Global health experts and scientists are calling on governments to adopt risk-proportionate regulation for nicotine products, warning that existing policies are not adequately addressing the needs of the world’s more than one billion smokers.
The appeal follows the release of scientific and economic evidence discussed at international summits on tobacco harm reduction. Experts said emerging research indicates that encouraging smokers to shift to less harmful alternatives could significantly reduce global smoking-related deaths.
According to the Global State of Tobacco Harm Reduction report, smoking-related mortality could decline substantially if a portion of smokers transition away from combustible cigarettes.
The report estimates that if 20 percent of the world’s smokers switched to low-risk smoke-free alternatives within the next 10 to 15 years, smoking-attributable deaths could be cut in half by 2060.
Experts said global tobacco control policies require a “reset” that places greater emphasis on innovation and supports the use of lower-risk alternatives such as e-cigarettes, nicotine pouches and heated tobacco products.
Former World Health Organization Policy Research function director Tikki Pang and former World Health Organization official Derek Yach, alongside Institute for Economic Affairs economist Chris Snowdon and Clearing the Air co-founder Peter Beckett, warned that failure to adjust policy frameworks could lead to prolonged health and economic burdens, particularly in low- and middle-income countries.
“Our findings suggest that embracing harm reduction alongside conventional measures could roughly double the lives saved compared to current policies alone,” the authors said in a joint report.
“Across the 23 countries analyzed, over 14 million additional premature deaths could be averted by 2060. Extrapolated worldwide, over 100 million lives could be saved – preventing over 3 million deaths a year,” they said.
Several studies cited by the experts reinforce evidence supporting harm reduction strategies.
A comprehensive Cochrane review found high-certainty evidence that e-cigarettes are more effective at helping smokers quit than traditional nicotine replacement therapies. Meanwhile, Public Health England previously reported that vaping is 95 percent less harmful than smoking cigarettes.
University College London researcher Dr. Robert West said efforts to reduce tobacco-related disease should be based on epidemiological evidence about the relative harms of nicotine products.
Imperial College London professor Dr. David Nutt noted that smoking continues to cause approximately eight million deaths annually worldwide and that smoke-free alternatives may significantly reduce risks among individuals who continue to use nicotine.
Research from the Rutgers Institute for Nicotine and Tobacco Studies also suggests that nicotine pouches could contribute to harm reduction strategies.
Cristine Delnevo, director of the institute, led a study published in JAMA Network Open examining the potential public health implications of nicotine pouch use.
“For people who smoke or use other nicotine products and don’t want to stop using nicotine, switching completely from the more harmful product and moving down the risk continuum with nicotine pouches is likely good for public health,” Delnevo said.
During a panel organized by the International Association on Smoking Control & Harm Reduction (SCHORE) in Athens, around 200 experts representing 51 countries stressed that tobacco control policies should be grounded in scientific evidence.
“Tobacco control strategies must be reshaped to include harm reduction, and lower-risk alternatives should be actively encouraged alongside cessation and prevention measures,” they said in their position statement.
In the Philippines, Professor Christopher Cabuay examined the potential economic impact of harm reduction policies in a study titled “Assessing the Impact of Shifting to Non-Combusted Alternatives to Reduce the Economic Cost of Tobacco-Related Illnesses.”
The research estimated that if half of adult Filipino smokers shifted to non-combustible alternatives, the country could save about $3.4 billion annually, equivalent to roughly 0.87 percent of gross domestic product.
