Five Questions that Will Define the Future of Harm Reduction

Progress has been made in nicotine over the past few decades and continues to be. New science continues to emerge. New products reach scale. The decisions made over the next few years will shape outcomes for a generation of smokers.

Five questions stand out.

First, can we close the knowledge gap?

Despite multiple conversations with clinicians, the misunderstanding of nicotine remains. Many doctors still believe nicotine causes cancer. It does not. The harm from smoking comes from combustion, not from nicotine itself. This misconception influences medical advice and limits harm reduction pathways. Until it is addressed, progress will remain constrained.

Second, what happens when policies backfire?

Well-intentioned regulation can produce unintended outcomes. Evidence discussed in recent research and expert forums shows that restricting access to safer alternatives can reduce switching and increase cigarette consumption. These effects are not neutral. Effective policy must be grounded in evidence, not intuition.

Third, how do we reach the billion people still smoking?

The majority of smokers live in low- and middle-income countries. Solutions developed in high-income settings do not always translate. Infrastructure, affordability and cultural context matter. Harm reduction must be global by design.

Fourth, what role will technology play?

AI-driven cessation tools, real-world evidence platforms and personalised interventions are advancing rapidly. Regulators and clinicians now face urgent questions about evaluation, integration and oversight. Frameworks must evolve alongside the technology.

Finally, can we move fast enough?

The window for impact is measured in years, not generations. That can only come through collaboration among the change makers in science, industry and policy formation when they pursue a shared purpose. 

These questions do not have simple answers. They demand rigorous, multidisciplinary dialogue.

In Brussels this March, WNC will bring together the scientists researching these issues, the policymakers grappling with them, the innovators building potential solutions and the clinicians seeing the consequences firsthand.

Make sure you are in the room.