Dear Healthcare Practitioner,

India's tobacco epidemic disproportionately burdens underserved populations, with 253 million users in 2022 (Global Action to End Smoking, 2022) and a projected rise if inequities persist. While overall adult smoking prevalence dipped to 9.3% in 2024 (Global State of Tobacco Harm Reduction, 2024), vulnerable groups—rural communities (where smokeless tobacco use hits 21.4%, GATS-2 India 2016-17 Update) and low-income urban workers—face 2-3 times higher exposure risks (WHO Global Tobacco Report 2025). Safer Novel Alternatives (SNAs) offer a 50-70% quit rate boost in equitable access models (Cochrane Systematic Review 2021 Update), but barriers like affordability and awareness hinder progress. This edition explores RWE on bridging these gaps for inclusive cessation.

Real-world evidence (RWE) from Sweden's SNA integration shows a 70% smoking decline among low-SES groups (European Journal of Public Health 2025), reducing disparities by 40%. In India, rural users (58% of total, NFHS-5 2025) report 80% quit failures due to limited access (Research Square 2025), with women in low-income households facing 2x relapse rates (75% within six months, Breaking the Cycle Study 2025). Urban migrants, affected by stress (77%, NFHS-5), see only 4.1% pharmacotherapy use (Lung India 2025). Equitable SNA deployment could avert 350,000 smokeless tobacco deaths annually (Oxford Academic 2025).