Global health experts are urging policymakers to adopt risk-based regulation of nicotine products, saying that such an approach could significantly accelerate the decline of smoking worldwide.
Scientists and economists presented findings from recent global forums indicating that current tobacco control strategies may not sufficiently address the needs of more than one billion smokers.
The Global State of Tobacco Harm Reduction report estimates that if just 20 percent of smokers switch to lower-risk smoke-free alternatives within the next decade to 15 years, smoking-related deaths could be reduced by half by 2060.
Experts said achieving this outcome will require a policy “reset” that encourages innovation and promotes the availability of alternatives such as e-cigarettes, nicotine pouches and heated tobacco products.
Among those supporting the reform are former World Health Organization Policy Research function director Tikki Pang, former WHO official Derek Yach, Institute for Economic Affairs economist Chris Snowdon and Clearing the Air co-founder Peter Beckett.
They warned that maintaining the current policy trajectory could lead to continued health and economic burdens in many 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.
Scientific evidence cited by the experts supports the effectiveness of harm reduction strategies.
A Cochrane review reported high-certainty evidence that e-cigarettes help smokers quit more effectively than traditional nicotine replacement therapies, while Public Health England previously concluded that vaping is 95 percent less harmful than combustible cigarettes.
University College London researcher Dr. Robert West said public health goals should be supported by policies that accurately reflect the relative risks of nicotine products.
Imperial College London professor Dr. David Nutt noted that smoking causes around eight million deaths annually and that smoke-free alternatives can significantly reduce harm for smokers who are unable or unwilling to quit nicotine.
Evidence from the United States also points to the potential role of nicotine pouches in harm reduction.
Cristine Delnevo of the Rutgers Institute for Nicotine and Tobacco Studies led a study published in JAMA Network Open examining the public health implications of these products.
“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 discussion hosted by the International Association on Smoking Control & Harm Reduction (SCHORE) in Athens, more than 200 experts from 51 countries emphasized the importance of science-driven policy.
“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, a study by Professor Christopher Cabuay highlights the economic implications of shifting smokers to non-combustible alternatives.
His study estimates that if half of adult smokers in the country switched to smoke-free products, annual savings could reach $3.4 billion, or about 0.87 percent of the nation’s gross domestic product.
