Former WHO Researchers Call for Harm Reduction to Tackle Smoking
A new article in the medical journal The Lancet argues that UK tobacco and nicotine policy needs to shift its focus. As well as preventing young people from starting to smoke, policy must also aim to reduce smoking rates among current adults smokers. According to the researchers, creating a “smoke-free generation” is not enough to stop the harms caused by smoking.
Key Takeaways
- Policy focus must broaden: Preventing youth smoking is not enough—policies must urgently reduce smoking among current adult smokers.
- Harm reduction is essential: Less harmful nicotine alternatives like e‑cigarettes can significantly reduce smoking-related risks.
- Current strategies are imbalanced: Too much focus on youth access risks means policymakers underestimate the immediate harm to adult smokers.
- Overregulation can backfire: Banning or heavily restricting alternatives may keep smokers on cigarettes or fuel black markets.
Focus on Today’s Smokers
The article, written by Ruth Bonita and Robert Beaglehole, two former senior WHO officials analysed the UK’s Tobacco and Vapes Act 2026, which bans the sale of tobacco to anyone born after 2009. However, the authors—both former senior officials at the WHO —say these kinds of measures will primarily have an impact in the long term and do not address the serious health risks of today.
Instead, they stress the urgent need to reduce smoking among adults who currently smoke, with the goal of reaching very low smoking rates within one generation.
Harm Reduction is Key
A central conclusion from the authors is that harm reduction—meaning enabling access to less harmful alternatives to cigarettes—is essential to speed up progress.
The article highlights that people smoke for nicotine but die from the harmful by‑products of combustion. Alternatives such as e‑cigarettes and other nicotine products can therefore play an important role in reducing harmrisk.
At the same time, the authors note that harm reduction has historically been under-prioritised, especially in international policy frameworks.
Criticism of Current Policies
The authors argue that current strategies often focus too heavily on potential risks to youth, while underestimating the immediate harm caused by continued smoking among adults.
They also warn that overly strict regulation or bans on alternative products could lead to unintended consequences—such as smokers continuing to use cigarettes or the growth of black markets.
Marina Murphy, Senior Director of Scientific Affairs at Haypp, welcomes the analysis and says it reflects a growing shift in the policy debate:
“The Lancet article highlights a key challenge in current tobacco policy. We talk a lot about future generations, but too little about the millions of adults who smoke today and need better alternatives right now.”
She also underlines the importance of proportionate regulation:
“If the goal is truly to reduce disease and death, policies must clearly distinguish between cigarettes and smoke-free alternatives. Otherwise, we risk slowing progress instead of accelerating it.”
A Three-Part Strategy
The article concludes that an effective approach must combine three elements: prevention, supply regulation, and a clear focus on harm reduction. Without this, the goal of a smoke-free UK risks being pushed far into the future.
