On the occasion of World No Tobacco Day 2026, CoEHAR brought together experts in medicine, public health, economics, and global health at the LXII Scientific Meeting of the Italian Society of Economics, Demography and Statistics (SIEDS), held at the University of Catania from 27 to 29 May.
The dedicated session, entitled “A One Health Approach to Tobacco Harm Reduction: Linking Clinical, Environmental, and Socio-Economic Systems for Population-Level Impact”, highlighted the need for evidence-based strategies capable of addressing the persistent global burden of smoking-related disease through an integrated public health framework.
Moderated by CoEHAR Director Prof. Giovanni Li Volti, the session featured presentations from Prof. Riccardo Polosa (University of Catania, CoEHAR Founder), Prof. Donald Kenkel (Cornell University, USA), and Dr. Yusuff Adebayo Adebisi (University of Glasgow, UK).
Opening the scientific discussion, Prof. Polosa reviewed decades of evidence on the health consequences of tobacco combustion and the potential role of combustion-free nicotine products in supporting smoking cessation and reducing exposure to the toxicants responsible for smoking-related disease. His presentation emphasized a reality that remains largely unchanged worldwide: despite decades of tobacco control efforts, there are still more than one billion smokers globally, and smoking continues to cause millions of preventable deaths every year. Within this context, tobacco harm reduction was presented not as an alternative to smoking cessation, but as an additional strategy for smokers who are unable or unwilling to quit nicotine entirely. Particular attention was devoted to CoEHAR’s scientific contributions, including the REPLICA Project, coordinated by prof. Giovanni Li Volti and prof. Massimo Caruso, and clinical studies showing improvements in respiratory symptoms, mucociliary clearance, cardiovascular parameters, and smoking abstinence among smokers who completely switch away from combustible cigarettes.
The session also explored the economic and social dimensions of tobacco control through the contribution of Prof. Donald Kenkel. His presentation focused on the relationship between smoking, socioeconomic inequalities, taxation policies, and tobacco harm reduction. Kenkel highlighted how smoking is increasingly concentrated among lower-income and socially disadvantaged populations, contributing to persistent health inequalities. While higher cigarette taxes remain one of the most effective tools for reducing tobacco consumption, he noted that they may also disproportionately burden vulnerable groups. Drawing on evidence from health economics and public policy research, he argued that regulatory frameworks should encourage smokers to switch from combustible cigarettes to substantially lower-risk non-combustible nicotine products. According to Kenkel, appropriately designed harm reduction policies have the potential not only to reduce smoking prevalence but also to help address smoking-related socioeconomic inequalities.
Complementing these perspectives, Dr. Adebisi focused on the methodological challenges involved in generating reliable evidence for tobacco harm reduction policies. His presentation explored the role of Real-World Evidence, causal inference methods, and interdisciplinary research in evaluating the long-term impact of smoke-free alternatives on health, environmental sustainability, and socio-economic outcomes. Adebisi emphasized that many of the remaining debates surrounding tobacco harm reduction are increasingly methodological rather than conceptual. As evidence accumulates from randomized trials, cohort studies, and population-level analyses, the challenge is no longer whether lower-risk nicotine products differ from cigarettes, but how to accurately quantify their impact on public health and integrate this evidence into policy decisions.
Reflecting the broader theme of the SIEDS meeting, the session adopted a One Health perspective, recognizing that smoking-related harm extends beyond individual disease and affects healthcare systems, economic productivity, environmental sustainability, and social wellbeing.
“The future of tobacco control will depend on our ability to integrate scientific evidence across disciplines,” said Prof. Li Volti. “The One Health framework provides exactly this opportunity, bringing together medicine, public health, economics, and environmental sciences to better understand how innovative harm reduction strategies can contribute to improving population health.”
“Reducing the burden of smoking requires more than slogans,” said Prof. Polosa. “It requires science, innovation, and the willingness to evaluate all evidence-based options capable of moving smokers away from combustible tobacco. Tobacco harm reduction should be considered an integral part of a comprehensive public health strategy aimed at saving lives and reducing the enormous burden of smoking-related disease.”
The event concluded with a shared message: while smoking cessation remains the optimal goal, reducing exposure to combustion should remain a public health priority. Achieving meaningful progress against smoking-related disease will require rigorous science, international collaboration, and pragmatic policies focused on reducing harm and improving population health outcomes.
As World No Tobacco Day 2026 reminds us, the fight against smoking is far from over—but evidence-based innovation, interdisciplinary collaboration, and a One Health vision can help accelerate progress toward a healthier future.
