A new study led by 2 former WHO leaders found that embracing harm reduction alongside conventional measures could roughly double the number of lives saved compared to current policies alone. Photo credit: Debora Cartagen, USCDCP, Pixnio.
Former senior officials of the World Health Organization (WHO) called for major reforms to global tobacco policy and urged governments to adopt tobacco harm reduction (THR) strategies. They warned that ignoring safer nicotine alternatives could cost millions of lives in the decades ahead.
In a new report, former WHO research director Tikki Pang, former WHO executive Derek Yach, head of lifestyle economics at the Institute of Economic Affairs Chris Snowdon, and Clearing the Air co-founder Peter Beckett said the Framework Convention on Tobacco Control (FCTC) needs a “reset” that includes safer nicotine products such as e-cigarettes, heated tobacco devices, and oral nicotine pouches.
The authors said wider access to low-risk products could sharply reduce smoking-related deaths, especially in low- and middle-income countries where cigarette consumption remains high. They projected that if at least 20% of smokers worldwide switch to lower-risk products within the next 10-15 years, smoking-related deaths could fall by half by 2060.
Their analysis of 23 countries shows that THR adoption could prevent more than 14 million premature deaths by 2060. The authors said these country-level findings show how large the global impact could be if governments integrate harm reduction into tobacco control strategies.
“Our findings suggest that embracing harm reduction alongside conventional measures could roughly double the lives saved compared to current policies alone,” the report says. “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.”
The authors warned that without urgent changes, low- and middle-income countries will face severe health and economic burdens. They urged governments to challenge outdated views during the FCTC 11th Conference of the Parties (COP11) meeting and expressed concern that current discussions may increase restrictions on safer alternatives instead of supporting broader adoption.
The report highlights countries where harm reduction has already driven major declines in smoking. Heated tobacco use has increased in Japan, South Korea, Italy, Poland, and Germany. Vaping has gained ground in the US, UK, Russia, and Romania, contributing to rapid drops in cigarette smoking as millions shift to lower-risk products. The authors also noted that Nordic countries have pushed smoking and cancer rates to global lows through widespread use of snus and nicotine pouches.
The report says male smoking rates remain above 45% in countries such as Indonesia, China, Egypt, and Jordan. The authors said scientific institutions must ensure that healthcare providers understand harm reduction, calling “uninformed or misinformed clinicians” a major barrier to adoption.