Safer nicotine alternatives like vapes will ‘inevitably and soon’ replace combustible cigarettes worldwide, former president of the Australian Drug Law Reform Foundation Dr Alex Wodak told the Global Forum on Nicotine (GFN) in Warsaw. When they do the public health impact will be ‘akin to the introduction of vaccination’, he said.
Tobacco harm reduction products such as vapes, nicotine pouches, heated tobacco products and snus were ‘vastly less harmful’ than cigarettes, as well as being effective smoking cessation aids. However, people worldwide were finding their access to them blocked, hampered or under threat, delegates heard.
Just as there had been ‘vehement and protracted opposition to every new harm reduction intervention for drugs’, this was now the case with nicotine, Wodak said. Almost 50 countries now banned the sale of vapes, while the EU continued to prohibit snus. Tobacco harm reduction was ‘an existential threat to organisations committed to a tobacco control “endgame”,’ he said – which would become ‘obsolete‘ once safer nicotine products replaced cigarettes.
Around a billion people worldwide still smoke, ‘fuelling millions of preventable deaths’ according to the World Health Organization (WHO). The organisation, however, remains opposed to e-cigarettes, with its director of health determinants, Etienne Krug, last year stating that they were fuelling ‘a new wave of nicotine addiction’. An independent review commissioned by Public Health England, however, concluded that they were around 95 per cent less harmful than smoking.
The UK’s Tobacco and Vapes Act, which passed into law earlier this year, contains measures to phase out the legal sale of tobacco to anyone born after January 2009 as well as tighten the regulations around vape flavouring and packaging. Although more than a million people in the UK quit smoking last year, the cost of smoking to society in England alone is almost £45bn a year, according to new analysis from ASH – a figure that includes healthcare, social care and lost productivity.
While outright bans on safer nicotine products were common, the ‘spirit of prohibition’ was also evident in policies such as bans on vape flavours, caps on nicotine content and tax measures that made them unaffordable for the populations most in need of them, GFN delegates heard.
‘Prohibition fails by every measure,’ said GFN director Jessica Harding. ‘It damages public health and costs lives by encouraging people to keep smoking. And rather than eradicating safer nicotine products as intended, it fosters illicit markets that operate without consumer protections or age restrictions. The biggest victims of prohibition are the vulnerable populations that smoke at the highest rates, disproportionately people who are on low incomes and marginalised. It is their right to health that is under attack.’
Global Forum on Nicotine 2026, including live streaming of sessions, here
ASH ready reckoner available here