Dialogue still needed for meaningful embracing of harm reduction

Despite the tobacco control movement’s firm stance and relentless efforts against tobacco while citing the product’s negative effects on public health, the need for a more balanced and collaborative approach has been identified to be key towards having meaningful solutions that favour the same public health.

Some stakeholders believe the anti-tobacco industry sentiments have only managed to suppress meaningful engagements, resulting in the globe not being able to leverage on the tobacco harm reduction research to develop safer alternatives to combustible tobacco.

During the Global Nicotine Forum, GFN 2024 held in Warsaw, Poland, Analyst Vivien Azer indicated that harm reduction is good not only for consumers but also for other shareholders.

She says there have been significant changes for global tobacco companies as a result of harm reduction efforts, reflecting an understanding that consumers want to shift to reduced-risk products.

Analyst Vivien Azer

She explains, “The harm reduction ambition that Philip Morris International (PMI) for instance has laid out is that it is not just good for consumers, it is not just good for public health, but it is also very good for shareholders that they are migrating their portfolio away from combustible cigarettes. Their ambition for 2030 is for two-thirds of their revenue to come from non-combustible products.”

Azer points out that in China, major public companies account for the vast majority of the total nicotine marketplace and are in a position to drive change in consumer behavior, and are already controlling two-thirds of that market, with PMI being the leader with over 28 percent share and British American Tobacco BAT coming second.

Tobacco and nicotine sector consultant Jonathan Fell says the transformation of the tobacco industry to harm reduction strategies has the potential to bring tremendous public health benefits and yet is often viewed with suspicion by public health and tobacco control communities.

“Maybe this is because it is market-driven and not a top-down health initiative of the sort that they may be more used to supporting. Perhaps if you substitute market-driven for consumer-driven to make the point that these are educated, empowered individuals making the choices that best suit them, it becomes a more palatable concept,” Mr. Fell adds.

Mr. Fell says public health and tobacco control communities did a fantastic job of demonising harm reduction forgetting that it is not just about somebody selling a product but also about people buying the same products.

He says consumers need to make choices about what they want, but putting the tobacco industry out of business has become the major goal for a lot of people rather than addressing the individual needs and desires of the public.

This is done without regard for the millions of people who are addicted to tobacco and cannot quit, hence needing safer alternatives offered through harm reduction techniques that have been proven by science.

Veteran anti-smoking advocate David Sweanor advises, “Good policy is contagious. Consumers will be ahead of consumers in most markets and in all these places, it will be people like law enforcement who argue that they have better things to do than go and find out if people are using a product that is less hazardous than cigarettes.

The harm reduction strategies that are being promoted especially for populations that cannot quit tobacco smoking because they are addicted have actually been proven to be safe by several studies that have been conducted by scientists for years now.

PMI Vice President of Global Scientific Engagement Gizelle Baker says science is not based on trust but that it is about having an audience that will interrogate the data and come to their conclusions because information is shared.

PMI Vice President of Global Scientific Engagement Gizelle Baker

She says, “Where there should be absolutely no trust or maybe even mistrust is when the data is not shared, when methods used to collect the data are not available and it does not matter what industry or lack of industry you come from. If you don’t make methods and your data available so that they can be interrogated, that’s where misinformation comes from.”

Experts in the field of tobacco harm reduction believe there is a great story to tell because there is real evidence that safer alternatives work to reduce the cancers associated with combustible tobacco.

Sweden has been cited as a good example in this area where safer alternatives have reduced the risk of cancers, with New Zealand and Australia following suit.

Former Director of Action on Smoking and Health UK and Director of Counterfactual Consulting Clive Bates is concerned that medical societies, professional bodies and activist groups are creating a cultural environment that is hostile to tobacco harm reduction, and the science to some extent is reflecting that environment with norms being established in that direction.

He however says that evidence from smokers who have switched to safer alternatives already points to the fact that harm reduction is already helping people, especially those who are addicted to combustible tobacco.

A concerted effort is however needed among all stakeholders including the tobacco control communities, as evidence from science has been widely shared.

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