Public health authorities advised to provide guidance and not rules on harm reduction
According to the United States of America National Library of Medicine, harm reduction refers to policies, programs and practices that aim to minimize negative health and social impacts associated with a product use, and is usually cost effective, evidence based and has a positive impact on individual and community health.
However, when it comes to harm reduction on tobacco, some quarters are still skeptical about embracing it, despite smoking killing more than eight million people globally per year, as outlined by the World Health Organisation (WHO).
Tobacco control activists continue to accuse tobacco companies of manipulating debates over harm reduction for policy advantage, but industry players still argue that smoke-free products are the solution for millions of people who are addicted to smoking because they are safer than cigarettes.
During a recent webinar on the ‘Framework Convention on Tobacco Control, Challenges and Prospects for the World Health Organisation (WHO)’, recently moderated by Formiche Editor Giorgio Rutelli, public health experts indicated that the rigidity by WHO and activists to accept harm reduction is making the public lose trust in authorities, because science has already proven that smoke-free products are much safer than smoking combustible cigarettes.
David Sweanor, Professor and President of the Advisory Board for The Centre of Health Law, Policy and Ethics at the University of Ottawa in Canada hinted that discussions against harm reduction from poorly informed people who are driven by ideologies stemming from political and religious beliefs rather than public health principles that are science based, is a real threat to a smoke-free future.
Professor Sweanor says because of this, public health authorities such as the WHO need to pay attention to maintaining credibility by giving objective guidance on the principles of harm reduction for the sake of people’s health, and not giving rules on what not to do, as the public will stop listening to them because people now know that harm reduction works.
He says, “by coming with rules against tobacco and harm reduction when people already know that harm reduction works as science has proved it, we are going to cause more disease by preventing smokers from embracing smoke-free products.”
Professor Sweanor was among the first people to work full time in policy measures to reduce the harms from cigarette smoking over 40 years ago and said that the development of the Framework Convection on Tobacco Control did not have adequate consultations from stakeholders, resulting in the document having rules for the majority but not informed by science.
“When the WHO seeks to defend the outcome of discussions from poorly informed people who were meeting behind closed doors without involving experts to add their voice on the practicalities that govern public health, the world risks having more deaths from tobacco. That is what happens when something that acts as guidance becomes a set of rules, with authorities refusing to listen to any critics,” He said.
He said that he was among the international experts who wrote a letter to the WHO pointing out the problems the world is facing because of the opposition to harm reduction.
“We wrote to them outlining the challenges we see when they stop accepting harm reduction, and they ignored us. They will not talk to us. You know, that is the problem. And that’s what happens when something that should act as guidance such as the framework convention on tobacco control becomes instructional, treated like religious or political law, without anyone allowed to question it,” Professor Sweanor added.
Professor Sweanor said that this scenario brings into disrepute the principles of public health, because the public will stop paying attention to bodies such as WHO or domestic health organisations as they are saying things that people know to be untrue.
He explains that this is why there is need to pay attention to maintaining credibility in public health so that people, especially those addicted to tobacco are assisted, instead of their health being compromised due to continued smoking.
He emphasizes, “The countries that have had declines in tobacco related deaths are those that are ignoring the WHO’s advice against harm reduction. Countries such as Sweden, Norway, Iceland, Japan and others have allowed substitutes to replace cigarettes with smoke-free products”.
Professor Sweanor added, “The smoking problem can be eliminated globally by substituting tobacco with low-risk products. The opportunity is there and things like the framework convention on tobacco control should be facilitating that instead of standing in the way.”
And adding his voice to the discussion, Professor David Polosa of Internal Medicine at the University of Catania and Founder of CoHEAR Research Centre for Harm Reduction from Smoking said it is unfortunate that despite now having a solution to the challenges associated with smoking, the world is still blindfolded to the truth.
“There is now plenty of evidence that shows that these devices like heated tobacco products are at least 80 to 90 percent less toxic compared to combustion tobacco,” He said adding, “This challenge is not an individual country issue, but demands immediate collective action.”
He is however worried that this collective action seems to recruit people from different sides of the debate, and more on one side than the other, which is against harm reduction.
Professor Polosa said through experience, science is producing excellent results that prove that smoke-free products work and it is now up to the authorities at an international level and in respective countries to accept them.
He admitted that there is indeed still some level of risk to some smoke-free products that needs to be investigated, but that the benefits far outweigh the concerns.
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