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in less than a decade, we have witnessed a major, global transformation in the way that nicotine is consumed, from a mechanism that kills over half of its users to the emergence of safer alternatives which pose a fraction of the harm For further information about the Global State of Tobacco Harm Reductions work, or the points raised in this GSTHR Briefing Paper, please contact [email protected] About us: KnowledgeActionChange (KAC) promotes harm reduction as a key public health strategy grounded in human rights

1 2 3 "'Stand By Your Man'"

Sample selection A multistage sampling method was employed to select a representative sample of secondary school students aged 1319 years in Thailand (Figure 1)

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