The Tobacco Transformation Index seeks to accelerate tobacco harm reduction by encouraging tobacco companies to reduce the health impacts caused by tobacco use, beginning with the elimination of its highest risk products. Key to this approach is monitoring companies’ activities and investments as they pertain to high-risk products versus reduced-risk products.

In the absence of an established, internationally standardized spectrum of risk for tobacco products, the Foundation for a Smoke-Free World in 2020 commissioned a scientific literature review to identify a relative risk assessment between products. This process was repeated ahead of the 2022 Index.

The relative risk assessment is based on a systematic review of previous scientific studies of the health risk associated with nicotine products. Studies are reviewed in detail to extract data and assess the level of risk for each product type. The products are analyzed in terms of their toxin emissions and epidemiological data, which were combined on a scale from 0 to 100 (low to high risk) to derive a combined risk score for each product. Additional details on the relative risk assessment are available in the publication “Nicotine Products Relative Risk Assessment: A Systematic Review and Meta-analysis.” 

The relative risk assessment, summarized in the adjoining figure, was applied in the same way in the 2022 Index as it was applied in the 2020 Index. This involves each product’s relative risk being used as a multiplier for each Index Company’s sales and product offer in HRPs and RRPs. For example, volume sales of cigarettes was multiplied by the relative risk of cigarettes (100), while volume sale of chewing tobacco was multiplied by its relative risk, to reflect the different level of risk associated with each type of product.