• The report’s analysis shows that rising use of safer nicotine products (SNP) has coincided with declining smoking prevalence across multiple countries and regions;
  • Exclusive GSTHR estimates suggest that globally, 200 million people now use SNP;
  • SNP use is equivalent to a fifth to a quarter of the global smoking population;
  • Since 2025, the balance of global policy has moved further toward restrictive regulation and safer product bans, while cigarettes remain universally legal.

Today, the GSTHR, launches The Global State of Tobacco Harm Reduction 2026: A Situation Report. The report is the fifth in a unique series documenting tobacco harm reduction’s development, history and possible futures.

The GSTHR research team’s analysis indicates that rising use of SNP, which include nicotine vapes, pouches, snus or heated tobacco products (HTP), has coincided with falls in smoking prevalence across 28 countries. The GSTHR researchers also developed new estimates for the global number of vapers and HTP users that were separately accepted for publication in two peer-reviewed journals, Global Epidemiology and JMIR Public Health and Surveillance.

Covering developments from January 2025 to early 2026, the Situation Report offers a comprehensive overview of the international regulatory and policy landscape, the latest independent research on SNP and their role in smoking cessation, and the human cost of policies blocking harm reduction. Smoking remains a leading cause of preventable death worldwide, responsible for eight million deaths every year. A summary of the report follows overleaf.

Co-author Giorgi Mzhavanadze said: “It’s no coincidence that countries leading in tobacco harm reduction are also the world’s top performers on reducing smoking rates. Our analysis shows a pattern: across 28 countries, the rise of SNP use has coincided with clear falls in smoking prevalence. In Sweden, Norway, Iceland, New Zealand and the UK, the use of SNP has already overtaken smoking. This is substitution at work – and it’s good news for individual and public health.”

Co-author Harry Shapiro said: “For too long, international tobacco control has done little to help almost a billion people who still smoke – many of whom can’t or don’t want to stop using nicotine. Millions are now using safer products instead of deadly combustible tobacco. Making these products inaccessible through restrictive regulation or bans denies those who smoke access to tools that could reduce individual and population-level harm. Prohibition doesn’t improve public health – it just gifts organised crime new opportunities.”

David MacKintosh, GSTHR Project Director, said: “Since emerging in the 1980s as part of the response to the HIV/AIDS crisis, harm reduction has saved countless lives. In the 21st century, the sheer number of people who still smoke globally means that if harm reduction were equitably applied to tobacco use, the life-saving potential would be even greater. The Global State of Tobacco Harm Reduction has been documenting the approach since 2018; today we’re proud to launch our fifth major report, offering original research, analysis and reflections on where tobacco harm reduction stands in 2026 – as well as what its future might look like.”

The report authors drew on multiple publicly available sources of information, including market data, data on the epidemiology of smoking and use of SNP, and the extensive country-based information held in the online GSTHR database.

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The Global State of Tobacco Harm Reduction 2026: A Situation Report is authored by Harry Shapiro and Giorgi Mzhavanadze, with research analysis by Tomasz Jerzyński.

Funding note: The report was funded with a grant from Global Action to End Smoking, an independent, U.S. nonprofit 501(c)(3) grant making organization, accelerating science-based efforts worldwide to end the smoking epidemic.