Shapiro, Harry and Mzhavanadze, Giorgi (2026) The global state of tobacco harm reduction 2026: a situation report. Global State of Tobacco Harm Reduction.
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This report covers developments and progress in harm reduction for tobacco from January 2025 to the early months of 2026.
The publication is divided into three main sections. In Trends, data and evidence, we explore the prevalence shifts that are demonstrating the global scale of substitution of combustible tobacco for SNP, the shifts in the international regulatory and policy landscape, the impact of comparative pricing of nicotine products on equity of access, and the latest independent research on SNP and their role in smoking cessation. We also consider some early signals of population-level health impacts of tobacco harm reduction.
In Barriers and challenges to tobacco harm reduction, the continued institutional opposition of the WHO is discussed, although signs of a potential pushback from some countries are also noted. Ongoing media misreporting about the relative risks of SNP is examined, as is growing evidence of widespread public misperceptions, even in countries benefiting from the switch away from combustible cigarettes.
Finally, The human cost of anti-tobacco harm reduction policies draws together modelling evidence of population-wide benefits of broad scale substitution of smoking for SNP, and analyses the unintended consequences of prohibition, with consumers increasingly exposed to illegal and unsafe SNP markets often controlled by organised crime syndicates.
Case study Ireland pg. 20
B Substances > Tobacco (cigarette smoking)
B Substances > Tobacco (cigarette smoking) > Nicotine product (e-cigarette / vaping / heated)
B Substances > Tobacco (cigarette smoking) > Nicotine product (e-cigarette / vaping / heated) > Nicotine pouch / snus
G Health and disease > Public health
HJ Treatment or recovery method > Substance disorder treatment method > Cessation of tobacco / nicotine use
J Health care, prevention, harm reduction and treatment > Harm reduction > Substance use harm reduction
MM-MO Crime and law > Organised crime
MM-MO Crime and law > Substance related offence > Tobacco offence
MM-MO Crime and law > Substance use laws > Tobacco / nicotine laws
MP-MR Policy, planning, economics, work and social services > Policy > Policy on substance use
MP-MR Policy, planning, economics, work and social services > Economic aspects of substance use (cost / pricing)
VA Geographic area > International
VA Geographic area > Europe > Ireland
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