We had the privilege of sitting down with Amanda Wheeler, to discuss important issues in tobacco harm reduction, such as: how do we correct misinformation in this space? What benefit has Juul had in converting people from smoking to vaping? What role do flavours play in harm reduction?
To see some mini clips from the webinar, click HERE.
Or click below to watch the full webinar on our YouTube Channel.
“The availability of nicotine with minimal harm justifies a complete rethink of our approach to this legal recreational drug.”
The latest article by Clive Bates of Counterfactual Consulting in the tobacco reporter magazine provides some interesting insights into his views on the weirdness of why low risk nicotine products are being demonised and compared with class A drugs such as heroin or cocaine. Clive discusses the benefits of nicotine, from improved cognition and focus to reducing stress and anxiety, and asks the question: why are we not re-looking at nicotine and considering that its use is not all that harmful? What if the real problem was always the inhalation of toxic smoke while trying to consume nicotine for its benefits?
Clive discusses the several forms that this ‘weirdness of harms’ takes when it comes to this low – risk drug.
On 14 July 2022, a Malaysia press release reported that the draft of the proposed Tobacco and Smoking Control Bill had been approved by the Cabinet. Health Minister Khairy Jamaluddin said: “The Bill was approved by Cabinet yesterday. So I will be sending it to Parliament for this session". The proposed Bill contains provisions to prohibit the sale of cigarettes, tobacco, and vape products to those born after 2005.
13 public health experts were prompted to respond to this proposed legislation, and they started by applauding the government’s efforts to strengthen the prevention and control of combustible tobacco-related disease and premature death. However, they warned of the unintended consequences of regulating non-combustible, reduced-risk products in the same way as combustible cigarettes. They emphasised two important points about ENDS:
In this letter sent to the Malaysian PM and Cabinet, the experts urged them to support smokers by encouraging a mass switch from high-risk cigarettes to low-risk ENDS by using risk-proportionate regulation, thus accelerating the end of the epidemic of smoking-related disease. Read the full letter here.
A letter from an international group of health leaders, from the EU, North and South America, Africa and Asia has been submitted to the Bangladesh Minister of Health, calling for the Ministry to consider not prohibiting the use of smoke free nicotine-based alternatives to combustible cigarettes and to use evidence-based regulatory policy to do more to protect the health of Bangladesh's 164,7 million people. In particular, the 34,7% of adults in Bangladesh who still consume combustible cigarettes. The experts have called on the Bangladesh government to support smokers by encouraging a mass switch from high-risk cigarettes to low-risk ENDS and accelerating the end of the epidemic of smoking-related disease.
Click here to read the letter.
The call was made by public health experts gathered at the ninth edition of the Global Forum on Nicotine, held in Warsaw this month.
The Global Forum on Nicotine (GFN) is an annual event that has been held since 2014 in the form of an international conference focusing on the future of nicotine products, their legal regulations and the impact of these products on public health. Hosting hundreds of public health experts, nicotine consumers and activists from across the world, the event’s theme was ‘tobacco harm reduction is here for good’.
The forum’s theme explained that tobacco harm reduction through safer nicotine products can hasten the end of smoking, and calls for government stakeholders to explore the science behind this approach. Policy and regulatory changes are needed in order to maximize its potential and the barriers to its implementation around the world.
Countries applying progressive tobacco harm reduction policies are witnessing a significant fall in smoking rates. Whereas those following the World Health Organization’s (MPOWER) guidance continue to experience excessive smoking-related illnesses and deaths.
A new study (conducted by Dr. Lars M. Ramström) launched at the forum shows implementation of the World Health Organization’s tobacco control measures known as MPOWER has no clear association with low-levels of tobacco-related mortality.
Instead, the independent research by the renowned tobacco dependence researcher, shows that switching from smoking to Swedish-style snus, a safer nicotine product, is a more effective strategy to reduce the harms caused by tobacco.
Presented to hundreds of delegates, as well as over 50 international experts on tobacco and nicotine science, the new findings by Dr. Lars Ramström provide further evidence that the World Health Organization must embrace tobacco harm reduction as part of its global tobacco control strategy by supporting the use of safer nicotine alternatives to quit smoking.
On the 22nd June, a webinarhosted by thr.net took place. Moderated by Dr. Delon Human and Jessica Perkins from tobaccoharmreduction.net, the panel featured leading medical expert Dr. Konstantinos Farsalinos, Professor Sharifa Ezat Wan Puteth, President of the Malaysian Society for Harm Reduction and Professor Neil McKeganey, director of the Centre for Substance Use Research at the University of Glasgow.
“Many Malaysian smokers are seeing ecigs, and other non-combustible nicotine alternatives as their fire escape. We need to promote evidence-based regulation that gives comfort to consumers to switch from the most harmful to the least harmful alternatives." - said Dr Delon Human.
