Use of tobacco dates to prehistory. But it didn’t become one of the world’s most consumed drugs simply because of its psychoactive and addictive properties. As the market shifts from conventional to non-combustible nicotine products, it’s worth remembering how aggressive public relations campaigns and organised scientific denialism were not peripheral features in the normalisation of new tobacco products. The industry’s historical capacity for shaping public perception and avoiding regulation remains an important lesson, even as cigarettes are abandoned for pouches and vapes.

We explore the history and possible futures of tobacco and nicotine use, drawing on scenarios created by futurists at the Copenhagen Institute for Futures Studies in collaboration with a global team of health experts and policymakers.

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“The natives brought the fruit, wooden spears and certain dried leaves which gave off a distinct fragrance.”

Christopher Columbus, 1492

Tobacco had been smoked, burned, ingested, and sniffed throughout the Americas for millennia before Europeans first observed men in Cuba “drinking” smoke from rolled leaves and pipes in November 1492. A month earlier, Columbus had discarded the dried leaves offered to him as a token of friendship by the Arawak people in the Bahamas, not understanding their use or properties.

Supposedly, the crewman Rodrigo de Jerez was the first non-American to take up “smoking” – although that term had yet to be invented. It was a habit which awarded him a place in prison (and hell, presumably). Upon returning to his native Ayamonte in Spain, he was arrested by Inquisitors citing that only the Devil can blow smoke from his mouth and nose.

What the Devil had brought home could not be contained – and early suggestions that the lure of this new vice might be resisted soon collapsed. Jean Nicot, a French diplomat who had travelled to Portugal in 1559 to negotiate a marriage between a six-year-old princess and a five-year-old king, is credited for being the first to bring tobacco from the Iberian Peninsula to France. It’s a disputed claim, but Carl Linnaeus nevertheless decided to name the tobacco plant after Nicot, as well as the alkaloid and mind-altering chemical found within it, nicotine. The introduction of tobacco to the French court did much to make smoking fashionable and aided in its spread throughout Europe. Nicot, inadvertently, became the first in a long line of successful tobacco admen.

As it had done in the Americas, tobacco found wide use by Europeans, who cultivated the plant for decoration, enjoyment, and for its purported medicinal properties. Some medical texts published in the late 1500s claimed it was a cureall, offering effective treatment for a host of ailments that included migraine, toothache, gout, ulcers, deafness and, notably, asthma. One work, published in 1587 by the Dutch physician Giles Everard, described tobacco as a universal medicine and stated that the “very smoke of it is held to be a great antidote against all venome and pestilential diseases.”

Yet for all its perceived usefulness, the addictive properties of tobacco began to receive notice as well, including in the unwillingness of patients to give up the drug even after recovery. Its harmful effects were also starting to be documented. The English physician Eleazar Duncon the Elder wrote that the plant might as well be known by the name of “youths-bane”, as by tobacco.

Worries like these did little to curb the drug’s spread. In tobacco, Europeans had found a new outlet for that recurring human impulse toward mood alteration and intoxication. During the 1600s, smoking became increasingly commonplace not just in Europe, but across Eurasia. With European colonisation of the new world, tobacco was re-exported there as well.

Even then, long before public health became an institutionalised concern, there were those who advocated strongly for universal tobacco regulation. In 1661, a Danish physician and advisor to King Christian IV, Simon Paulli, wrote that “If any champion for tobacco should ask me whether I would have the Pope, the Emperor, and all the Kings, Electors, Princes, and Dukes in Europe, prohibit and discharge the use of tobacco? I answer, that such a revolution is really to be wished for.”

His call, and that of others wary of the plant’s deadliness, may seem farsighted to us today, but fell mostly on deaf ears in their own time. It wasn’t until a few centuries later, when tobacco-use had become globally entrenched, that the necessity of regulation found wide agreement.

“To all whom it may concern: Be it known that I, JAMES A. BONSACK, of Bonsack’s, in the county of Roanoke and State of Virginia, have invented a new and Improved Cigarette-Machine…”

United States Patent Office, 1881

The 20th century became the century of the cigarette. The Bonsack Machine, named after its inventor, could reportedly roll as many smokes a day as 48 workers, paving the way for the cigarette’s graduation to ubiquitous consumer good. Despite protests from cigarette rollers and cigarmaker’s unions, machinery – ever the curse of the labourer – won out, and mechanised mass production followed.

In the trenches of World War I, cigarette smoking offered a calming respite from the hail of bombs and bullets. Cigarettes were distributed via field rations to the millions of soldiers fighting on all sides – a premonition of the hold tobacco would continue to have on young generations – and the war became a major milestone in tobacco becoming the world’s most cherished addiction.

