Global Action Community Newsletter
Tobacco Harm Reduction Helps People Quit
So why don’t more public health groups embrace it?
Earlier this month, data from the U.S. Centers for Disease Control and Prevention revealed one of the greatest public health wins in recorded history: In 2023, the smoking rate for adults reached its lowest level in 60 years.
According to a new report, just 7.9% of adults smoked cigarettes exclusively. Since 2017, this number dropped from 26.6 million to 19.8 million, translating to a reduction of 6.8 million adults.
Yet the accompanying report didn’t see this news as positive. Instead, the authors focused on the fact that over the same period of time, the number of adults who exclusively used e-cigarettes increased by 7.2 million. In other words, “current tobacco product use among adults has not changed since 2017.”
This is where Global Action stands apart from traditional public health: We see this news as a victory. Every decline in smoking puts us one step closer to our goal—eliminating all death and disease caused by smoking.
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Global Action is working to unlock the public health potential of tobacco harm reduction. We support people who smoke and can’t or otherwise won’t quit to transition to far less harmful alternatives, including e-cigarettes.
A growing body of strong scientific evidence indicates e-cigarettes help adults who smoke quit at higher rates than traditional nicotine replacement therapies. The highly regarded Cochrane Review analyzed over 88 studies to conclude that “there is high certainty that nicotine EC [e-cigarettes] increases quit rates compared to nicotine replacement therapy.” In the U.S., the Food and Drug Administration (FDA) has also made it clear that generally, products like e-cigarettes and nicotine pouches are less harmful than cigarettes.
Real-world evidence also shows the benefit of tobacco harm reduction. Sweden, for example, has the lowest smoking rate in Europe—an achievement widely attributed to the popularity of snus, a noncombustible tobacco product. The FDA has also concluded the use of several snus products “instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis.”
Despite this, many countries have banned the sale of snus, and the U.S. public health community has largely failed to acknowledge snus would present much less risk for people who transition from cigarette smoking.
We see reduced-risk nicotine products as vital tools to help fight the leading cause of preventable death right alongside traditional nicotine replacement therapies and other cessation supports. Rather than shy away from these successes, public health groups must embrace tobacco harm reduction to move adults away from smoking.
All my best,
Jeff Willett
VP, Strategic Engagement
Global Action to End Smoking
By the Numbers
7.9%
The number of adults in the United States who reported exclusively smoking cigarettes in 2023, according to new data from the U.S. Centers for Disease Control and Prevention. This translates to about 19.8 million people, and it is the lowest level of cigarette smoking among U.S. adults in 60 years.
The country’s national objective for it’s Healthy People 2030 goal is for smoking rates to reach 6.1% or lower. Based on the CDC’s current estimates, the country will likely meet or exceed those current goals.
Get the facts
Are nicotine pouches dangerous?
Global health authorities have concluded that nicotine pouches, which do not contain tobacco, are significantly less risky than cigarettes.
Nicotine pouches fit in a person’s mouth. They contain nicotine, the addictive stimulant in tobacco, and some flavorings, but not the dangerous chemicals found in combustible tobacco products.
Global health authorities in some parts of the world, including the U.S., have concluded that nicotine pouches are appropriate for the protection of public health, which means that the potential benefits for adults who smoke in switching outweigh the potential risks to youth or those who have never used nicotine. They are a form of tobacco harm reduction.
Similar to e-cigarettes, nicotine pouches are not risk-free. Nicotine should not be used by anyone who has never used it before—especially youth.
More answers to common questions about nicotine and tobacco use can be found on Global Action’s Get the Facts page.
Tobacco and health around the world
Country snapshot: Bosnia and Herzegovina
In 2022, an estimated 28.2% of the population of Bosnia and Herzegovina, including 33% of men and 23.6% of women, smoked cigarettes. In 2021, it was estimated that tobacco was the 2nd highest risk factor driving the most death and disability combined in the country.
- Tobacco was responsible for an estimated 6.7 thousand deaths, which is about 26.5% of total deaths.
- Of tobacco-related deaths, 5.8 thousand or 87.0% were due to smoking, and 1.2 thousand or 17.3% were due to secondhand smoke.
- Heated tobacco products are available and regulated as other smoking tobacco products, subject to the same regulations as combustible cigarettes.
For references and to view other country profiles, visit our pages on
Tobacco and Health Around the World.
Thank you for your support
Give the gift of a healthier tomorrow.
We are taking bold action to find global solutions to end death and disease caused by tobacco, particularly combustible cigarettes. We are one of the only public health groups to embrace tobacco harm reduction as the best viable strategy for ending the global smoking epidemic.
We’re proud to support grantees such as Knowledge Action Change, which recently published this free course on tobacco harm reduction.
Your support makes this work possible. Together, we can build a future where no one suffers from tobacco-related disease.
Thank you for your support in the fight against smoking.
Get to Know Global Action
Global Action has awarded more than 175 grants to institutions that support the work of over 100 scientists, covering 46 countries on four continents.
Our organization is an independent, U.S. nonprofit 501(c)(3) grantmaking organization whose mission is to end combustible tobacco use, which remains the leading preventable cause of death globally. Through September 2023, Global Action received charitable gifts from PMI Global Services Inc. Global Action does not seek or accept funding from companies that produce tobacco or non-medicinal nicotine products.
To learn more about our work, visit our website.
Disclaimer: This newsletter does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this newsletter are for informational and educational purposes only and does not constitute providing medical advice or professional services. No material in this newsletter is intended to be a substitute for diagnosing or treating a health problem or disease. Those seeking personal medical advice should consult with a licensed physician or other qualified health care provider. Always seek the advice of your licensed physician or other qualified health care provider regarding a medical condition or with any questions you may have regarding treatment and before undertaking a new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you read in this newsletter. No physician-patient relationship is created by this newsletter. Global Action doesn’t make representations, express or implied, with respect to the information provided here.