Global State of THR 2024
Changes in combustible tobacco and SNP markets
Although market data alone has its limitations, it is possible to discern two key shifts in the tobacco and nicotine market: 1) the share of SNP in the total tobacco and nicotine market is increasing, and 2) inflation-adjusted combustible tobacco sales are declining, while SNP sales are experiencing rapid growth. Most of these changes have been in high-income countries, where consumers have more disposable income, access to online sales, fewer restrictions on SNP, and higher public awareness of the risks associated with smoking.
See "The Global State of Tobacco Harm Reduction 2024: A Situation Report" for more information.
Retail volume of cigarette and HTP markets in selected countries
Heated tobacco product (HTP) sales have seen significant growth since 2016, in Asia Pacific and Western and Eastern Europe. In many countries, this has coincided with a drop in cigarette sales. Data on retail volume sales of cigarettes and HTP are both measured in sticks, but one HTP stick may not be a perfect substitute for people who smoke, as it contains a lower dose of nicotine than one cigarette. Nevertheless, retail volume sales figures do suggest varied substitution effects in the following countries:
- approximately one–to-one substitution of HTP sticks for cigarettes: Hungary, South Korea, Italy, Germany.
- cigarette sales drop faster than HTP sales increase: Slovakia, Czech Republic, Russia, Japan, Greece.
- cigarette sales drop slower than HTP sales increase: Kazakhstan, Lithuania, Portugal.
See "The Global State of Tobacco Harm Reduction 2024: A Situation Report" for more information.
Estimated global number of vapers (2024)
Although challenging, the GSTHR team has continued to work hard to develop estimates for the global number of vapers. For our 2021 estimate, we employed a method of assumed similarity for countries with missing data, and averaged the prevalence of vaping across WHO regions, World Bank income classification groups, and the legal status of e-cigarettes in each country. Our final estimate was 82 million vapers globally in 2021. Our 2024 estimates were produced using new data and an improved forecasting method. The GSTHR now estimates that the global number of vapers has increased, reaching 114 million in 2023.
See "The Global State of Tobacco Harm Reduction 2024: A Situation Report" for more information.
At least one kind of SNP…
As of 2024, at least one category of safer nicotine product (nicotine vapes, heated tobacco products, snus or nicotine pouches) is legally available in 129 countries. This covers four billion people, which represents 71% of the global adult population. Meanwhile, as of 2024, 100% of the global adult population can legally purchase deadly combustible cigarettes.
See "The Global State of Tobacco Harm Reduction 2024: A Situation Report" for more information.
About 54% of the global adult population live in countries where nicotine vapes are legally available
About 54% of the global adult population, equivalent to 3.1 billion people, live in countries where nicotine vapes are legally available. In contrast, 36% (2 billion people) reside in countries where vaping is banned, while 10% (610 million people) are in countries with no specific legislation or available information. As of 2024, 100% of the global adult population can legally purchase deadly combustible cigarettes.
Excise tax burden on e-liquids (2023)
By 2023, among countries permitting the sale of nicotine vapes, at least 52 had implemented taxes on them. Of these, 37 tax all e-liquids, while 17 only tax those containing nicotine. Most impose a specific excise tax on e-liquids, with 30 applying a uniform tax rate and nine using a tiered system. Out of 52 countries which tax nicotine vapes, Belarus had the highest excise tax burden at 88%. This was followed by Portugal at 85%, Norway at 78%, and Kazakhstan at 77%. The lowest excise tax burdens were noted in Costa Rica and Paraguay (both at 4%), Kenya (3%), and Croatia (0%).