This was also around the time when smoking began to take its central role in modern culture, in no small part due to the aggressive and pervasive public relations efforts (with an added dose of scientific denialism) of a tobacco industry approaching the zenith of its power and influence. Even as proof of the harmful effects of tobacco mounted, companies nevertheless advertised cigarettes as safe. On billboards, in radio, magazines, and television ads, brands cultivated an image of smoking as not only harmless, but rebellious and fun-loving as well.

A problem persisted: men smoked at much higher rates than women. To rectify this, campaigns such as “Reach for a Lucky Strike instead of a Sweet” linked smoking to maintaining a slim figure. The American PR pioneer Edward Bernays saw in the burgeoning feminist movement an opportunity where others saw a threat of social upset. He famously hired women to march during the Easter Sunday Parade in 1929 while smoking their “torches of freedom” – linking cigarettes to women’s emancipation at a time when women smoking in public was frowned upon.

Smoking reached its peak in prevalence during the mid-20th century, and a pandemic of diseases like lung cancer, heart disease, and COPD followed. The adverse health effects of smoking now began to come more sharply into focus. In 1962, a UK Royal College of Physicians Report identified smoking as a major health risk, sparking calls for advertising restrictions and public smoking bans. In the US, the 1964 First Surgeon General Report concluded that smoking causes lung cancer, initiating a wave of tobacco regulation. A leaked memo sent from tobacco giant Philip Morris’ president George Weissman to the company’s CEO described the report as a “propaganda blast” and outlined suggestions for how to publicly undermine and deflect the impact of the findings.

Yet other public health milestones continued to follow in subsequent decades, including the 1989 EU resolution calling on members states to ban smoking in public areas. The latter part of the century saw an emphasis on protecting non-smokers from second-hand exposure, and in many countries, regulation broke the tobacco industry’s ability to advertise products freely.

Today, largely as a result of regulatory pushback, the heyday of the cigarette has ended. Although it remains among the biggest worldwide causes of death, conventional smoking is in global decline. The WHO estimates that the number of tobacco users has dropped from 1.38 billion in 2000 to 1.2 billion in 2024. Those hoping for a smoke-free future can see things slowly moving in the right direction.

Of course, the story doesn’t end here – and “smoke-free” may itself be misguided goal considering the tobacco industry’s demonstrated flexibility in reshaping its product portfolio and adapting to regulatory pressure. Cigarettes may be in decline, but nicotine use will remain big business for the foreseeable future, as the tobacco industry transitions from combustion to alternative delivery systems.

“I truly believe the innovation has only just started… in the coming decades, with the help of long-term epidemiological data, I think it will be revealed that next-generation products like vapes are clearly harm reduced compared to combustible tobacco – hopefully creating a pathway for tens of millions more smokers to leave cigarettes behind.”

Hon Lik, inventor of the modern e-cigarette

In recent years, a flurry of novel products has sprung up to plug the gap left behind by declining cigarette sales. Heated tobacco, eCigarettes, and nicotine pouches are among the most sought-after products marketed to new generations of users – often advertised a less harmful alternative to cigarettes.

The message to smokers is clear: Leave cigarettes behind – but not nicotine. Philip Morris’ open support for a “smoke-free world”, on the surface an admirable initiative from a cigarette manufacturer, coincides with significant investment in research into and the marketing of non-combustible nicotine products positioned as reduced-risk alternatives.

New nicotine products are catching on quickly. The global vape market was valued at just $28 billion in 2023 but is projected by Grand View Research to reach $183 billion by 2030. Unchecked growth in alternative nicotine usage, some now worry, could risk renormalising addiction and reversing gains in tobacco control.

Scenarios for 2040

The future, of course, is always in play. In 2025, the Copenhagen Institute for Futures Studies (CIFS) developed four scenarios for nicotine and tobacco use towards 2040. The scenarios were constructed with participation from a range of experts from health advocacy, academia, policy and regulation based in Europe, Latin America, Asia, and the US.

Scenarios such as these highlight the pathways to alternative outcomes while expounding the uncertainties that these pathways hinge on. These include the prevalence (or lack of) tobacco control policies, the strength of global cooperation around prevention and regulation, as well as developments in alternative nicotine product use and smoking rate.

What then, would be the ‘best case’ scenario for 2040, from a public health perspective?

