Can alternative nicotine products put the final nail in the smoking coffin?

Introduction:
This review by Karl Fagerström examines the impact of alternative nicotine products such as e-cigarettes, heated tobacco, and snus on smoking prevalence in various countries. The study aims to determine if the adoption of alternative nicotine products can help reduce smoking prevalence faster than traditional tobacco control measures.

Key Points:

* The study compares smoking prevalence in countries with high adoption of alternative nicotine products such as the UK, Sweden, Norway, New Zealand, and Japan, with neighboring countries with lower uptake of these alternatives.
* The UK and New Zealand have seen a more significant decline in smoking prevalence compared to the EU27 and Australia, respectively, despite similar tobacco control measures.
* The availability and use of snus in Sweden and Norway have contributed to their record-low prevalence of smoking and the lowest level of tobacco-related mortality in Europe.
* Japan has seen a successful transition from tobacco smoking to heated tobacco products (HTPs), with a lower smoking prevalence compared to Australia, despite stricter tobacco control policies.
* The study suggests that more rapid adoption of alternative nicotine products may help reduce smoking prevalence faster than traditional tobacco control measures focused on prevention and cessation alone.
* The WHO should consider proposing bold actions to eradicate smoking, including support for less harmful alternatives, and far stricter regulations and taxes on combusted products.
* The current status quo is unacceptable, with the number of smokers remaining virtually unchanged despite a steady decrease in global prevalence.

Main Message:
The study suggests that alternative nicotine products can contribute to lower smoking rates and the associated disease burden. The WHO should consider endorsement of harm reduction as a bolder policy to put the final nail in the smoking coffin and accelerate global progress in reducing cigarette consumption and tobacco mortality.

Fagerström, K. (2022). Can alternative nicotine products put the final nail in the smoking coffin? Harm Reduction Journal, 19(1), 131. https://doi.org/10.1186/s12954-022-00722-5