An end to smoking is within reach – it must not be allowed to slip away

In a landmark new Global State of Tobacco Harm Reduction (GSTHR) report, experts are calling on global policymakers to seize the opportunity to bring about an end to smoking, which every year kills eight million people worldwide. Despite years of investment and effort, international tobacco control measures have stalled: the number of smokers has remained static at 1.1 billion for twenty years. But the past two decades have also seen the emergence of new options to reduce smoking-related death and disease, which are not caused by nicotine, but by thousands of chemicals released when tobacco burns.

Tobacco harm reduction encourages people who smoke and who either cannot, or do not want to stop using nicotine, to switch to significantly safer products, including vapes (e-cigarettes), tobacco-free nicotine pouches, Swedish-style snus and heated tobacco products. GSTHR estimates show that over 112 million people already use them worldwide. Yet these significantly safer products face prohibitive regulation or bans in many countries, while the sale of deadly combustible cigarettes is universally legal.

The Global State of Tobacco Harm Reduction 2022: The Right Side of History, from UK-based public health agency Knowledge·Action·Change, charts the history of tobacco harm reduction to date, and considers the future for a strategy that could end smoking. The disruptive potential of safer nicotine products – to public health, to governments and regulators, and to commercial interests – has been significant and is not yet fully realised.

In the report, author Harry Shapiro documents the search for safer ways to use nicotine, beset with many false starts. He explores the role of individual innovators and nicotine consumers in the development of safer products and harm reduction, the establishment of the Chinese vaping industry, and the mistrust seeded by the late entrance of the traditional tobacco industry into the safer product market. It has also led to the spread of mis- and disinformation, which is currently inhibiting the potential of safer products to save lives.

At the report launch, GSTHR Project Lead, Professor Gerry Stimson, argued that policymakers must integrate tobacco harm reduction into the international response to smoking, giving millions of adult smokers new choices to support them to quit. “Ideology must be set aside in favour of an openness to new thinking, and a critical but balanced evaluation of the science. Evidence shows that people will switch away from deadly smoking to safer nicotine products if they are given the chance. An end to smoking is within reach – we must not let it slip from our grasp.”

Source – Knowledge·Action·Change