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Leading harm reduction experts debunk the notion that vaping is a gateway to smoking, advocating for evidence-based harm reduction strategies

Recent claims by Otago University in New Zealand that vaping is a gateway to smoking have been disputed by leading global harm reduction experts Roberto Sussman, Konstantinos Farsalinos, and Gerry Stimson. These experts have highlighted the importance of harm reduction strategies in reducing the negative health impacts of smoking.

According to Dr. Roberto Sussman, "There is no evidence that vaping is a gateway to smoking. In fact, [studies have shown that vaping can be an effective tool for smoking cessation](https://www.cochrane.org/news/latest-cochrane-review-finds-high-certainty-evidence-nicotine-e-cigarettes-are-more-effective)." Dr. Konstantinos Farsalinos adds, "The vast majority of vapers are former smokers who have successfully quit smoking thanks to vaping."

Gerry Stimson, a public health expert and advocate for harm reduction, emphasizes that "Harm reduction [strategies like vaping are essential in reducing the negative health impacts of smoking](https://www.tobaccoharmreduction.net/thr). We need to focus on providing smokers with safer alternatives to cigarettes, rather than demonizing harm reduction strategies like vaping."

As Dr. Sussman notes, "We need to focus on harm reduction strategies that work, rather than relying on outdated and inaccurate claims about vaping being a gateway to smoking." Dr. Farsalinos adds, "The evidence is clear: [vaping can be an effective tool for smoking cessation and harm reduction](https://www.tobaccoharmreduction.net/benefits)."

Nancy Loucas, Executive Coordinator of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates ([CAPHRA](https://caphraorg.net/)), who compiled these comments, also disputed the recent claim by [Otago](https://www.otago.ac.nz/) [University](https://www.otago.ac.nz/) that vaping is a gateway to smoking. In her view, the recent claim by Otago University is not supported by the evidence and could discourage smokers from trying vaping as a tool for smoking cessation.

According to recent data, the smoking incidence rates in New Zealand have fallen significantly over the past 5 to 10 years. The current smoking rate of New Zealand adults is 8% in 2021/2022, which has decreased from 16.5% in 2015 and from 27% in both men and women in 1993. Vaping has played a significant role in the reduction of smoking rates in New Zealand over the past 5 to 10 years.

According to research published in the [NZ Medical Journal](https://journal.nzma.org.nz/journal-articles/an-evaluation-of-a-new-zealand-vape-to-quit-smoking-programme), the current vaping rate in New Zealand is 8.3% of adults being categorized as daily e-cigarette users, up from 6.2% in the previous year.

"We need to [focus on harm reduction strategies that work](https://www.tobaccoharmreduction.net/thr-products), rather than relying on outdated and inaccurate claims about vaping being a gateway to smoking. The evidence is clear: vaping can be an effective tool for smoking cessation and harm reduction," Ms. Loucas said.

Read more on [Tobacco Harm Reduction](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf). Follow us on [Twitter](https://twitter.com/Tobaccoharmred1) and [LinkedIn](https://www.linkedin.com/company/tobaccoharmreduction-net/).

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Leading harm reduction experts dispute claim that vaping is a gateway to smoking.

Harm reduction experts challenge the claim that vaping leads to smoking, emphasizing evidence of vaping's effectiveness in smoking cessation

Leading Experts Dispute Vaping as a Gateway to Smoking: Focus on Harm Reduction Strategies

Review written by **[Joseph Magero, of Campaign for Safer Alternatives / CASA](https://safer-alternatives.org/about-us/what-we-do)**

[**New research**](https://www.kcl.ac.uk/news/vaping-substantially-less-harmful-than-smoking-largest-review-of-its-kind-finds) from the [**Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London**](https://www.kcl.ac.uk/ioppn) has found that the use of electronic cigarettes rather than traditional cigarettes leads to a substantial reduction in exposure to toxicants that cause cancer, lung disease, and cardiovascular disease.

The [**systematic review**](https://www.kcl.ac.uk/news/vaping-substantially-less-harmful-than-smoking-largest-review-of-its-kind-finds), commissioned by the **[Office for Health Improvement and Disparities](https://www.gov.uk/government/organisations/office-for-health-improvement-and-disparities)** in the **[Department of Health and Social Care](https://www.gov.uk/government/organisations/office-for-health-improvement-and-disparities)**, represents the most comprehensive review of the risks of vaping to date. The findings were; while vaping is not risk-free (particularly for people who have never smoked), it poses a small fraction of the health risks of smoking in the short to medium term.

It is the eighth successive time that a review commissioned by the main **public health body in England**, the Office for Health Improvement and Disparities, has found that electronic cigarette use is far less risky than cigarette smoking. 

In the report, researchers expressed concern that “around two-thirds of adult smokers, who would benefit from switching to electronic cigarettes, have no idea that vaping is less harmful”.

Perceptions about the relative harms of tobacco smoking and vaping among smokers are out of line with current evidence. An exploration of the available studies found that levels of tobacco-specific nitrosamines, volatile organic compounds, and other toxicants implicated in the main diseases caused by smoking were significantly lower in e-cigarette users. Among e-cigarette users, overall levels of nicotine were lower or similar to cigarette smokers.

The levels of exposure to cancer-causing and other toxicants are drastically lower in people who use electronic cigarettes compared with those who smoke traditional cigarettes. Helping people switch from smoking to vaping should be considered a priority if Governments are to achieve a smoke-free world in our lifetime.
The evidence has strengthened and shows that e-cigarettes have the potential to reduce the harm caused by smoking. We must educate people about the reduced risk of alternative products such as electronic cigarettes.

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Vaping is substantially less harmful than smoking, Largest Review Finds!

Restrictions create black market for unregulated, mislabelled nicotine vaping products

Since 1 October 2021, nicotine liquid has been classified as a [**prescription-only medicine in Australia**](https://www.health.nsw.gov.au/pharmaceutical/Pages/nicotine-vaping.aspx#:~:text=From%201%20October%202021%2C%20all,4%20(prescription%20only)%20medicines.). Australia is the only country that classifies nicotine vaping products (NVPs) as such, in other Western countries nicotine liquid is seen as a consumer product.

The Australian model has been **an embarrassing failure**. Although the aim was to allow adults to access nicotine vapes with a doctor's support and prevent youth vaping, the opposite effect is the reality. It has created a thriving black market that sells **unregulated, mislabelled nicotine products** to adults and to children.

The [Australian Medical Association (AMA)](https://www.ama.com.au/) is pushing to increase NVP restrictions. This approach will:

- Fuel the black market by driving the sale of NVPs further underground
- Reduce adult access to vaping, as very few doctors are willing to prescribe NVPs
- Increase youth smoking, as vaping diverts young people away from smoking
- Lead to more smoking, as vaping is the most effective and popular quitting aid in Australia and worldwide

Watch [Dr Colin Mendelsohn's](https://colinmendelsohn.com.au/)full interview [here](https://www.youtube.com/watch?v=ZrZ6a91jEp0).

For more information about nicotine products and smoking cessation, [click here](https://www.tobaccoharmreduction.net/thr-products).

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AUSTRALIA'S PRESCRIPTION-ONLY MODEL FOR VAPING HAS BEEN AN EMBARRASSING FAILURE

Expert says Australia's prescription-only vaping model is a failure

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**](https://www.health.govt.nz/system/files/documents/publications/hp7801_-_smoke_free_action_plan_v15_web.pdf) 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**](https://www.health.gov.au/initiatives-and-programs/national-tobacco-strategy#:~:text=The%20draft%20National%20Tobacco%20Strategy%202022%E2%80%932030%20is%20being%20developed,closes%20on%2024%20March%202022.). 

***“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**](https://www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/e-cigarettes-and-vaporisers) and [**Royal Australian College of General Practitioners**](https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/supporting-smoking-cessation) 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**.

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The Australian Department of Health is seeking feedback on how to reduce smoking in the draft National Tobacco Strategy 2022-2030.

Oral Nicotine Delivery Systems such as vaping, nicotine pouches, and snus represent the next generation of smokeless, tobacco-free nicotine products.

Over the last two decades, vaping, nicotine pouches and a range of other less harmful products have completely transformed the nicotine space. Oral Nicotine Delivery Systems, or ONDS, represent the next generation in smokeless, tobacco-free nicotine products.

Scientific evidence surrounding the benefits of nicotine pouches and snus has been mounting. A recent [study](https://pubmed.ncbi.nlm.nih.gov/32466721/) from the [Karolinska Institute in Sweden](https://ki.se/en), which involved 400,000 participants and covered 9-million-person years, has shown that there is no association between snus use and oral cancer. A separate [study](https://www.linkedin.com/pulse/systematic-review-confirms-harmful-health-outcomes-from-cother-hajat/) conducted by the physician and epidemiologist, [Dr. Cother Hajat](https://uk.linkedin.com/in/cother-hajat-b912261a) shows that we should not classify all oral tobacco or nicotine products in the same risk camp, and that snus confers no excess risks for oral and many other cancers, cardiovascular disease, and chronic lung diseases. When taking the scientific evidence into consideration, it comes as no surprise that the US Food and Drugs Administration (FDA) has [authorised](https://www.fda.gov/news-events/press-announcements/fda-grants-first-ever-modified-risk-orders-eight-smokeless-tobacco-products) Swedish Match's snus as being appropriate for the protection of public health under its modified risk tobacco product (MRTP) guidance.

Regulators and international organisations continue to group [oral nicotine products](https://oralnicotine.com/oral-nicotine/what-is-it) with combustible tobacco products, ignoring [the evidence of their positive impacts](https://oralnicotine.com/publications). The WHO's [latest report](https://www.who.int/publications/i/item/9789240061484) on oral health fails to distinguish between [snus and toxic smokeless tobacco products](https://oralnicotine.com/oral-nicotine/benefits) and raises unscientific concerns about the [potential negative effect of nicotine from vaping on oral cancer.](https://oralnicotine.com/publications)

Sweden assumes the [Presidency of the Council of the European Union](https://www.consilium.europa.eu/en/council-eu/presidency-council-eu/) in January 2023, so right now is the perfect time to look at the role snus has played in allowing them to become the European leader in smoking cessation.

Sweden has the lowest smoking rate in the EU at [6%](https://www.folkhalsomyndigheten.se/the-public-health-agency-of-sweden/living-conditions-and-lifestyle/andtg/tobacco/), compared to the EU average of 23%. As a result of this, Sweden has the lowest tobacco mortality rate in Europe. Snus has been at the centre of the reduction measures, but in recent years, nicotine pouches and e-cigarettes have proven to be [useful additional tools for Swedish smokers aiming to quit.](https://oralnicotine.com/oral-nicotine/benefits) The progressive, pro harm-reduction Swedish model is clearly distinct from the tobacco control policies proposed by other EU Member States. Ensuring that [less harmful alternatives to smoking, such as nicotine pouches and vapes](https://www.tobaccoharmreduction.net/thr-products), are accessible will be paramount to ensure that other countries can replicate Sweden's success.

At [Tobaccoharmreduction.net](https://www.tobaccoharmreduction.net/) and the [Oral Nicotine Commission](https://oralnicotine.com/about-us), we have developed an advocacy instrument, which addresses public misconceptions surrounding tobacco harm reduction.


