Nicotine alternatives ‘can turn world smoke-free by 2040’

Increased use of smoke-free nicotine products such as vapes and oral pouches can turn the world ‘smoke-free’ by 2040, according to ground-breaking new research by international health experts.

The major new study, published in the prestigious Nature journal, concludes that global efforts to end smoking are stalling and warns that sticking with traditional strategies could cost millions of lives.

The research finds that while longstanding tobacco control measures such as taxation, advertising bans and warning labels have driven progress, their impact is now plateauing, particularly among older, more addicted and disadvantaged smokers.

Around one billion people still smoke worldwide, causing more than seven million deaths annually.

The report authors, led by Robert Beaglehole, a New Zealand public health physician and former director at the World Health Organization (WHO), stress: “Decades of evidence demonstrate that it is exposure to smoke from combustion – not nicotine – that drives tobacco-related disease.”

The study points to mounting real-world evidence that smoke-free alternatives are significantly less harmful than cigarettes and can accelerate quitting at scale.

Countries that have embraced these alternatives, including Sweden, New Zealand, Japan, the UK and the United States, have recorded some of the fastest declines in smoking rates.

“The rapid emergence of regulated non-combustible (smoke-free) nicotine products has created a historic opportunity to accelerate the end of the smoking epidemic,” the report says.

Dr Delon Human, leader of Smoke Free Sweden, said: “This landmark study confirms what Sweden’s experience has already shown: if you give smokers access to safer alternatives, they will switch and smoking rates will collapse.

“The tragedy is that many policymakers still treat all nicotine products the same, ignoring the overwhelming evidence that smoke-free alternatives are far less harmful than cigarettes. That confusion is costing lives.”

The report sets out an ambitious but achievable global goal of reducing smoking prevalence to below 5% by 2040 – the internationally recognised “smoke-free” benchmark – but stresses that this will only be possible if harm reduction is fully integrated into tobacco control strategies.

Without such a shift, progress will remain too slow. In Europe, current trends suggest the EU may not reach smoke-free status until the end of the century.

Dr Human warned that proposed revisions to the EU’s Tobacco Products Directive risk moving in the opposite direction: “At the very moment when the science is pointing towards harm reduction, Europe is considering restrictions that could limit access to the very products helping smokers quit.

“If the EU makes it harder for adults to access safer alternatives – through flavour bans, excessive taxes or overregulation – it will delay the end of smoking by decades.”

The study calls for a risk-proportionate approach to regulation, with stricter controls and higher taxes on cigarettes, while ensuring that safer nicotine products remain accessible, affordable and acceptable to adult smokers. It also urges clearer public communication to correct widespread misperceptions about the relative risks of nicotine products.

It concludes: “The scientific evidence, policy tools and real-world experience needed to end the global smoking epidemic now exist. What remains limited is political willingness to fully integrate tobacco harm reduction into global tobacco control.”