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GSTHR 2026: 200 Million Safer Nicotine Users Signal a Global Shift Away From Smoking

admin — Fri, 21 Aug 2026 13:09:24 +0000

The global nicotine market is undergoing a profound transformation, with millions of smokers moving away from combustible tobacco and towards safer nicotine products. Yet while consumers are increasingly embracing tobacco harm reduction, governments are often moving in the opposite direction.

The Global State of Tobacco Harm Reduction (GSTHR) 2026 Situation Report estimates that around 200 million people worldwide now use safer nicotine products (SNPs), including vapes, heated tobacco products, snus and nicotine pouches. That figure represents roughly one-fifth to one-quarter of the world’s approximately one billion smokers. The report’s central message is striking: the question may no longer be whether tobacco harm reduction will become a major force in nicotine use, but when policymakers will fully recognise it.

Where safer nicotine use goes up, smoking goes down

GSTHR analysis found that increasing use of safer nicotine products has coincided with declining smoking prevalence across 28 countries. In several nations—including Sweden, Norway, Iceland, New Zealand and the UK—use of safer nicotine products has already overtaken smoking.

Sweden, of course, still provides the most compelling example. High levels of snus and nicotine-pouch use have developed alongside exceptionally low smoking rates. GSTHR reports that daily smoking among Swedes aged 16–84 was 5.4% in 2024, while daily snus use stood at 15.7%. Among 16- to 29-year-olds, daily smoking had fallen to just 2%.

Nevertheless, the international pattern provides strong evidence that consumers can substitute lower-risk nicotine products for cigarettes when those alternatives are accessible and acceptable. The scale of this transition is now difficult to dismiss. GSTHR’s peer-reviewed estimates indicate that approximately 129 million people vaped in 2025, while around 78 million used heated tobacco products in 2024, in addition to tens of millions using snus and nicotine pouches.

The evidence for vaping as a cessation tool is undeniable

Vaping is not risk-free, but the relevant public-health comparison for an adult smoker is generally not vaping versus doing nothing. It is vaping versus continuing to inhale cigarette smoke. Reliable evidence increasingly supports that distinction. The latest Cochrane living systematic review included 104 studies involving 30,366 adults who smoke and found that nicotine e-cigarettes help more people quit smoking for at least six months than nicotine replacement therapy. For every 100 people using nicotine e-cigarettes, approximately eight to 11 may stop smoking, compared with around six using NRT.

Recent research is also adding to the evidence on toxicant exposure. A randomised clinical trial published in JAMA Network Open found that adults who switched from cigarettes to a nicotine pod-based e-cigarette experienced reductions in certain biomarkers associated with cigarette smoke exposure. The study concluded that effective nicotine delivery may help facilitate both smoking cessation and reductions in toxicant exposure.

Prohibition has never decreased demand

One of the report’s most important warnings concerns the growing disconnect between consumer behaviour and government policy. GSTHR found that restrictive measures targeting safer nicotine products vastly outnumbered policies expanding access during the period examined. By March 2026, it estimated that 109 countries—around one-third of the world’s population—had banned safer nicotine products outright.

But prohibition does not necessarily eliminate demand. The US provides a useful illustration. Research published in the American Journal of Preventive Medicine found that the amount of nicotine contained in e-cigarettes sold monthly increased by 249.2% between February 2020 and June 2024, while standardised unit sales rose by only 34.7%. Disposable products accounted for much of this expansion.

The lesson is that consumer demand for nicotine alternatives remains substantial even when regulators attempt to restrict particular products. Excessively restrictive policies can therefore create opportunities for illicit suppliers while removing regulated products from legitimate businesses.

The inequality problem

Perhaps the biggest missed opportunity lies in low- and middle-income countries, where most of the world’s smokers live. GSTHR reports that safer nicotine products remain disproportionately accessible in high-income countries. In many lower-income markets, cigarettes remain the cheapest nicotine product, while alternatives carry a significant price premium.

That creates a particularly troubling policy contradiction. The people who could potentially gain the most from switching away from combustible tobacco are often those facing the greatest financial barriers to doing so. Tobacco harm reduction should therefore not simply mean allowing safer products to exist. They need to be affordable, appropriately regulated and realistically accessible to adult smokers.

Change is already underway. Will lawmakers choose to keep up?