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The Swedish harm reduction approach reduces smoking rates

[**THR.net**](https://www.tobaccoharmreduction.net/thr) sat down with [**Michelle Minton**](https://twitter.com/michelleminton) of the [Reason Foundation](https://reason.org/) for the latest #WomenInTHR episode, in honour of [**World Mental Health Day in October**](https://www.mentalhealth.org.uk/our-work/public-engagement/world-mental-health-day). We discussed the topics listed below (click on each one to watch the clips):

> [Addiction and nicotine](https://www.youtube.com/watch?v=P70-EoQaKt8&t=1s)

> [Mental Health Disorders and The Benefits of Nicotine](https://www.youtube.com/watch?v=cyMOZXOu4jQ)

> [Anti Smoking Campaign Effects On Youth](https://www.youtube.com/watch?v=--axrVx7W4Q&t=249s)

> [Narratives Prevent People From Objectively Looking At The Evidence](https://www.youtube.com/watch?v=YOIk19p_Kso)

> [The Quit or Die Approach in Tobacco Control](https://www.youtube.com/watch?v=tYzi15IEUBw)

> [Work and research into nicotine](https://www.youtube.com/watch?v=xhlAml08MeU) 

> [The unspoken benefits of tobacco and nicotine](https://www.youtube.com/watch?v=3vCkdpV-m2k) 

Click on [**this link here**](https://www.youtube.com/channel/UCyHKweBxXVzcskK-HOo8PEg/featured) to access our YouTube channel with mini clips for small and digestible videos.

Click below to watch the part called > “[**Mental Health Disorders and The Benefits of Nicotine**](https://www.youtube.com/watch?v=cyMOZXOu4jQ)”


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Latest #WomenInTHR webinar with Michelle Minton now on YouTube

Women in THR: Coffee Chat with Michelle Minton | Mental Health Diagnosis & Nicotine

Implementing the Philippine nicotine products Regulation Act will save lives, says harm reduction advocates


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"Any concerns about youth vaping are well covered in last year's landmark vape law. The Philippines has more than enough regulations and safeguards now in place, without a Senator trying to relitigate everything," says Nancy Loucas, Executive Coordinator of CAPHRA ([Coalition of Asia Pacific Tobacco Harm Reduction Advocates](https://caphraorg.net/)).

Her comments follow the Senate recently adopting a resolution denouncing the sale and marketing of e-cigarettes and other vape products towards the youth. It saw [Senator Pia](https://en.wikipedia.org/wiki/Pia_Cayetano) [Cayetano](https://en.wikipedia.org/wiki/Pia_Cayetano) deliver a speech where she claimed vape flavours and designs draw young people to the products.

Last year, smokefree advocates around the world celebrated the Philippines passing the Republic Act 1190, otherwise known as the 'Vaporized Nicotine and Non-Nicotine Products Regulation Act'.

Regulation of the importation, manufacture, sale, packaging, distribution, use and communication of vaping products such as e-cigarettes and heated tobacco products (HTPs) became law on 25 July 2022.

At the time advocates said the law strongly protects minors, helps to eradicate blackmarkets, ensures safety standards, and critically delivers adult accessibility to viable alternatives for smokers desperate to quit.

"Without doubt, the legislation and regulations are aimed at protecting youth, despite it not being expressly stated in the statute. For example, there are provisions that expressly provide prohibition on selling to minors.

She says there is also a provision where it is expressly stated that flavour descriptors that unduly appeal to minors are prohibited. This includes candy, fruits, desserts, and cartoon graphics.

Late last year, following the passing of the vape law, the Department of Trade and Industry (DTI) issued the Implementing Rules and Regulations (IRR).

"It's the DTI's mandate and responsibility to implement the new vaping laws. The Philippines doesn't need any more Senate speeches and resolutions. It just needs the regulator and retailers to work together to ensure young people are protected as was clearly intended," says Nancy Loucas.

Clarisse Virgino, Philippine representative to the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), agrees that any issues pertaining to the vape law now lie with the DTI.

"This is not a Senate issue but an issue around implementation. We must let the DTI do its job and positively work with the industry and retailers to make sure they're educated and compliant. Many parties, including consumer advocates, worked on the vape law in good faith. Let's continue that good faith," says Ms Virgino.

She says despite political argument at the edges the Philippines now leads the charge in Tobacco Harm Reduction (THR) among its Asian neighbours.

"Our country has endured a terrible smoking epidemic for decades, with nearly 90,000 Filipinos dying annually from smoking-related diseases. We've now adopted a successful THR strategy which will see smoking rates fall. Ours is landmark and leading legislation. It just needs time to bed in.

"The 2022 vape law will deliver real results and help eradicate smoking. Our focus now must be to ensure 16 million Filipino smokers have a viable path to switch to safer nicotine products," says Clarisse Virgino.

For a free digital media repository on tobacco harm reduction in Asia Pacific

- including media releases, images, and graphics - please visit [https://apthrmedia.org](https://apthrmedia.org/)

**About CAPHRA**

The Coalition of Asia Pacific Tobacco Harm Advocates is a regional alliance of consumer tobacco harm reduction advocacy organizations. Its mission is to educate, advocate and

represent the right of adult alternative nicotine consumers to access and use of products that reduce harm from tobacco use.

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Time to support Filipino vape law, not relitigate it

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."

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SAJID JAVID PLOTS VAPING REVOLUTION TO HELP POOR LIVE LONGER

[**October is Mental Health Awareness Month**](https://www.who.int/campaigns/world-mental-health-day). We take this time of year to acknowledge the widespread concerns among the general public, including mental health which is a crucial piece of the puzzle that makes up an individual's overall health and wellness.

Of the general population, only a minority are smokers. In a population of those with a history of depression and a propensity for recurrent depression, a majority are smokers. 

[**Smoking rates among people with mental health disorders are disproportionately higher than average country smoking rates across the globe**](https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often). The association between cigarette smoking and mental health conditions becomes stronger relative to the severity of the mental health condition, with the highest levels of smoking found in psychiatric inpatients. 

[**Nicotine has mood-altering effects**](https://www.tobaccoharmreduction.net/updates#Nicotine_the_weirdness_of_harm) that put people with mental disorders at higher risk of smoking and nicotine addiction. Many of them associate smoking cigarettes with stress relief and relaxation.

Important to note, individuals with mental health conditions die on average 10–20 years earlier than the general population, and smoking is the single largest factor accounting for this difference.

One in every two people who smoke (including those with mental health issues) will die of a smoking-related illness. But many think quitting will worsen their mental health problems or impact their social lives and friendships.

In most cases, people with mental illness lack access to cessation aids to help them quit. This makes it even more challenging for them to quit smoking.

Stopping smoking suddenly through willpower alone or cold turkey is the least effective way to quit. It’s a well-known fact that quitting smoking improves one’s physical health. A recent [**Cochrane systematic review shows that stopping smoking is linked to improved mental health. The review summarizes evidence from 102 observational studies involving over 165,900 people.**](https://www.cochrane.org/news/featured-review-stopping-smoking-linked-improved-mental-health)

Action to reduce smoking among people with mental health challenges should be a high priority, whether through nicotine replacement therapy or safer nicotine products. No other action would do more to reduce the life expectancy gap among this group. 

Pragmatic approaches are absolutely essential to improve outcomes. The lack of cessation services in many low and middle-income countries makes the scale of the task to reduce smoking among people with mental health challenges inherently complex.

With current tobacco control strategies showing meagre results and **NRTs unaffordable** to most smokers with mental health challenges, the introduction of accessible, market-driven harm reduction measures into the mix is a vital way forward. Reduced-risk products can significantly lower smoking rates among individuals with mental health challenges.

In line with the [**mental health awareness month**](https://www.who.int/campaigns/world-mental-health-day), smokers should quit smoking to protect their mental health. Looking to the future, an approach to reducing smoking among persons with mental health issues that includes a wide range of safer nicotine products would provide governments with the tools to significantly improve health outcomes at a minimal cost. 


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Mental Health Awareness Month: Smoking and Harm Reduction. New Article By Joseph Magero.

The 10th edition of GFN celebrated a decade of progress in tobacco harm reduction. Experts discussed challenges, opportunities, and evidence-based approaches to nicotine use

**13 June 2023**

*Written by: Joseph Magero*

In Warsaw this June, [The Global Forum on Nicotine (GFN)](https://gfn.events/) celebrated its 10th edition, with a packed program reflecting on the last decade in safer nicotine use. The event brought together over 400 researchers, public health professionals, policymakers, and advocates to share scientific findings and insights.

This year's theme centered on reflecting on the challenges and successes of tobacco harm reduction over the past decade and sought to identify the priorities for advocates, academics, scientists, policymakers, manufacturers, and distributors in the future.

As usual, the GFN tackled controversial subjects head-on, in respectful debates involving all stakeholders. Public health advocates who attended the forum emphasized evidence-based approaches to nicotine use and policy-making. They revisited the key milestones of the last ten years, assessed today's complex political, regulatory, and scientific environment, and discussed the challenges and opportunities of the future.

Dr. Alex Wodak, a retired physician, hosted a session on reducing the environmental impacts of tobacco harm reduction. The panel included Dr. Colin Mendelsohn, a medical practitioner, academic, and researcher in smoking cessation and tobacco harm reduction for 40 years; who said that 'disposable vapes cause environmental harm but far less than cigarette butts.'

Clive Bates, former Director of Action on Smoking and Health (UK), sought testimonies from the audience on how the last decade can influence and inform the next. Delegates expressed concern as the W.H.O. makes preparations for the [10th session of the Conference of the Parties](https://fctc.who.int/who-fctc/governance/conference-of-the-parties/tenth-session-of-the-conference-of-the-parties) to the [W.H.O F.C.T.C.](https://fctc.who.int/who-fctc/overview) in Panama City later this year. They called on the World Health Organization (W.H.O) to stop its opposition to the tobacco harm reduction approach and insistence on banning less harmful alternative products, and instead rely on scientific research to support evidence-based policymaking.

Experts were particularly worried about the W.H.O F.C.T.C.'s push for a ban on [vapes and other smoke-free alternatives](https://www.kcl.ac.uk/news/vaping-substantially-less-harmful-than-smoking-largest-review-of-its-kind-finds), which would deprive smokers, especially those from L.M.I.C.s, of [the most effective means to quit cigarette smoking](https://www.cochrane.org/news/latest-cochrane-review-finds-high-certainty-evidence-nicotine-e-cigarettes-are-more-effective). 'It is absolutely clear that consumers across the world are demanding lower-risk alternatives,' said Dr. Sud Patwardhan, co-founder of the Centre for Health Research and Education ([CHRE](https://chre-uk.com/)).

As GFN 2023 finally came to an end, the comprehensive discussions provided invaluable insights into the facilitators and barriers to smoking cessation and transitioning to low-risk tobacco and nicotine products. The take-home message was, by relying on scientific evidence, we can make more informed, rational, and evidence-based choices that are grounded in the best available knowledge and understanding of the world around us.

This year's winner of the prestigious 2023 [Michael Russell Award](https://gfn.events/michael-russell/awards/) was Professor Gerry Stimson.

Follow us on [Twitter](https://twitter.com/Tobaccoharmred1) and [LinkedIn](https://www.linkedin.com/company/tobaccoharmreduction-net/).

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Global Experts Convene in Warsaw For The Global Forum on Nicotine

The 10th edition of GFN celebrated a decade of progress in tobacco harm reduction. Experts discussed challenges, opportunities, and evidence-based approaches to nicotine use.

