Understanding Research Gaps and Priorities for Tobacco Harm Reduction in LMICs - Sahan Lungu

Tobacco use is among the leading preventable causes of premature death worldwide, with disproportionate effects in low-income and middle-income countries (LMICs). Global tobacco control efforts have shown inconsistent results, highlighting the need for innovative approaches, such as tobacco harm reduction (THR), to complement existing strategies. We aimed to identify gaps in THR research in the global and LMIC contexts. We conducted a bibliometric review, using Scopus, to identify articles addressing THR published from January 2014 to August 2024. Research output was categorized by product type, geographical focus, volume of research output, and funding sources. A narrative synthesis was performed to outline research gaps and propose a strategic research agenda. THR research remains disproportionately concentrated in high-income countries and reflects a clear divergence between public and private research agendas. More research is needed to evaluate the long-term impacts, affordability, and real-world effectiveness of THR products using rigorous and standardized methodologies in diverse settings. Strengthening the evidence base in LMICs will be essential for developing affordable, accessible, and acceptable THR strategies tailored to local needs.