The way people consume tobacco has been through several changes over the decades with the emergence of various smokeless tobacco alternatives gaining attention. These alternatives, which include products like snus, chewing tobacco, nicotine pouches and heated tobacco products, offer individuals an alternative way to satisfy their nicotine cravings while potentially reducing the associated health risks. One of the key motivations behind the exploration of these alternatives lies in their potential to reduce health risks when compared to combustible cigarettes. Unlike traditional cigarettes, which involve the combustion of tobacco and the generation of harmful smoke, smokeless alternatives eliminate the need for combustion. This reduction in harmful smoke exposure can result in a decreased risk of lung cancer, respiratory diseases, and cardiovascular issues commonly associated with smoking. The use of smokeless tobacco has deep historical roots, spanning different cultures and regions. Chewing tobacco, for instance, has been used by indigenous communities for centuries. It was a significant practice among Native American tribes long before tobacco products became commercialized. Similarly, snus, a moist tobacco product placed under the upper lip, has a rich history in Scandinavia, where it is a cultural tradition enjoyed by many. These traditions highlight that smokeless tobacco alternatives have been an integral part of societies across the globe. An increasingly shared viewpoint suggests that adult smokers who fully transition to tobacco- or nicotine-containing products designed not to burn tobacco might face a lower risk of harm compared to persisting with traditional smoking. According to studies, smokeless tobacco products are generally believed to pose a lower risk profile than combustible cigarettes. For instance, research indicates that snus has been associated with lower risks of lung cancer and other smoking-related diseases due to its absence of combustion. These findings, along with ongoing studies, underscore the potential harm reduction that these alternatives can offer to individuals seeking nicotine satisfaction without the detrimental effects of smoking. In the first-ever clinical trial of fourth-generation electronic cigarettes, researchers found that adults who switched to e-cigarettes had lower levels of a major carcinogen compared to smokers who continued using combustible cigarettes. One notable example of a country that has adopted a progressive stance on harm reduction is the United Kingdom (UK). In recent years, the UK has been at the forefront of promoting reduced-risk alternatives for smokers. The smoking rate in the UK has been steadily declining over the years, reaching to an all-time low of 13.3% in 2021. These statistics highlight the consistent efforts and successful strategies implemented in the UK to combat smoking, resulting in a significant decline in the overall smoking rate over the years. Public health agencies, such as Public Health England, have recognized the potential of e-cigarettes to help smokers quit or reduce their tobacco consumption significantly. As Pakistan considers the regulation of smokeless alternatives, it’s imperative to weigh the potential benefits against any perceived challenges. By learning from international experiences and tailoring regulations to fit the local context, Pakistan has the opportunity to shape its tobacco landscape in a way that supports public health goals.