Global Forum on Nicotine (GFN) 2023: Reflecting on Safer Nicotine Use

A [**new study**](https://onlinelibrary.wiley.com/doi/10.1111/add.16063) published in **Addiction** (by [**the society for the Study of Addiction**](https://www.addiction-ssa.org/)) has found significant harm reduction when switching from smoking to vaping or dual use. Following a [**systematic review**](https://ebn.bmj.com/content/14/3/64), this [**secondary analysis**](https://www.indeed.com/career-advice/career-development/secondary-analysis) incorporated nine studies from Greece, Italy, Poland, the United Kingdom and the United States. It features **1,299 adult participants** who smoked combustible cigarettes (CC), switched completely from smoking CC to electronic cigarettes (EC), or who switched to using both CC and EC (dual users). 

In a **secondary analysis**, researchers work with previously collected existing data (secondary data) to perform a new study. This allows researchers to work with large data sets, as they can work with data from multiple studies. A **systematic review** uses all the existing research and also secondary research (research on research). A high-quality **systematic review** is one of the most reliable sources of evidence to guide clinical practice, as it delivers a meticulous summary of the available primary research in response to a research question.

Measurements for the study were conducted using **carbon monoxide (CO) and other biomarkers**. [**Biomarkers (biological markers**)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3078627/) are biological molecules found in body fluids or tissues that signal a normal or abnormal process or a condition or disease. Measuring biomarkers enabled the researchers to indicate how biomarkers of harm change based on participants’ smoking/vaping behaviour. 

The study found exhaled CO (eCO) to be lower in participants who switched to EC completely than those who smoke CC or are dual users. eCO was also significantly lower in dual users than in CC only participants. 13 biomarkers were measured to compare EC versus CC – of these, 12 were lower in the EC groups. 25 biomarkers were measured when comparing EC to CC and dual use – of these, the results were lower for EC groups for 12 measures and for dual use groups for 5 measures. 

This secondary analysis confirms that exclusive EC use is associated with lower levels of biomarkers of harm than the exclusive use of CC or dual use. This supports the broad scientific consensus that the greatest health improvements come from ceasing the use of CC completely, and that (although not completely without risk) EC is a reduced-risk alternative that offers harm reduction benefits. An analysis such as this study not only informs debates concerning the potential harms and benefits of dual use but also illustrates the changes a smoker might expect if they switched completely to ECs or dual use.

Access [**www.tobaccoharmreduction.net**](https://www.tobaccoharmreduction.net/thr) to learn more about tobacco harm reduction.

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New study finds that switching from smoking to vaping or dual use significantly reduces potential harm

Dr. Marewa Glover is an experienced behavioural scientist, prolific author, and a compassionate advocate for tobacco harm reduction.

We sit down with [**Dr. Marewa Glover**](https://twitter.com/marewaglover), Director at the [Centre of Research Excellence: Indigenous Sovereignty & Smoking](https://coreiss.com/home). Dr. Glover is a Māori (New Zealand indigenous) behavioural scientist with over 30 years' experience in public health. She has written over [100 scientific papers](https://coreiss.com/publications) and is well known for her compassionate insight and **advocacy on tobacco harm reduction**. Dr. Glover was appointed as Tobacco Section Editor for the international [Harm Reduction Journal](https://harmreductionjournal.biomedcentral.com/about?gclid=Cj0KCQiAiJSeBhCCARIsAHnAzT_WapZOUObnh1u7UnkPUv6q6UOEHk9amGdjk0_66yR17cgn5cF4k3MaAqLaEALw_wcB) in 2019.

Click [here](https://www.youtube.com/watch?v=AsYMs8QLHCQ) to watch the **full episode** or on the topics below from the episode:

[Current Work](https://www.youtube.com/watch?v=etYzWcExHw0)

[SNUS was Never Illegal](https://www.youtube.com/watch?v=r3IATv2hIoE)

[NZ has Highest Priced Tobacco Relative to Income](https://www.youtube.com/watch?v=N0jC7wPGtyw)

[The Lack of Cessation Advice in NZ for Women](https://www.youtube.com/watch?v=s-PUOz8cDQc)

[There's No Good Basis to Deny Pregnant Women THR](https://www.youtube.com/watch?v=NLlpg7Ifpc8)

Click [HERE](https://www.tobaccoharmreduction.net/resources) to read more about tobacco harm reduction **RESOURCES.**

Click [HERE](https://www.tobaccoharmreduction.net/thr) to read our home page and access our **THR E - BOOK.**

Meet DR. MAREWA GLOVER in latest #WomeninTHR episode

Women in THR: Coffee Chat with Dr Marewa Glover | Full Webinar

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](https://media.thr.net/strapi/5839390b594654146dcd9da3c8accd4c.pdf) to read the letter. 

![MoH Bangladesh.png](https://media.thr.net/strapi/ae1b796d04be9e11ce01ac6b5315951c.png)



Bangladesh Public Consultation on ENDS: Letter Submitted By Experts to Bangladesh MoH Offering Comments On The Smoking and Tobacco Products Usage (Control) Act, 2005 (Amended in 2013).

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: **tobaccopolicy@gov.wales** for further details.

Government page to read more about the Consultation: [HERE](https://gov.wales/tobacco-control-strategy-wales-and-delivery-plan-html)

**How to respond**

Submit your comments by **31 March 2022**, in any of the following ways:
1. Complete our [**online form**](https://www.smartsurvey.co.uk/s/7KG7WK/)

2. Download, complete our [**response form**](https://www.google.com/url?q=https://gov.wales/sites/default/files/consultations/2021-11/consultation-questions_0.docx&sa=D&source=docs&ust=1647604864379064&usg=AOvVaw2cuT-gSLP4rqsf1VXA1zYY) 
 and email TobaccoPolicy@gov.wales

3. Download, complete our [**response form**](https://www.google.com/url?q=https://gov.wales/sites/default/files/consultations/2021-11/consultation-questions_0.docx&sa=D&source=docs&ust=1647604864379064&usg=AOvVaw2cuT-gSLP4rqsf1VXA1zYY) and post to:

Risk Behaviours Team
Welsh Government
Cathays Park
Cardiff
CF10 3NQ


![Welsh Post.png](https://media.thr.net/strapi/61e582c51141968c72ddf39b3776eb82.png)



The Welsh Government is seeking comments on the draft long term tobacco control strategy for Wales: A Smoke-free Wales and our first two year delivery plan: Towards a Smoke-Free Wales: Tobacco Control Delivery Plan 2022-2024.

On 14 July 2022, a Malaysia [**press release**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) reported that the draft of the proposed [**Tobacco and Smoking Control Bill**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) had been approved by the Cabinet. [**Health Minister Khairy Jamaluddin**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) said: “The Bill was approved by Cabinet yesterday. So I will be sending it to Parliament for this session". The proposed [**Bill**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) contains provisions to prohibit the sale of cigarettes, tobacco, and vape products to those born after 2005. 

[**13 public health experts**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) were prompted to [**respond**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) 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**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) of regulating non-combustible, reduced-risk products in the same way as combustible cigarettes. They emphasised two important points about ENDS: 
1. They do not involve combustion and so do not create products of combustion, and
2. To an increasing extent, they can replace smoking for many smokers. 

In this [**letter sent to the Malaysian PM**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) 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**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf).

[![Malysia Letter to PM ENDS July 2022.png](https://media.thr.net/strapi/817108fed617cb95c560befe8c5f8ede.png)](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf)
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Letter to Malaysian PM: A Call for Risk-Proportionate Regulation of ENDS

Discover how biomarkers are challenging conventional wisdom in tobacco control. Researchers Derek Yach and Gerhard Scherer introduce a groundbreaking approach to evaluating the harm reduction potential of tobacco alternatives like e-cigarettes. 

[A new research paper](https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/10.1002/dta.3567) is challenging a long-standing belief in the tobacco control community. For too long, potentially less harmful alternatives like e-cigarettes have been dismissed due to "lack of evidence." Now, researchers Derek Yach and Gerhard Scherer present a promising tool that could change this narrative: biomarkers.

"The reluctance to accept less harmful nicotine products, such as e-cigarettes, has always been rooted in the fear of the unknown and the desire for long-term evidence. Our research now showcases a robust method to bridge this knowledge gap sooner than previously imagined," said Derek Yach, one of the authors of the study.

Biomarkers are measurable substances in our bodies – present in fluids, tissues, and cells. They give information about our exposure to certain compounds and potential physiological effects. The use of these biomarkers could revolutionise the way we evaluate the harm reduction potential of new generation tobacco and nicotine products (NGPs). Instead of waiting for decades to understand the long-term effects of these products, we can rely on these indicators for quicker assessments.

"The future of public health depends on us embracing modern methodologies. Biomarkers offer a real-time snapshot of exposure levels, eliminating the traditional waiting period of 40-50 years to understand the effects of new products on our health," Gerhard Scherer, the research co-author commented.

A critically important application of this technology is in the life and health insurance industry. Currently, most insurers do not recognise the drastically reduced risk posed by smokefree alternative nicotine products, in comparison with combustible cigarettes.

“Insurers and their clients stand to gain by better quantifying and reducing smoking risk, using new technology such as biomarkers”, remarked Derek Yach.

With over a billion people globally facing health risks due to combustible cigarette consumption and a staggering eight million deaths linked to such cigarettes annually, the urgency for safer alternatives cannot be understated. NGPs like e-cigarettes and heated tobacco products hint at a future with reduced harm from tobacco. This study could be the key to unlocking that future.

[Watch the webinar here](https://www.youtube.com/watch?v=sWxc8Lrg0S0&ab_channel=TobaccoHarmReduction) on the breakthrough research paper, held Wednesday 13 September 10 AM EST.


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Revolutionizing Tobacco Control: Biomarkers Pave the Way for Safer Alternatives

Discover how biomarkers are revolutionizing tobacco control, providing a quicker and safer way to assess alternatives like e-cigarettes. Learn more here.

Biomarkers: A Game-Changer for Assessing Harm Reduction in Tobacco Alternatives.

We were joined by **[Michelle Minton](https://twitter.com/michelleminton)**, *nicotine researcher* and *policy analyst* to discuss key topics in tobacco harm reduction. We talked about things like: the unspoken benefits of tobacco and nicotine, the truth about vaping and popcorn lung and how narratives can prevent people from objectively looking at evidence. 

To see some **mini clips** from the webinar, click [**HERE**](https://www.youtube.com/channel/UCyHKweBxXVzcskK-HOo8PEg).

Or click below to watch the **full webinar** on our YouTube Channel.

Michelle Minton, THR Advocate and Policy Analyst at The Reason Foundation, talks to THR.net 

Women in THR: Coffee Chat | Michelle Minton Webinar Full

Local legislators are making it harder for citizens who smoke to switch to safer nicotine options, say tobacco harm reduction advocates. 

[**APTHR M**](https://apthrmedia.org/)[**edia**](https://apthrmedia.org/) **Press Release.**

 "Raising the legal age for buying cigarettes to 20 is a good move, but effectively banning e-cigarettes is disappointing from Taiwan," says Nancy Loucas, executive director of the [Coalition of Asia Pacific Tobacco Harm Reduction Advocates](https://caphraorg.net/) (CAPHRA).

"We're all for getting tougher on cigarettes but only if smokers and those desperate to quit have a viable, accessible alternative. Taiwan's legislators are sadly only making it harder for the 19% of citizens who smoke to switch to safer nicotine options," she says.

