Two former senior officials of the World Health Organization (WHO) have urged governments worldwide, including Bangladesh, to adopt tobacco harm reduction (THR) as a core public health strategy arguing that it could save more than 100 million lives globally and approximately 9 lakh lives in Bangladesh by 2060.
The appeal comes ahead of the WHO Framework Convention on Tobacco Control (FCTC) COP11 meeting in Geneva, where global delegates will evaluate progress and set future directions for tobacco control. According to recent research led by Dr. Derek Yach, one of the key architects of WHO’s original tobacco control framework, countries like Bangladesh could save nearly 900,000 lives by adopting safer nicotine alternatives such as vaping and heated tobacco products instead of enforcing outright bans.
Dr. Yach, who played a pivotal role in shaping WHO’s tobacco policy in the 1990s, co-authored a new position paper with Dr. Tikki Pang, former Director of Policy Research at WHO, along with economist Chris Snowdon of the Institute for Economic Affairs and Peter Beckett, co-founder of Clearing the Air. The paper is available in six languages, including English, French, Spanish, and German, on Clearing the Air’s website.
The authors argue that the current global tobacco control framework must undergo a radical overhaul, shifting from prohibitionist approaches to harm reduction a scientifically validated strategy that supports adult smokers in transitioning to safer nicotine products.
“This is a moment that requires courage,” the paper concludes. “Courage for governments to challenge old dogmas, courage for industry to align its resources with public health, and courage for civil society to uphold science over ideology.”
Yach and Pang also criticized certain scientific societies and journals for failing to educate healthcare professionals about harm reduction.
“Scientific societies and journals must recognise their ethical responsibility to ensure that the benefits of harm reduction are widely understood among healthcare professionals. Uninformed or misinformed clinicians remain a key barrier to adoption,” they wrote.
They further noted that the same institutions that combated vaccine misinformation during the COVID-19 pandemic must now show equal commitment to evidence-based nicotine research.
The paper highlights a growing divide between developed and developing nations. In Japan, South Korea, Italy, Poland, and Germany, heated tobacco products have already helped millions quit smoking. Meanwhile, Sweden, Norway, Denmark, and Iceland have achieved some of the world’s lowest smoking and cancer rates through widespread use of snus and nicotine pouches.
In contrast, countries such as Indonesia, China, Egypt, and Jordan still record male smoking rates exceeding 45 percent levels that Britain last saw in the 1960s.
For Bangladesh, where more than 35 million adults use tobacco in some form, the authors warn that ignoring harm reduction could result in long-term health and economic strain. The adoption of safer nicotine alternatives, they argue, could accelerate the decline in smoking and help the country achieve its national health goals under the Sustainable Development Goals (SDGs) framework.
“Harm reduction for tobacco is not a theoretical debate but a proven strategy with lifesaving outcomes,” the authors assert. “Countries that resist it will only prolong suffering and economic burden for their populations.”
They acknowledge, however, that changing the narrative will be challenging for policymakers, given the historical distrust toward the tobacco industry. Still, they emphasize that public health pragmatism as seen in harm reduction efforts related to HIV prevention, opioid substitution therapy, and alcohol consumption must now extend to nicotine.
With science offering a clear path forward, Bangladesh has the chance to turn evidence into action to move from restriction to reform, and from caution to compassion. Such a shift could save nine lakh lives and reshape the region’s public health future.