Working with consumers to end tobacco’s death toll
With many global challenges, the solutions are a troubling combination of uncertain, disruptive, expensive, and lengthy. But sometimes we have the good fortune to be able to rapidly deal with problems, such as those that can be addressed through measures such as sanitation and vaccination. Add tobacco’s toll to that list.
We have encountered similar issues with contaminated drinking water, unsanitary food, and cooking and heating with open fires; situations where we can empower people to have far healthier lives through interventions that reflect science and available technologies.
But ironically these corporate interests are assisted in perpetuating the lethal status quo by national and global health bodies that seek to limit or prohibit any product substitution. Their actions are as misconstrued as, say, environmental groups opposing replacements for fossil fuels. Such abstinence-only approaches repeat a longstanding pattern of seeking to use the power of the state to impose one’s moral views on the behaviour of others.
But in this case, the groups pushing an abstinence-only agenda on alternatives to lethal nicotine products are redirecting time and money that could be driving down the use of toxic products. It is like attacking sanitary food while leaving widescale availability of contaminated alternatives. Their abstinence-only agenda only applies to the far safer alternatives.
Countries including India have banned low-risk products, like vaping, etc. that heat rather than burn tobacco. Worse, the World Health Organisation, which used to be at the forefront of efforts to reduce smoking, gave an award to India for a policy that protects the cigarette business. How could they have gone so far wrong? Why would the WHO actively oppose far safer products for such an enormous number of people?
This is done while ignoring the tremendous success of product substitution as a key part of a rational strategy to reduce tobacco’s toll. A strategy that has given Sweden by far the lowest smoking rates and tobacco-caused disease rates in the European Union, that allowed Norway to cut smoking in half in just a decade and that has played the key role in Japan reducing cigarette sales by a remarkable 40% in just last five years. Countries attacking product substitution have failed to come anywhere close to reducing smoking.
Japan merely allowed into their market products that heat tobacco without creating the toxic stew that comes from burning it. Sweden and Norway used a very low-risk oral product. This raises the key question of just how rapidly a country could drive down the use of lethal tobacco products. Policies meant to discourage smoking can be joined by ones that facilitated change by making many more low-risk alternatives available, used risk-proportionate regulation of all tobacco/nicotine products, and communicated honestly with consumers about relative risks.