In January, lawmakers approved the third reading of the [Tobacco Hazards Prevention Act](https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=L0070021#:~:text=No%20person%20shall%20provide%20tobacco,in%20form%20of%20tobacco%20products.), banning e-cigarettes and requiring [heated tobacco products (HTPs)](https://www.tobaccoharmreduction.net/thr-products) to comply with the law.

Amendments place e-cigarettes in the 'cigarette-like product' category, effectively banning their use as well as the sale, provision or manufacturing of their necessary components. The amendments take effect a month after their publication by the Government.

People who use HTPs or e-cigarettes that are not approved by authorities would face fines as would those who manufacture, import, provide or advertise tobacco products, or non-approved HTPs.

Taiwan is an island nation 100 miles off the east coast of mainland China. It has a population of about 24 million, of which about 19 percent of adults are believed to smoke.

"Sadly, Taiwan now joins some other countries in Asia which have outright vaping bans in place. The [World Health Organization (WHO)](https://www.who.int/) and its Bloomberg Philanthropies - funded allies will no doubt be pleased. Their meddling and pressure have worked again.

"The move, however, goes against growing international science and public outrage that such bans are an affront to human rights and improving public health outcomes," says [Ms Loucas](https://nz.linkedin.com/in/nancy-loucas).

She says the fact that a relatively progressive nation like Taiwan can be convinced to ban vaping is the talk of the global [Tobacco Harm Reduction (THR) community](https://www.tobaccoharmreduction.net/community).

All eyes will be on [COP10 in Panama](https://fctc.who.int/newsroom/news/item/17-11-2022-panama-host-upcoming-cop10-mop3) this coming November - hosted by the [World Health Organization's Framework Convention on Tobacco Control (FCTC)](https://fctc.who.int/who-fctc/overview) which continues to press for signatory states to adopt ever more restrictive policies, including outright bans.

Recently, [CAPHRA](https://caphraorg.net/) wrote to its delegates from around the world, noting that two high-profile studies, which have been quoted by tobacco controllers regarding the dangers of nicotine and vaping, have since been retracted and removed from significant medical journals.

'Consumers' rights to choose to use less harmful products to switch from smoking remain under tremendous threat from FCTC's continuing failure to address scientific evidence, democratic processes and human rights,'  [CAPHRA](https://caphraorg.net/) wrote.

[Ms Loucas](https://nz.linkedin.com/in/nancy-loucas): "Taiwanese lawmakers say their amendments help ratify their commitments to WHO's FCTC. However, the FCTC has a mandate to pursue harm reduction as a core tobacco control policy - a position it has singularly failed to acknowledge or implement since its inception. Taiwan is conveniently overlooking that.

"Taiwan's smokers have the right to avoid adverse health outcomes and to access less harmful nicotine products as alternatives to smoking. It is very disappointing Taiwan's lawmakers are buying into WHO's discredited position," says Nancy Loucas.

For a free digital media repository on tobacco harm reduction in Asia Pacific - including media releases, images, and graphics - please visit [https://apthrmedia.org](https://apthrmedia.org/)

 **About CAPHRA**
  The [Coalition of Asia Pacific Tobacco Harm Advocates](https://caphraorg.net/) is a regional alliance of consumer tobacco harm reduction advocacy organizations. Its mission is to educate, advocate and represent the right of adult alternative nicotine consumers to access and use of products that reduce harm from tobacco use.

You can also find further information on [tobaccoharmreduction.net](https://www.tobaccoharmreduction.net/thr) regarding advocacy and resources for consumers and health professionals.

Taiwan vaping ban disappointing for its many smokers

Approximately 30% of adults between 15-64 are current smokers in Spain - shows the latest available data. There is a well-funded and vocal abstinence-only tobacco control establishment in Spain, and it seems to do its utmost to fight tobacco harm reduction. 

Clive Bates’ latest blog post with text, commentary and a 2 minute video explaining THR is well worth a read/listen and can be found here: [**A powerful declaration makes a compelling case for tobacco harm reduction**](https://clivebates.com/a-powerful-declaration-makes-a-compelling-case-for-tobacco-harm-reduction/). His [**tweet is here**](https://twitter.com/Clive_Bates/status/1585542869720469505). 

The international letter can be found here: [**Less Harm: international declaration for a smoke-free Spain (PDF)**](https://clivebates.com/documents/SpainInternationalLetterOct2022EN.pdf)

“So this is a call for the government to pay a little less attention to them and to reflect more on the opportunity to do better through THR.” says Clive. “Tireless work and energy from [**Carmen Escrig**](https://twitter.com/EscrigCarmen) to pull this together and kudos to the [**Plataforma para la reducción del daño por tabaquismo**](https://www.porlareducciondedanoportabaquismo.org/).”

![Spain Declaration.png](https://media.thr.net/strapi/9f1056f874fce92d60fae6e9ffade330.png)



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 Published letter from Spanish THR advocates signing a declaration for a smoke-free Spain backed by 170 national and international experts. “Useful beyond Spain and a great piece of work” - says Clive Bates of Counterfactual Consulting Ltd.

![E-Cig banners-01 (1).png](https://media.thr.net/strapi/7de2fdaf4efcceb096fb5ddf942363a0.png)

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.**
 
Click [HERE ](https://media.thr.net/strapi/0cbd3b34cef86dad0032528c324d2f7b.pdf) to read the full report, or [HERE](https://media.thr.net/strapi/e43d913841406aa46d3684a9ae4eeb48.pdf) to read the Executive Summary.









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In Favour of Flavour - A Key Report On How Flavours in Tobacco Harm Reduction Save Lives

Australian government could prevent up to 104,200 deaths by 2080 by relaxing restrictions on vaping products, says Georgetown University (USA) study.

A [**study**](https://doi.org/10.1093/ntr/ntac210) carried out by a leading institution investigates the potential impact of reducing the restrictions on vaping products on public health in Australia. The accepted manuscript, which is published in the journal **Nicotine & Tobacco Research**, was authored by leading researchers **Professors David Levy, Coral Gartner, Ron Borland and Michael Cummings.**

**[Click here](https://tobaccoharmreduction.net/en/articles/Georgetown-University-(USA)-st)** to read the full article. 

To access our **e - book** click [**here**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf).

[**Click here**](https://www.tobaccoharmreduction.net/thr-products) to review some information about **smoking cessation products** and to find out more about saving lives through THR advocacy click [**here**](https://media.thr.net/documents/THR_-_Lives_Saved.pdf). 

![SAVM study - Aus.jpeg](https://media.thr.net/strapi/f235d472c8d6f96ab6938deb2ead7e96.jpeg)





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Relaxed controls on vaping products could prevent Aussie deaths

Clive Bates, Director of Counterfactual Consulting, refutes the false activist proposition that kids are hooked by the flavours in e-cigarettes.

[**Clive Bates**](https://twitter.com/Clive_Bates?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor), Director of [Counterfactual Consulting](https://clivebates.com/), not only challenges but refutes the **false activist proposition** that kids are hooked by the flavours in e-cigarettes. In his article, [**The Bullshit Asymmetry Principle**](https://modelthinkers.com/mental-model/bullshit-asymmetry-principle), he assiduously challenges this premise by asking and answering five questions.

1. Do flavours cause youth tobacco or nicotine use? No, adolescents already open to tobacco use are those mostly prone to vaping, regardless of flavours.
2. So, what _does_ cause youth tobacco or nicotine use? It is not related to tobacco product features but to the characteristics of the individual and their circumstances, such as genetics, parental smoking, poverty, delinquency, rebelliousness, low self-esteem, peer group, etc.
3. What would teenage vapers do if they were not vaping? Teenagers interested in nicotine would likely revert to cigarettes, cigars or other tobacco products because the underlying demand remains unchanged.
4. How would a ban on flavours work? Prohibitions change the supply side for the worse. They cause new hazards due to informal manufacturing and workarounds. Illicit supply might also bring adolescents into contact with criminal networks.
5. What is really going on with youth vaping? Youth vaping follows two broad patterns: frivolous and experimental use (faddish, infrequent use) and determined nicotine use (teenagers who would otherwise use cigarettes or other tobacco products).

[Read the full article](https://tobaccoreporter.com/2022/12/01/the-bullshit-asymmetry-principle/) for more details.


![flavors.jpeg](https://media.thr.net/strapi/cb475fb5c6dd1b86ab079b665fd9beb9.jpeg)


A compelling lie: e-cigarette flavours hook kids 

We had the privilege of sitting down with [**Amanda Wheeler**](https://twitter.com/amandawheeler32?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor), to discuss important issues in [**tobacco harm reduction**](https://www.tobaccoharmreduction.net/thr), 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**](https://www.youtube.com/channel/UCyHKweBxXVzcskK-HOo8PEg/featured).

Or **click below to watch the full webinar** on our YouTube Channel.


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Amanda Wheeler, THR Advocate And Owner of Jvapes, Talks To THR.net On Recent Webinar

Women in THR: Coffee Chat | Amanda Wheeler Webinar Full

"Balancing Consideration of the Risks and Benefits of E-Cigarettes" - this must-read article demonstrates a considerable win for tobacco harm reduction. It not only accurately summarises why THR is being unfairly stymied, but also proposes sensible recommendations for vaping regulation.  

Balancing Consideration of the Risks and Benefits of E-Cigarettes

On September 28th, a new **Asia Harm Reduction Alliance** platform was launched, to bring together consumers, policymakers, and harm reduction experts in the health care community in the Asia Pacific and the Middle East region. 

The new website, along with a [**Twitter page**](https://twitter.com/HRA_asia) and [**YouTube Channel**](https://www.youtube.com/channel/UC_IPnHiXfRrRBBlhBPmZgAA), will provide advocates with up-to-date information on tobacco, alcohol, and drug health policy, scientific research, and news.

Dr. Marewa Glover, Director, Centre of Research Excellence: Indigenous Sovereignty & Smoking, New Zealand, is featured on the site as one of the champions of the platform, along with six other health experts. Dr. Marewa Glover quotes: 

*“**There are compassionate and more cost-effective ways to reduce smoking prevalence. One of these is to encourage switching to a low-risk alternative. The use of e-cigarettes (vaping) has been found to be more effective than nicotine replacement therapy in enabling people to quit smoking**”*

To read more and visit the website, [**click here**](https://asiaharmreductionalliance.net/).

![AsHRA_color_light_bg.png](https://media.thr.net/strapi/ce9b18da365e34a6fd289ae08f21432a.png)








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New Platform Revealed: The Asia Harm Reduction Alliance 

On the 22nd June, a [**webinar** ](https://www.youtube.com/watch?v=RnSgB5AxPfU&t=307s)hosted by thr.net took place. Moderated by [**Dr. Delon Human**](https://www.tobaccoharmreduction.net/dr-delon-human) and [**Jessica Perkins**](https://www.linkedin.com/in/jessica-perkins-963a4b32/) from ****tobaccoharmreduction.net****, the panel featured leading medical expert [**Dr. Konstantinos Farsalinos**](https://twitter.com/FarsalinosK), [**Professor Sharifa Ezat Wan Puteth**](https://www.linkedin.com/in/sharifa-ezat-wan-puteh-b2b05b196/), President of the Malaysian Society for Harm Reduction and [**Professor Neil McKeganey**](https://twitter.com/McKeganey1), 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**](https://twitter.com/HumanDelon). 


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.


