Nicotine Science and Policy

In its fifth major report, the Global State of Tobacco Harm Reduction (GSTHR) estimates around 200 million people are now using safer nicotine products (SNP), equivalent to a fifth to a quarter of the global smoking population. Analysis shows a consistent pattern of increasing SNP use alongside declining smoking prevalence across 28 countries; in Sweden, Norway, Iceland, New Zealand and the UK, SNP use has overtaken smoking. Meanwhile, global policy has shifted further toward SNP restriction or bans in 2025/6. Published by Knowledge•Action•Change with funding from Global Action to End Smoking, GSTHR: A Situation Report 2026 is out now. https://gsthr.org

A fairer fight against lung cancer starts by focusing on the people still most exposed to smoke. Smoking remains the dominant preventable cause, yet too many smokers are given warnings without enough realistic routes away from combustible tobacco. Tobacco harm reduction can strengthen prevention by reducing exposure before disease develops. The goal should be practical risk reduction for those at highest risk, not a public health model that only rewards complete abstinence.

The “ban it” instinct is becoming a substitute for responsibility. Public health can reduce risk without treating adults as incapable of making informed choices. Tobacco and nicotine policy should provide accurate information, support and safer alternatives, rather than defaulting to restrictions that remove autonomy while doing little to address real behaviour. A society built only on bans may look safer on paper, but it can leave people less trusted, less informed and no better protected.

Consumer evidence belongs at the centre of tobacco harm reduction research. Measuring what people think, feel and do helps explain why some products support switching, why others fail, and how regulation affects behaviour outside controlled settings. Numbers alone cannot capture trust, motivation, stigma or product appeal. Better policy needs data on real consumers, not only assumptions about how they should act.

Prisons show why harm reduction has to deal with practical risks, not only ideals. Safer vape access can reduce second-hand smoke exposure, support people who smoke and lower fire risks linked to illicit or improvised products. That is public health in a controlled environment: fewer hazards, clearer rules and less pressure on staff and residents. Ireland’s approach should recognise that reducing harm often starts with making the safer option workable.