The Polish capital, Warsaw, earlier this summer hosted the 12th edition of the Global Forum on Nicotine (GFN), featuring the participation of over 40 international experts. The discussions focused on one of the most pressing public health issues today: the growing spread of misinformation about low-risk nicotine products and its impact on global health policies. This year's forum was held under the theme: "Challenging Perceptions – Effective Communication for Tobacco Harm Reduction", highlighting the importance of adopting a transparent, evidence-based scientific dialogue that empowers consumers to make informed decisions about using nicotine products within harm reduction strategies. Misinformation: An Obstacle to Progress Participants in the forum highlighted the dominance of alarming narratives and selective interpretations of scientific data in the public discourse about nicotine products. Despite growing scientific evidence confirming the effectiveness of alternatives such as nicotine pouches, heated tobacco, and "snus" in reducing the harms of traditional smoking, misinformation remains a major obstacle to the adoption of these solutions by both individuals and policymakers. Experts pointed out that many governments still approach nicotine with caution—without distinguishing it from the act of smoking itself—which contributes to dangerous confusion that could undermine governmental and public health efforts to combat tobacco-related risks. Experts stressed that nicotine has been used since the 1990s as a smoking cessation aid, without being the direct cause of smoking-related diseases. Research indicates that the real risks lie in the combustion of tobacco, which produces thousands of toxic chemical compounds. Cigarette smoke contains more than 6,000 chemicals, around 100 of which are known to cause serious illnesses such as cancer, heart and lung diseases. For her part, Dr. Manal Abdel Khalek, a gastroenterology consultant from Egypt, said: "Nicotine is not classified as a carcinogen by the International Agency for Research on Cancer (IARC), nor by the U.S. Food and Drug Administration (FDA) or the UK's National Health Service (NHS). This classification is not merely an academic matter, it is a fundamental element in formulating and adopting effective public health policies and programs." Abdel Khalek added, "Health policies should be based on scientific evidence, not on fears or social stigma. When we sideline science in favor of ideology, we fail to protect those we are supposed to serve. Tobacco harm reduction is not a form of leniency; it is a genuine commitment to the principle of health equity." Criticism of Global Health Institutions The forum also discussed the role of the World Health Organization (WHO) and its continued promotion of a "total abstinence" approach, which some experts considered a disregard for the needs of millions of adult smokers who could benefit from less harmful alternatives. Professor Riccardo Polosa from the University of Catania said: "The WHO selectively picks references and distorts scientific evidence to support the abstinence-only narrative. This approach has severe consequences for the lives of millions of smokers worldwide." Call to Adopt Best Practices and Not Overlook Progress Participants noted that countries that have adopted tobacco harm reduction strategies by allowing the circulation of low-risk nicotine products have seen a significant decline in smoking rates, far surpassing the results of policies focused solely on abstinence. Countries such as New Zealand, the United Kingdom, Japan, and Sweden were highlighted as successful models: – Sweden: It is on the verge of becoming the first smoke-free country, with adult smoking rates dropping to near 5%, thanks to the widespread use of "snus," nicotine pouches, and other alternatives. – Japan: It has recorded more than 40% decline in cigarette sales since 2016, coinciding with the spread of heated tobacco products. – United Kingdom: It integrated e-cigarettes into its national smoking cessation strategy, achieving one of the fastest declines in smoking rates in Europe. – New Zealand: Adopted a balanced regulatory framework that allows access to low-risk nicotine products while maintaining strong protections for young adults, leading to a continued decline in smoking rates. Commenting on these experiences, Dr. Manal Abdel Khalek said, "These countries are not only reducing smoking rates, but they are also redefining the concept of success in public health. We should draw inspiration from their experiences and stop viewing harm reduction as a threat. Rather, it is a life-saving tool that should be used responsibly and guided by science." She added, "Public health must be inclusive, and every individual has the right to access better options and accurate information that helps them make informed decisions about their health." A Look into the Future The forum concluded with a unified call for global health authorities to adopt harm reduction as a legitimate and necessary strategy in tobacco control. Participants stressed that effective communication—rooted in science and empathy—is key to reducing smoking-related deaths and achieving real improvements in public health. Dr. Manal Abdel Khalek concluded her remarks by saying: "We hope that the upcoming meeting of the WHO Framework Convention on Tobacco Control (FCTC) in November will adopt a more realistic and inclusive approach. We must take into account the potential of lower-risk products—such as e-cigarettes, heated tobacco products, and nicotine pouches—in reducing the health and social burden of smoking, especially for those who struggle to quit completely. We need evidence-based, not ideology-driven, policies that strike a balance between protecting public health and providing realistic alternatives for adult smokers."
