Panel: Economics of Harm Reduction

The panel was moderated by economist and author Sinclair Davidson, who argued that through irresponsible fiscal policy on tobacco and nicotine products, the Australian government had created a well-organized illegal market that would be impossible to eliminate even if the government changed course.

The market for next-generation products (NGPs), Tim Phillips, managing director of Tamarind Intelligence, said, is a complicated, quickly moving sector, which today has a significant global volume of over $50 billion and more than 100 million users. Market development heavily depends on product regulation. In North America, vape products dominate the market, with a small but growing portion of nicotine pouches. In Europe, the Middle East and Africa, vapes are still growing but at a slower pace while heated-tobacco products (HTPs) are establishing themselves in some markets. In the Asia-Pacific region, HTPs are the most popular NGPs. Despite overall increase, the global NGP market still has headroom compared to the combustible cigarette market with its value of $800 billion. Phillips suggested that in 10 years’ time, vape products and HTPs could overtake combustible cigarettes, but he pointed out regulatory issues, consumer confidence and the debate about disposable vapes as headwinds for the sector. The latter issue, he added, could be solved through innovative technologies.

James Lambert, director of economic consulting Asia at Oxford Economics, warned that a harsher regulatory and fiscal stance on reduced-risk products (RRPs) could create negative economic and health consequences over time. Bans of RRPs will favor the illicit trade, especially in markets where illicit trade is difficult to manage and mitigate and where price sensitivity is higher. For optimal policy, Lambert proposed three key principles: Tailoring the restrictions of use to different market segments to eliminate youth use and at the same time provide adult smokers access to options; differentiating the treatment of RRPs from conventional tobacco products to incentivize the adoption of healthier alternatives; and finding constructive policy stances that include regulatory and fiscal measures to incentivize innovation of less hazardous products.

Comparing the U.S. tobacco market pre-2005 and after, David Levy, professor of oncology at Georgetown University, said that the advent of Juul in 2018 was a game changer that fueled competition among the cigarette industry, which had reluctantly ventured into vape products and independent players. At the same time, nicotine pouches were growing, like vapes taking market share from cigarettes. Levy predicted that HTPs will become more popular and are likely to be favored by tobacco companies because they are more profitable and because the companies have a first-mover advantage. He expected competition among HTP manufacturers and nicotine pouch manufacturers to intensify and wondered whether the Food and Drug Administration, in its focus on a menthol cigarettes and cigars ban, would recognize the role of harm-reduced substitutes.

Paul Blair, regional director of external affairs at Philip Morris International, emphasized that there is no one-size-fits-all approach to the transformation opportunities and needs of the tobacco industry. The industry, he said, must be aware of three areas. First, supply: Companies have to take the risks of transformation to meet consumer demand. Second, demand: Consumers will continue to want to quit or are looking for less hazardous products, regardless of any stringent regulations on reduced-harm products. Third, an affordable and accessible marketplace: Cost incentives to quit smoking are extremely important to consumers even in high-income countries as smokers are often from low-income and middle-income groups. A tax differential between RRPs and combustible cigarettes is hence essential, Blair stated, both in the signal it sends to consumers and businesses and because of the cost differential in this journey. To further reduce the U.S. smoking rate, which presently stands at 11 percent, Blair recommended making available a wide range of RRPs and creating a favorable public policy environment.

Anna Choi, assistant professor in the Department of Public Administration at Sejong University, presented the results of her study on the role of vape products and HTPs in encouraging smokers in South Korea to switch from combustible cigarettes.

A huge tax hike on cigarettes of about 40 percent in 2015, she said, significantly depressed cigarette consumption. A subsequent health ministry report implying that RRPs were potentially even more dangerous than smoking impacted negatively on the electronic nicotine-delivery system (ENDS) market.

Since 2017, RRPs and combustibles have been taxed at almost the same rate, eliminating the cost advantage of the former. Despite this, ENDS’ market share increased from 2 percent in 2017 to 17 percent in 2023.