By Timothy S. Donahue

Top Takeaways:

• Bold forecast: Yach says 100 million deaths could be prevented by 2060 through wider adoption of smoke-free nicotine products
• Pouch growth: Global oral nicotine pouch users are projected to more than double by 2030, reaching about 80 million users worldwide
• Policy divide: The report argues that countries embracing harm reduction are seeing faster smoking declines than those pursuing prohibitionist approaches

A new report from Derek Yach, a tobacco harm reduction advocate and former World Health Organization official, argues that smoke-free nicotine products could play a central role in reducing smoking-related disease worldwide over the next several decades.

Released at the Next Generation Nicotine Delivery conference in Miami, Nicotine 2030: An Outlook on Smoke-Free Nicotine, Global Health, and Regulatory Innovation makes a comprehensive case for integrating tobacco harm reduction into public health policy. The report was compiled by Yach’s Global Health Strategies LLC and supported by the synthetic nicotine manufacturer Zanoprima Lifesciences.

“The end of smoking is within reach — if policy catches up with evidence,” Yach wrote in the report’s executive summary.

At the center of the report is Yach’s “core finding.”

“If 20 percent of the world’s 1.05 billion smokers switch to verified low-risk nicotine products within 15 years, approximately 100 million premature deaths can be averted by 2060 — the largest single health gain achievable through behavioral change this century,” the report states.

Yach argues that the nicotine market has undergone a dramatic transformation over the past decade.

According to the report, daily vapers rose from 22 million to 114 million between 2016 and 2025; oral nicotine pouch users grew from 8 million to 35 million; and heated tobacco consumers expanded from 4 million to 25 million. By 2030, Yach projects that oral nicotine users could reach approximately 80 million globally.

The report places particular emphasis on nicotine pouches, which it describes as one of the fastest-growing smoke-free categories. Yach argues that “the enemy is smoke, not nicotine,” a phrase that recurs throughout the report and serves as a central theme of its harm-reduction framework.

The report also highlights synthetic nicotine as an emerging segment within the nicotine market. “Synthetic nicotine — tobacco-free, free of tobacco-specific nitrosamines, and produced with a fraction of the land, water and greenhouse-gas footprint of leaf extraction — is moving from laboratory curiosity to a projected US$9-10 billion global market by 2030,” Yach wrote.

A significant portion of the report focuses on what Yach sees as the widening divide between countries that permit reduced-risk products and those that restrict them. “The paradox is clear: prohibition-oriented approaches have coincided with negligible reductions in total smoker numbers,” the report states.

Examples cited include Sweden, Japan, the United Kingdom, and the Philippines. Yach notes that Sweden achieved adult daily smoking rates below 5% through the widespread use of snus and nicotine pouches, while Japan saw a 52% decline in cigarette sales from 2014 to 2023 after adopting heated tobacco products.

The report contrasts those outcomes with those in countries such as India, where vaping products are banned. “India, in contrast, restricts access to safer nicotine alternatives through bans on e-cigarettes and nicotine pouches, limiting viable ‘off-ramps’ for smokers,” Yach wrote.

Beyond public health, the report presents an economic case for harm reduction. It cites support from the International Monetary Fund for risk-proportionate taxation and discusses Swiss Re research on insurance pricing for users of smoke-free nicotine products.

Yach also argues that illicit trade remains a major consequence of prohibition-focused policies. “Product bans have consistently failed to suppress demand; instead, they shift it into unregulated channels where quality control is absent, youth protections are non-existent and tax revenue is lost,” the report states.

Among its recommendations, the report calls for governments to replace prohibitions on reduced-risk products with quality standards, adopt risk-based taxation frameworks, improve communication about relative risk, and expand access to smoke-free alternatives in low- and middle-income countries.

“The enemy is smoke, not nicotine,” Yach concludes. “Every year of delay costs approximately 8 million lives.”