Former directors of the World Health Organization (WHO) are calling for a sweeping reform of global tobacco policy to adopt harm reduction strategies, saying a shift to low-risk alternatives like e-cigarettes and heated tobacco products could save over 100 million lives by 2060.
In a report, the experts advocate for a “reset” in the Framework Convention on Tobacco Control (FCTC) to integrate these new technologies. They estimate that transitioning just 20 percent of global smokers to low-risk nicotine products within the next 10 to 15 years would cut smoking-related deaths in half by 2060.
Their analysis of 23 countries suggests more than 14 million otherwise premature deaths could be avoided. Extrapolated worldwide, they estimate integrating tobacco harm reduction (THR) could prevent more than 3 million deaths every year.
“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 of the report—former WHO Policy Research function director Tikki Pang, key architect of WHO’s tobacco policy Derek Yach, economist Chris Snowdon and Clearing the Air co-founder Peter Beckett—warn that without urgent changes, low and middle-income nations will face immense health and economic burdens.
The authors urged governments to challenge outdated views during the FCTC 11th Conference of the Parties (COP) meeting in Geneva on November 17,2025. They expressed concern that current discussions may lead to more restrictions on safer alternatives instead of supporting their widespread adoption.
They identified several countries where harm reduction has significantly reduced smoking rates. Heated tobacco product use has surged in Japan, South Korea, Italy, Poland and Germany, while vaping has gained ground in the United States, United Kingdom, Russia and Romania, resulting in rapidly falling cigarette prevalence as millions transition to lower-risk alternatives. The report also pointed to Nordic countries that have pushed smoking and cancer incidence to global lows due to the widespread availability of snus and nicotine pouches.
The report says that male smoking rates remain above 45 percent in countries such as Indonesia, China, Egypt and Jordan. The experts cited the need for scientific institutions to ensure that healthcare providers are properly informed about harm reduction, calling “uninformed or misinformed clinicians” a key barrier to adoption.
