Recently, a science-backed, innovative public health strategy, characterized by a risk reducing approach, has gained increased popularity among public health experts and policy-makers, promising remarkable results in terms of bringing down cigarette consumption and reducingharm to smokers’ health. It is clear that the best choice for anyone is never to start smoking in the first place. We cannot, however, ignore that there are more than a billion smokers globally. The idea of risk-reducing or harm reductionstrategies for tobacco is to present those adults who intend to continue smoking access to products that are scientificallyproven to present less risk of harm for than continued smoking. 

Majority of harm caused by cigarettes comes from the smoke produced as a result of the burning of tobacco. Therefore, based on the principle of harm reduction for tobacco, science has helped design products that are smoke-free, that is, they do not burn tobacco and do not produce smoke, thus, are considerably reducing risks to the health of smokers. E-cigarettes, Heated Tobacco Products, snus, and nicotine pouches are a few examples of such smoke-free alternatives. These smoke-free products only deliver nicotine which, while not risk-free, is not the primary cause of smoking-related diseases. This nicotine is also a key ingredient in nicotine replacement therapies designed to help smokers quit smoking. Nicotine, therefore, plays an important role in helping adult smokers who would otherwise continue to smoke to switch to science-backed smoke-free products that are less harmful than cigarettes. According to the 2016 Royal College of Physicians report, “The main culprit is smoke and, if nicotine could be delivered effectively and acceptably to smokers without smoke, most if not all of the harm of smoking could probably be avoided.” 

A study by health professors at Brown University found that adults who switched to e-cigarettes had lower levels of a major carcinogen compared to smokers who continued using cigarettes. Another recent UCLA-led study shows that switching to smoke-free products has prominent positive biological impacts on adult smokers who move away from cigarettes to these less harmful alternatives and that they significantly cut down on risks of cardiovascular diseases that are otherwise heightened due to cigarette smoking.  

More and more countries are beginning to realise that the best way to reduce harm from smoking is to provide consumers with better choices such as electronic cigarettes and HTPs. Thailand is in the process of adopting a law that will lift the ban on vaping to provide adult smokers with smoke-free alternatives that are considered less harmful than cigarette smoking. England is one of the first countries in the world to lead in tobacco harm reduction strategies. England may also officially license vaping as a medicine to help smokers curb cigarette use. Existing efforts to discourage people from taking up smoking and encouraging those who smoke to quit must continue. However, supplementing these measures with a harm reduction approach and scientifically substantiated smoke-free products can accelerate a decline in smoking.