The 3 eminent academics discussed the need for regulation of tobacco harm reduction (THR) products in Malaysia, and misconceptions about alternative nicotine products and flavours. Watch the webinar below.
There are 1,1 billion smokers worldwide and combustible tobacco products continue to kill more than 8 million of its consumers per year. Although most smokers want to quit, only 4% succeed. For those adult smokers who are unwilling or unable to quit smoking, non-combustible, nicotine-based alternative products now offer a "fire-escape". These products represent "Harm reduction strategies", envisioned in Article 1(d) of the WHO's Framework Convention on Tobacco Control (FCTC). What are the regulatory hurdles to accelerating tobacco harm reduction, as adjuvant to tobacco control? What regulatory principles need to be established, scaled and leveraged to save more lives of adult smokers? How can we harness harm reduction innovation to make preventive tobacco control more efficient, and free up resources for global healthcare?
We were joined for a virtual dialogue by a distinguished panel of harm reduction experts;
The RESET framework was discussed by the panel. The below information shines some light on what exactly this framework entails:
R = Risk - based regulation (labelling, packaging, promotion)
E = Ensuring intended use (prevent youth access, safety)
S = Safety and Quality (ingredients, product standards, testing + conformity with chemical and electronic regulation)
E = Environmental Considerations (lifecycle of ENDS, regulating environmental impact, align with ESG standards)
T = Traceability and Fiscal Policies (regulation ensuring product authenticity throughout supply chain, risk-proportionate fiscal polices)
The webinar recording can be seen here.
This month, we mark three important events: International Harm Reduction Day on 7 May, World Vape Day on 30 May and World No Tobacco Day on 31 May. In spite of the dualistic impression one derives from the war-like language that often mars discussion between ‘tobacco control’ and ‘tobacco harm reduction’ (THR) communities, they actually share a common goal: to minimise tobacco-related disease and premature death. This misrepresentation of facts is squandering the opportunity to help millions of smokers switch to much less harmful products, such as nicotine vapes and pouches. Herein lies the difference in approach amongst THR advocates; backed by evidence and pragmatism, THR supports the provision, rather than prohibition, of safer alternatives to those who are struggling to quit cigarettes.
Read our full article on the six ways in which harm reduction differs to prohibition.
Call for evidence deadline: 17th June
The EU commission would like to hear your views on the modern ways to manage and curb smoking addiction. Future tobacco regulation must be based on sound data and evidence to ensure risk – proportionate regulation is adopted for new product categories.
The Commission will evaluate the tobacco control legislative framework, namely the promotion, sponsorship, product regulation and advertising, in the broader context of other related tobacco control policies. This comes in response to the rapid rise of recent technological advancements in emerging products.
This evaluation will assess to what extent the framework has fulfilled its goals and whether it is able to support a ‘Tobacco-Free Generation’ by 2040, as announced in the Europe’s Beating Cancer Plan.
In late 2021, Kantar undertook a study in Taiwan regarding** usage and attitudes towards vaping**, tobacco products and cigarettes. In addition, Kantar worked on the survey design, analysis and reporting of results.
Most respondents were concerned that banning vaping would increase the black market and they would strongly welcome a law ensuring risk - proportionate regulations of alternative nicotine products (as long as evidence showed that they helped smokers to switch from cigarettes) and forbidding sales to minors.
Click here to read our full article on the study.
It is notable that many vapers still expect to receive disapproval for using e-cigarettes, however on balance, vaping is still MORE likely to receive approval from peers and family than smoking cigarettes or using heated or oral tobacco products.
In late 2021, Kantar undertook a study regarding usage and attitudes towards vaping, tobacco products and cigarettes in Malaysia. In addition, Kantar worked on the survey design, analysis and reporting of results. The study was completed with those people who used e-cigarettes and/or other tobacco products. Questions covered a range of topics including current usage and perceptions of products including attitudes towards quitting smoking and methods used to help giving up. Read our full article here.
To read the Kantar summary report, click HERE.
Dr Mendelsohn’s book provides a comprehensive and practical how-to guide for smokers considering vaping as a safer alternative to smoking, but it also delves into a deeper analysis into societal beliefs around vaping. In Part 3 (‘Controversies and Solutions’), Dr Mendelsohn dissects how we have reached a point in the debate where an appreciation of the scientific evidence supporting vaping is not enough to overcome the vehement backlash: “Much of the opposition is not about the evidence. It is driven more by hidden ideological, moral, political, and other agendas. [Part 3] explores how anti-vaping groups defend the indefensible and justify their position without the support of science”.
Click here to read the full review.
