Smoke-free products
deserve appropriate
and risk-proportionate
regulation
The World Health Organization estimates there areabout 1 billion smokers in the world today—and come
2025 the number will be roughly the same¹.

Science and technology have enabled thedevelopment of alternatives for adults whowould otherwise continue smoking. For
example, e-cigarettes, heated tobacco products
and oral smokeless products.
Provided they are scientifically substantiatedand manufactured under appropriate quality andsafety controls, they can be a better choice tocontinued smoking. This is because smoke-freealternatives do not burn tobacco.
Everyone knows that smoking causes serious
disease and is addictive. There is no doubt thatthe best choice a smoker can make is to quit
tobacco and nicotine completely.
But for those adults who would otherwise
continue to smoke, better, smoke-freealternatives now exist.

However, there are many countries around theworld where the only tobacco and nicotine
products that can be legally sold are smoked,
such as cigarettes.
And even where better, innovative alternatives
to cigarettes are available, existing policies often
impede access to them. This has to change.
Adult smokers need to be able to accessaccurate information about these better
alternatives.

Science andtechnology haveenabled thedevelopmentof smoke-freealternatives.

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Some in the public health community have called
for smoke-free alternatives to be regulated inthe same way as cigarettes because the longterm effects of these products are unknown.
But regulatory decisions should be based on thetotality of the evidence regarding alternative
products and their potential to be much lessharmful than continuing to smoke.
Experts and national health authorities—theU.S. Food and Drug Administration (FDA) as
well as the UK Office for Health Improvement
and Disparities, among others—have rigorously
reviewed the science behind smoke-free
products, acknowledging harm reduction as a
viable and much-needed approach to tobacco
control.
A growing number of public health and policy
experts recommend that regulation should
follow a fundamental principle: products thatcarry different levels of risks should be regulateddifferently and in proportion to the risks theypose. We agree.
We support and encourage the regulation ofboth cigarettes and smoke-free alternatives,
but in most countries, regulation has notbeen adjusted to take into account recent
developments in science and technology.
This prevents the many adults who would
otherwise continue smoking from learning about
and accessing better alternatives, and in turnmeans accepting the status quo and the fact
they will continue to smoke cigarettes, the mostharmful form of nicotine consumption.

Change needs to happen nowIt’s our view that all tobacco and nicotine
products should be regulated. The question thatremains is not if they should be regulated, but
how they should be regulated.
Governments have a crucial role in defining theway forward. They can influence the pace andscale at which adult smokers switch to better
alternatives by adopting risk proportionate
regulations that keep pace with scientific andtechnological progress.
The commercialization of smoke-freealternatives cannot come at the expense ofyouth or people who don’t smoke. Sensible
regulation is key to striking the right balance.

This means adopting regulation that recognizes
the role smoke-free alternatives can play inmoving those adults who would otherwise
A call for risk-proportionatecontinue to smoke away from cigarettes, whileregulation
protecting youth and non-smokers.

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How should regulation be formed toprotect the public?
Regulation should allow adult users
to access information about better
alternatives to cigarettes and encourage
adult smokers to switch to these if they
don’t quit altogether.
Regulation should aim to incentivize
adult smokers to switch to smokefree products while minimizing
unintended consequences, such asuse by non-nicotine users and minors.

Regulation should set minimum safety andquality standards for smoke-free products.

Regulation should acknowledge thefundamental differences between
combustible tobacco products (such ascigarettes), and scientifically substantiatedtobacco and nicotine-containing productsthat are smoke-free.
Regulation should have a framework forpost-market surveillance designed to ensurethat the products are only being adopted
by current smokers who would otherwise
continue to smoke and not being used byformer smokers, non-smokers, youth.

1. WHO global report on trends in prevalence of tobacco smoking 2000-2005, 2018

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