PRESS RELEASE

Harm Reduction must become a pillar of Public Health: Key outcomes from the 8th Summit on THR

ATHENS. Thursday, October 2, 2025.

Two hundred experts from 51 countries convened in Athens and online to discuss evidence-based strategies, stressing that science —not ideology— must guide global tobacco control.

The 8th Summit on Tobacco Harm Reduction organized in Athens and as a hybrid event, concluded its works yesterday, October 1st. About 200 Tobacco Harm Reduction advocates from 51 countries convened in Athens —and virtually— to discuss strategies to implement harm reduction as a valuable public health strategy for smokers who cannot or will not quit. As underlined across all sessions “While cessation remains the gold standard, alternatives such as e-cigarettes, heated tobacco, and oral nicotine products represent a pragmatic, science-based option.”

Find all Sessions, Keynotes and Panel Discussions ON DEMAND at the broadcasting platform.

SCOHRE Board Members, Professors I. Ikonomidis, D. Sweanor, A. Fal, K. Farsalinos, and F. Mili, addressed the opening remarks and presented of this Summit’s goals, and next, Karl Fagerstrom in his opening speech referred to the “History and future of nicotine, plus some learnings from the Swedish endgame.” Sweden has reduced smoking prevalence to just 5%, the lowest in the European Union — a success largely attributed to the widespread use of snus, traditionally common among Swedish workers. This achievement is clear proof that tobacco harm reduction works, supported by robust real-world data (RWD). And yet, despite this undeniable evidence, snus remains banned across the rest of Europe. It is time to revisit this policy and ensure that science — not ideology — guides public health decisions.

Dr. Stelios Kympouropoulos, Psychiatrist and Former Member of the European Parliament, shared his thoughts concerning the importance of harm reduction tools for improving public health and the need for scientific data-guided respective political and regulatory decisions in the EU. He stressed that quitting smoking benefits not only physical but also mental health, reducing anxiety and depression while improving concentration and quality of life. Harm reduction is a duty when safer, regulated alternatives exist, and can serve as a complementary strategy, as non-combustible alternative products, if strictly regulated, are less harmful than conventional cigarettes. At the same time, strong measures are needed to protect young people. Dr Kympouropoulos suggested five key policy pillars for the EU reiterating that “Europe must invest in smart and practical regulation, grounded in science, aimed at reducing smoking and protecting youth, while also preventing the growth of illegal markets.”

European Policy and Public Health issues were discussed from various perspectives during the Summit. At the panel discussion chaired by Professor Andrzej Fal, experts Mr. Martin Smatana (Slovakia), Professor Ranko Stevanovic (Croatia), and Dr. Jiri Votruba (Czech Republic) addressed the challenge of rising public healthcare costs in Europe. The panel agreed that most countries cannot continue increasing healthcare budgets. Professor Fal emphasized that chronic diseases impose a significant economic burden, making harm reduction and rehabilitation essential prevention strategies with both medical and economic benefits. The session highlighted prevention tools used in Croatia, Czech Republic, and Slovakia, and Professor Fal referenced the Polish Society of Public Health’s recommendations to the European Parliament for the EU Tobacco Control Directive, including pricing, market regulation, and investment in evidence-based research.

Ms. Christina-Maria Kravvari, Secretary General of Public Health, presented the main points of the new Greek legislation on “Minors’ protection from tobacco and alcohol products” approved in July 2025. The new law establishes a coherent framework ultimately closing legislative gaps. She emphasized that, “Since 2019, our tobacco control policy has been based on evidence and strict scientific evaluation of new nicotine products including their relative harmfulness,” and added that this approach led to Greece achieving the second largest reduction in smoking prevalence in the EU during 2020 to 2023 according to the EU barometer. “It is an approach rooted in realism and in our duty to strengthen public health protection.” In this framework, Greece adopts zero tolerance for the exposure of minors to tobacco, nicotine and alcohol to provide youth an environment free of addiction and harm as a strategic choice for the future of Greek society. Ms Kravvari also reaffirmed the Greek Minister of Health’s position that “Greece welcomes the revision of the Tobacco Products Directive provided that all preparatory steps such as evaluation report, proper impact assessment, public consultation, etc. are carried out correctly and that revision is based on real and up-to-date scientific evidence.” Discussion on the new legislation followed with Professors Ignatios Ikonomidis, David T. Sweanor and Anastasia Barbouni.

A lively panel discussion around “Consumer and healthcare professionals’ misconceptions on the harms of nicotine” was chaired by Prof. Konstantinos Farsalinos, who underscored the need to confront persistent misconceptions. Professor Giovanni Li Volti noted that many healthcare professionals mistakenly consider nicotine itself as highly harmful — a misconception reinforced by contradictory scientific literature. Rohan Andrade Sequeira presented the case of India, where widespread use of smokeless tobacco has contributed to exceptionally high rates of oral cancer. Damian Sweeney emphasized the importance of consumer engagement, urging individuals to share their positive experiences with novel tobacco products directly with policymakers. The panel concluded that the scientific community must consistently communicate evidence-based findings across all audiences and channels, while media outlets carry the responsibility to correct misinformation quickly and provide balanced coverage of harm reduction, avoiding sensationalism.

