Publications

The global tobacco epidemic continues to pose a significant public health threat, accounting for over eight million deaths annually. Despite major policy advances under the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC), tobacco use remains deeply entrenched, particularly in low- and middleincome countries where industry expansion, weak regulation, and limited cessation support persist. This narrative review examines global tobacco harm reduction (THR) strategies as complementary approaches to conventional tobacco control. It explores product-level interventions such as nicotine replacement therapies (NRTs), pharmacotherapies, and safer nicotine alternatives, including electronic cigarettes and heated tobacco products, alongside population-level policies, including taxation, smoke-free laws, and marketing restrictions. The review highlights that while nicotine replacement therapies remain the safest and most evidence-based cessation aids, emerging reduced-risk products continue to raise ethical, regulatory, and equity challenges. A comparative analysis of high-, middle-, and low-income contexts highlights disparities in access, regulation, and public awareness of harm reduction. The paper further identifies gaps in surveillance, monitoring, and policy coherence that limit the global effectiveness of THR initiatives. Overall, it argues that effective harm reduction requires an integrated approach that balances risk mitigation, equity, ethical governance, and industry accountability to accelerate global progress toward reducing tobacco-related diseases and eventual cessation.