CASAA’s Fall: A Stark Reminder of What Happens When Harm Reduction Can’t Afford to Speak

As CASAA closes, the world confronts a hard truth: harm reduction advocacy is vital—but dangerously underfunded, misunderstood, and vulnerable.

Consumerfacing advocacy has always been the engine driving tobacco harmreduction (THR) forward. Now that engine is losing one of its most influential components, the Consumer Advocates for SmokeFree Alternatives Association (CASAA). For 15 years the preeminent U.S. grassroots organization has been defending access to lowerrisk nicotine products. But sadly, as of August 2025, it will cease all legislative activity because of insufficient funding. And while the group’s website will remain online as an educational archive, its realtime mobilization of 250,000 registered members will end.

CASAA’s closure is more than a U.S. story, it underscores a worldwide reality. When consumer advocacy relies on shoestring budgets and sporadic industry grants, it becomes fragile precisely when it is most needed. Across the globe, regulatory battles over vapes, heatedtobacco products and nicotine pouches are intensifying, and opponents of harm reduction often wield the claim that support from the nicotine industry discredits any consumer voice. CASAA’s experience demonstrates how that stigma can translate into dwindling donations and, ultimately, silence.

Since its founding in 2009, CASAA produced legislative alerts, filed court briefs, spoke at publichealth conferences and provided statebystate tracking tools—accomplishments delivered largely by volunteer labour. It postponed flavour bans, delayed Food and Drug Administration (FDA) rules and ensured consumers testified at hearings where only industry and publichealth groups had previously held the floor. Such achievements prove that organised users of safer products can recalibrate policy debates otherwise dominated by abstinenceonly narratives.

Why sustainable funding matters
The organisation survived on roughly US $2,000 a month from small donors—far short of the US $10,000 needed for basic operations, such as billtracking software and member communications. Larger contributions came from independent vape businesses and, later, from tobacco companies that market reducedrisk products. When policy clashes emerged—most recently over “PMTA registry” bills that would wipe out nonFDAauthorised vaping products—those corporate donors withdrew support, unwilling to bankroll an organisation opposing their commercial interests. CASAA chose mission over money, but the financial fallout proved fatal.

Sadly, this situation isn’t unique to this one group. A 2023 global audit had indicated that this instability is the norm for such organizations, not the exception. The Global State of Tobacco Harm Reduction (GSTHR) project surveyed 52 active consumer organisations worldwide and discovered that 31 received no funding at all. Combined annual income for the remaining 21 groups amounted to just US $310,000—a sum Bloomberg Philanthropies spends in a single day of its US $160 million antivaping campaign.

Most advocacy work within such organizations is done by volunteers: only seven groups reported any paid staff, employing a total of 13 people across five continents. These lean operations survive mainly through passion, not payroll, and many affiliate under regional umbrellas such as ETHRA (Europe), CAPHRA (AsiaPacific), CASA (Africa) and ARDT Iberoamérica (Latin America).

In the Philippines, where smoking causes an estimated 117,000 deaths each year, the consumer advocacy group Vapers PH faced similar financial struggles while supporting the Vaporized Nicotine Products Act. Opponents accused the group of being influenced by “Big Tobacco,” which discouraged donors and led to a drop in funding. In France, Sovape relied heavily on crowdfunding after pharmaceuticalfunded NGOs lobbied against any ties to vape companies. As a result the group announced their dissolution in October 2024. The pattern is clear: consumer organisations that fight for access to scientifically proven safer products walk a funding tightrope, vilified if they accept industry money, starved if they do not.

The importance of consumer advocacy
Yet the existance of such groups is crucial. Realworld experience is a form of data policymakers cannot obtain from clinical trials alone. In the United Kingdom, testimony from exsmokers swayed Parliament to back the “SwaptoStop” kit distribution programme, contributing to a record decline in smoking prevalence to 12.9 % in 2022. In Japan, consumer demand for heatedtobacco products hastened a 43 % drop in cigarette sales between 2015 and 2022, the steepest fall on record. And in Sweden—now under 6 % daily smoking—public acceptance of nicotine pouches cemented political will to keep flavours legal. Each of these success stories was amplified by organised user voices.

CASAA’s board insists the decision is a tactical retreat, not surrender, noting that millions of U.S. adults now use vaping or oralnicotine products. Those consumers still possess tremendous political potential if their stories reach lawmakers. But without a coordinating hub, statelevel proposals to tax, flavourban or outright prohibit safer products will face weaker pushback.

Rebuilding a global THR advocacy network
Internationally, the lesson is stark: THR movements must diversify funding, cultivate donor bases beyond industry, and build crossborder alliances to share resources when one node falters. Digital platforms can preserve institutional memory, yet realtime advocacy still requires paid staff and modern infrastructure.

CASAA’s sunset should galvanise, not demoralise, the harmreduction community. Policymakers are increasingly confronted by evidence that adult smokers quit more successfully with regulated alternatives—daily vaping raises cessation odds eightfold, according to a 2021 peerreviewed study. Ensuring these alternatives remain available demands a resilient advocacy ecosystem. If CASAA’s fall reminds the world that consumer organisations are indispensable yet perishable, its legacy will continue steering the global conversation toward pragmatic, lifesaving policy.