Enlightening interview with Dr Derek Yach by Taco Tuinstra from Tobacco Reporter, in which Dr Yach explains how the innovation of THR represents the single most impactful public health opportunity. In his remarks, he described how independently verifying the science underpinning reduced-risk products transformed his thinking with regards to engaging with industry:
"The history of distrust is very deep, and very difficult to overcome. In my mind, the way I overcame it was by actually looking at the science, and looking at the evidence, and realising that the benefits for public health were so big that I needed to overcome my initial concerns.
It doesn’t require you trusting industry to move ahead, it requires you verifying what they are saying they are doing: verify the quality of the science, verify it in terms of long-term studies, look at the genomics, the metabolomics, the epidemiological and clinical studies. There’s no trust involved in that - just an independent ability to judge the science." - Dr Derek Yach
Full interview HERE 👇
AHRA (Africa Harm Reduction Alliance) hosted a Twitter Chat with the prominent THR advocate Aishat Alaran (@alaranaishat) to learn more about one of the women behind the Campaign for Safer Alternatives (C.A.S.A) organisation. Aishat spoke openly and candidly about why it is important to have equal representation of females and males in THR, saying that ‘smoking is not limited to one gender, so the fight to reduce smoking should not be restricted to a single gender’.
She also told AHRA about her mother, who has constantly been a source of inspiration for her, “She sets positive examples for me that constantly reminds me to strive to become the best version of myself.”
When asked how she pushes for systemic change around ideas that are new or not popular, she speaks candidly about what she feels needs to be done to “change the status quo”. She also cites another prominent THR advocate named Professor Marewa Glover as being another source of inspiration, especially when working under her leadership during a Tobacco harm Reduction Scholarship. Impressively, Professor Glover has 100 publications to her name.
Click HERE to access the new E – Book.
In a change that will favour vaping consumers today, Italy has adjusted its tax on e-liquids for the fourth time in four years.
The tax rate on e-liquids containing nicotine will decrease from €0.175 (U.S. equivalent: $0.19) per millilitre to €0.13, and the zero-nicotine e-liquid tax will fall from €0.13/mL to €0.08. The new, lower tax rates are in line with the levels set in 2021 (these levels had seen an increase in January 2022).
Italy has experienced a turbulent history when it comes to vaping products. In 2014, the Government made vapes as expensive as cigarettes, which meant that 75% of the ‘thriving’ vape industry had been wiped out. The tax was the highest in the EU, which almost doubled the price of e-liquid. This meant that vapers were now seeking the black market and some returned to smoking.
However, in 2019 the vaping community applied pressure to the Parliamentary legislators and they finally reduced the tax rate by 80%, to a far more reasonable €0.08 per mL for e-liquids containing nicotine, and €0.04 for nicotine-free e-juices. However, last year the legislators increased the tax yet again, only to (finally) reduce them today.
This is an opportunity for vapers to be heard before the anti-vaping policy is locked in for the rest of the decade.
The draft strategy lacks urgency. It sets a very modest goal of <10% adult daily smoking by 2025. In sharp contrast, New Zealand recently set a target of <5% daily adult smoking by 2025 for all population groups including Maori and Pacifica groups. Vaping is a key element of this plan.
Please make a submission before the deadline of 24 March 2022. More information about making a submission can be found HERE.
“The main element missing from the draft Strategy is tobacco harm reduction, ie the use of safer nicotine alternatives such as vaping, heated tobacco products, Swedish snus and nicotine pouches for smokers who are unable to quit with other methods”
Vaping is supported by the Royal Australian and New Zealand College of Psychiatrists and Royal Australian College of General Practitioners for smokers who are unable to quit with conventional strategies. However, the draft strategy ignores their advice. In Australia it is easier to purchase a deadly cigarette than a far safer alternative.
Continuing the traditional 'quit or die' approach will result in a continuing sluggish decline in Australian smoking rates and another embarrassing failure to reach the smoking target. Smokers are being thrown under the bus. We need to do better.
The draft strategy sets out the Welsh Government’s vision for a smoke-free Wales by 2030, this means achieving a smoking prevalence rate in adults of 5% or less over the next eight years.
To support this ambition, they will be driving forward work across their three key themes of Reducing Inequalities, Future Generations and a Whole-System Approach for a Smoke-Free Wales.
The consultation will close on 31 March 2022. They want to hear views and get feedback on their plans for tobacco control in Wales from everyone affected by tobacco in Wales, including the public, young people and stakeholders.
They are also planning engagement events during the consultation period. If you would like to be involved, please contact them at: [email protected] for further details.
Government page to read more about the Consultation: HERE
How to respond
Submit your comments by 31 March 2022, in any of the following ways:
Complete our online form
Download, complete our response form and post to:
Risk Behaviours Team Welsh Government Cathays Park Cardiff CF10 3NQ
A group of world-renowned tobacco harm reduction experts spoke at the Africa Tobacco Harm Reduction Forum (ATHRF) a week ago, to discuss a potentially transformational product for the Africa market: #OralNicotine (Is it a gateway to a smoke-free Africa?).