**Key misconceptions and the role of health practitioners**


The **[Kantar survey](https://media.thr.net/strapi/57d0472d80a9339de39153e6793d973b.pdf)** showed that many adults in Malaysia are misinformed about the relative risk of THR products such as vaping. More than a third of Malaysians perceive them as more harmful or as harmful as cigarettes. “These figures underline the importance of health practitioners to encourage the efforts of smoking cessation”, argued [Professor Neil McKeganey](https://twitter.com/McKeganey1).


However, the survey shows that just **4%** of people who **vape** said that they were encouraged to do so by a health practitioner. This also stems from the fact that many of them do not understand the relative risks of vaping or the fact that nicotine itself does not cause cancer. 


All the speakers agreed that there is a huge role to be played by health practitioners in advising smokers to switch to less risky products, such as vaping. But in order to do that, misconceptions about reduced-risk products need to be dispelled. 


[**Professor Sharifa Ezat**](https://www.linkedin.com/in/sharifa-ezat-wan-puteh-b2b05b196/) spoke about THR encountering resistance from regulators and policymakers, since it’s a relatively new concept and the risk perception is skewed by exaggerated and fear-mongering media reports. 


The survey also found that **52% of Malaysian smokers** perceive vaping to be less harmful than smoking cigarettes. On this basis, **86%** said that vaping should be made available to smokers as a *less harmful* product and **90%** believe that **vaping should be actively promoted as a less harmful** alternative to smoking cigarettes.


The good news from the survey, however, is that those who have actually managed to switch to vaping, did so in order to cut down on smoking or quit completely (**49%**). 


**The use of flavours in vaping**


The [**Kantar survey**](https://media.thr.net/strapi/57d0472d80a9339de39153e6793d973b.pdf) showed that nearly a third of respondents (**61%**) who **vape** used **fruit flavours**, hence the use of flavours is a powerful way for people to cut down on or quit smoking entirely. [**Dr Farsalinos**](https://twitter.com/FarsalinosK) commented on the issues of flavours, and highlighted that if products do not taste good, smokers will unlikely want to use them to quit smoking. What can prevent e-cigarette users from relapsing back into cigarettes, is to provide a variety of flavours for them to choose between - keeping the e-cigarette experience more interesting. 


**We need to provide practical solutions through risk - based regulation**


In **[Malaysia](https://twitter.com/Tobaccoharmred1/status/1539529585695539202)** today, e-cigarette products are unregulated, which on the one hand means that users can easily access products that can help them to switch or quit smoking; but on the other hand it provides poor quality manufacturers the opportunity to use potentially dangerous ingredients - causing harm to consumers. 


The [**Kantar study**](https://media.thr.net/strapi/57d0472d80a9339de39153e6793d973b.pdf) saw that consumers are willing to embrace regulation of THR products, and the members of the panel agree that regulation is necessary to avoid having any substandard items on the market that could be dangerous to people’s health. However, as proven by other countries, bad regulation can cause people to switch back to smoking or never switch to vaping in the first place.


Success can only be achieved through proper information, knowledge and favourable legislation. [**Professor McKeganey**](https://twitter.com/McKeganey1) said that what will be important for any future legislation of THR products in Malaysia is that it increases the accessibility, availability and safety of these products compared to cigarettes. 


This webinar was the start of a much-needed debate in **Malaysia on tobacco harm reduction**. It highlighted how consumers feel about it and where it can go next. 


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NEW WEBINAR - MALAYSIA: ON THE PATH TO LIFE - SAVING ALTERNATIVES. A CALL FOR REGULATION TO PROTECT CONSUMERS

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**](https://hints.cancer.gov/view-questions-topics/question-details.aspx?PK_Cycle=5&qid=1282#) 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**](https://drive.google.com/file/d/1o0mlqZaMMUeD7Eapc1H0CdSsTz4HsuxE/view) 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**](https://medium.com/the-great-vape-debate/the-cdcs-evali-screwup-ff09f4c3e187): "The CDC made a gross error. The CDC's miscommunication is actually killing people, in my opinion."

Recommended reading:
-  [**Letter from Iowa's Attorney General Tom Miller and 75 public health experts to the CDC**](https://drive.google.com/file/d/1o0mlqZaMMUeD7Eapc1H0CdSsTz4HsuxE/view)
-  [**Marc Gunther's article 'The CDC’s EVALI screwup'**](https://medium.com/the-great-vape-debate/the-cdcs-evali-screwup-ff09f4c3e187)

![HINTS survey 2020 misinformation.png](https://media.thr.net/strapi/58605f6c56e2a8322ded4a7fd2501154.png)


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The misnomer of 'EVALI' is "actually killing people"

**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**](https://www.tobaccoharmreduction.net/articles/BOOK-REVIEW:-DR-COLIN-MENDELSO) to read the full review.

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Book Review: Dr Colin Mendelsohn's 'The Healthy Truth About Vaping'

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**](https://www.youtube.com/watch?v=7MaaYZZdrCc) to watch his presentation


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Public health implications of vaping in Germany: Prof Levy’s SAVM model predicts 4.7 million life years saved, and 300,000 deaths avoided by 2060

LIVES SAVED | What if German smokers switched to vaping? 🇩🇪

A group of world-renowned tobacco harm reduction experts spoke at the Africa Tobacco Harm Reduction Forum ([**ATHRF**](https://www.athrf.org/)) 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**](https://www.youtube.com/watch?v=KJBIix8q4IM) on the AHRA YouTube channel!


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Oral Nicotine in Africa: A Call for Product Safety Standards, says Tobacco Harm Reduction Experts

Africa Tobacco Harm Reduction Forum: A Gateway to a Smoke-free Africa | 14 February 2022, Nairobi

This [**study**](https://pubmed.ncbi.nlm.nih.gov/36250607/) (published by the [**National Library of Medicine**](https://www.nlm.nih.gov/)) is amongst a few that have considered the impact of e-cigarette flavors on smoking cessation outcomes. This study examines the effects of e-cigarette use and e-cigarette flavors on quit attempts and the quit success rate of smokers. 

[**Click here to read the full study**](https://pubmed.ncbi.nlm.nih.gov/36250607/).

[**Click here to access more resources on tobaccoharmreduction.net**](https://www.tobaccoharmreduction.net/resources).

[**Click here to access our e-book on tobacco harm reduction**](https://www.tobaccoharmreduction.net/thr). 

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Key United States Survey: Large study shows that smokers who try e-cigarettes are more likely to try to quit smoking, or to quit smoking entirely. Those using flavoured e-cigarettes are more likely to quit smoking successfully. 

The World Health Organization’s recently released 8th report on the global tobacco epidemic relating to new and emerging products,  is deeply flawed and unscientific according to a tobacco sector expert. This thought-provoking assessment also explains why the report is raising concern about the influence that Bloomberg Philanthropies exerts on WHO policy.

Concern over unscientific stance in WHO's 8th report on global tobacco epidemic

Discover why Health Canada's proposed vaping flavor regulations are crucial for balancing youth protection and adult harm reduction in Canada. Have your say!

**Why the consultation is important to THR:**


Health Canada has identified the availability of a variety of desirable flavours in vaping products, despite the current vaping restrictions, as one of the factors contributing to the rapid rise in youth vaping in Canada. However, banning almost all flavours, will make it less likely for adult smokers to switch to less harmful vaping products, or use them to quit tobacco altogether. Ultimately, the unintended consequence of such a ban can be very detrimental to both tobacco control and harm reduction. 

**How you can help**
 

Health Canada is seeking comments from health partners, general public, interested members of the industry, and people who vape, use tobacco products, or use both vaping and tobacco products. Please send in your comments before the deadline. 


**How to participate**


[mail](https://www.canada.ca/en/health-canada/programs/consultation-proposed-vaping-product-flavour-regulations-order.html#a4)
[email](mailto:hc.pregs.sc@canada.ca)



**Comments submitted**

Health Canada is seeking comments on their proposed ban on flavours in vaping products (e-cigarettes).  Deadline: 2 September 2021(at noon EDT)

Why Consultation Matters for THR: Health Canada's Vaping Flavor Regulations

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. 

**References**

1. Vaping 360: [https://vaping360.com/vape-news/113815/italy-will-reduce-e-liquid-tax-april-1st/](https://vaping360.com/vape-news/113815/italy-will-reduce-e-liquid-tax-april-1st/)

![2 hands for Italy post.jpg](https://media.thr.net/strapi/87c2bcc76eacff986d85a3a64b8fedc0.jpg)


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Today (April 1st 2022) - Italy reduces tax on e-liquids 

The FCTC is a treaty that was adopted by the World Health Organisation in 2003, and remains in force today. 

It seeks to protect present and future generations from the harms associated with tobacco consumption. However, its prohibitionist approach toward less harmful novel nicotine products - such as e-cigarettes, vapes, and pouches – is outdated, ideologically driven, and squandering the opportunity to save lives. 

One hundred experts have come together to call on the WHO leadership to launch a comprehensive rethink in their stance to tobacco harm reduction, before the COP9 summit in November. The letter makes seven key points, and then delivers six recommendations – all based on contemporary scientific evidence and expertise.

Click **[HERE](https://media.thr.net/strapi/89229bee7fc5b89d6d6ec9fad08412b1.pdf)** to read the letter.



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100 experts sign a public letter on the failure of the WHO’s current Framework Convention on Tobacco Control (FCTC), urging a comprehensive rethink before COP9

Discover how flavors aid tobacco harm reduction. The latest 2023 research by Dr. K. Farsalinos highlights flavors' role in smoking cessation.

A [new and updated revision of the "Case for Flavours in Tobacco Harm Reduction"](https://media.thr.net/strapi/34d52398d9056adece15e8bda5172870.pdf?updated_at=2023-08-29T12:28:33.423Z) by Dr. [Konstantinos Farsalinos](mailto:kfarsalinos@gmail.com), originally published in 2022, has been newly released for 2023.

The latest report contains updated studies on flavours, showcasing the most recent and up to date research, including the findings of a longitudinal study on non - tobacco vs tobacco flavours, and the effects on smoking abstinence. The study also describes how vaping non-tobacco flavours was not associated with youth smoking initiation but was associated with increased adult smoking cessation.

Read the [full report](https://media.thr.net/strapi/34d52398d9056adece15e8bda5172870.pdf?updated_at=2023-08-29T12:28:33.423Z) to learn more about how flavours save lives in tobacco harm reduction.

[Click here](https://www.tobaccoharmreduction.net/updates/flavours) to access more content on flavours on [THR.net](https://www.tobaccoharmreduction.net/thr).

![flavour-review.png](https://media.thr.net/strapi/cc8124fe583a68bf399f3dd01ed025b4.png)

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UPDATED - THE CASE FOR FLAVOURS IN TOBACCO HARM REDUCTION, TO SAVE LIVES BY DR KONSTANTINOS FARSALINOS

Discover the updated report by Dr. K. Farsalinos on the role of flavors in reducing tobacco harm. New studies show flavors' impact on smoking cessation. Learn more.

Flavours in Tobacco Harm Reduction: Latest Research 2023

Sweden approaches historic milestone of being Europe’s first ‘smoke-free’ country, says new report.

