine, with a recommendation expected by October 2027. A vote by the UN Commission on Narcotic Drugs is then scheduled for March 2028. If successful, it would be the first time in more than 75 years of international drug control that a widely consumed recreational substance has been added to the schedules alongside drugs such as LSD and cannabis.
Palau’s president, Surangel S. Whipps Jr., said the initiative was driven by the scale of the crisis. “Millions die every year. More than a billion are dependent on nicotine — most of them hooked as children. We could not look away,” he said. The country’s submission argues that nicotine itself is directly toxic, particularly to developing brains, and that its addictive properties cause lasting harm even when separated from the carcinogens in tobacco. Palau has already taken strong domestic action, banning e-cigarettes in 2023 after evidence showed that nearly half of Palauan adolescents had used them.
The case for a ban: addiction as harm
The core of Palau’s argument rests on whether addiction and dependence — in the absence of other major health consequences — are themselves harmful. Smoking, which remains the leading cause of preventable death worldwide, taught regulators that highly addictive habits can have catastrophic consequences that only become obvious later. Tobacco and nicotine products currently cause more than seven million deaths annually, with projections of up to one billion deaths this century if no decisive action is taken. Yet the products at the centre of the modern debate — vapes, nicotine pouches, and other tobacco-free nicotine devices — present a more complicated picture. As the then head of the WHO, Gro Harlem Brundtland, put it in 2000, “a cigarette is the only consumer product which when used as directed kills its consumer”. Synthetic nicotine, freed from the carcinogens in tobacco, seems to offer addiction without the same immediate lethality.
Risks and benefits: the adolescent brain is most vulnerable
Nicotine’s most serious and best-documented health impact is on the developing brain. The brain continues to mature until around age 25, and nicotine can disrupt the formation of brain circuits that control attention, learning, mood and impulse control. Studies show that adolescents can become addicted more easily than adults because of faster synapse formation. The U.S. Surgeon General concluded as far back as 1988 that the processes driving nicotine addiction are similar to those behind heroin and cocaine addiction. Nicotine also impairs endothelial function through sympathetic activation, oxidative stress and nitric oxide depletion — effects observed in users of traditional cigarettes, e-cigarettes and nicotine pouches alike, even without other tobacco constituents. A WHO report found that children are, on average, nine times more likely than adults to vape worldwide. Some e-cigarettes contain harmful ingredients beyond nicotine, including heavy metals such as nickel, tin and lead, volatile organic compounds, and flavouring chemicals that are safe to eat but hazardous when inhaled. An outbreak of lung injuries associated with e-cigarette use in 2019 highlighted the potential for acute physical harm.
However, there are also benefits to consider. There are still 1.2 billion smokers worldwide, and a recent Cochrane review found that people who switch to vaping are twice as likely to quit smoking compared with those using nicotine replacement therapy. A recent report from the Royal College of Physicians in the UK found that “current evidence suggests nicotine itself confers little risk to health”. The tension between these findings — that nicotine in isolation may be relatively low-risk for adults, but that its delivery systems and its effects on adolescents carry significant dangers — lies at the heart of the regulatory debate.
Regulatory gaps and the Whac-A-Mole problem
Regulators have struggled to keep pace with the rapid evolution of nicotine products. The UK did not introduce vape-specific legislation until 2016; the previous law covered tobacco only. Nicotine pouches, which contain no tobacco leaf, currently sit in a regulatory grey area because they are not classed as tobacco products. Reading between the lines of Palau’s submission, there is clear frustration with the way the market for nicotine products sprang up rapidly in a regulatory vacuum and targeted children specifically. The WHO’s Framework Convention on Tobacco Control does not extend to nicotine as a molecule across all its delivery forms, which is precisely the gap Palau’s UN initiative seeks to close.
The UK is now moving to address these issues through the Tobacco and Vapes Act 2026, a landmark piece of legislation that aims to create a “smoke-free generation”. From January 1, 2027, it will be illegal to sell tobacco products to anyone born on or after January 1, 2009. The Act also introduces restrictions on vaping products: disposable vapes were banned from June 1, 2025; flavoured products, packaging and advertising are being tightened; vaping will be prohibited in cars carrying children and in public spaces such as playgrounds, outside schools and hospitals; and a ban on advertising and sponsorship for vapes and nicotine products will take effect on June 1, 2027. A new Vaping Products Duty of £2.20 per 10ml of e-liquid will be introduced from October 1, 2026, alongside a proposed licensing scheme for retailers. For nicotine pouches, new laws will set a legal minimum age of 18 and require age verification.
Other jurisdictions offer models for a middle ground. The Canadian province of Quebec has fully banned flavoured vapes and limits the sale of nicotine pouches to pharmacies. New Zealand passed a similar generational tobacco ban in 2022 but repealed it in 2024. The Maldives introduced a generational tobacco ban in late 2025, prohibiting anyone born in 2007 or later from buying, using or smoking tobacco, alongside a strict countrywide ban on vaping.
Palau’s global initiative, meanwhile, would cut the problem off at its source by treating nicotine itself as a controlled substance. The WHO-ECDD review is expected to begin in late 2026. If the UN vote in March 2028 supports Palau’s proposal, the consequences for the worldwide nicotine market — including the rapidly growing synthetic nicotine sector — would be profound. The science on pure nicotine use remains limited, and downstream products such as vapes are not benign. Addictive substances are by definition difficult for individuals to control, which is why countries may need to manage them — whether through national legislation, as the UK is attempting, or through the unprecedented step of a global ban.
