Alternative Nicotine & Smoking Cessation: Findings From Case Studies in Five Countries

64 Pages Posted: 5 Oct 2023

Date Written: October 3, 2023


Since 2010, several nations with impressive histories of smoking cessation have witnessed the proliferation of Electronic Nicotine Delivery Systems (ENDS). Advocates suggest that ENDS offer an effective and safer substitute for combustible tobacco. Critics fear that ENDS could expose consumers to novel harms, discourage smoking cessation and may even renormalize tobacco use. Different nations have adopted radically different regulatory strategies ranging from outright bans to active encouragement of ENDS-led smoking cessation. Consumer behavior around ENDS hinges not only on the features of the products and their appeal relative to other substitutes (including NRTs and combustible tobacco), but also on public perceptions towards the novel product category and the details of the regulatory environment. This paper distills findings from case studies of five nations: Australia, Canada, Japan, South Korea and the UK to explore how consumer behavior responds to regulatory decisions. Recommendations for policy-makers and the research agenda are provided.


Funding Information: This study was funded with a grant from the Foundation for a Smoke-Free World, Inc. (“FSFW”), a U.S. nonprofit 501(c)(3) private foundation.

Conflict of Interests: FSFW had no role in the planning or execution of this survey/report/study, data analysis, or publication of results. FSFW’s mission is to end smoking in this generation. FSFW accepts charitable gifts from PMI Global Services Inc. (PMI); under FSFW’s Bylaws and Pledge Agreement with PMI, FSFW is independent from PMI and the tobacco industry.

Suggested Citation

Hampsher-Monk, Samuel and Heussler, Lowry, Alternative Nicotine & Smoking Cessation: Findings From Case Studies in Five Countries (October 3, 2023). Available at SSRN: or

Samuel Hampsher-Monk (Contact Author)

BOTEC Analysis ( email )

25350 Magic Mountain Parkway
Suite 300
Santa Clarita, CA 91355
United States
2139445669 (Phone)

Lowry Heussler

BOTEC Analysis, LLC ( email )

322 N. Mansfield Avenue
Los Angeles, CA 90036

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