• South Korea, Ireland and Estonia all show emerging but different shifts away from cigarettes, coinciding with a rise in the use of safer nicotine products;
  • New Briefing Paper considers these trajectories, how they differ and their implications for global harm reduction progress.

Research carried out for the Global State of Tobacco Harm Reduction (GSTHR) 2026: A Situation Report identified 28 countries in which smoking rates have fallen as safer nicotine product (SNP) use has risen; in five countries, SNP use has overtaken smoking. A new GSTHR Briefing Paper, The next wave of tobacco harm reduction? Emerging transitions from smoking to safer nicotine products in South Korea, Ireland and Estonia, takes a closer look at three countries that are showing signals of substitution - and unpicks some of the factors that could support, stall or obstruct this process.

The Briefing Paper finds that:

  • Smoking can fall without government endorsement of tobacco harm reduction. None of the three countries considered has a formal THR strategy; nevertheless, where SNP remain available and acceptable to consumers, shifts away from cigarettes still took place. This is shown most clearly in Estonia, where current smoking fell from 26.1% to 19.0% between 2020 and 2024, while current vaping more than tripled, from 3.8% to 13.5%.
  • There is no single route away from cigarettes, and progress can stall.
    Price, availability, culture and consumer preference will determine which products lead, and whether switching is complete. In South Korea, many consumers now use several SNP alongside cigarettes. In Ireland, vaping is well established (8% of adults), but smoking has been stuck at 17% since 2019.
  • Poorly designed policy risks halting or reversing progress. Protecting young people and adult harm reduction should be pursued jointly - without making safer alternatives less appealing, less affordable and less accessible to adults who smoke.
  • Misperceptions about relative risk prevent switching. In Ireland, 74% of adults mistakenly believe that vaping is as harmful or more harmful than smoking. Governments and public health organisations should share accurate harm reduction information aimed at all adults who smoke.

Giorgi Mzhavanadze, GSTHR Economist, commented:
“Evidence from South Korea, Ireland and Estonia shows that, when they can, people who smoke will opt for safer alternatives. But these transitions are not inevitable and can be easily disrupted or reversed. When considering safer nicotine products, policymakers should always ask: will this make it easier or harder for adults who smoke to make the safer choice?”

For further details and all references, read the full GSTHR Briefing Paper, The next wave of tobacco harm reduction? Emerging transitions from smoking to safer nicotine products in South Korea, Ireland and Estonia.

The latest major report in the landmark series from the GSTHR project, the Situation Report 2026, offers in-depth coverage and analysis of recent developments and progress in harm reduction for tobacco - download it now.

About us: Knowledge·Action·Change (K·A·C) promotes harm reduction as a key public health strategy grounded in human rights. The team has decades of experience of harm reduction work in drug use, HIV, smoking, sexual health, and prisons. K·A·C runs the Global State of Tobacco Harm Reduction (GSTHR) which maps the development of tobacco harm reduction and the use, availability and regulatory responses to safer nicotine products, as well as smoking prevalence and related mortality, in over 200 countries and regions around the world. For all publications and live data, visit https://gsthr.org

Our funding: The GSTHR project is produced with the help of a grant from the Global Action to End Smoking, Inc. (“Global Action”), a US nonprofit 501(c)(3) private foundation, accelerating science-based efforts worldwide to end the smoking epidemic. Global Action had no role in designing, implementing, data analysis, or interpretation of this Briefing Paper. The contents, selection and presentation of facts, as well as any opinions expressed herein, are the sole responsibility of the authors and under no circumstances should they be regarded as reflecting the positions of Global Action.