Common myths and misconceptions (LMIC focus)

Even with growing evidence for THR, several myths still slow its acceptance in LMICs.

A common misconception is that all nicotine products are equally harmful. In fact, most of the harm from tobacco comes from burning it - not from nicotine itself. When tobacco burns, it releases thousands of toxic chemicals that cause disease. Non-combustible products like vapes, nicotine pouches, and snus deliver nicotine without combustion, making them far less harmful [^1], [^2]. Understanding this difference is key to creating fair and science-based tobacco policies.

Another frequent myth is that THR encourages youth smoking or addiction. Evidence from countries with regulated THR markets shows that youth smoking continues to decline even as adult who smoke switch to safer alternatives [^3], [^4]. Good regulation, such as age limits, clear product standards, and responsible marketing, helps protect young people while still giving adults access to less harmful products. Framing THR as a threat rather than an opportunity can block progress and deny people who smoke practical tools to reduce their health risks.

A final myth claims that THR weakens tobacco control. In reality, it strengthens it by adding new options to reduce harm where quitting support is limited. Safer nicotine products can help people who smoke move away from cigarettes in settings with few cessation clinics or costly NRTs. Unfortunately, prohibition-style messaging and misinformation have spread across many LMICs, often claiming that all nicotine products are equally deadly.

These narratives, sometimes echoed by well-meaning officials or advocacy groups, can lead to bans or heavy taxes that keep safer options out of reach. Combating misinformation with clear, evidence-based communication is essential to making tobacco control more effective, inclusive, and equitable.