Combustible tobacco among most harmful products, says scientist

Combustible tobacco products are harmful not only for smokers but also because their smoke has prejudicial effects on non-smokers, says Professor David Nutt, an English scientist specializing in the research of drugs.

Professor David Nutt

The observation was made during the Global State of Tobacco Harm Reduction (GSTHR) — Burning Issues virtual conference — on Wednesday last week in his presentation entitled ‘Estimating the harms of nicotine products in the 21st century’.

Nutt, neuro-psychopharmacologist specializing in the research of drugs that affect the brain and conditions such as addiction, anxiety and sleep argues that that smokers, that don’t quit, should be encouraged to use other innovative sources of tobacco that reduce harm on people’s health.

He disclosed that from the 14 range of nicotine products that were surveyed in 2014, it was found out that half – the combustible ones – of it affects non-smokers.

Nutt added that smoking has scored highly on the mortality rate (at over 8 million deaths a year) through lung cancer.

He said overall, if people can use other non-combustible sources of nicotine such as e-cigarettes or heated tobacco products, population harm can be much lower.

The professor took cognizance that e-cigarettes (vaping) is the answer for the next generation and hope that the World Health Organisation (WHO) can step forward and support this innovation.

Recently, the United States Food and Drug Administration (FDA) has after substantial scientific assessment found that a new smokeless tobacco invention, the ‘IQOS’,  manufactured by Phillip Morris International (PMI), to reduce exposure to harmful compounds, because this product also delivers nicotine in a non-combustible way.

All science done on the PMI innovation show that switching completely from conventional cigarettes to IQOS system significantly reduces the body’s exposure to harmful chemicals that are found in cigarette smoke.

The IQOS system heats up tobacco but does not burn it and according to the FDA recent decision this significantly reduces the production of harmful and potentially harmful chemicals – consequently a former smoker who switches is also inhaling a reduced amount of toxicants

Nutt is chairman of Drug Science, a non-profit organisation which he founded in 2010 to promote independent, evidence-based information on drugs and until 2009, he was professor at University of Bristol, heading its psychopharmacologist unit.

Australia’s Member of Parliament, Fiona Patten brought the topic — ‘Who should politicians listen to when developing policy?’, saying scientists should be listened to on harm reduction options that should discourage people from combustible smoking by using tobacco harm reduction (THR) products.

COVID-19 has shown us how fickle politicians can be about evidence, science and medical advice.

“When we are developing policy on tobacco we ask, how can we reduce harm? When we are developing policy on alternative nicotine products we ask, is it safe? We are failing to change the question to ask how we can reduce harm,” she said.

“There has been some progress made at WHO, but not recognizing harm reduction is nothing short of deceptive” she also stated when asked to comment on the WHO refusing the harm reduction concept.

In his presentation, Chimwemwe Ngoma, director of Tobacco Hard Reduction (Malawi) said low and middle income countries (LMICs) are not sufficiently resourced to implement and adopt THR and “the situation  is further complicated in countries where the economy is reliant on income from tobacco cultivation.

“The challenges affecting THR in LMICs are that government policies and regulations are being unduly influenced by flawed science and anti-harm reduction lobbying.

“Flawed public health information in many countries is confusing and misleading people who want to switch away from smoking.

“In most low and middle income countries, THR products are either banned completely, heavily taxed or there are no specific laws that govern them,” Ngoma said.

He added that there is lack of knowledge and limited access to THR in most LMICs and that these less harmful products are very expensive compared to the easily accessible combustible cigarettes.

“Though some smokers wish to quit, they are unable to do so because they are so addicted to the nicotine and relapse rates are staggeringly high.”

Referring to ministry of health he said that  “preventing access to these THR products through bad policy denies people from their right to good health” adding that “policy should encompass issues to do with access to credible information, science and making THR products accessible.”

Touching on ‘The Framework Convention on Tobacco Control (FCTC) — accountability, policy and regulation, Marina Foltea, — founder and Managing Director at Trade Pacts, a consultancy based in Geneva advising global companies and governmental institutions on international trade agreements and economic organisations, as well as public policy — said guidelines should not encroach on people’s rights but rather to help them to make right choices on THR.

Martin Cullip, adviser to the Freedom Association’s “Freedom to Vape” campaign agreed on this, saying there was great need to involve the consumer in the whole process of formulating and determining policies.

“There exists a massive imbalance of a small number of well-funded groups that exercise power (WHO, EU, national governments) and 98 million safer nicotine product users around the world that are negatively affected” he said.

All the speakers at the launch of “Burning Issues: The Global State of Tobacco Harm Reduction (GSTHR) 2020”, the latest in a landmark report series from UK-based public health agency Knowledge Action Change (KAC), were in favour of tobacco harm reduction, taking cognizance that there are over a billion smokers in the world and the figure is not likely to drastically drop soon and the best solution is to offer the innovative scientific THR options.

According to WHO records, over 8 million people die from smoking-related diseases such as lung cancer and the unfortunate part of this public health crisis is that it also affects non-smokers.

Thus the encouragement on the use of THR products as campaign for good global health practices.

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