New research from UK-based public health agency Knowledge Action Change (KAC) reveals only nine users of safer nicotine products for every 100 smokers worldwide. 

Global tobacco control’s hostility to tobacco harm reduction is risking the health and lives of millions with LMIC worst hit, say experts.

The launch of the launch of “Burning Issues: The Global State of Tobacco Harm Reduction (GSTHR) 2020” took place online yesterday, the original conference cancelled due to COVID-19 restrictions.

Organisers said: “Tobacco harm reduction supports people to quit smoking by using safer nicotine products (SNP) including vaping devices (e cigarettes), heated tobacco products (HTP) and pasteurised oral snus, improving health and reducing deaths by enabling people to use nicotine without the smoke that causes disease.”

The authors of Burning Issues reveal an estimate for the total global number of users of safer nicotine products, showing that there is an urgent need to scale up tobacco harm reduction if its full public health potential is to be realised:

  • There are only nine SNP users for every 100 smokers globally, mainly in high income countries;
  • Overall, 98 million people are estimated to use safer nicotine products worldwide;
  • Of those, 68 million are vapers, with the largest vaping populations in the US, China, the Russian Federation, the UK, France, Japan, Germany and Mexico;
  • 20 million are HTP users; with most HTP users in Japan, where cigarette sales have dropped by 32% since 2016 when HTP were launched;
  • 10 million are US smokeless or snus users.
  • They say that official monitoring of SNP use is currently limited – yet is essential to understand their impact and potential in tackling smoking-related death and disease. Nevertheless, these numbers demonstrate the scale of consumer uptake and acceptance of these products as alternatives to combustible tobacco, which kills half its users.

“Meanwhile, the global public health crisis of smoking is ongoing and deadly. 1.1bn people smoke worldwide, a figure that has remained unchanged for two decades despite billions spent by governments and the World Health Organization (WHO) on tobacco control. 80% of the world’s smokers live in low and middle income countries (LMIC), and eight million people die due to smoking-related disease every year. The WHO estimates that one billion people will die of smoking-related disease by 2100.”

Professor Gerry Stimson, Emeritus Professor at Imperial College London and KAC Director, said: “This is a decisive moment for the future health of 1.1 billion smokers around the world, who deserve better than the status quo. Policymakers engaged in the current European Commission Tobacco Products Directive revision and next year’s WHO FCTC Conference of the Parties must consider the evidence for tobacco harm reduction’s role, listen to consumers, and deliver policies that genuinely focus on reducing the global toll of smoking- related disease and deaths as quickly as possible. If integrated into tobacco control, harm reduction could be a gamechanger in the battle against non-communicable disease.”

Harry Shapiro, Executive Editor of Burning Issues, added: “Our data shows that, worldwide, millions of people are choosing to improve their own health by switching from combustible tobacco. But this needs to scale up, fast. Tobacco harm reduction should become a genuine consumer-led public health success. But instead, we are seeing the start of a war on nicotine.”

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