Legal availability of different safer nicotine products in 2024 (percentage of global adult population aged 18+)
Analysis of the global landscape for SNP by product type reveals significant regulatory diversity. About 54% of the global adult population live in countries where nicotine vapes are legally available, while 36% reside in countries where they are banned. HTP are legally available to 36% of the global adult population, while 50% of the population lives in areas where they are banned. Snus is legally available to 58% of the global adult population, making it more widely accessible than both vaping products and heated tobacco. But 32% of people live in countries where snus is banned. Nicotine pouches are legally available to 35% of the adult population, while 50% of the population resides in areas where they are banned. Meanwhile, as of 2024, 100% of the global adult population can legally purchase deadly combustible cigarettes.
EMPOWERED model
The WHO’s MPOWER model should be broadened to accommodate the huge potential of harm reduction, as shown in our EMPOWERED diagram. The revised system must monitor the degree to which countries are assisting adult tobacco users to switch away from the most dangerous modes of consumption. Under the new EMPOWERED model, enforcement interventions would be balanced with a broader public health approach that enables adults who use risky tobacco to make informed choices about their health.
The relative risk spectrum of 15 nicotine product categories
The crucial difference between all safer nicotine products and traditional cigarettes is that none of them deliver nicotine to the user through the combustion of tobacco. By not burning tobacco, all of these products, to varying degrees, are safer than continued smoking. A 2022 systematic review and meta-analysis by Rachel Murkett and colleagues showed the relative risk of different nicotine-containing products, and the stark difference in risk between those that are combustible and non-combustible.
The three-dimensional framework for harm minimisation
Dependence on nicotine - a compulsion to continue using it - is certainly a reality. But when isolated from smoking, nicotine has relatively low health risks. David Abrams and colleagues developed what they called “a three-dimensional framework for harm minimisation”. This proposes a ‘sweet spot’ for safer nicotine products, an optimal point where the risks to health are low, but the appeal to the user is high, due to the product’s ability to deliver nicotine in a way that is on a par with smoking.
Changes in the SNP market
As of 2024, the global safer nicotine product (SNP) market is undergoing significant changes. Market estimates suggest that nicotine vaping products are no longer dominant by value, having been replaced in 2020 by heated tobacco products (HTP). This was due to both an increase in the number of HTP users, and the fact that HTP are generally more expensive than vapes.
Limitations on the availability of flavours in legal sales of nicotine vaping products (2024)
Access to flavours is another important factor incentivising the substitution of smoking by safer nicotine products or helping avoid a relapse to smoking. The regulation of flavours varies significantly across different countries: there are no restrictions on flavours for nicotine vapes in 41 countries, allowing a wide range. However, 10 countries have implemented restrictions, permitting only tobacco, mint, and menthol flavours, or in some cases, only tobacco, or no flavours at all.
Limitations on the availability of flavours in legal sales of heated tobacco products (2024)
Access to flavours is another important factor incentivising the substitution of smoking by safer nicotine products or helping avoid a relapse to smoking. The regulation of flavours varies significantly across different countries: 30 countries allow all heated tobacco product flavours, whereas 25 countries have put restrictions in place.
Legal availability of heated tobacco products (2024)
Heated tobacco products are legally available to 36% of the global adult population, while 50% of the population lives in areas where these products are banned. The remaining 14% are in regions with no clear regulatory stance. Meanwhile, as of 2024, 100% of the global adult population can legally purchase deadly combustible cigarettes.
Legal availability of snus (2024)
Snus is legally available to 58% of the global adult population, making it more widely accessible than both vaping products and heated tobacco. However, 32% of people live in countries where snus is banned, and 10% are in areas with unclear regulations. Meanwhile, as of 2024, 100% of the global adult population can legally purchase deadly combustible cigarettes.
Excise duty on nicotine vaping products compared to excise duty on cigarettes
Taxation of safer nicotine products and rates of excise tax are rapidly changing worldwide, along with regulatory frameworks. An increasing number of countries are introducing excise taxes on these products, or raising existing excise tax rates. However, as of 2024, where safer nicotine products are legally available, they generally enjoy more favourable taxation compared to cigarettes – although not always proportionate to their relative harms. This map illustrates the diverse taxation approaches to nicotine vaping products globally.