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A major new report shows a pivotal shift in the global smoking landscape, highlighting the growing use of safer nicotine products, such as heated tobacco and nicotine pouches. The Global State of Tobacco Harm Reduction 2024 report (GSTHR 2024) underscores the significant substitution of traditional cigarettes with these alternatives – a change that promises to reduce tobacco-related harm and save millions of lives worldwide.
The report presents compelling evidence of a rapid global transition away from combustible tobacco, with inflation-adjusted sales of traditional cigarettes declining, while sales of safer nicotine products have surged six-fold since 2015. Notably, heated tobacco products (HTPs) and nicotine pouches are emerging as key substitutes in many countries.
Heated tobacco has proven particularly impactful in countries such as Japan, South Korea and Italy, where cigarette sales have decreased in tandem with the rise in HTP use. Similarly, in regions like Hungary and Slovakia, HTP adoption is nearly mirroring the decline in traditional smoking, creating a one-to-one substitution effect. These shifts are occurring far faster than traditional tobacco control measures have been able to achieve, providing strong evidence that safer nicotine products are helping people reduce or quit smoking altogether.
The need for safer alternatives to combustibles
The report also sheds light on the increasing accessibility of safer nicotine products. Over two-thirds of the global population now lives in countries where at least one form of these products is legally available, compared to 100% of adults who can still legally purchase cigarettes. Despite this progress, the report warns that cigarettes are still the default option in many regions, and safer alternatives are often hindered by restrictive regulations. Countries with supportive policies, such as the UK, Japan and New Zealand, have seen marked declines in smoking rates, thanks in part to their embrace of these alternatives as part of harm-reduction strategies.
Heated tobacco and nicotine pouches are part of a broader harm-reduction movement that recognises the need for safer alternatives to combustible cigarettes. Unlike traditional tobacco products, these innovations eliminate the dangers associated with smoke inhalation, such as cancer, heart disease and lung conditions, by removing the combustion process.
Many in the harm-reduction business stress that the increasing use of safer nicotine products provides a crucial opportunity to significantly lower smoking rates and tobacco-related deaths. Gerry Stimson, co-founder of Knowledge-Action-Change, which runs the GSTHR project, has said that “the cigarette is a dirty delivery system”. He emphasises that governments need to create supportive environments where consumers are encouraged and empowered to make the switch to these less-harmful options.
Strict regulations keep less-harmful products off the market
The report, however, also calls out significant challenges. Many countries, influenced by groups such as the World Health Organization, continue to resist the potential benefits of safer nicotine products, often imposing heavy regulations that limit access to them. In some cases, these alternatives are banned entirely, leaving cigarettes as the only available option. The authors of the report advocate for a regulatory framework that allows safer products to flourish, rather than imposing blanket bans that keep harmful products like cigarettes on the market.
The impact of safer nicotine products, especially HTPs and nicotine pouches, could be profound. With more than 140m nicotine consumers worldwide already using safer alternatives, the potential for these products to reduce smoking prevalence and related mortality is substantial. By providing smokers with accessible, less-harmful options, the world stands on the brink of a public health breakthrough. If supported by thoughtful regulation, safer nicotine products could become a cornerstone in the global effort to eliminate smoking-related diseases, delivering one of the most significant public health gains of the 21st century.
As the evidence mounts and consumer demand grows, the report makes a clear call: it’s time for governments to recognise the opportunity safer nicotine products present in the fight against tobacco-related harm. By shifting from prohibition to regulation, policy-makers can help millions of smokers make the switch to safer alternatives, driving down smoking rates and saving lives in the process.
– Antonia Di Lorenzo TobaccoIntelligence staff
Photo: Emma Simpson
