Why does banning products not work?
Banning both cigarettes and smoke-free nicotine products fails public health goals because it ignores the realities of addiction, consumer behavior, and harm reduction. History shows that outright prohibitions lead to black markets, unregulated products, and continued use rather than cessation. Smokers who can’t or won’t quit are left with no safer alternatives, increasing illicit cigarette trade and unsafe DIY nicotine use. Instead of reducing harm, such bans remove regulated, lower-risk options, making it harder for smokers to transition away from combustible tobacco. A harm reduction approach—offering safer alternatives while discouraging smoking—has proven far more effective in reducing smoking rates and related diseases.
Why do we need alternative products?
We need alternative nicotine products because not all smokers can or will quit, and providing safer options significantly reduces smoking-related harm. Traditional cessation methods like patches and gums have limited success, while harm reduction products—such as e-cigarettes, snus, and nicotine pouches—offer a realistic, less harmful pathway for smokers to switch away from combustible tobacco. Countries like Sweden, where alternatives are widely used, have the lowest smoking rates and smoking-related diseases in Europe, proving that offering alternatives is a more effective public health strategy than prohibition or abstinence-only approaches.
Tobacco harm reduction - so what?
THR saves lives—it’s that simple. Smoking kills over 8 million people a year, and while quitting nicotine entirely is ideal, many smokers can’t or won’t quit. THR provides safer alternatives like e-cigarettes, nicotine pouches, and snus, which dramatically reduce exposure to harmful chemicals found in cigarettes. Countries like Sweden and the UK have proven that embracing THR leads to lower smoking rates, fewer smoking-related diseases, and massive public health gains. Ignoring THR means accepting preventable deaths. The real question isn’t “So what?”, but “Why aren’t we doing more?”
If I am a smoker, but don’t want to give up nicotine, how do I reduce risk?
Quit cigarette smoking completely or switch to a less harmful nicotine product. Options include electronic cigarettes, oral nicotine or smokeless tobacco, heated tobacco products (heat-not-burn) or pharmaceutical products (e.g. inhalers, lozenges, patches and nicotine gum).
Do e-cigarettes help smokers quit cigarettes?
Yes. Four elements of evidence suggest that e-cigarettes are effective in helping people to quit smoking:
- Evidence from randomised controlled trials, notably Hajek et al. [21], which showed vaping to be about twice as effective as NRT.
- Observational studies (examining what happens when people use e-cigarettes) for example, Jackson et al, “Use of e-cigarettes and varenicline are associated with higher abstinence rates following a quit attempt in England.”
- Population data (unusually rapid reductions in smoking prevalence and cigarette sales), for example, Zhu S-H et al.
- Thousands of testimonials by users who have struggled to quit using other methods. See, for example, CASAA testimonials.
Are e-cigarettes and other vaping products dangerous?
For all practical purposes, e-cigarettes show a 95-99% reduction in harm, compared to cigarettes. Exposure to nicotine itself is not especially harmful and mostly under the control of the user through ‘titration’ – smoking or vaping in a way that provides the desired nicotine dose.
McNeill, A., Brose, L. S., Calder, R., Hitchman, S. C., Hajek, P., & McRobbie, H. (2015). E-cigarettes: an evidence update. Public Health England
How harmful is nicotine?
Consuming nicotine is not totally risk-free, and can lead to dependence. However, its benefits far outweigh the risk of smoking. Nicotine has similar effects to caffeine found in coffee. There is no evidence that nicotine causes any substantial risk for cancer, and the risk for cardiovascular disease is minimal. It’s the smoke, not the nicotine that is responsible for nearly all premature death and disease. Most people can consume nicotine safely – with nicotine replacement therapy (NRT) such as gum, inhalers, lozenges, sprays or patches. However, pregnant women should avoid nicotine as it may have a negative effect on foetal development.
Smoke Free Sweden. (2024). No Smoke, Less Harm: How Non-Combustible Nicotine Alternatives Can Accelerate Tobacco Control and Harm Reduction, to Save Millions of Adult Smokers’ Lives.
How successful are tobacco harm reduction strategies?
In those countries where THR is recognised and proportionate, risk-based regulation is in place, significant net public health gains have been demonstrated. For example, in the United Kingdom, electronic cigarettes have become the method of choice to quit smoking. In Sweden, a significant number of people replaced smoking cigarettes with ’snus’ (a Swedish smokeless tobacco product). Smoking prevalence has decreased to as low as 6%, whereas the average in the EU is still around 26%.
Smoke Free Sweden. (n.d.). The Swedish Experience: A Roadmap to a Smoke-Free Society. Smoke Free Sweden.
If THR is so effective, why is it not recognised more widely?
THR faces many barriers in its efforts to reduce harm and save lives. Most barriers start with misperceptions and disproportionate tobacco regulation. For example, non-differentiation between combustible and non-combustible nicotine products causes confusion among consumers. Misleading media reports exacerbate the misperceptions.
