Safer nicotine products sales increased six-fold since 2015: report

Safer nicotine products (SNP) are increasingly substituting for cigarettes, with inflation-adjusted combustible tobacco sales in decline and SNP sales increasing six-fold since 2015, a new report has shown.

The Global State of Tobacco Harm Reduction 2024: A Situation Report (GSTHR 2024), shows strong evidence of association between the rise in SNP use and a corresponding decrease in smoking in many countries, at rates far exceeding those achieved by tobacco control measures alone.

The publication is the fourth in a landmark series from UK-based public health agency Knowledge∙Action∙Change (K∙A∙C), which, since 2018, has demonstrated how tobacco harm reduction (THR) using safer nicotine products can mitigate the devastating impact of smoking-related diseases that continue to cause eight million deaths every year.

The extent to which SNP are replacing and substituting for combustible and risky oral tobacco products is the report’s central theme. Co-authored by experts in harm reduction, data science and economics, GSTHR 2024 considers what is driving these changes, how different regulatory environments have developed, and the complex interplay between products, consumers, and policy and regulation.

Uses the latest evidence and new data projections, the report shows that while sales of combustible tobacco remain significantly higher than sales of SNP, two key shifts are occurring in the tobacco and nicotine market: firstly, the total market share of SNP is increasing, and secondly, inflation-adjusted combustible tobacco sales are declining, while SNP sales are experiencing rapid growth.

Although the nominal value of combustible tobacco sales increased from $752 billion (£593bn) in 2015 to over $1 trillion in 2024, when adjusted for inflation (and assuming a constant currency value), combustible tobacco sales actually decreased to $685 billion in 2024 – an 8.9 per cent decline. Meanwhile, inflation-adjusted SNP sales grew nearly sixfold from 2015, reaching, in non-adjusted terms, $96 billion in 2024.

Further analysis shows, however, that Chinese data skews these figures. China’s tobacco market accounts for an astonishing $344 billion of the $1 trillion global combustible tobacco market. Despite being the global centre of production for nicotine vapes, the Chinese market for all SNP is extremely small, at less than 1.2 per cent of its market for combustibles. GSTHR analysis removing China from the calculations reveals the true scale of the acceleration in the global SNP market: it has reached 12.3 per cent of the total tobacco and nicotine market in 2024, up from virtually zero in 2004.

Adding weight to the substitution argument, analysis of prevalence data shows there is strong evidence of an association between the rise in SNP use and a corresponding decrease in smoking prevalence in the following countries: Sweden, Norway, New Zealand, the UK, the US, Ireland, Luxembourg and the Philippines, and to a lesser extent, Austria and Lithuania.

The rates of reduction in many countries far exceeds those achieved by tobacco control measures alone, the report notes.

Market data also show that as the popularity of heated tobacco products (HTP) accelerates in numerous markets, there is a coincidental decline in cigarette sales, again suggestive of a substitution effect. In Kazakhstan, Lithuania and Portugal, cigarette sales have been dropping but more slowly than HTP sales have increased.

However, in Hungary, South Korea, Italy and Germany, there has been approximately a one-to-one substitution of HTP sticks for cigarettes, and in Slovakia, Czechia, Russia, Japan and Greece, cigarette sales have dropped faster than HTP sales have increased.

Research undertaken for GSTHR 2024 shows that more than two-thirds of the world’s adult population – in nearly 130 countries – can now legally access at least one form of SNP. Access to combustible tobacco products, known to kill up to half of all users, remains legal for 100% of the world’s adult population.

The report also reveals, in an update to previous GSTHR research, that the global number of vapers has increased from 58 million in 2018, to reach an estimated 114 million in 2023. With 30 million people using other safer nicotine products, this means the GSTHR estimates there are now around 144 million users of SNP worldwide.

The report also profiles four countries that have enabled THR to drive down smoking rates – the UK, Japan, Norway and New Zealand.

“People talk about a war on smoking, a war on nicotine or a war on vapes. But you don’t conduct a war against inanimate objects. This is a war against people. Those against tobacco harm reduction don’t want people to use safer nicotine products. They’re putting everything in their path to stop them, to the detriment of public health. And keeping people smoking just keeps more profits flowing to the tobacco industry,” Harry Shapiro, executive editor and lead author of GSTHR 2024, said.

“Despite the many barriers, we estimate that 140 million people around the world are using safer nicotine products. Many countries are showing significant reductions in smoking or falls in cigarette sales as SNP use increases, far faster than tobacco control has achieved alone. Safer nicotine products are here to stay. Let’s hope they are allowed to stub out the cigarette for good.”

Professor Gerry Stimson, co-founder of K∙A∙C which runs the GSTHR project, added: “Harm reduction is often thought about as policies and strategies, driven by public health. But it isn’t only this. It’s also what people do themselves to reduce risks and improve their own health. Governments and both international and national health organisations need to help create an environment in which people can be informed and empowered to make those safer choices. And the evidence from this report shows that – when safer products are appropriate, acceptable, accessible and affordable – people will switch, in fact are already switching, in their millions.”