Ammon – Making decisions regarding the formulation and approval of radical initiatives and an effective strategic framework to reduce smoking and control its negative effects in the long term is an important and pivotal requirement for public health. This is exactly what the COP10 Conference of the Parties to the WHO Framework Convention on Tobacco Control (FCTC) seeks to achieve, which is the governing body of the convention, and which will be held in Panama during the period between 5 and 9 February of this year 2024.
The strange and disappointing paradox witnessed by this conference is that its basic papers recommend treating alternative products the same as traditional cigarettes, and subjecting them to regulation in a similar, if not more strict, manner, without any consideration of the fundamental differences between the two categories, the most important of which are the implications of the consumption of the two categories, which are promising for the alternatives. Because it eliminates the process of burning tobacco, which is behind most of the diseases associated with smoking, not nicotine.
This recommendation is a step backwards with unrealistic and logical decisions and directions, which lead to undermining the concept of an innovative harm reduction policy, and inhibiting the upward trajectory of its positive results in reducing the consumption of traditional cigarettes, as evidenced by the experiences of many countries, at a time when the traditional policy is not making any progress. Despite her call to quit immediately.
The harm reduction policy, which is seen as a successful strategy in protecting public health through experience and evidence, has contributed, when adopted in relation to combating many societal and health challenges, to reducing the damage resulting from many wrong behaviors and habits, which have negative repercussions. Hence, the wisdom is to apply harm reduction policy on a broader scale within the most prominent challenges represented by the continuation of traditional smoking. So that it is adopted as a central and reliable strategy within the World Health Organization Framework Convention on Tobacco Control (FCTC), reinforced by several bold measures to reduce demand and supply, as this is an absolute necessity, in light of the current insufficiency of them.
While the WHO FCTC has been influential in encouraging a global response to tobacco control, it has been difficult to demonstrate a strong and consistent link between the implementation of the Convention’s limited measures and the spread of traditional smoking, and thus the persistence of negative effects of traditional cigarette consumption. And its increase.
What increases the confusion, especially with regard to unifying effective efforts to achieve better results on the path to a smoke-free world, is that the agreement, although it does not prohibit harm reduction methods, assigns the decision whether or not to adopt it to states and governments, while allowing them to decide how to regulate products. This means limiting options that may be less harmful and healthier for the 1.3 billion adult smokers around the world who are at increased risk of premature death, as the World Health Organization continues to pursue the traditional policy.
What is striking, when listing all these facts, is the absence of scientific justification for the World Health Organization’s position regarding its decisions regarding treating alternative products and nicotine products with the same mechanism by which traditional products are dealt with, while ignoring the necessity of following a different approach depending on the category based on its proportionality to the fundamental differences, repercussions and potential risks of each. Of which. What is clear here is that the World Health Organization still needs to play a positive leadership role by providing the technical support that falls under its responsibility to countries that are moving to adopt alternative and nicotine delivery products, including Swedish snus, nicotine pouches, heated tobacco, and chewing tobacco, and to motivate countries Which has not yet moved to adopt it, rather than stand by and instigate its ban, which was evident in its blessing of the step taken by India to ban the production, import and circulation of electronic cigarettes, which is similar to what 34 countries around the world are currently doing, including low- and middle-income countries.
The numbers and results of the countries that have adopted alternative products on the ground demonstrate the extent of the mistake that India and other countries make when banning these products. Significant declines in the prevalence of smoking coincided with the adoption of alternatives. New Zealand, for example, witnessed a significant decline in the daily smoking rate among adults from 13.3% as is the case between 2017 and 2018 to 6.8% as it is currently between 2022 and 2023. This is thanks to the widespread availability of alternatives, including e-cigarettes, to adult smoking consumers, which indicates a 49% decrease within 5 years. In the same period, with government support and appropriate regulatory measures, the trend towards alternatives by adult daily smokers increased by 2.6% to 9.7%.
