In Latvia, 34% of the population uses tobacco and nicotine-containing products. While two-thirds of them smoke traditional cigarettes—the most harmful tobacco product—new smokeless products are gradually replacing them, according to recent studies. Experts also acknowledge the positive trend, pointing out that addictions cannot be completely cured, and therefore, prohibition and penalty policies are not effective in combating the use of addictive substances. However, it is possible to effectively reduce the harm caused by addictive substances if complex and evidence-based harm reduction strategies are applied.
Positive trend – cigarettes are gradually being replaced by smokeless products
According to the results of a survey conducted by the research company SKDS in the summer of 2024, which was presented on September 11 at an expert seminar “Trends and Reality of Tobacco Harm Reduction in 2024,” a quarter of Latvia’s population aged 18 to 75 regularly uses tobacco and nicotine-containing products, while 9% use them occasionally. 29% of respondents used tobacco and nicotine products in the past but no longer do, while 36% have never used them.
Although cigarette smoking remains the dominant way of starting smoking and using tobacco products—with 85% starting regular usage with cigarettes—a positive trend is emerging: cigarettes are gradually being replaced by smokeless products that release fewer harmful substances.
“Survey data show that the overall number of tobacco and nicotine product users in society is not changing, but cigarette users are gradually starting to choose less harmful alternatives, and the number of users of the most harmful tobacco product—cigarettes—is decreasing in Latvia,” emphasizes Arnis Kaktiņš, director of SKDS.
Compared to 2022, the share of cigarette users in 2024 has decreased from 72% to 67%, while the number of e-cigarette users has increased from 38% to 43%, the number of heated tobacco users has risen from 16% to 21%, and the number of users of nicotine pouches (without tobacco) has increased from 3% to 8%.
Better well-being and no smelly smoke
Professor Aija Zobena from the University of Latvia, a sociologist, emphasizes that among younger people, traditional cigarette smoking is decreasing as it is seen as an unhealthy habit. Therefore, less harmful alternatives to cigarettes, such as smokeless products, are being sought. Transitioning to smokeless products is often interpreted as a step towards quitting smoking. The tobacco harm reduction strategy is supported by many studies and is applied in countries like Sweden and the United Kingdom. Its goal is to encourage smokers to choose less harmful products, thereby reducing the damage caused by tobacco products,” says A. Zobena.
Respondents who have replaced cigarette smoking with smokeless products such as e-cigarettes, heated tobacco, or nicotine pouches more often acknowledged that it has generally had a positive effect on their well-being or health.
Users of smokeless products emphasize the main reasons for using these products – they do not produce smoke, do not leave bad breath, or make hands and clothes smell (59%), are less bothersome to others (50%), and can be used indoors (50%). Additionally, 31% of respondents started using smokeless nicotine products because they are a less harmful alternative to smoking cigarettes and other traditional tobacco products, 30% because of the wider variety of flavors, and 24% to quit or reduce smoking cigarettes and other traditional tobacco products.
Overall, 28% of respondents believed it would be better if traditional tobacco smokers, who cannot completely quit, tried to switch to alternative smokeless products.
Addictions cannot be defeated by bans
At the seminar, psychologist Ļudas Vincentas Sinkevičius, a lecturer at the Lithuanian University of Health Sciences, pointed out the ineffectiveness of bans and the need for a complex approach to addiction issues. “It is quite illusory to believe that the world will ever reach a point where there are no addictions and people will stop using addictive substances. It must be understood that addictions are not so much about specific substances but more about behavioral problems. Therefore, addiction reduction requires complex solutions and a multi-faceted approach. Addiction is not curable, and a person will have to live with it for their entire life. The problem cannot be solved by banning substances, persecuting addicts, or imposing penalties. However, harm reduction approaches show quite good results. For example, harm reduction is effective in cases of opioid and nicotine addiction, while it is not applicable in cases of alcohol and stimulant use,” said V. Sinkevičius.
Māris Sproga, a board member of the Smokeless Industry Association, is convinced that the shift towards a smoke-free society in Latvia is inevitable, despite the ineffective ban policies: “It is important to understand the links between societal behavioral problems and addictions, which cannot be cured, rather than continuously ignoring reality and comforting ourselves with prohibition policies as a panacea for all pressing issues. Unfortunately, Latvia’s responsible institutions particularly stand out by living in their own ‘bubble’ and being unable to engage in dialogue.”
Growing threats from the gray market
Evaluating the Saeima’s decision to allow only tobacco-flavored e-cigarettes and nicotine pouches to be sold in Latvia from 2025, 39% of respondents who use these products at least once a month emphasized that they would still buy these products with other flavors from online stores, social networks, or friends and acquaintances. Meanwhile, 37% of respondents indicated that they would buy these products with other flavors from foreign stores whenever possible. Only 18% admitted that they would buy the tobacco-flavored products available in Latvia. Another 16% are considering quitting tobacco and nicotine products, while 8% are ready to resume smoking cigarettes.
“The research clearly shows the public’s position and the likely actions of users—on the one hand, people will buy products abroad, and tax revenues will not stay in Latvia. On the other hand, the more bans there are, the greater the organized crime will be in this area. Another feature is that bans on new products will lead people to return to more harmful products,” notes A. Kaktiņš.
Saule Bernotiene, a representative of the European Life Science & Knowledge Institute (ELSKI), emphasized that such policies and bans have no scientific basis. Lithuania’s experience also shows that such flavor bans indirectly support organized crime, as the trade in tobacco and nicotine products is taken over by organized criminal groups, increasing illegal trade through social media channels. It should be noted that greater harm is potentially caused to the users themselves, as various products of unknown quality and origin enter the market. At the same time, state revenues decrease, reducing the ability to increase funding for healthcare.”
Unlike bans that aim to radically change people’s behavior, harm reduction strategies focus not on changing user behavior but on changing the products with the goal of reducing the harm of the product itself. “It has been proven that vapes contain on average 97.44% fewer toxic substances than cigarettes, while heated tobacco contains on average 89.15% fewer toxic substances. Vape and heated tobacco users are more likely to quit smoking, and they suffer less from cardiovascular and respiratory system damage,” notes S. Bernotiene.
The expert also emphasized that an ongoing issue is the awareness and preparedness of healthcare professionals to participate in smoking harm reduction. “Healthcare professionals have a duty to inform and advise patients based on the latest available clinical and scientific data. They must have sufficient knowledge to encourage patients to make informed and thoughtful decisions about their treatment. It is important that patients can receive advice on how to implement smoking cessation or harm reduction strategies and get appropriate help during this process,” explained S. Bernotiene.
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