Three former directors at the World Health Organization say a global smoking rate below 5% by 2040 is achievable if tobacco harm reduction is formally integrated into the WHO Framework Convention on Tobacco Control. Writing in Nature Health recently, Robert Beaglehole, Ruth Bonita, and Tikki Pang argued that progress in reducing smoking has slowed in many high-burden countries and that current policy debates increasingly conflate nicotine use with the harms of smoking. They called for a “risk-proportionate regulatory framework” that maintains strict controls on combustible tobacco while allowing regulated access to smoke-free alternatives that can displace cigarettes without encouraging youth uptake.
The authors pointed to examples including Japan, Sweden, and New Zealand, where wider adoption of heated tobacco, snus, nicotine pouches, and vaping coincided with sharp declines in smoking rates. Former WHO director Derek Yach described the commentary as significant but questioned whether large, high-smoking countries would follow those models. The paper maintains that combining established FCTC measures with broader access to regulated smoke-free products offers the most realistic path toward the 2040 goal, even as current FCTC leadership has shown little openness to revisiting its stance on harm reduction.
