From Smoke to Smokeless: The globe discusses harm reduction

Last month’s Global Forum on Nicotine in Warsaw unearthed a wealth of new findings and experiences that will have policymakers around the world revisiting their approach to tobacco control and modern tobacco and nicotine-based harm reduction products. Some of the key observations shared by tobacco control specialists is how excessive regulation has driven people underground and fuelled the growth of substantial illicit drugs.

Leading this argument was Australian Tobacco Harm Reduction Association Founding Chairman Colin Mendelsohn, a country with some of the most stringent tobacco control laws, and where harm reduction products like nicotine vaping products are restricted under their current regulatory framework.

”While well intended, highly restrictive regulations just don’t work. History has shown that harsh restrictions on a popular product simply send it underground. People find other ways of getting it. Australia now has one of the highest youth vaping rates in the Western world. Politicians have a responsibility to understand the effect the policies they are pushing are likely to have in the real world. When policy fails, the costs – monetary or otherwise – can be significant,” Mendelsohn said.

He revealed that more than 90% of Australia’s vapers use the black market that is controlled by organised crime groups that have led to turf wars, in what is now the second biggest illicit drug market in the country.

The three-day forum saw the convergence of professionals from the tobacco, nicotine, health and related industries, plus, lobby groups and served as an ideal platform for the sharing of the latest discoveries and trends on nicotine and tobacco harm reduction products.

Addressing the gathering was National Institute of Medicine in Warsaw Prof. Andrzej Fal, who noted lawmakers must look more carefully at what is happening around them on the ground and be more flexible, plus, better understand the concept and offering of harm reduction products. Fal pointed out that governments hardly question harm reduction in hard drugs, and therefore why should anyone be opposed to harm reduction in tobacco and nicotine.

“I do not remember in the history of homo sapiens, any culture that wasn’t smoking things and drinking [alcohol]. I’m not quite sure that we can stop doing that, so that’s why harm reduction is the word that will go with us forever. Excise taxes can help control smoking, but as well as high prices for cigarettes, there needs to be much lower prices for several alternatives that are proven to have lower harms,” he said.

One of the primary concerns surrounding tobacco control is its top-down approach, which was discussed during the forum. Very little action is based on real research and findings on the ground, and are often driven by theory and other interests. Tobacco control policy needs to sit alongside public health policy and social security but be balanced so that it doesn’t undermine its very purpose for existence. It was noted that most health professionals do not understand the context and purpose of reduced harm products, and pointed out that effective education on such products would be in comparison cheaper than treatment of cancer.

With regards to products such as vape, it was revealed that some governments have chosen to simply ban them rather than regulate, and this has simply opened the door to counterfeit and illicit products that potentially proffer more harm than good. Pointing to the ‘Prohibition’ example of the 1930s US, some speakers remarked bans on products such as vape could for example mean we would not know what kind of ingredients will go into counterfeit products of tomorrow.

“The right path is the introduction of technical regulations and control. The risk of bans is that a law is passed, but the products continue to be sold but without any control. We must expand our vision. While being prudent, we must not hide behind the bans.”

British American Tobacco’s Head of Scientific Regulation, Summer Hanna, told the Global Nicotine Forum “the regulatory landscape is evolving, and we believe that an increasing number of countries will look to progressive policies and regulations that advance tobacco harm reduction by recognising the importance of smokeless products. The NHS adds that whilst Vaping is not completely harmless, it is supported for adults to quit smoking. The science behind the research has been compelling.

Addressing the gathering Global Action to End Smoking CEO Cliff Douglas said it was the responsibility of all groups to listen to people and offer other alternatives to people who cannot or don’t want to stop smoking. 

“One of the most common misconceptions is that we have ‘solved’ this epidemic. We must recognise and build upon the reality that well over a hundred million people across the globe have already made the decision to use vaping and other non-combusted nicotine products in their dedicated personal efforts to reduce harm from smoking,” Douglas stated.

BAT’s Global Head of Policy, Flora Okereke said that the journey of transformation has begun, and over the next 15 years many smokers may consider migrating to reduced risk products based on science. 

Participants at the forum stressed on the need to deploy effective regulation as opposed to bans, to educate consumers and health practitioners on reduced harm products, combat the growth of dangerous counterfeit products and illicit markets, and stop the rampant growth of illegal activities surrounding illicit tobacco and nicotine-based products.