*Public Health Experts Urge Countries Around the World to Follow the Swedish Example*

**STOCKHOLM, Sweden, Mar 14, 2023**

**PUBLIC health experts launched a major new report today (TUESDAY) to mark Sweden approaching the historic milestone of becoming Europe's first 'Smoke Free' country.**

**Sweden is on course to drop below a 5% tobacco smoking prevalence rate in the coming months. This is the level below which the country will be considered officially 'Smoke Free'.**

**No other country in the European Union is even close to replicating this achievement and none are currently on track to even achieve it by the EU's target of 2040, in 17 years time.**

**The country's groundbreaking strategy to minimize the harmful effects of tobacco smoking and save lives is detailed in a new report entitled "** **The Swedish Experience: A roadmap for a smoke-free society** **," presented [today](https://www.youtube.com/watch?v=S-5SCNad53s) at an international research seminar in Stockholm.**

According to the report's authors, Sweden's approach, which combines tobacco control methods with harm minimisation strategies, could save 3.5 million lives in the next decade if other EU countries adopt similar measures.

"Quitting smoking like Sweden saves lives," says Dr. Anders Milton, one of the report's authors. "It has annually saved more than 3,400 lives in Sweden. If all other EU countries did as Sweden did, 3.5 million lives could be saved in the coming decade, in the EU alone."

**Combination of tobacco control with harm minimization**

The Swedish model combines recommendations in the WHO Framework Convention for Tobacco Control (FCTC), including reducing the supply and demand of tobacco, banning smoking in certain places, but it adds an important element: accepting smoke-free products as less harmful alternatives.

"It's about combining tobacco control with harm minimisation," explains Dr. Delon Human, another of the report's authors. "There are no risk-free tobacco products, but e-cigarettes, for example, are 95% less harmful than cigarettes. It is far better for a smoker to switch from regular cigarettes to e-cigarettes or nicotine pouches than to continue smoking."

**Public health benefits for individual and society**

The benefits of Sweden's strategy are enormous, with the country having the lowest percentage of tobacco-related diseases in the EU and a 41% lower incidence of cancer than other European countries. The report also describes how the percentage of smokers in Sweden has dropped from 15 percent to 5.6 percent of the population in 15 years, putting it on track to achieve smoke free status 17 years ahead of the EU's 2040 target

"Sweden has a very successful tobacco strategy that should be exported," says Professor Karl Fagerström, who also authored the report..

"It would be of enormous benefit to the world if more countries did as Sweden did with measures that reduce supply and demand while having differentiated tax rates that give smokers financial incentives to switch from cigarettes to less harmful alternatives," Dr. Fagerström added.

**About the report**

The report was commissioned by Health Diplomats, an international organization working to improve access to healthcare, encourage innovation and the use of harm reduction to minimize the negative impact of alcohol, food, nicotine and drugs.

[The full report is available here: ](https://media.thr.net/strapi/a2e4589c40fabbdfaae76bc7e1e3128e.pdf)

**Some of the report's conclusions and suggestions for implementation in other countries.**

1. Recognize smoke-free products as less harmful and that they pose significantly less risk than smoking. Encourage smokers to switch from cigarettes to less harmful alternatives.

1. Provide fact-based information. It is clear that there are no risk-free tobacco products. But, for example, e-cigarettes are 95% less harmful than cigarettes. Of course, it is better for a smoker to switch from regular cigarettes to e-cigarettes, although it is not without risk.

1. Policy decisions that make smoke-free alternatives more accessible than cigarettes. For example, differentiated taxes give smokers financial incentives to switch from cigarettes to less harmful alternatives.

**About the report's authors:**

Dr. Anders Milton, formerly chairman of the Swedish Medical Association, the Swedish Red Cross and the World Medical Association.

Prof. Karl Fagerström, docent and internationally recognized expert in addiction research and smoking cessation.

Dr. Delon Human, physician specializing in global public health issues. Former advisor on public health issues to, among others, three WHO directors-general and the UN secretary-general.

Swedish version:

**Ny expertrapport visar: Sverige snart rökfritt – Sveriges framgångsrika strategi räddar liv och bör gå på export**

**Sverige blir rökfritt 2023\*. Därmed blir landet först i EU att nå rökfrihet, något inget annat EU-land är i närheten av. I en ny rapport som presenteras i [dag](https://www.youtube.com/watch?v=S-5SCNad53s) redogörs för Sveriges framgångsrika strategi för att minimera tobaksrökningens skadeverkningar och därmed rädda liv. Om övriga EU-länder gjorde som Sverige gjort skulle miljontals liv kunna räddats under det kommande decenniet – bara i EU.**

Rapporten "_The Swedish Experience: A roadmap for a smoke free society"_ presenterades i dag på ett internationellt forskarseminarium i Stockholm. I rapporten uppmanar författarna andra länder att ta efter Sveriges framgångsrika strategi, som kombinerar metoder för tobakskontroll med skademinimeringsstrategier.

- Att sluta röka som Sverige räddar liv. Det har årligen räddat fler än 3 400 liv i Sverige. Om alla andra EU-länder gjorde som Sverige skulle 3,5 miljoner liv kunna räddas under det kommande decenniet, bara i EU, säger dr Anders Milton, en av rapportens författare.

**Kombitation av tobakskontroll med skademinimering**

En viktig del i den framgångsrika svenska strategin är att man proaktivt implementerat det som Världshälsoorganisationen (WHO:s) ramkonvention för tobakskontroll föreslår: att införa en rad åtgärder för att minska utbud och efterfrågan av tobak, liksom skademinimeringsåtgärder.

- I grunden handlar det om att kombinera åtgärder för tobakskontroll, som att förbjuda rökning på vissa platser, med att acceptera rökfria produkter som mindre skadliga. Det finns inga riskfria tobaksprodukter. Men exempelvis är e-cigaretter 95% mindre skadliga än cigaretter. Självklart är det bättre för en rökare att byta från vanliga cigarretter till e-cigaretter eller vitt snus, även om det inte är riskfritt, säger dr Delon Human, en av rapportens författare.

**Folkhälsovinster för individ och samhälle**

I rapporten redogörs för hur andelen rökare i Sverige på 15 år gått från 15 procent till 5,6 procent av befolkningen. Folkhälsovinsterna är enorma. Bland annat har Sverige lägst andel tobaksrelaterade sjukdomar av alla EU-länder och 41 procent lägre förekomst av cancer än andra europeiska länder.

- Sverige har en mycket framgångsrik tobaksstrategi som bör gå på export. Det skulle vara till enorm nytta för världen om fler länder gjorde som Sverige med åtgärder som minskar utbud och efterfrågan samtidigt som man exempelvis har differentierade skattesatser som ger rökare ekonomiska incitament att byta från

cigaretter till mindre skadliga alternativ, säger professor Karl Fagerström, en av rapportens författare.

**Några av rapportens slutsatser och förslag för implementering i andra länder.**

1. **Erkänn rökfria produkter som mindre skadliga** och att de utgör en betydlig mindre risk än rökning. Uppmuntra rökare att byta från cigaretter till mindre skadliga alternativ.

1. **Ge faktabaserad information som skapar acceptans.** Det är tydligt att det inte finns riskfria tobaksprodukter. Men exempelvis är e-cigaretter 95% mindre skadliga än cigaretter. Självklart är det bättre för en rökare att byta från vanliga cigarretter till e-cigaretter, även om det inte är riskfritt.

1. **Politiska beslut som gör rökfria alternativ mer tillgängliga än cigarretter.** Till exempel differentierade skatter som ger rökare ekonomiska incitament att byta från cigaretter till mindre skadliga alternativ.

**Om rapporten**

Rapporten har tagits fram på uppdrag av Health Diplomats, en internationell organisation som arbetar för att förbättra tillgången till hälso- och sjukvård, uppmuntra innovation och användning av skademinskning för att minimera den negativa effekten av tobak, alkohol, livsmedel och droger.

[Hela rapporten finns här:](https://media.thr.net/strapi/838c66b26020a0a75d7d7d931d34ecbf.pdf)

**Om rapportens författare**

**Dr Anders Milton,** tidigare bland annat ordförande för Svenska Läkarförbundet, Svenska Röda Korset och World Medical Association.

**Prof. Karl Fagerström** , docent och internationellt erkänd expert inom beroendeforskning och rökavvänjning.

**Dr Delon Human,** läkare specialiserad på globala folkhälsofrågor. Tidigare rådgivare om folkhälsofrågor till bland annat tre WHO-generaldirektörer och FN:s generalsekreterare.

\*Det europeiska natverket for tobaksforebyggande arbete (ENSP) och Varldshalsoorganisationen (WHO) anser att lander ar officiellt "rokfria" nar mindre an 5 procent av den vuxna befolkningen roker tobak.

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SWEDEN’S STUNNING SMOKE FREE SUCCESS PROVIDES A ROAD MAP THAT COULD SAVE LIVES OF MILLIONS - MAJOR NEW REPORT

Sweden's Smoke-Free Success Provides Global Road Map

[**AHRA** ](https://ahra.info/)(Africa Harm Reduction Alliance) hosted a [**Twitter Chat**](https://twitter.com/AfricaHRA/status/1511661651812134915) with the prominent [**THR**](https://www.tobaccoharmreduction.net/) advocate [**Aishat Alaran** (@alaranaishat)](https://twitter.com/alaranaishat) to learn more about one of the women behind the [**Campaign for Safer Alternatives**](https://safer-alternatives.org/) (**C.A.S.A**) organisation. [**Aishat**](https://twitter.com/alaranaishat) spoke openly and candidly about why it is important to have equal representation of females and males in [**THR**](https://www.tobaccoharmreduction.net/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**](https://ahra.info/e-book-ensuring-female-leadership-and-diversity-in-thr/) 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**](https://www.tobaccoharmreduction.net/) advocate named [**Professor Marewa Glover**](https://twitter.com/Tobaccoharmred1/status/1466068505132998666) as being another source of inspiration, especially when working under her leadership during a Tobacco harm Reduction Scholarship. Impressively, **[Professor Glover](https://twitter.com/Tobaccoharmred1/status/1466068505132998666)** has [**100 publications**](https://twitter.com/Tobaccoharmred1/status/1466068505132998666) to her name.

Aishat recently spoke at the [**Africa Tobacco Harm Reduction Forum**](https://www.youtube.com/watch?v=KJBIix8q4IM&t=4548s) in Nairobi in February, where a [**social media post quoting her**](https://twitter.com/AfricaHRA/status/1493186953709330436) received the highest reach on all of our [**THR.net**](https://www.tobaccoharmreduction.net/) and [**AHRA**](https://ahra.info/) platforms! 

Click **[HERE](https://media.thr.net/strapi/d6df0b5d5aae3275836ce74646bc35dd.pdf)** to access the **new E – Book**. 

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NEW E – BOOK: FEMALE LEADERSHIP IN THR. INTERVIEW WITH AISHAT ALARAN, PHARMACIST AND RESEARCHER

Unfortunately, last week scaremongering headlines circulated worldwide, based on an abstract from an unpublished study. Subsequently it has been [**WITHDRAWN**](https://newsroom.heart.org/news/e-cigarette-users-face-15-higher-risk-of-stroke-at-a-younger-age-than-traditional-smokers) 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**](https://www.acsh.org/news/2021/11/12/vaping-and-stroke-risk-new-study-hypes-wrong-conclusion-15933) of the data, this claim was shown to be methodologically flawed. Click [**HERE**](https://www.sciencemediacentre.org/expert-reaction-to-unpublished-conference-presentation-claiming-e-cigarette-users-face-15-higher-risk-of-stroke-at-a-younger-age-than-traditional-smokers/) to read more on prominent experts' reaction to the flawed claim.

