Cessation Over Harm Reduction: WCTC 2025 Draws a Hard Line Against Less Harmful Nicotine Products

Dublin, Ireland — The World Conference on Tobacco Control 2025 (WCTC) brought together global public health leaders to confront the ongoing tobacco epidemic, but for tobacco harm reduction advocates, the event highlighted a concerning resistance to innovation in cessation strategies.

While the conference reaffirmed global commitments to traditional tobacco control measures, taxation, advertising bans, and behavioural support, it largely dismissed the growing body of evidence supporting reduced-risk nicotine alternatives such as vapes, nicotine pouches, and heated tobacco products.

Harm Reduction Marginalized

Sessions on tobacco harm reduction (THR) were limited and often framed through a lens of scepticism. Most speakers portrayed e-cigarettes and related products as threats, particularly to youth, despite emerging data showing their potential to help adult smokers transition away from combustible tobacco. For example, findings from the Cochrane Living Systematic Review once again confirmed that nicotine e-cigarettes can be more effective than traditional nicotine replacement therapies for smoking cessation. Yet these insights received limited recognition among the broader conference narrative.

The overall stance seemed to reflect a dated interpretation of harm reduction, one that overlooks real-world consumer behaviour and fails to engage with adult smokers who cannot or will not quit using traditional methods.

A Call for Balance

As smoking remains a leading cause of preventable death globally, especially in low- and middle-income countries, the failure to robustly explore harm reduction strategies represents a missed opportunity. Policymakers must begin to differentiate between combustible tobacco products and non-combustible alternatives with substantially lower risk profiles. Regulation and innovation are not mutually exclusive.

The declaration by global health advocate Dr Derek Yach, released alongside the conference, called for proportional taxation, greater access to cessation tools—including nicotine pouches and vapes, and increased investment in research for low-income countries. His alternative vision underscored the importance of science, choice, and pragmatism in ending the smoking epidemic.

Conclusion

WCTC 2025 delivered essential messages on cessation and equity but missed the chance to fully embrace a comprehensive harm reduction approach. As the global tobacco control community looks to the future, it must ask: Are we listening to smokers and meeting them where they are?