Looking closely at these numbers, one will notice that smoking rates in New Zealand are declining despite the increasing cost of living, which is due to the absence of any policies that oppose and undermine the innovative harm reduction policy of tobacco control. This decrease highlights the important goals that can be achieved, exceeding the World Health Organization’s goals to reduce the prevalence of smoking by 30% over 15 years, during the period from 2010 to 2025. New Zealand’s 2022 smoking ban legislation includes a “tobacco-free generation.” “, a 90% reduction in smoked tobacco retail outlets, and mandatory retail tobacco disposal.
The New Zealand government elected in November 2023 is committed to reaching the 2025 zero-smoking target, by reducing smoking prevalence by 5% or less in the adult consumer population, but intends to repeal the smoke-free legislation for 2022. However, given implementation timelines, Fears that this cancellation will expose the path to the larger goal of eliminating smoking by 2025 to setbacks seem to be floating on the surface, noting that expectations do not indicate any effects for any of the three main measures before the year 2025, while unintended or unintended negative consequences could emerge. Based on recent progress, it seems likely that New Zealand’s goal of eliminating smoking will be achieved through consensus rather than forced cessation, and through greater support for switching to alternative products.
In a related context, other high-income countries have succeeded in reducing the prevalence of smoking by using a range of low-risk nicotine delivery devices to complement the demand and supply reduction measures set by the Framework Convention on Tobacco Control. Sweden, known for its snus consumption, has the lowest prevalence of daily smoking among adults in the world, which fell to 6% in 2022, accompanied by a lower death rate from smoking-related diseases. Norway has achieved similar success in reducing the prevalence of smoking in the context of increased use of Swedish snus and alternative products, including electronic cigarettes, while vaping has helped adults in England to quit smoking. The significant decline in cigarette consumption in Japan is linked to the rapid adoption of alternative products that heat tobacco instead of burning it. In contrast, less progress has been made in low- and middle-income countries; The ability to control tobacco, which is accompanied by the political will to advance tobacco control measures, is weaker, and therefore the ability to reduce its harm is less.
In fact, those who oppose the adoption of policies to reduce the harms of tobacco, despite the close and direct link between this innovative policy and the decline in smoking prevalence, excuse the inability at the present time to measure the impact of alternative products in the long term, compared to knowing the effects of traditional products because they are known. More than half a century ago. Although alternative vaping products may not be completely harmless, especially for non-smokers, the risk of significant, long-term harm from the components of these products is likely to be low, especially for smokers. Comparing it to the damage caused by consuming traditional cigarettes that rely on burning and smoking tobacco.
The second excuse is the widespread availability of e-cigarettes in the absence of adequate controls and regulations, and the argument is that this encourages youth addiction to nicotine consumption and enables the e-cigarette industry to act unethically. In this regard, there is little evidence to suggest that the consumption of alternative products, including e-cigarettes, necessarily leads to motivation to smoke among young people, and although the proportion of non-smoking youth who use e-cigarettes is increasing, it is still at a low level. To some extent. Here it is necessary to point out the need for stricter regulations, including imposing restrictions on sales, and implementing appropriate health promotion campaigns to prevent youth smoking, but these measures must be balanced with the health needs of older people who smoke and need support to quit smoking.
Skepticism about the tobacco industry’s motivations to develop and sell smoke-free alternative products while continuing to expand tobacco markets in low- and middle-income countries is understandable, but the behaviors, aspirations, and motivations of smokers who cannot or do not want to quit may be less It has resulted in the development of a group of alternative products, the main goal of which is to reduce the harmful effects resulting from the consumption of tobacco and traditional cigarettes in a more effective way than traditional methods that have not yielded and are not expected to yield any results. Reducing traditional cigarette smoking is the most effective way to prevent tobacco-related deaths, and reducing tobacco harm is the quickest and fairest way to reduce smoking prevalence. Hence, the World Health Organization should adopt these innovations, especially scientifically proven ones, and countries that have reaped the benefits of innovative harm reduction policies, such as New Zealand, Sweden, Norway, England, and Japan, should encourage countries participating in COP 10 to support proposals that would To quickly reduce smoking rates through innovative methods and mechanisms. The world’s 1.3 billion people, half of whom will die prematurely, deserve this initiative.
