GSTHR Press release

Monday 30 January 2023

New survey reveals scale of consumer advocacy for safer nicotine products - and need for recognised role in global policymaking

  • Most consumer advocacy organizations run by volunteers who successfully quit smoking using safer nicotine products
  • All report significant activity and success despite lack of financial and human resources
  • None report receiving tobacco or pharma industry funds – and total global consumer advocacy budget dwarfed by millions available to those advocating against tobacco harm reduction

A landmark global survey investigating the role and activities of consumer organizations advocating for access to safer nicotine products (SNP) and tobacco harm reduction has been released.

The new study was carried out by the Global State of Tobacco Harm Reduction, a project of UK public health agency, Knowledge•Action•Change. The first of its kind, the research was published in Wiley’s open access journal, Public Health Challenges.

It reveals that there are 54 active consumer advocacy groups working around the world to raise awareness about, and promote the availability of, and access to, SNP, which include nicotine vaping products (e-cigarettes), Swedish-style snus, nicotine pouches and heated tobacco products.

Tobacco harm reduction is a potentially life-saving intervention for millions of people across the world. To those who currently use high-risk tobacco products, like cigarettes and some oral tobaccos, it offers the chance to switch to a range of SNP that pose fewer risks to their health.

Global State of Tobacco Harm Reduction estimates show that these harm reduction options are now being used by an estimated 112 million people worldwide. Many SNP consumers may be unaware of the political, policy, and regulatory issues surrounding these products, despite bans or restrictions in many countries, but the last 15 years has seen the emergence of small grassroots advocacy organizations, set up and run by nicotine consumers, with most (36) only being established since 2016.

The research, based on a detailed survey, found that the vast majority of organizations (42) were operated entirely by volunteers, most of whom had successfully quit smoking with the help of SNP.

Only seven of the groups had any contracted or paid staff (13 people globally) and for the last full year, the total funding for all organizations surveyed amounted to just US$309,810. This is in stark contrast to the millions of dollars spent on campaigns by actors such as Bloomberg Philanthropies seeking to limit access to SNP such as nicotine vaping products. The paper also notes that none of the consumer advocacy organizations reported receiving funding from tobacco or pharmaceutical companies.

Many of these organizations were members of four regional umbrella organizations covering Latin America (ARDT Iberoamerica), Africa (CASA), Europe (ETHRA), and Asia-Pacific (CAPHRA).

But even with the support of these larger bodies, this research found that individual consumer advocacy organizations are potentially fragile, concluding that groups must now transition from an initial start-up phase to a position where they are better resourced.

Yet, despite the precariousness of their existence, all of the organizations were able to report significant activity and successes in the promotion of tobacco harm reduction as a public health strategy, through information dissemination, media engagement and contributions to policy development.

The paper’s lead author was Tomasz Jerzyński, Data Scientist for the Global State of Tobacco Harm Reduction project. He said: “This survey offered a unique opportunity to map these advocacy organizations for the first time and provide valuable insight into how they are operating all over the world. The sustainability of these organizations is one of the main concerns that has come out of the data. All of these groups face challenges due to their small numbers of core workers and their dependence on volunteers.”

Speaking about the survey, another of its authors, Professor Gerry Stimson, Director of K•A•C and Emeritus Professor at Imperial College London, said: “This paper starkly demonstrates the major imbalance in resources available to consumer organizations advocating for access to safer nicotine products and those opposed to tobacco harm reduction, unfairly skewing the debate. It also highlights why consumer groups must be recognised as legitimate stakeholders in the policy sphere. These organizations have been set up, and are run by, people who have chosen to improve their own health by switching to SNP – people who have significant expertise to offer, and whose lives are directly affected by policymaking in this area. The views of safer nicotine product consumers must therefore be central to the development, crafting, and implementation of health policies going forwards – including at the next Framework Convention on Tobacco Control COP meeting this November, in Panama.”


Notes to editors

For more detailed results from the paper, click here, but here are some of the survey’s findings:

Of the 54 groups identified in this paper, 52 completed a detailed questionnaire designed to uncover more about the way their organizations are run and the work they do.

The paper found there was a wide geographical presence with 13 organizations operating in Latin America, 8 in Africa, 24 in Europe, 5 in the Asia-Pacific region and 2 in North America. However, there are no such organizations in Eastern Europe and Central Asia, or the Middle East.

The groups operated in 27 languages including Bahasa Melayu, Chichewa, Danish, Dutch, English, Estonian, Filipino, Finnish, French, German, Greek, Hindi, Hungarian, Italian, Kiswahili, Luganda, Mandarin, Nigerian Pidgin English, Norwegian, Portuguese, Romanian, Spanish, Swahili, Swedish, Swedish, Thai, Tumbuka, and Turkish.

In the previous 12 months, these achievements included: gaining print, and broadcast media coverage, making submissions to consultations by government and regulatory and advisory organizations, participation in public hearings, hosting webinars and face-to-face meetings, contacting parliamentarians, helping new organizations to launch, running social media campaigns, organizing protests, pursuing legal challenges, developing contacts with government ministries, and contributing to the development of national e-cigarette standards.

Contact: For further information, please contact either Oliver Porritt at [email protected] or on +44 79 30 27 99 16 or Ruth Goldsmith at [email protected] or on +44 78 01 84 51 92.

About us: Knowledge·Action·Change (K·A·C) promotes harm reduction as a key public health strategy grounded in human rights. The team has over forty years 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

Our funding: The GSTHR project is produced with the help of a grant from the Foundation for a Smoke-Free World, a US non profit 501(c)(3), independent global organization. The project and its outputs are, under the terms of the grant agreement, editorially independent of the Foundation.