Global State of Tobacco Harm Reduction

Switching to safer nicotine products could be a life-saving approach for millions of people who use high-risk tobacco like combustible cigarettes.


GSTHR maps the global, regional and national availability and use of safer nicotine products, regulatory responses to them, and the public health potential of tobacco harm reduction (THR). Explore any country's data on smoking, vaping, snus, HTP - enter a country in the search box, or find it on the globe.

For nicotine, the route of administration is crucial to the level of risk. Vapes, pouches and other safer nicotine products significantly reduce the health risk.

  • Smoking Tobacco
  • Nicotine Vapes (E-cigarettes)
  • Snus
  • Heated Tobacco Products
  • Nicotine Replacement Therapy
  • Nicotine Pouches
  • Traditional Smokeless
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Four out of five of the world’s smokers are in LMIC. In these countries where most of the eight million deaths caused by tobacco occur each year, rates of tobacco use are falling very slowly.

  • Smoking Tobacco
  • Nicotine Vapes (E-cigarettes)
  • Snus
  • Heated Tobacco Products
  • Nicotine Pouches
Learn More

When combined with other drugs, evidence shows that nicotine has the capacity to increases the body’s uptake of one or both substances.

  • Smoking Tobacco
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Earth
  • Country Data

    Smoking, vaping, snus and heated tobacco data, with the regulations in place, for every country.

  • Resources

    Explainers, briefing papers, major reports and country case studies, many in several languages.

  • Chart Builder

    Compare countries and products over time, then download your chart or share it with a link.

Read and download major GSTHR reports:

SitRep2026 Cover
Not if, but when:
GSTHR Situation Report 2026

The report charts growing consumer demand for tobacco harm reduction, despite widening policy gulf. The rising use of safer nicotine products (over 200 million adults) has coincided with declining smoking prevalence across multiple countries.

GSTHR (Situation Report)
A Situation Report
Global State of Tobacco Harm Reduction 2024

The fourth in our biennial GSTHR series, this report tracks the extent to which safer nicotine products are replacing and substituting for combustible and risky oral tobacco products. It is split into two parts, A Global Perspective and Regional and National Insights.

GSTHR2022 RSH Cover
The Right Side of History
Global State of Tobacco Harm Reduction 2022

The third report in our biennial GSTHR series documents the search for safer ways to use nicotine and charts the history of tobacco harm reduction with the emergence of new safer nicotine products.

Fighting the Last War
Fighting the Last War:
the WHO and International Tobacco Control

This 2021 report from K∙A∙C’s Global State of Tobacco Harm Reduction argues that “tobacco control policy is frozen in time” while “innovative non-combustible nicotine technology and supporting evidence have moved forwards”.