The largest tobacco harm reduction summit (this year held online) has concluded from Athens in Greece. The 3rd Scientific Summit on Tobacco Harm Reduction: Novel products, Research & Policy, tackled everything tobacco harm reduction related with the participation of numerous scientists and experts from around the world.
Professor Panos Vardas, Chairman of the Heart Sector of the Hygeia Hospitals Group, chaired a session entitled, “Public Health Policy & Regulation and what is expected in the future?”
While Professor Karl Fagerstrom emphasised the role of nicotine in harm reduction.“Nicotine/Tobacco is an ideal area for harm reduction,” he said. “Since it is used largely because of nicotine and pure nicotine, and even unburned tobacco, it is much less of a problem than its health consequences.”
Policy makers should take note of countries which have successfully implemented THR strategies
The Professor went on to give examples from countries successfully practicing THR with different kind of products, such as snus in the case of Sweden and Norway, and e-cigarettes in the UK. “Today e-cigarettes are still the most used aid to quitting, as it is an easier, more gradual approach characterised by high similarity to cigarette smoking.” he said.
“When smokers want to quit cigarette smoking, they decide which approach they will use considering both the similarity to cigarettes and its harmfulness.”
Dr. Michael Toumbis presented the recent tobacco control data and tobacco control progress, pointing out that although WHO FTTC (Framework Convention on Tobacco Control) provides a comprehensive strategy for parties to combat the tobacco epidemic, unfortunately it fails in embracing THR except in the case of NRT use, which data has shown are less effective fir smoking cessation than the safer alternatives mentioned above.
Sadly, he continued, the current rate of progress in tobacco control is not fast enough and therefore all effective ways to accelerate smoking should be endorsed. “Harm reduction approach can complement proven current tobacco control efforts of prevention and cessation,” Dr. Toumbis said. “The opportunity depends on finding the appropriate balance between product safety, customer appeal and regulations targeted specifically to decrease the use of conventional, combusted tobacco products.”
Regulations should be relative to harm
Dr. Toumbis added that tobacco control strategies should adopt the concept of harm reduction in developing coordinated regulations, policies, and interventions to encourage smokers to switch to proven safer alternatives, and regulations should be relative to harm.
“Harm reduction is an evidence-based approach to tobacco control, which, along with other proven tobacco control interventions, can simultaneously prevent youth from starting to smoke and help current smokers stop, saving many lives more quickly than would otherwise be possible.”
Renowned harm reduction expert Mr. Clive Bates, pointed out that “Public health risk communication is key for tobacco control policies and programs, since perceptions of the targeted population can largely affect their results and efficacy.”
Most people still believe that the nicotine in cigarettes is what causes cancer
“A recent UK survey”, he explained, “showed that only 12.5% of participants believed that some smokeless tobacco products, such as chewing tobacco and snuff, are less harmful than tobacco smoking and only 3.6% believed that electronic cigarettes are much less harmful compared to smoking cigarettes.”
He added that a shocking 56.5% of the participants believed that it is the nicotine in cigarettes that causes most of the cancer caused by smoking. To this effect he continued, public health risk communication should be based on the consumer’s perspective and not the corporate one, and warnings should be based on the magnitude of risk to facilitate clarity.
“New harm reduction products should de-normalise smoking and not normalise it,” he pointed out. “Unfortunately, in the name of uncertainty, we are over-regulating these products.”
Sadly, NRT isn’t used as a THR tool, products are often hidden to the smokers who don’t plan on quitting, nicotine in them is still often misrepresented as the cause of diseases from smoking, and products are made unattractive by design and by marketing.
A product/practice is harm reduction if it is used instead of the risky one from the start, you can get a disease the first time or get pregnant, don’t have to get an STD to use condoms… and you can get hepatitis with the first shared needle…
And in the case of nicotine, itself not a serious issue, there are only unfounded barriers to use it to avoid smoking from the start.