This review describes the evolution of smoking prevalence in countries with relatively high adoption of alternative nicotine products such as e-cigarettes, heated tobacco, and snus compared to neighboring countries where these products are less prevalent.
The data indicate that countries with high adoption of alternative nicotine products have been able to achieve lower smoking rates.
The findings suggest that adoption of alternative nicotine products may help in reduce smoking prevalence faster than traditional tobacco control measures solely focused on prevention and cessation.
Background
A recent commentary by Beaglehole and Bonita posited that tobacco control is not working for most of the world [1]. Given that the overall number of tobacco users has barely changed in the last three decades, they recommended that the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) incorporate strategies designed to reduce the harms caused by burnt tobacco by replacing cigarettes and other combusted tobacco products with non-combusted alternative products that deliver nicotine in far less harmful ways.
Indeed, as succinctly summarized by Vaughan Rees, “the best, evidence-based interventions are dated, overrated and cannot meet the challenge of reducing tobacco-related harm in this century [2].” Despite a growing awareness that current approaches are falling short, very few countries have adopted harm reduction policies as part of their tobacco control strategy. Notable examples include United Kingdom [3] and New Zealand [4], which explicitly encourage the use of vaping for smoking cessation and harm reduction. Alternative nicotine products have also seen significant uptake in Sweden, Norway, and Japan, which do not necessarily endorse their use to reduce smoking-related harms.
Karl Fagerstrom – Harm Reduction Journal – 2022-12-10.
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