By Sylvia Chepkoech
The stiff opposition from anti-tobacco activists notwithstanding, steam seems to be gathering on the world’s quest for better alternatives for adult smokers.
The number of smokers shifting to the less harmful alternatives is on a steady rise globally. According to statistics in the disclosures by The Global State of Tobacco Harm Reduction (GSTHR), more and more adult smokers are adopting these alternatives.
In recent years, the tobacco industry has committed to working towards reducing the harm from smoking by replacing cigarettes with better, scientifically substantiated alternatives. This has attracted opposition from anti-tobacco activists, including the World Health Organization (WHO), who insist on the use of neither conventional cigarettes nor the better alternatives and today don’t seem to recognize the difference between these two categories.
In its 2020 report Tobacco harm reduction and the right to health, the GSTHR argues: “ So far, the WHO has remained implacably opposed to tobacco harm reduction through the use of safer nicotine products. The organization continues to urge signatories to the international legislation concerned with tobacco control, the Framework Convention on Tobacco Control (FCTC), to instigate outright product bans”.
Amidst this deadlock, it appears that the shift to these safer alternatives is already underway. Smokers, who are increasingly more health-conscious and are seeking fast adopting alternatives that cause reduced harm. In countries such as Japan where heated tobacco was first introduced to adult smokers, the reduction in cigarette smoking accelerated at unprecedented speed. This demonstrates that, as with any other public health promotion policy, risk reduction should complement prevention and cessation efforts.
The latest statistics from Philip Morris International, one of the world’s largest tobacco firm, which has about 15 percent of the global market share and has committed itself to deliver a smoke-free future, offer a glimpse of the ongoing shift.
From revenues generated from its smoke-free products and volume of shipments to actual numbers of users making the shift, the firm’s recently released Integrated Report 2019 indicates manifold growth in this respect in 2019. This has been greatly supported by substantial investment towards delivering a smoke-free future. Today, 98 percent of the company’s research and development is geared towards smoke-free products and over 70 percent of its commercial efforts.
Similarly, BAT has indicated that globally, 10 percent of its revenues for the 2020 half-year ending June 30, came from non-combustible categories. Locally, BAT Kenya is investing in a KSh2.5 billion modern oral nicotine factory. The firm has also been introducing new categories, such as the tobacco-free oral nicotine pouch, as part of efforts to offer consumers greater choice of innovative and less risky products.
BAT and Philip Morris International have reported the number of users of their non-combustible alternatives at 9.7 million and 15.4 million respectively.
With these shifting trends, consumers taking up these smoke-free products, it is incumbent upon governments and other supra-national bodies to join hands with the industry to make these alternatives available to all.
Regulators need to consider the science and evidence behind innovative smoke-free products in the interest of smokers and public health at large.
The US recently led the way with the Food and Drug Administration (FDA) authorizing the marketing of IQOS in the US as a Modified Risk Tobacco Product (MRTP) – reducing exposure of consumers to harmful and potentially harmful compounds -, marking a turning point in the unending debate on modified risk tobacco alternatives. Being the first time that the FDA has granted marketing orders for an innovative electronic alternative to cigarettes, it marked a major regulatory precedent.
The FDA’s MRTP framework paves the way for consumers to be provided with factual information to enable them to make informed choices. This is likely to further contribute to a decline in smoking prevalence and further adoption of better alternatives.
The challenge now is for more nations to take a similar route. Hardline stances that are not backed by credible scientific research are dangerous for the general public – and especially smokers – who are the ones who suffer the most from it. If people who smoke are not entitled to get access to and accurate information about better alternatives, they might stay with or return to cigarettes. And this goes against the interests of public health.
Ignoring the consumers’ shift is akin to the regulators burying heads in the sand. Better alternatives need to be recognized, scientifically assessed, regulated, and made available to smokers who would otherwise continue to smoke.
This is good for addressing the public health concerns that are associated with the global issue of smoking.