Restrictions on safer alternatives will fuel Bangladesh’s tobacco crisis, report warns
STOCKHOLM – 1st September 2025 – Restrictions on safer alternatives to cigarettes will fuel the tobacco epidemic that is responsible for more than one in five of all deaths in Bangladesh, according to a major report by international health experts released today.
The landmark study, Tale of Two Nations: Bangladesh vs. New Zealand, reveals a stark contrast between two nations’ approaches to tobacco control and their dramatically different outcomes.
Bangladesh is one of the largest consumers of tobacco worldwide, with smoking rates among men reaching an alarming 34.1% – four times higher than in New Zealand. Millions more use smokeless tobacco products such as zarda and gul, which are linked to severe health risks, including oral cancer, heart disease and stroke.
The human cost of this crisis is staggering, with tobacco-related diseases responsible for 21.9% of deaths in the country. According to international health experts, integrating the use of safer alternatives alongside existing tobacco control measures could save up to 920,000 lives in Bangladesh by 2060.
Dr. Md. Shariful Islam Dulu, co-author of the report and founding trustee of the Bangladesh Harm Reduction Foundation, said: “Bangladesh’s restrictive approach to safer alternatives such as vapes and nicotine pouches is a tragedy in the making.
“We have clear global evidence supporting the benefits of smoke-free alternatives, yet activists and policymakers are pushing for bans on life-saving alternatives. This risks worsening our country’s tobacco crisis, leaving millions with no viable option but to continue smoking or using dangerous smokeless tobacco products.”
While New Zealand has almost halved its smoking prevalence since 2015 – bringing it down to just 6.9% of adults – Bangladesh’s smoking rate has only dropped modestly from 23% to 17% over the same period. New Zealand is now on the cusp of becoming one of the first countries in the world to attain official smoke-free status.
Report co-author Dr. Delon Human, leader of Smoke Free Sweden and former Secretary-General of the World Medical Association, said: “New Zealand is reaping the benefits of a pragmatic approach that integrates harm reduction into its tobacco control strategy. By officially endorsing smoke-free alternatives such as vaping, they provided smokers with viable pathways to quit combustible tobacco. The results speak for themselves – an almost 50% reduction in smoking rates in just a few years.”
However, Bangladesh is moving in the opposite direction. Policymakers have imposed a blanket ban on the import of vapes and heated tobacco products, effectively creating outright prohibition and driving demand toward unregulated black-market products.
The report makes seven key recommendations for Bangladesh, including adopting harm reduction strategies, developing science-based regulations and implementing targeted educational campaigns for healthcare providers.
Dr. Dulu said: “Bangladesh has the opportunity to achieve a public health revolution. But will it embrace a modern, evidence-based tobacco control strategy, or will it continue down a path that leaves millions trapped in tobacco addiction? The lives of nearly one million Bangladeshis by 2060 hang in the balance.
“We have a moral obligation to provide smokers with safer alternatives. Traditional tobacco control measures alone have proven insufficient – it’s time to embrace the harm reduction approaches that are saving lives around the world.”