Clive Bates, a leading policy expert in tobacco control, in his speech contrasted the original expectations of the Framework Convention on Tobacco Control (FCTC) with today’s reality, describing it as “a good idea gone wrong.”  The FCTC was created to address the global smoking crisis by reducing its health, social, economic, and environmental impacts, providing countries with a framework that included advertising bans, higher taxes, sales restrictions, and cessation support. “But was this effective?” Mr. Bates asked. He argued that the current emphasis on nicotine and addiction has diverted attention from the core objective of reducing smoking-related harm. He highlighted five major diversions from the FCTC’s original goal: (1) Misplaced risk comparisons between cigarettes and novel products. (2) Excessive focus on nicotine and addiction. (3) Exclusive attention on youth. (4) Preoccupation with the tobacco industry. (5) Prohibition of lower-risk alternatives. “We have to go back to the objective,” Mr. Bates stressed. “There is one and only one big idea: to transform nicotine use from high-risk to low-risk behaviour.”

David T. Sweanor, J.D, chaired a very interesting panel discussion focused on the decline of public trust in health authorities, with an emphasis on nicotine and tobacco issues and stressed that global trust in government is at 52%, and even lower in the Western liberal democracies. On the other hand, a global study indicated overall trust in science remains high. Panellists Martin Cullip, Filip Tokic and Mary Stamp, agreed that while it takes time to build trust, it cannot be rebuilt overnight. This is why it is important to tell the truth and follow scientific evidence. Mr. Sweanor closed the panel with an optimistic note: “Despite all the misinformation, the barriers, and even the prohibitions, the market keeps changing at a remarkable rate and people are moving ahead, regardless of the wrong messages and policies.”

Uniting Perspectives for Tobacco Harm Reduction

The session “Uniting Perspectives for Tobacco Harm Reduction,” as a conclusion to the Summit, highlighted the growing international debate on the role of harm reduction in tobacco control strategies and efforts to reach consensus. Leading experts and advocates committed to reshaping the global fight against smoking participated in the panel discussion.

Despite increasing scientific evidence that alternative nicotine products (such as vaping, nicotine pouches, and heated tobacco products) can benefit smokers who switch from traditional cigarettes, acceptance remains limited. Only a few countries, such as the UK and New Zealand, have adopted such strategies, while resistance continues—fueled by the uncompromising stance of the World Health Organization (WHO). Speakers from Italy and the Czech Republic shared concrete progress and methodology to pursue the wider adoption of THR. Professors Pasquale Caponnetto and Francesco Fedele presented the Italian approach, while Lubos Petruzelka and Jiří Votruba shared their memorandum and advocacy efforts in the Czech Republic.

Professor Ignatios Ikonomidis, President of SCOHRE ―the International Association of independent experts on Smoking Control & Harm Reduction― reaffirmed the Association’s commitment to reshaping tobacco control: “Harm reduction must become a recognized pillar of public health policy, alongside prevention and cessation. Increasing the knowledge of healthcare professionals, regulators, policymakers, and the public is essential. The evidence is undeniable: switching from cigarettes to less harmful nicotine products can save lives. Yet, misconceptions, resistance, and misinformation continue to hold back progress. Science, not ideology, must guide policy, and collaboration is essential — across countries, professions, and communities. Together, with partners and stakeholders, we are building momentum for a smoke-free world,” he concluded.

Two eye opening sessions about the diversity of implementation of policies and novel tobacco product control are Africa and Asia led by Prof. Solomon T. Rataemane and Prof. Sharifa Ezat Wan Puteh, respectively. Speakers shared the diverse landscape in their countries: Tunisia (Limic area) and Morrocco, in Africa; Malaysia, Hong Kong, and Philippines, in Asia.

Research Track Sessions

Thirty scientific papers were presented this year, in 4 Research Track Sessions where new findings were shared on epidemiology and social issues, innovation & novel products, toxicology & aerosol chemistry, preclinical and clinical evaluation, biomarkers evaluation, smoking cessation and regulatory issues. View here the 8th Summit’s Abstract Book.

*Countries represented at the 8th Summit:

Albania, Argentina, Armenia, Austria, Belarus, Belgium, Bhutan, Botswana, Bulgaria, Brazil, Canada, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Greece, Hong Kong, Hungary, India, Ireland, Israel, Italy, Japan, Kazakhstan, Kenya, Kuwait, Lithuania, Malaysia, Mexico, Morrocco, Rep. of North Macedonia, Pakistan, Philippines, Poland, Portugal, Romania, Russian Federation, Serbia, Singapore, Slovakia, South Africa, South Korea, Spain, Sweden, Switzerland, The Netherlands, Tunisia, UAE, United Kingdom, U.S.A., Uzbekistan.