The relationship between declining cigarette smoking and the growing use of non-combustible nicotine products is becoming an important consideration for tobacco-control policy. While countries such as Sweden, Japan and the United Kingdom are frequently discussed in this context, emerging patterns elsewhere offer further opportunities to examine how consumers respond to different products and regulatory environments.
A September 2026 briefing paper from the Global State of Tobacco Harm Reduction (GSTHR) examines developments in South Korea, Ireland and Estonia. The three countries present contrasting experiences: substantial adoption of heated tobacco products alongside continued cigarette use, a smoking decline that has stalled, and a more recent acceleration in smoking reduction accompanied by increased vaping.
These trends raise questions about how product availability, consumer preferences and regulatory choices may influence transitions away from combustible tobacco.
South Korea: Product Adoption Does Not Always Mean Complete Switching
South Korea has experienced a substantial long-term decline in smoking. Adult smoking prevalence fell from 35.1% in 1998 to 17.7% in 2022, with much of this progress occurring before heated tobacco products entered the market in 2017.
By 2022, heated tobacco product use had reached 5.9% of adults. However, the briefing highlights growing use of multiple nicotine products, including continued cigarette smoking alongside heated tobacco use.
This distinction matters. Increased adoption of non-combustible products does not necessarily indicate that consumers have stopped smoking. The potential health benefits depend partly on whether smokers switch completely, reduce cigarette consumption or continue using multiple products.
South Korea’s experience highlights the importance of measuring changes in combustible tobacco use alongside the uptake of alternatives.
Ireland: A Smoking Decline That Has Lost Momentum
Ireland provides a different picture. Adult smoking prevalence declined from 23% in 2015 to 17% in 2019 but remained at approximately 17% in 2025, despite continued tobacco-control efforts.
Vaping prevalence increased from 3% in 2015 to 8% in 2023 before stabilising. The GSTHR briefing also reports that, in 2025, half of current vapers were former smokers, while approximately one-third continued to smoke.
Ireland has introduced additional restrictions on vaping products, including an excise tax on e-liquids that took effect in November 2025. Further proposals concerning advertising, packaging and flavours were approved by the government in March 2026.
These measures reflect legitimate concerns about youth protection. However, their effects on adult smoking behaviour remain uncertain. Ireland’s smoking plateau began before the most recent restrictions, so it cannot be attributed to those policies.
The relevant regulatory question is whether additional restrictions can reduce youth uptake without creating unnecessary barriers for adults seeking alternatives to cigarettes.
Estonia: An Emerging Shift Worth Monitoring
Estonia presents one of the more notable recent patterns identified in the briefing.
Between 2020 and 2024, current smoking prevalence fell from 26.1% to 19.0%, while current vaping increased from 3.8% to 13.5%. Daily smoking also declined as daily vaping became more common.
The simultaneous changes are consistent with possible substitution away from cigarettes. However, population-level figures cannot establish whether the same individuals switched products or whether other factors contributed to the decline.
Estonia has maintained legal access to non-combustible alternatives despite restrictions on advertising, flavours and sales. Proposed regulatory changes introduced for consultation in July 2026 could impose further limits on nicotine content, flavours and distance sales.
Future data will be important in determining whether smoking continues to decline and how changes to product regulation affect both adult use and youth protection.
What These Different Experiences Mean for Regulation
The three countries illustrate why nicotine regulation should be informed by real-world outcomes rather than product uptake alone.
South Korea demonstrates that widespread adoption of alternatives can coexist with continued smoking. Ireland highlights the difficulty of sustaining reductions in smoking prevalence, while Estonia presents an emerging pattern of declining smoking alongside increased vaping.
None of these experiences establishes a simple causal relationship between nicotine-product availability and smoking reduction. Differences in national policies, consumer behaviour, economic conditions and survey methods also limit direct comparisons.
Nevertheless, the findings reinforce the importance of evaluating whether regulatory frameworks support sustained reductions in combustible tobacco use.
For policymakers, this means examining complete switching, continued dual use, youth initiation and changes in smoking prevalence while maintaining appropriate product standards and consumer protections.
A risk-proportionate approach should recognise differences between combustible and non-combustible products without overlooking nicotine dependence or uncertainties surrounding long-term health effects.
As more countries consider restrictions on emerging nicotine products, South Korea, Ireland and Estonia offer useful examples of why regulatory success should ultimately be measured by improvements in public-health outcomes.
Source
Global State of Tobacco Harm Reduction (September 2026). The Next Wave of Tobacco Harm Reduction? Emerging Transitions from Smoking to Safer Nicotine Products in South Korea, Ireland and Estonia.
