Quitting smoking and nicotine completely is clearly the most effective strategy for reducing the harm from smoking.
However, Tobacco Harm Reduction is an opportunity to help prevent tobacco-related disease and premature death by encouraging cigarette smokers who can’t or won’t quit, to switch to a smoke-free, nicotine alternative.
The smoking of cigarettes still remains the biggest single cause of non-communicable deaths in the world.
According to the World Health Organization (WHO), it caused eight million deaths in 2017 alone. If current trends persist, another BILLION tobacco-related deaths will occur during the 21st century.
We have created the ultimate THR resource for Policy Makers and Health Professionals
Millions of smokers have been able to quit smoking by switching to reduced-risk THR products such as:
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Electronic cigarettes (also known as ENDS or vaping products)
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Oral Nicotine Pouches or Swedish Snus
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Heated Tobacco Products (also known as heat-not-burn)
Learn About THR
ACCORDING TO THE WHO’S CONSTITUTION:
“Enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.
In the same spirit, tobacco harm reduction is reflected in Article 1(d) of the Framework Convention on Tobacco Control (FCTC). This states that “tobacco control itself means a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.”
World Health Organization. (1946). Constitution of the World Health Organization
What are the misconceptions about tobacco harm reduction?
What is often misunderstood in harm reduction,
is relativity of risk.
Harm reduction is practised to minimise risk in other ways, e.g.:
Helmet use for bicycles and motorcycles
Vaccines to minimise the effect of Covid infections
Using contraception for safe(er) sex
Clean needles and syringes for drug users in supervised conditions
Understanding The Risk Continuum
In THR, the Royal College of Physicians (RCP) states that the hazard to health, arising from long-term vapour inhalation from e-cigarettes, is unlikely to exceed 5% of the harm from smoking tobacco. With oral nicotine products, there is no vapour, so it is potentially even less harmful.
THR encourages smokers to move down the risk continuum by switching from the highest-risk tobacco products – combustible cigarettes – to the least harmful nicotine and tobacco products.
Products along the harm reduction continuum. Adapted from Nutt et al. 2014 and Abrams et al. 2019
THR Supporting Statements
There is a growing list of respected scientific and public health organisations that have reviewed all the evidence. They have concluded that THR and nicotine products are safer than smoking (and help smokers quit). This includes various governments, intergovernmental organizations and NGOs.
The Big Questions About THR:
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?”
