Harm reduction experts claimed that bans on vaping perpetuate cigarette dependence across numerous countries and are not effective in bringing down smoking rates.
The Global State of Tobacco Harm Reduction (GSTHR) report, funded by Global Action to End Smoking, shows that tobacco causes around 8 million deaths each year, with many occurring in low- and middle-income countries (LMICs) where vaping remains restricted.
According to World Health Organization (WHO) statistics, global tobacco consumption remained steady at 1.25 billion users in 2022, underscoring limited progress since the adoption of the Framework Convention on Tobacco Control (FCTC) in 2005.
In LMICs, which account for 80 percent of the world’s smokers and most tobacco-related deaths, smoking rates show little decline.
Restrictions on safer alternatives are linked to persistently high male smoking rates—over 45 percent—in Indonesia, China, Egypt, and Jordan, according to the GSTHR report.
Advocates also highlight the failure of prohibition in countries such as Mexico, India, and Singapore. Harm reduction expert Kurt Yeo, co-founder of VSML (Vaping Saved My Life) noted that limited cessation support and the scale of illicit cigarette markets hinder quitting efforts in many African nations.
Dr. Rohan Andrade Sequeira, a cardio-endocrine consultant, highlighted the challenge faced by India’s 250 million tobacco users, noting that nicotine replacement therapy (NRT) has a global success rate of just 7 percent. “There’s no way out for these patients who are suffering from behavioral patterns of using tobacco or nicotine,” Sequeira said.
By contrast, countries that allow less harmful alternatives report notable declines in smoking prevalence. The GSTHR notes that supporting access to smoke-free products is linked to falling smoking rates.
Researchers at the University of Queensland (UQ) report that smoking rates in New Zealand have fallen at twice the pace of Australia’s, pointing to the potential public health benefits of less restrictive vaping regulation.
Australia permits nicotine vapes only by prescription, while New Zealand allows adult sales under flavor and marketing rules.
Wayne Hall, Emeritus Professor at UQ’s National Centre for Youth Substance Abuse Research, reported that adult daily smoking in New Zealand fell by 10% annually from 2016 to 2023, double the 5% yearly decline seen in Australia.
“The larger decline in smoking in New Zealand closely mirrors vaping rates: in 2023, 9.7% of New Zealand adults vaped daily, compared to only 3.5% of Australian adults,” Hall said.
Pippa Starr, founder of ALIVE (Australia, Let’s Improve Vaping Education), slammed WHO-backed policies, pointing to Australia’s “massive black market” and the 66 daily deaths from smoking-related illness.
The United Kingdom, Japan, and Sweden experienced swift adoption of smoke-free alternatives, resulting in declining cigarette use and lower smoking rates. In the UK, smoking dropped from 24% in 2005 to a projected 10.8% in 2025, while vaping rose to 10%.
Smoking in New Zealand declined from 28.9% in 2000 to 10.9% in 2021, while vaping is expected to reach 13 percent by 2025.
Harm reduction advocate Bengt Wiberg cited Swedish government figures showing a 72% decline in smoking among 16- to 29-year-olds over the past decade, coinciding with a 72% increase in snus and nicotine pouch use.
Dr. K. Michael Cummings of the Medical University of South Carolina concluded that data from Sweden, New Zealand, the United States, and England show consumer access to lower-risk nicotine products under a free-market approach accelerates declines in cigarette use and supports better public health.
The GSTHR report estimates that if one-fifth of global smokers adopt low-risk alternatives within 10 to 15 years, smoking-related deaths could be reduced by half by 2060.
