Global Non-Combustible Nicotine Use Reaches 200 Million as Smoking Declines in 28 Countries

Executive summary

The Global State of Tobacco Harm Reduction (GSTHR) reports that approximately 200 million people globally use non-combustible nicotine products such as e-cigarettes, heated tobacco devices, nicotine pouches, and snus. This figure reflects a growing shift away from combustible cigarettes in 28 countries analyzed, where declining smoking rates correlate with increased uptake of alternative nicotine delivery systems. Despite this trend, regulatory constraints are intensifying in key markets, creating tension between public health goals and product accessibility.

Regulatory risk: Expanding restrictions on non-combustible nicotine products may hinder access to lower-risk alternatives for adult smokers seeking to switch.

What happened

The GSTHR 2026 report compiles data from 28 countries showing parallel trends: declining cigarette consumption and rising use of non-combustible nicotine products. These include e-cigarettes, heated tobacco units, nicotine pouches, and snus. The report estimates that around 200 million individuals currently use these products, though it does not confirm whether they have fully transitioned from smoking or are dual users. The data also reveal that regulatory environments in many of these nations are becoming more restrictive, with bans on flavors, advertising limits, and product approval delays emerging as common policy tools.

Country-level trends

• Europe: Strong growth in nicotine pouch and snus usage, particularly in Nordic countries and Germany.
• Asia-Pacific: E-cigarette adoption surges in Japan, South Korea, and Australia, driven by heated tobacco and pod-based systems.
• North America: Vaping remains stable but faces tightening regulations, especially around youth access and flavor availability.
• Latin America and Southeast Asia: Early-stage adoption with increasing interest but limited market infrastructure.

Why it matters

This data set underscores a pivotal moment in global tobacco control: the emergence of viable, lower-risk alternatives to smoking is gaining traction. If even a fraction of current smokers transition to non-combustible products, the potential public health benefit could be substantial. However, the absence of causal proof linking product use to smoking cessation means policymakers must balance evidence-based harm reduction with precautionary regulation. The fact that 28 countries show concurrent declines in smoking and increases in alternative product use suggests a meaningful behavioral shift—yet regulatory overreach risks undermining it.

Market impact

Product innovation and investment are accelerating in response to demand signals. Heated tobacco brands like IQOS and Ploom are expanding beyond Japan into Europe and North America. Nicotine pouches, long dominant in Scandinavia, are entering mainstream U.S. and Canadian retail channels. E-cigarette manufacturers are adapting formulations to meet evolving regulatory standards, including reduced nicotine concentrations and flavor restrictions. Retailers are adjusting inventory strategies to prioritize regulated, compliant products while phasing out unapproved variants.

Market operator signal: Companies investing in compliance-ready platforms and regional product portfolios are better positioned to sustain growth amid tightening rules.

Regulatory impact

Despite growing evidence of shifting consumer behavior, regulatory pressure is mounting. In the EU, the upcoming implementation of the Tobacco Products Directive (TPD) 3 will impose stricter requirements on device design, labeling, and marketing. The UK’s MHRA has delayed approvals for several new vaping products, citing safety concerns. In the U.S., FDA continues to limit flavored e-liquids and restricts claims about harm reduction. Meanwhile, countries like Thailand and India have introduced outright bans on e-cigarettes and nicotine pouches, citing youth protection concerns—even as adult smoking rates remain high.

Regulatory landscape comparison

Who is affected

• Adult smokers: Primary beneficiaries if switching leads to reduced exposure to combustion-related toxins.
• Vape retailers and distributors: Face compliance costs, product withdrawal risks, and supply chain disruptions.
• Manufacturers: Must adapt R&D and marketing to meet diverse national standards.
• Public health agencies: Confront conflicting mandates—reducing youth initiation while enabling adult smoking cessation.
• Regulators: Grappling with inconsistent data, political pressure, and international divergence in policy approaches.

Dawsen Take

The 200-million-user estimate is not just a number—it represents a measurable shift in consumer behavior toward lower-risk nicotine consumption. While not all users have quit smoking, the correlation between declining smoking rates and rising use of non-combustible products across 28 nations suggests a structural change in the market. The real challenge lies in aligning regulation with evidence: overly restrictive policies may inadvertently protect youth from nicotine exposure at the cost of denying adults access to safer alternatives. A balanced approach—one that supports adult substitution without normalizing youth use—is critical to maximizing public health outcomes.

What to watch

• How the EU’s TPD 3 implementation affects product availability and innovation timelines.
• Whether the U.S. FDA accelerates its premarket review process to reduce backlogs.
• Emerging black market activity in countries with strict bans, such as India and Thailand.
• Long-term tracking of smoking cessation rates in regions with high non-combustible product adoption.
• Investor sentiment shifts toward companies focused on compliance and regional adaptation.

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Original source: 2FIRSTS | GSTHR Estimates 200 Million People Use Non-Combustible Nicotine Products as 28 Countries Show Rising Use Alongside Falling Smoking Rates