Combustible cigarettes remain the most dangerous way to consume nicotine, killing up to two-thirds of long-term users. Nicotine is what makes people want to smoke, but it’s the toxic chemicals produced by combustion—not nicotine itself—that cause an array of deadly diseases. 

Many people who smoke are unable or unwilling to quit nicotine. For them, the good news is that smoke-free nicotine options such as vaping products and heated tobacco carry vastly lower risk than cigarettes, especially when properly regulated.

Where these products are available and affordable to adults, smoking falls and lives are saved; where they are banned or priced out of reach, the cigarette market is effectively protected.

In 2025, more Asian governments chose the latter path. Vietnam implemented and then tightened a total ban on safer nicotine options. It was joined, right at the end of the year, by Bangladesh.

For people who smoke in Dhaka, Hanoi or Bangkok, the choice is often between a deadly product and an illicit market fraught with risk amid law enforcement raids.

Full bans on safer nicotine products already existed in markets such as Thailand and India, where they have obstructed smoking cessation while fueling illicit trade. Extreme tax proposals and product restrictions in countries like Malaysia and the Philippines meanwhile risk making safer options more expensive or harder to obtain than cigarettes.

For people who smoke in Dhaka, Hanoi or Bangkok, the choice is often between a deadly product and an illicit market fraught with risk amid law enforcement raids. Yet their governments claim to have made progress.

When governments prioritize public health over ideology—or at least, allow consumers to make their own choices—very different outcomes are possible.  

New Zealand’s pragmatic vaping regulations have helped drive adult smoking to some of the lowest levels in the world. Sweden can boast similar success, thanks to widespread availability of snus and nicotine pouches.  The United Kingdom has seen millions of people switch from smoking to vapes. And Japan—a welcome Asia-Pacific outlier—has recorded a globally unprecedented decline in cigarette sales, linked to uptake of heated tobacco products.

These are not theoretical models; they are real-world public health gains.

But Asia-Pacific governments are under intense pressure not to replicate these wins, from a network of anti-nicotine NGOs funded by United States billionaire Michael Bloomberg and from the World Health Organization itself.

Asia-Pacific simply cannot afford strategies that preserve the status quo.  

The WHO’s tobacco treaty was created to reduce harm, yet its current guidance often encourages prohibitionist policies that shut out consumers and sideline evidence that safer nicotine products are critically important smoking-cessation tools.

This is the very opposite of harm reduction (which the WHO actually supports when it comes to other forms of drug use). With nicotine, instead of meeting people where they are and reducing risk, policymakers are narrowing options and increasing risk.

Around eight million lives are lost to smoking-related disease every year—the majority of them in the Asia-Pacific region. Widespread use of risky forms of oral tobacco only adds to a devastating public health burden that is borne overwhelmingly by low- and middle-income countries. 

Asia-Pacific simply cannot afford strategies that preserve the status quo.   

The real choice facing regulators is no longer whether they “like” safer nicotine products. It is whether they want fewer people to die, or not.

Image (adapted) via Picryl/Public Domain

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