The fifth in our landmark series of reports, The Global State of Tobacco Harm Reduction (GSTHR) 2026: A Situation Report covers developments and progress in harm reduction for tobacco from January 2025 to the early months of 2026.
The publication is divided into three main sections. In Trends, data and evidence, we explore the prevalence shifts that are demonstrating the global scale of substitution of combustible tobacco for SNP, the shifts in the international regulatory and policy landscape, the impact of comparative pricing of nicotine products on equity of access, and the latest independent research on SNP and their role in smoking cessation. We also consider some early signals of population-level health impacts of tobacco harm reduction.
In Barriers and challenges to tobacco harm reduction, the continued institutional opposition of the WHO is discussed, although signs of a potential pushback from some countries are also noted. Ongoing media misreporting about the relative risks of SNP is examined, as is growing evidence of widespread public misperceptions, even in countries benefiting from the switch away from combustible cigarettes.
Finally, The human cost of anti-tobacco harm reduction policies draws together modelling evidence of population-wide benefits of broad scale substitution of smoking for SNP, and analyses the unintended consequences of prohibition, with consumers increasingly exposed to illegal and unsafe SNP markets often controlled by organised crime syndicates.
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 our online GSTHR database.