“Most of the participants involved in building the scenarios agreed that the best outcome is one where a global cultural hold of smoking has weakened, where combustible cigarettes are all but eliminated, and in which new generations of young people have grown up without tobacco in their environment or peer circles and thus are less susceptible to marketing of new nicotine products,” says Aron Szpisjak, Director and Head of Health at CIFS and the lead author on the report.

This scenario, which was named “Endgame Generation”, sees a tobacco industry in crisis due to a series of major scandals that have revealed the true extent of their interference in shaping health policy and reversing generational bans. Add to their troubles the 2037 release of Quitavax, a speculative breakthrough pharmaceutical treatment for nicotine addiction that helps boost cessation efforts.

“Even in a positive scenario like this, it would take a lot of factors converging in order for nicotine use to be anywhere close to disappearing globally by 2040,” explains Aron Szpisjak. “One reason is the adaptability of the tobacco industry that we’ve seen time and time again throughout history. As regulations in high income countries tighten, it’s likely that the industry shifts its focus to other markets with more lax regulation – and to developing new products that are being marketed as less harmful alternatives,” he explains.

What about the seemingly very human attachment to the calming and mind-altering effects of nicotine – won’t this also remain a factor in the continued prevalence of nicotine and tobacco products, smoke-free or otherwise?

“Definitely. But I think that the history of nicotine and tobacco consumption, particularly the industry’s adversarial relationship to medical science coupled with aggressive marketing strategies should be a lesson to us, today and in the future. With these new nicotine products, the problem is that their health effects, including the use of different products in combination, are underexplored – yet the industry still tries to promote them as harm free.”

Lifestyle-oriented promotion campaigns, influencer marketing, and creative use of regulatory loopholes – as with nicotine pouches not being included in EU regulation on tobacco products – show signs of an industry that is adept at shifting gears and changing tactics. New products, eventually more sophisticated biotechnological delivery systems, will surely emerge. Often, Szpisjak points out, new products do not replace cigarettes among users, but are used concurrently, creating poorly understood and potentially dangerous chemical cocktail effects.

To contrast the “Endgame Generation” scenario in which the era of mass nicotine consumption is coming to an end, Szpisjak and his team also explored outcomes that saw further entrenchment of the tobacco industry and nicotine habits. Regulation in the past was slow to catch up to the industrial scaling and mass marketing of the tobacco industry, so who’s to say in they won’t win out again in the future? The “Ashtray Planet” scenario represents a world in which tobacco and nicotine use remains widespread across much of the world, continues to carry cultural weight, and finds fertile ground in new generations of nicotine users as public concerns shift elsewhere.

“Progress is not a straight line,” says Aron Szpisjak. “Although the last few decades have been characterised by stronger regulation in many countries, there have been major recent setbacks as well. 2025 saw the US officially leaving WHO, for instance. It’s not unthinkable that governments in other countries may begin retreating from public health leadership as well, some perhaps even actively rol ling back past tobacco control measures, repealing smoke-free laws and deregulating advertisement in the pursuit of economic gains.” Szpisjak adds that the surge in adoption of new nicotine products worldwide, especially among young generations, makes the scenario equally plausible.

“In the Ashtray Planet scenario, we’re seeing some fundamental disruptions take place. Once-promising international cooperation around tobacco control erodes, and global agreements like the WHO Framework Convention on Tobacco Control lose their enforceability,” Szpisjak explains. “We explored why and how such a situation might arise. One factor that would make it plausible is a shift in public concern to more immediate crises, which could include economic instability, authoritarian politics, worsening environmental disasters, and mounting inequality. In a world that is perceived as more chaotic, with more fires to put out, we could see political or social energy for sustained tobacco control efforts dwindle.”

Szpisjak’s scenarios emphasise how the interplay between policy decisions, public engagement, industry tactics, and health system responsiveness shapes the future. Rather than offering predictions, they force a shift in perspective by looking back from the future, asking “how did we get here?” Their implications, in a very concrete sense, can be measured in the most brutal metric there is: human lives.

“Chronic respiratory diseases kill millions of people each year, and they place an immense strain on health systems worldwide”, says Szpisjak. “This is not a minor concern. The difference between the more optimistic and the more bleak scenarios is hundreds of millions of lives lost or saved towards 2040. Neither of the scenarios are passive outcomes, and the more positive ones require targeted and sustained action. Without that, the Ashtray Planet may be where we end up.”

The Copenhagen Institute for Futures Studies published the scenarios discussed in this article, along with two others, in the report “The Future of Chronic Respiratory Diseases (CRDs) and Nicotine Consumption”. The report can be read and downloaded at cifs.dk.

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