Smoking remains one of the world’s largest preventable causes of death, responsible for millions of deaths every year. The economic consequences are similarly enormous, including healthcare expenditure, lost productivity and premature mortality. Yet tobacco control policy frequently focuses on reducing nicotine use rather than prioritising the elimination of the most dangerous form of nicotine consumption: combustible tobacco. Emerging evidence suggests these objectives should not be confused.

The 2026 GSTHR report describes a world in which consumers are already conducting a vast, largely uncoordinated experiment in substitution. Around 200 million people have chosen safer nicotine products, while smoking continues to decline in many countries where those products are available. For policymakers, the opportunity is clear. Rather than treating every nicotine product as equivalent, regulation can distinguish between levels of risk, protect young people and non-smokers, maintain product standards and give adult smokers credible alternatives to cigarettes.

The Recent Motions Across the Globe Keeping Cigarettes on Top and Safer Alternatives Underground

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Virginia Governor Signs Bills To Protect Marijuana Users’ Parental Rights And Allow Medical Use In Hospitals

admin — Tue, 14 Apr 2026 03:50:06 +0000

Virginia’s governor has signed bills to allow patients to use medical marijuana in hospitals and protect the parental rights of cannabis consumers.

Gov. Abigail Spanberger (D) on Monday also also recommended that lawmakers adopt amendments to legislation that is aimed at providing resentencing relief to people with prior marijuana convictions.

Meanwhile, advocates are awaiting her action on separate bills to legalize and regulate recreational marijuana sales in the state ahead of a midnight deadline.

Here’s a look at the cannabis legislation that Spanberger has already acted on:

Protect Marijuana Consumers’ Parental Rights

The governor signed a bill to protect the rights of parents who use marijuana in compliance with state law.

HB 942 from De; Nadarius E. Clark (D) states that a “person’s legal possession or consumption of substances…alone shall not serve as a basis to restrict custody or visitation unless other facts establish that such possession or consumption is not in the best interest of the child.”

The new law also specifies that a parent or legal guardian can’t be construed to have failed a drug test over legal substances such as cannabis.

The legislation is consistent with a measure Clark sponsored last session that advanced through the legislature, only to be vetoed by then-Gov. Glenn Youngkin (R).

“This is a significant victory for Virginia parents who consume cannabis responsibly,” JM Pedini, development director for the advocacy group NORML and executive director for Virginia NORML, told Marijuana Moment. “It’s taken seven legislative sessions to secure these most basic protections and prevent courts from needlessly separating children from their families.”

Allow Patients To Use Medical Cannabis In Hospitals

Spanberger additionally signed legislation to let patients use medical marijuana in hospitals.

SB 332 from Sen. Barbara Favola (D) and HB 75 from Del. Karen Keys-Gamarra (D) build upon existing state law protecting health professionals at hospices, nursing homes and assisted living facilities that aid terminally ill patients in utilizing medical cannabis treatment from punishment by adding hospitals to the statute.

The new law also creates a working group under the Department of Health to “discuss the implementation process for providing cannabis products to patients within medical care facilities.”

“The work group shall assess any available federal guidance or proposed regulations on the use of cannabis products or changes to the schedule for cannabis products under the federal Controlled Substances Act (21 U.S.C. § 801 et seq.) as well as interaction with applicable state laws,” the legislation says.

Its members will include representatives of the Virginia Hospital & Health Care Association and the Virginia Health Care Association, as well as health care providers and palliative, hospice, and hospital volunteers familiar with issues associated with providing care to individuals experiencing chronic illness.

The measure directs the working group to submit a report to key legislative committees including “written guidelines for the use of medical cannabis within medical care facilities and the safe operations of medical care facilities” by November 1.

Meanwhile, the governor also proposed that lawmakers amend legislation to provide resentencing relief for prior cannabis convictions:

Provide Resentencing Relief For Prior Cannabis Convictions

Lawmakers sent Spanberger bills to allow people who have certain marijuana convictions on their records to receive resentencing relief, but she wants them to make changes.

As approved by lawmakers, SB 62 from Senate President Pro Tem Louise Lucas (D) and HB 26 from Rozia Henson, Jr. (D) would create a process by which people who are incarcerated or on community supervision for certain felony offenses involving the possession, manufacture, selling or distribution of marijuana could receive an automatic hearing to consider modification of their sentences.

