Tobacco harm reduction is good public health practice. E-cigarette, heated tobacco or snus eliminating combustion are considered harm reduction tools, even if bad information often undermines the efforts made so far to replace "traditional" cigarettes with innovative and technological products with a lower impact on our health. This is what emerged from the VIII edition of the Global Forum on Nicotine, the annual forum on nicotine.
Every day in the world 1,1 billion smokers they light a cigarette. A more or less constant figure for about 20 years despite the effort of national and international health institutions to reduce the number of new and old consumers. Many believe that the harmfulness of smoking is related to nicotine, actually this substance has a fairly low risk but is addictive. While combustion is what damages our body: thousands of toxic substances released when tobacco burns. For several years, scientists, doctors, non-profit institutions have been fighting for a harm reduction approach, those who cannot stop nicotine addiction can reduce the risks with electronic cigarettes or heated tobacco products.
According to the experts who attended theVIII edition of the Global Forum on nicotine (Gfn), underway in Liverpool, this approach is opposed on all levels. The problem for the experts is that the alternatives for harm reduction "work", and there are many studies in favour, but "institutions, politics and a certain number of scientists aim to discredit the harm reduction approach by smoke with attacks that discredit those who hold a different opinion,” he stressed Konstantinos Farsalinos, University of Patras and School of Public Health of University West Attica in Greece.
While the director of GFN, Gerry Stimson, professor emeritus from Imperial College Londrapur, highlighted that despite having now reached 98 million habitual smokers, the debate on the role of these alternative products in reducing the risks deriving from tobacco remains deeply divided. “In England, health authorities support e-smoking for smoking cessation and e-cigarettes are now the most popular aid to quit. In Japan, cigarette sales have dropped by a third since heated tobacco products arrived. Now the challenge is the accessibility to these products also for those who live in low-income countries”.
In his speech, even more firm the Mexican physicist Roberto Sussman, National University of Mexico: “in physics we are trained to disrupt current knowledge. Physics always advances by interruption. In the science of tobacco and nicotine, politics has taken over and science is in the background”.
Several organizations founded by Bloomberg Philanthropies have never presented scientific evidence on the harmfulness of alternative products, but try to insinuate doubts. Second Clive Bates, Director Counterfactual Consulting, “Everyone is conflicted in some way. Everyone who works in this field has had their own beliefs in the past.”
On the other hand, Brad Radu, professor of Medicine and expert on tobacco harm reduction policies at the University of Louisville (Kentucky), brought to the attention of the session the analysis of the disparity of economic resources invested in the USA by public bodies on the subject and those invested on safety of e-cigarettes and Ends, Electronic Nicotine Delivery Systems. In the face of this disparity in 2020 there was an explosion of research on the latter topic. The mission and funding strength of the National Institutes of Health that has focused on a tobacco-free society is influencing researchers to highlight the worst interpretations of all tobacco products in their studies.
An approach that still today clashes with an opposition of principle in spite of the many scientific evidences in support of the new nicotine inhalation tools, despite successful experiences such as the USA and the United Kingdom. And it's Christopher Snowdon (Institute of Economic Affairs, United Kingdom) author of the study "The Impact of Cop9 on vapers", to point the finger at theWorld Health Organization: “despite the numerous researches showing that vaping is 95% less harmful than conventional smoking and that vaping is not a gateway to cigarette consumption, WHO has progressively hardened its position, pushing for outright ban or extremely stringent regulation of these products”, a position which according to Snowdon represents “a threat to public health”.
"It is worrying that international tobacco control policy makers persist in pursuing a prohibitionist and irresponsible approach to tobacco and nicotine, while WHO actively perpetuates misinformation about new nicotine products," Stimson said. -. You are not doing public health a good service with a war on nicotine, it is as doomed as the war on drugs. WHO must review its efforts to help, by all means available, to do quit smoking that billion adults who still can't"
In Japan, cigarette sales have dropped by a third thanks to the introduction of heated tobacco products. Now the challenge is to make these products accessible also to those who live in low-income countries. If the experience of the United Kingdom represents a positive case for the supporters of the “vaping”, the same cannot be said for all countries. As for India, where e-cigarettes and heated tobacco products have recently been banned, even praised by the WHO, despite a huge diffusion of cigarettes among the Indian population.
Jagannath Sarangapani, a member of the Association of Vapers India (AVI), recalled that deaths in India from smoking are about 1 million a year. “But the cigarette market is flourishing and protected: the legislation on cigarettes hasn't undergone interventions for some time, taxation hasn't been touched for 3 years. Yet, the WHO has rewarded the Indian Ministry of Health for banning e-cigarettes and heated tobacco products, whose consumers represent just 0.02% of the market. The truth is that nothing effective has been done in India to solve the smoking problem and focusing only on that 0.02% of the market represented by innovative products, which are tools of harm reduction, does not make any sense. A paradox made even worse by the legislation on research: "On the one hand, the authorities complain about the lack of studies, on the other, the Indian regulation prohibits government bodies from carrying out studies on harm reduction tools".
“Although there are numerous researches that demonstrate how the vaping is 95% safer than traditional smoking, and that e-cigarettes do not encourage tobacco consumption, the opposition of the World Health Organization has consolidated even more over time, pushing for an outright ban or extremely stringent regulation of these products. , wrote Sarangapani, adding that in this way the WHO influences the policies of individual countries, spreading "negative judgments on vaping that do not correspond to scientific evidence".
“Assertions – continued Snowdon – which are also taken up by authorities such as the European Commission, which in preparing the new directive on tobacco products (which serves as a model for the regulation of many foreign countries) cited the declarations of the WHO. The FCTC secretariat's relentless opposition to vaping and other less harmful nicotine products is becoming a threat to the global health: in the absence of positive signals from the World Health Organization, the next conference of the parties of the FCTC secretariat scheduled for next November poses important risks not only for vaping, but also for public health ", reiterated the British journalist and writer. Governments that recognize the importance of vaping's contribution to tackling the harm caused by tobacco consumption they should take the opportunity of the conference to restate their point of view again and "stop their funding of the FCTC secretariat, if WHO continues to spread misinformation about e-cigarettes".
“Science is moving forward, but on the subject of "vaping" and the harm of smoking it is taking steps backwards due to negative influences coming not only from policy, but also from internal currents: in particular, on electronic cigarettes we have taken steps backwards in terms of research, less awareness of people even now that we have a much more in-depth knowledge of the subject and above all in terms of regulation. Thus Chris Snowdon underlining the need to carry out information campaigns capable of correcting this "growing ignorance on the social and political fronts, which is leading to increasingly restrictive policies".