Watch the full event recording HERE on the AHRA YouTube channel!
Misperceptions about the safety of vaping are rife; the misnomer of 'EVALI' is a major contributor. There is no evidence that anyone developed EVALI from nicotine #ecigs. Rather, it was illicit THC products containing Vit E Acetate.
The cost of this misinformation is that only 11.2% of respondents to the National Cancer Institute (NCI)'s 2020 HINTS survey said that e-cigarettes are safer than combustible cigarettes - a fact acknowledged by the Centers for Disease Control and Prevention.
75 public health experts, and Iowa's Attorney General Tom Miller, wrote to the Centers for Disease Control and Prevention in August 2021 petitioning for the lung injury to be renamed Adulterated THC Vaping Associated Lung Injury (ATHCVALI). This name communicates far more accurately to the public what health risks exist. However, the CDC has thus far declined to correct the misnomer of 'EVALI'.
One of the 75 public health experts, Michael Pesko (health economist at Georgia State University), said to reporter Marc Gunther: "The CDC made a gross error. The CDC's miscommunication is actually killing people, in my opinion."
The UK's Health Secretary, Sajid Javid MP, believes it is a “moral outrage” that England’s richest people are living for up to a decade longer on average than the poorest.
To help tackle this disparity, he is plotting a #vaping revolution, writes Caroline Wheeler in yesterday's edition of The Sunday Times.
"England will become the first country in the world to prescribe e-cigarettes on the NHS to help smokers quit as part of plans to increase life expectancy for the poorest.
Sajid Javid, the health secretary, believes it is a “moral outrage” that England’s richest people are living for up to a decade longer on average than the poorest.
He will announce plans to address the root causes when he unveils his health disparities white paper this spring. It is understood this will include a “vaping revolution” that will allow GPs to prescribe e-cigarettes on the NHS."
Dr Konstantinos Farsalinos’ multidimensional report on vaping flavours titled “The case for flavours in tobacco harm reduction to save lives” examines the science, consumer insights, risks and regulatory considerations relating to vaping flavours.
The review concludes that restrictions on vaping flavours would risk seriously reducing the life-saving potential of these innovative products.
Unfortunately, last week scaremongering headlines circulated worldwide, based on an abstract from an unpublished study. Subsequently it has been WITHDRAWN by the American Heart Association, who said: "This abstract will no longer be presented at Scientific Sessions 2021. Unfortunately, the researchers were not able to complete their presentation". The study claimed that e-cigarette users have a 15% higher risk of having a stroke at a younger age. However, after peer review and SCRUTINY of the data, this claim was shown to be methodologically flawed. Click HERE to read more on prominent experts' reaction to the flawed claim.
“People who regularly use vapes have much higher smoking cessation rates” explained Prof David Levy at the recent No Smoke Summit.
This is the key to the lifesaving potential of promoting nicotine vaping products to smokers who are struggling to quit cigarettes. Prof Levy’s newly published SAVM simulation model calculates deaths avoided and life years gained by 2060, if adult smokers switched to significantly less harmful vapes. The result? 1.8 million lives saved, and 38.9 million life years gained.
Click HERE to watch the Lives Saved video
In Germany’s population of 84 million, 1 in 4 people still smoke cigarettes. According to their ministry of health, smoking is the biggest preventable cause of death and disease in Germany. Meanwhile, there is mounting evidence that nicotine vaping products are significantly less harmful than combusted tobacco, and provide a viable escape route for smokers who want to quit, but can’t.
What would happen if Germany’s smokers switched to less harmful nicotine vaping products? At the No Smoke Summit in September 2021, Prof David Levy from Georgetown University explained with reference to his newly developed SAVM simulation model - 4.7 million life years saved, and 300,000 deaths avoided by 2060.
Click HERE to watch his presentation
Events which might help shape tobacco harm reduction (THR) science, policy, consumer engagement and products.
Recommended sites to learn more of tobacco control and harm reduction.
CANADA’S PROPOSED RESTRICTIONS ON FLAVOURS IN VAPING PRODUCTS COULD NEGATIVELY AFFECT MILLIONS OF ADULT SMOKERS, WARN INTERNATIONAL EXPERTS
Health Canada have sought comments on their proposed ban on vaping flavours, click below to read the comments.
WHO recognition of Tobacco Harm Reduction in the Framework Convention on Tobacco Control (FCTC). FCTC is the global legal treaty used to shape tobacco control policy.
Several individual and organizational public health influencers impact the debate on tobacco harm reduction science and policy. Please note that there are no links between this website and the bloggers, and do let us know if there are any individuals or groups we should add.
The European Union TPD is the regulatory framework concerning the manufacture, presentation and sale of tobacco and related products. Novel products and electronic cigarette regulation are addressed in Articles 19 & 20.