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Unsubstantiated scaremongering headlines: Expert reaction to unpublished abstract claiming '15% higher risk of stroke at a younger age' for e-cig users

With quitting smoking one of the toughest behaviours to change, the UK is leading the world with its Stoptober campaign, **Dr Derek Yach, President of the Foundation for a Smoke-Free World** told **Great Britain News.**

The month-long campaign focuses on encouraging some of the roughly 7-million smokers in the UK to quit for good or switch to safer alternatives.

View Derek's interview [HERE](https://www.youtube.com/watch?v=QUXto5l9ehI)



Time to Ditch Or Switch This Stoptober

This month, we mark three important events: [**International Harm Reduction Day**](https://www.hri.global/) on 7 May, [**World Vape Day**](https://worldvapersalliance.com/en_gb/world-vape-day/) on 30 May and [**World No Tobacco Day**](https://www.who.int/campaigns/world-no-tobacco-day/2022) 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**](https://www.tobaccoharmreduction.net/). 


The harm reduction approach is already enshrined in [**Article 1d**](https://treaties.un.org/doc/Treaties/2003/05/20030506%2002-12%20PM/Ch_IX_04p.pdf) of the World Health Organisation’s ([**WHO**](https://treaties.un.org/doc/Treaties/2003/05/20030506%2002-12%20PM/Ch_IX_04p.pdf)) Framework Convention on Tobacco Control ([**FCTC**](https://treaties.un.org/doc/Treaties/2003/05/20030506%2002-12%20PM/Ch_IX_04p.pdf)). And yet their policies and public discourse do not reflect this. In a recent update of the [**WHO website’s Q&A section about e-cigarettes**](https://www.who.int/news-room/questions-and-answers/item/tobacco-e-cigarettes), they continued to assert the following:
• *E-cigarettes are ‘dangerous’, ‘harmful’, and ‘toxic’* – with no reference to the [**relative risk**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf) compared to combustible cigarettes
• *E-cigarettes provide a gateway for youth to cigarettes* – this claim is not backed by any robust evidence, and has in fact been [**refuted by numerous public health experts**](https://www.ucl.ac.uk/news/2022/mar/e-cigarettes-not-substantial-gateway-smoking-young-people#:~:text=E%2Dcigarettes%20not%20a%20substantial%20gateway%20to%20smoking%20for%20young%20people,-11%20March%202022&text=E%2Dcigarette%20use%20in%20England,study%20led%20by%20UCL%20researchers.)
• *Vaping can cause lung injury, misnamed ‘EVALI’*– a misrepresentation that is [**'killing people'**](https://medium.com/the-great-vape-debate/the-cdcs-evali-screwup-ff09f4c3e187)
• *“To date, evidence on the use of ENDS as a cessation aid is inconclusive”* – please refer to the Cochrane Collaboration’s [**living systematic review**](https://www.cochrane.org/CD010216/TOBACCO_can-electronic-cigarettes-help-people-stop-smoking-and-do-they-have-any-unwanted-effects-when-used) indicating that [**e-cigarettes do help smokers quit**](https://www.cochrane.org/CD010216/TOBACCO_can-electronic-cigarettes-help-people-stop-smoking-and-do-they-have-any-unwanted-effects-when-used) cigarettes, and probably [**more effectively**](https://www.cochrane.org/CD010216/TOBACCO_can-electronic-cigarettes-help-people-stop-smoking-and-do-they-have-any-unwanted-effects-when-used) than nicotine replacement therapy.


This [**misrepresentation of facts**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf) is squandering the opportunity to help millions of smokers switch to much less harmful products, such as [**nicotine vapes**](https://www.tobaccoharmreduction.net/thr-products) and [**pouches**](https://www.tobaccoharmreduction.net/thr-products). Herein lies the difference in approach amongst [**THR advocates**](https://www.tobaccoharmreduction.net/advocacy); backed by evidence and pragmatism, THR supports the provision, rather than prohibition, of [**safer alternatives**](https://www.tobaccoharmreduction.net/thr-products) to those who are struggling to quit cigarettes. Here are **six ways in which harm reduction differs to prohibition**:


### **1. Dogmatic vs Open-minded**
In the FCTC’s biennial [**Conference of the Parties**](https://fctc.who.int/who-fctc/governance/conference-of-the-parties#:~:text=Conference%20of%20the%20Parties&text=Regular%20sessions%20of%20the%20Conference,of%20its%20next%20regular%20session.) (COP) meetings, ministers from around the globe convene to share their progress on implementation of tobacco control measures. These fora provide an opportunity for international cooperation. The problem is that they [**exclude**](https://clivebates.com/one-hundred-specialists-call-for-who-to-change-stance-on-tobacco-harm-reduction/) any perspective sympathetic towards harm reduction, despite [**reasoned imploration from hundreds of independent experts**](https://clivebates.com/one-hundred-specialists-call-for-who-to-change-stance-on-tobacco-harm-reduction/). Within these ideologically confined meetings, awards are given to those who **toe the dogmatic line** of condemning vaping. Astonishingly, in [**2019**](https://clivebates.com/prohibitionists-at-work-how-the-who-damages-public-health-through-hostility-to-tobacco-harm-reduction/) India’s health minister was lauded with special recognition for his country’s [**ban of e-cigarettes**](https://www.spectator.co.uk/article/the-whos-bizarre-war-on-e-cigarettes), despite [**robust evidence that they are at least 95% safer than cigarettes**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf). Rather than viewing all nicotine use with [**irreconcilable hostility**](https://tobaccoreporter.com/2020/11/01/the-irreconcilable-conflict-principle/), harm reduction advocates acknowledge that nicotine is not the enemy. They are open-minded about the [**continuum of risk**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf) of products, with the ultimate aim of helping people move away from the most harmful ones.


### **2. Punitive vs Compassionate**
After a [**recent ban of e-cigarettes in Hong Kong**](https://www.scmp.com/news/hong-kong/law-and-crime/article/3176654/hong-kong-police-make-first-arrests-under-law-banning) (despite [**evidence**](https://www.news.gov.hk/eng/2022/05/20220526/20220526_125509_474.html#:~:text=Hong%20Kong's%20smoking%20prevalence%20fell,a%20press%20conference%20this%20morning.) that they are helping reduce smoking rates), two people were recently [**arrested**](https://www.scmp.com/news/hong-kong/law-and-crime/article/3176654/hong-kong-police-make-first-arrests-under-law-banning) for selling nicotine vaping products. Whilst the sale of cigarettes remains legal and widespread, the cost of selling e-cigarettes is up to [**6-months imprisonment**](https://www.scmp.com/news/hong-kong/law-and-crime/article/3176654/hong-kong-police-make-first-arrests-under-law-banning). In contrast, on the [**Isle of Man**](https://www.bbc.co.uk/news/world-europe-isle-of-man-42909703), a 2008 ban on tobacco in prison led to inmates smoking illicit materials, including banana peels, tea bags, and nicotine patches. In response, a [**pilot scheme introduced the provision of regulated e-cigarettes for inmates**](https://www.bbc.co.uk/news/world-europe-isle-of-man-42909703) to use in their cells and outdoor spaces. Since the trial began, there have been 58% fewer behaviour warnings, a [**25% increase in intention to quit smoking**](https://www.bbc.co.uk/news/world-europe-isle-of-man-42909703), and an annual saving of £8500 on nicotine patches. 


### **3. Idealistic vs Pragmatic**
Riding in a car is an activity with inherent risks. Reasonable steps can be taken to minimise driving-related harm, such as seat belts and speed limits. Similarly, [**harm reduction proponents**](https://www.hri.global/what-is-harm-reduction) accept that e-cigarettes, like driving, are not completely risk-free. However, there is [**increasing evidence**](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub5/full), beyond reasonable doubt, that they are **significantly safer** than cigarettes. Bearing this in mind, and the fact that merely [**4-7% of smokers succeed in quitting**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf) using traditional measures, the pragmatic approach is to offer safer alternatives. A [**randomised trial**](https://www.nejm.org/doi/full/10.1056/NEJMoa1808779. 
) published in 2019 showed that using [**e-cigarettes nearly doubled the chance of quitting smoking**](https://www.nejm.org/doi/full/10.1056/NEJMoa1808779. 
) compared to nicotine replacement therapy. 


### **4. Ideological vs Evidence-based**
As described earlier, the WHO’s current stance is that “evidence on the use of ENDS as a cessation aid is inconclusive”. This statement is ideologically driven, rather than evidence-based. In contrast, a [**growing list**](https://clivebates.com/expert-statements-on-who-and-tobacco-harm-reduction/) of reputable and independent public health organisations and experts are acknowledging the [**tremendous potential of vaping to displace smoking**](https://clivebates.com/expert-statements-on-who-and-tobacco-harm-reduction/) and improve individual and population health. Two former directors of non-communicable disease control at the WHO, [**Prof Ruth Bonita**](https://clivebates.com/expert-statements-on-who-and-tobacco-harm-reduction/) and [**Prof Robert Beaglehole**](https://clivebates.com/expert-statements-on-who-and-tobacco-harm-reduction/), have [said](https://clivebates.com/expert-statements-on-who-and-tobacco-harm-reduction/): “WHO’s continuing disregard of the wealth of evidence on the value of these products is condemning millions of smokers to preventable disease and premature death.”


### **5. Stigmatising vs Accepting**
At the recent [**E-Cig Summit**](https://www.e-cigarette-summit.us.com/seminar/the-vape-shop-experience/) in Washington D.C., [**Marc Slis**](https://www.e-cigarette-summit.us.com/seminar/the-vape-shop-experience/) delivered a memorable address as an ex-smoker, vaper, and vape shop owner. Commenting on the anti-vaping lobby’s scaremongering campaigns, [he said](https://www.e-cigarette-summit.us.com/seminar/the-vape-shop-experience/): “Smokers are treated as acceptable collateral damage in a war against Big Tobacco. You trained the public to despise us. You trained us to despise ourselves”. It does not need to be this way; harm reduction practitioners are committed to [**meeting people ‘where they are’**](https://www.hri.global/what-is-harm-reduction) in their lives without judgement. Harm reduction focuses on motivating [**positive change**](https://www.hri.global/what-is-harm-reduction) through facilitation rather than coercion. 


### **6. Authoritarian vs Autonomous**
A prime example of prohibitionists’ authoritarian approach is how the [**International Network of Nicotine Consumer Organisations**](https://innco.org/) (INNCO) has been [**repeatedly denied observer status**](https://ahra.info/four-basic-consumer-rights-not-respected-by-the-anti-thr-lobby/) to the FCTC’s COP meetings. Rather than engaging with the very people impacted by their decisions on a daily basis, WHO continues to [**exclude them**](https://innco.org/) from the conversation. Conversely, harm reduction strategies emphasise the importance of empowering people to have [**control over their own health**](https://www.hri.global/what-is-harm-reduction) in order to live healthier lives. It respects people’s [**consumer rights**](https://ahra.info/four-basic-consumer-rights-not-respected-by-the-anti-thr-lobby/), including the [**right to choose**](https://ahra.info/four-basic-consumer-rights-not-respected-by-the-anti-thr-lobby/). 