The relief would apply to people whose convictions or adjudications are for conduct that occurred prior to July 1, 2021, when a state law legalizing personal possession and home cultivation of marijuana went into effect.

Under the governor’s proposed amendments, affected persons would have to proactively file petitions to get the relief instead of having the courts proceeding automatically. Spanberger’s suggestion also removes deadlines for court hearings on resentencing relief.

Similar legislation was approved by lawmakers last session but it was vetoed by Youngkin, the former governor.

Lawmakers are set to reconvene to address the governor’s proposals on this and other bills on April 22.

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Alcohol And Tobacco Are More Damaging To Users And Society Than Marijuana Is, Government-Funded Study Concludes

admin — Fri, 20 Mar 2026 23:44:24 +0000

Alcohol and tobacco cause far more harms to people who consume them, and to society overall, than marijuana does, according to a new government-funded study.

A panel of 20 experts with professional experience with substance use issues from across Canada were asked to evaluate 16 different drugs on 10 dimensions of harm to consumers, as well as six dimensions of harm to others, scoring each on a scale of 0 to 100.

“Alcohol causes the most harm overall, with a cumulative weighted score of 79,” the study, published in the Journal of Psychopharmacology, found. “It was followed by tobacco (45), nonprescription opioids (33), cocaine (19), methamphetamine (19), and cannabis (15).”

The analysis, which was supported with Canadian Institutes for Health Research grant funds, concluded that marijuana’s biggest harm comes not from its effect on consumers but instead is related to the illegal market.

“Cannabis’s highest weighted score was for organized criminal activity,” the paper, authored by a large team of academics affiliated with various research institutions throughout Canada, the United Kingdom and New Zealand, says. “Though more than 70 percent of Canadians who purchase cannabis now do so through legal sources, organized criminal groups are heavily involved in the remaining illegal cannabis market, from production to distribution.”

Marijuana—which was legalized nationally in Canada in 2018 but remains federally prohibited in the U.S.—is not completely without harms to consumers, however, with the study finding that it “also scored relatively high for mental harms to users (dependence, withdrawal, short- and long-term impairment of mental functioning), ranking third in that combined category.”

When it comes to alcohol, which is federally legal in the U.S., it “ranked first in 9 of the 16 harm categories: drug-related damage to physical health, withdrawal, short-term impairment of mental functioning, long-term impairment of mental functioning, loss of tangibles, loss of relationships, injury, family and social adversity, and economic cost,” the study found.

“This analysis of drug harms in Canada found that alcohol causes the most harm overall… Alcohol was followed by tobacco, nonprescription opioids (like fentanyl), cocaine, methamphetamine, and cannabis.”

Tobacco “ranked first in 4 of the 16 harm categories: drug-related mortality, drug-specific damage to physical health, dependence, and environmental damage,” the researchers wrote.

The paper concludes by urging governments to “consider the harm—both individual and societal—caused by drugs and by the laws and regulations that govern them” when developing drug policies.

The findings about relative harms of different substances may help explain why alcohol consumption—and particularly tobacco use—have been gradually declining over recent years, and why multiple surveys and studies have indicated that more adults are opting for marijuana.

For example, recent polling shows that younger Americans are increasingly using cannabis-infused beverages as a substitute for alcohol—with one in three millennials and Gen Z workers choosing THC drinks over booze for after-work activities like happy hours.

Another survey released last October found that a majority of Americans believe marijuana represents a “healthier option” than alcohol. And most also expect cannabis to be legal in all 50 states within the next five years.

Smoking marijuana is also associated with “significantly” reduced rates of alcohol consumption, according to a recent federally funded study that involved adults smoking joints in a makeshift bar.

A study published in 2024 that looked at adults who drink cannabis-infused beverages found more evidence of a “substitution effect,” with a significant majority of participants reporting reduced alcohol use after incorporating cannabinoid drinks into their routines.

In September, an international study identified a a “strong negative association” between tobacco use and legal medical marijuana sales, indicating a “strong potential substitution effect” where people choose to use cannabis where it is allowed instead of smoking cigarettes.

Meanwhile, as the Trump administration considers moving marijuana out of Schedule I, the most restrictive category under U.S. federal law, another recent study concluded that cannabis isn’t as dangerous as its current classification would suggest.

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