World No Tobacco Day Is Now a War on Harm Reduction

Lisa Ciarlone

May 31 marks the 38th annual World No Tobacco Day (WNTD), a global public health campaign initiated by the World Health Organization to “draw attention to the tobacco epidemic and the preventable death and disease it causes.” 

While the reduction of smoking-related illnesses is a critical public health goal, WNTD has increasingly become a platform for spreading misinformation, particularly about nicotine and tobacco harm reduction (THR) products.

This year’s theme, “Unmasking the Appeal: Exposing Industry Tactics on Tobacco and Nicotine,” claims that the tobacco and nicotine industries use “carefully engineered products and deceptive tactics to hook a new generation of users.” The WHO fixates on flavors, asserting they exist solely to entice children and teens into nicotine addiction. This narrative ignores mounting evidence: youth vaping is declining, and flavors play a vital role in helping adults quit smoking.

In the United States, youth vaping reached historic lows in 2024. Since 2019, youth use has consistently declined, as sales of flavored vapor products have increased. 

This year’s WNTD theme also ignores crucial youth survey data: youth don’t primarily cite flavors as the reason they vape. In 2021, 43.4 percent of middle and high school vapers reported using e-cigarettes to cope with anxiety, depression or stress. Just 13.2 percent cited flavors as the reason for use.

Conversely, adults overwhelmingly rely on flavors in e-cigarettes and other THR products to quit smoking and remain smoke-free. A 2016 study of 1,400 adult e-cigarette users found that those using flavored products reported greater satisfaction than those using tobacco-flavored ones. Most participants preferred non-tobacco options such as fruit, menthol, candy or coffee. Similarly, a survey in Harm Reduction Journal of 70,000 adult vapers revealed fruit, dessert and candy flavors were the most commonly used at initiation, while the use of tobacco flavors declined over time.

These findings are reflected in national data. According to the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, 7.7 percent of U.S. adults (20.2 million people) were e-cigarette users in 2023 — a 67.9 percent increase from 2016, or an additional 8.7 million adults vaping in 2023 compared to 2016. Sales data reinforce this. A 2024 study by the CDC Foundation and Truth Initiative showed a 47 percent rise in e-cigarette unit sales between 2019 and 2023, with flavored products accounting for 80 percent of those sales.

Meanwhile, youth vaping declined by 61.5 percent over the period.

Despite anti-nicotine rhetoric, THR products like e-cigarettes, heated tobacco and oral nicotine pouches are proven to help adults quit smoking. The Food and Drug Administration has authorized several such products, affirming they are “appropriate for the protection of public health.” Notably, in January, the FDA authorized the sale of a handful of nicotine pouches in a range of non-traditional flavors, including cinnamon, citrus and spearmint.

Yet, the WHO and other organizations continue their crusade against harm reduction. In 2023, the WHO called for a global ban on flavored vapes and urged countries to regulate them like combustible cigarettes. As recently as January 2025, Campaign for Tobacco-Free Kids, partnering with WHO for this year’s WNTD event, falsely warned of a “nationwide crisis of youth addiction” caused by flavored products. Not only do these campaigns ignore significant declines in youth use, but they disregard the aforementioned reasons why youth vape.

This persistent focus on youth, while politically expedient, sidelines the more than 1 billion adults worldwide who smoke. These adults deserve access to safer alternatives, not scaremongering campaigns that ignore science and undermine public health.

World No Tobacco Day, once a meaningful campaign to combat smoking, has devolved into a vehicle for nicotine prohibition and misinformation. If the WHO wants to reduce smoking-related death and disease, it must acknowledge the life-saving role that harm reduction and flavored products play for adult smokers.

Anything less is a disservice to global public health.

Originally published in Inside Sources.