![Prohibition vs Harm Reduction.png](https://media.thr.net/strapi/f70cead3f7c73c46d421f37845c1081a.png)



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SIX DIFFERENCES BETWEEN HARM REDUCTION AND PROHIBITION

Revolutionizing Tobacco Control: Dr. Colin Mendelsohn's Vision for Nicotine Harm Reduction in an Era of Information Overload

In our era of big data and hyperconnectivity, “we are drowning in information but starved for knowledge”, as [**John Naisbitt**](https://www.electronicdesign.com/content/article/21802367/drowning-in-information-but-starved-for-knowledge) once said. Since the inception of the like and share buttons on social media over 10 years ago, the [**fragmentation of societal perspectives into echo chambers has intensified**](https://www.theatlantic.com/magazine/archive/2022/05/social-media-democracy-trust-babel/629369/). To counterbalance this catalysation of our [**instinctively tribalistic tendencies**](https://www.theatlantic.com/magazine/archive/2022/05/social-media-democracy-trust-babel/629369/) to organise ourselves into groups with shared beliefs, we need rational thinkers who [**communicate clearly**](http://colinmendelsohn.com.au/dr-mendelsohn/) to challenge the status quo. 
In tobacco control, the decades-long [**status quo**](https://www.tobaccoharmreduction.net/thr) has been to view any nicotine use, regardless of delivery method, through a moralistic, binary lens. Out of this was borne the [**‘quit or die’**](https://www.tobaccoharmreduction.net/health) approach traditionally employed by [**well-meaning health professionals**](https://www.tobaccoharmreduction.net/health) in their interactions with smokers. However, as [**Dr Colin Mendelsohn**](https://colinmendelsohn.com.au/book/) explains in chapter 3 ([**‘Busting the Myths about Nicotine’**](https://colinmendelsohn.com.au/book/)) of his book, [**nicotine does not cause cancer, lung disease or heart disease**](https://ahra.info/what-is-pharmaceutical-grade-synthetic-nicotine-what-is-the-difference-between-s-nicotine-and-r-nicotine/). Backed by [**over 400 scientific publications**](https://colinmendelsohn.com.au/book/), and [**over 30 years of experience as doctor with a specialist interest in smoking cessation**](https://colinmendelsohn.com.au/book/), Dr Mendelsohn articulates compellingly how health professionals and smokers alike need to [**target the smoke**](https://www.tobaccoharmreduction.net/thr-products) from combustible tobacco as the noxious agent, not nicotine. 
By spearheading this revolution in thinking in Australia, [**Dr Mendelsohn**](http://colinmendelsohn.com.au/dr-mendelsohn/) represents one of a [**growing list of eminent global expert individuals and organisations**](https://clivebates.com/one-hundred-specialists-call-for-who-to-change-stance-on-tobacco-harm-reduction/) who support tobacco harm reduction as a pragmatic, compassionate, and [**innovative solution**](https://www.tobaccoharmreduction.net/thr-products) to the [**world’s leading preventable killer**](https://www.youtube.com/watch?v=tpPrDo3bMsU): smoking, not nicotine. 
We spoke to [**Dr Delon Human**](https://ahra.info/about-the-africa-harm-reduction-alliance/#delon), Physician and CEO of the [**Africa Harm Reduction Alliance**](https://ahra.info/), about [**Dr Mendelsohn’s book**](https://colinmendelsohn.com.au/book/). He praised its primary aim – to help smokers, as well as its appeal to a diverse audience: *“Public discourse about vaping and tobacco harm reduction has become increasingly polarised. In such a dogmatic environment, smokers are left wondering in the lurch about what the truth is. Dr Mendelsohn’s book cuts through the noise to provide a compelling and hysteria-busting case for nicotine vaping as a viable and life-saving alternative to combustible tobacco. His authority and clarity of communication is informed by a lifetime professional commitment to helping smokers quit or switch to safer alternatives, and a balanced consideration of scientific evidence; his book references over 400 scientific publications. Dr Mendelsohn’s rational, articulate and compassionate approach will appeal to smokers, their families, health professionals, and policymakers alike.”* – [**Dr Delon Human**](https://ahra.info/about-the-africa-harm-reduction-alliance/#delon).


Not only does [**Dr Mendelsohn’s book**](https://colinmendelsohn.com.au/book/) provide a comprehensive and practical [**how-to guide**](https://colinmendelsohn.com.au/book/) 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’**](https://colinmendelsohn.com.au/book/)), 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**](https://ahra.info/four-basic-consumer-rights-not-respected-by-the-anti-thr-lobby/): *“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”.* 
For [**health professionals**](https://www.tobaccoharmreduction.net/health), this book’s status as ‘required reading’ is cemented by the fact that the vast majority of doctors in a [**recent study**](https://link.springer.com/article/10.1007/s11606-020-06172-8) incorrectly believed that nicotine causes cardiovascular disease, COPD, and cancer. In contrast, [**evidence published this month from an Australian national survey**](https://pubmed.ncbi.nlm.nih.gov/35403757/) found that using nicotine vapes to quit smoking [**increased the odds of success by 68%-124%**](https://pubmed.ncbi.nlm.nih.gov/35403757/) compared to not using a vape. [**Dr Mendelsohn**](https://colinmendelsohn.com.au/book/)’s quest to share the healthy [**truth about vaping**](https://colinmendelsohn.com.au/book/) as a tool to help smokers quit is commendable; we highly recommend reading [**his book**](https://colinmendelsohn.com.au/book/).

![Twitter Infographics THR.NET (15).png](https://media.thr.net/strapi/05972b6c8a750bd860e0c0018544b696.png)

Challenging Tobacco Control Norms: Dr. Colin Mendelsohn's Revolutionary Approach to Nicotine

Revolutionizing Tobacco Control: Dr. Colin Mendelsohn's Innovative Approach to Nicotine and Harm Reduction

Revolutionary Approach to Nicotine: Dr. Colin Mendelsohn

Authored by [**Joseph Magero of CASA**](https://safer-alternatives.org/about-us/what-we-do).

Non-communicable diseases (NCDs)—including cardiovascular diseases, chronic respiratory diseases, and cancer—account for about **60%** of global deaths, mostly in low and middle-income countries. Smoking and tobacco use accounts for a sixth of these deaths.

Cigarette smoking is a major risk factor for noncommunicable diseases such as chronic respiratory diseases, cancer, heart disease and stroke, as well as a factor for some communicable diseases such as tuberculosis. Evidence obtained shows that important benefits of reducing smoking accrue quickly; a reduction in tobacco use rapidly decreases NCDs and healthcare costs.

Click **[HERE](https://tobaccoharmreduction.net/en/articles/In-Aid-of-World-Heart-Day-Th)** to read the full article. 

To access [**more resources**](https://www.tobaccoharmreduction.net/resources) on tobacco harm reduction, [**click here to read our e- book**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf), and [**HERE**](https://www.tobaccoharmreduction.net/thr-products) to read about reduced-risk products that can significantly reduce the likelihood of developing NCDs. 

![TSC-World-Heart-Day-Banner.jpg](https://media.thr.net/strapi/d3ff5fec927a5c35159636a08b990350.jpg)



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World Heart Day: 29th September: The Unrelenting Health Burden of NCDs - A Pleading Call for Tobacco Harm Reduction

The [**Institute for Addiction Research (ISFF)**](https://www.frankfurt-university.de/de/hochschule/fachbereich-4-soziale-arbeit-gesundheit/forschung-am-fb-4/forschungsinstitute/institut-fuer-suchtforschung-isff/) organised the **5th specialist conference on October 12th, 2022**. 

The 5th conference is about the ambitious goal of **reducing the smoking prevalence in the adult population to below 5% by 2040 (currently 32%)**: Which strategies can lead to the fact that this goal is also achieved?

They invited speakers who spoke on the following topics (click **[HERE](https://www.youtube.com/playlist?list=PLnRTcgVEfLKYkXJ5zgCkjKvekXlkWpqy8)** for the playlist);

1. Dual Use
 
2. "... and if we make it...?
What is to be expected for morbidity/mortality with low smoking prevalence, when are relief effects likely to occur?”
 
3. Recent developments: RESET (a framework for tobacco harm reduction products)
 
4. Workplace health promotion / smoking cessation

5. Nicotine – to blame for everything? About misunderstandings and facts about the premature mortality of smokers
 
6. Now it's getting tasteless - debate about flavors - what we know, what we should know
 
7. Flavors: Relevance from a consumer perspective
 
8. Smoking movers, non-smoking magistrates - social and health inequalities in smoking prevalence
 
9. The RauS study - variety of individual strategies from tobacco addiction
 
10. Position paper 2.0

Click on the video below to watch **Dr. Delon Human** discussing the RESET framework for THR.

To access more resources about tobacco harm reduction click [**HERE**](https://www.tobaccoharmreduction.net/thr).

To read our E-Book, click [**HERE**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf). 


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"5% by 2040 - can we do it? - Promising smoking cessation strategies". Frankfurt University E-Cig Conference brings together global experts on tobacco harm reduction.

Frankfurt University E-Cigarette Conference 2022 - RESET Dr Delon Human (English)

Discover key insights from the South American Seminar on Tobacco Harm Reduction in Brazil, emphasizing the potential for saving lives through empathetic approaches, accessible alternatives, and sound policy development.

On 11 May 2023, São Paulo hosted the South American Seminar on Tobacco Harm Reduction ([THR](https://www.tobaccoharmreduction.net/thr)). Experienced speakers, from fields including public health, academia and government, gathered to [discuss the future of THR](https://www.tobaccoharmreduction.net/community). The seminar also saw the launch of [pahra.net](https://pahra.net/en_za/tobacco-harm-reduction/) – the Pan America Harm Reduction Alliance (PAHRA) website that focuses on providing [accurate information on THR](https://media.thr.net/pdfs/Tobacco_Harm_Reduction_2021.pdf) and related topics.

Crucial takeaways:

- [**Potential lives saved**](https://www.emerald.com/insight/content/doi/10.1108/DAT-02-2020-0012/full/pdf?title=accelerating-an-end-to-smoking-a-call-to-action-on-the-eve-of-the-fctcs-cop9) with THR: As many as **3 million lives per year** can be saved by 2060 by embracing empathetic tactics to encourage individual smokers to quit or switch to non-combustible THR products.
- **Case studies** from Sweden, Japan, the UK, New Zealand and Germany: National approaches to THR must be based on Professor Michael Russell's statement that ["People smoke for the nicotine but die from the tar."](https://pahra.net/en_za/tobacco-harm-reduction-with-vaping/) The [case studies show](https://smokefreesweden.org/wp-content/themes/smokefreesweden/assets/pdf/reports/Report%20The%20Swedish%20Experience%20EN.pdf) that through affordable, accessible, socially acceptable alternatives to smoking, smoking rates (and the related disease burden and mortality rates) are drastically lowered.
- **Nicotine policy principles** such as [risk-proportionate regulation](https://pahra.net/en_za/thr-risk-continuum/), youth prevention, labelling, cessation and taxation: Through risk-proportionate regulation, regulators can positively impact THR. This involves very strict regulation of the most harmful products (such as cigarettes), while regulation of the least harmful products (such as vapes) focuses on consumer protection. This also impacts a country's approach to labelling, taxation, advertising and more.
- **Consumer insights** on the topics of misinformation, [cessation motives and methods, flavours, and nicotine misperceptions](https://www.tobaccoharmreduction.net/thr-products): A large proportion of current smokers indicate that they would like to stop smoking. With present methods, however, the effective quit rate is very low. Consumer education is crucial, as many believe that THR products (such as vapes, snus and tobacco pouches) are as harmful (or even more harmful) as combustible tobacco products.

Sound science-based policy development must not only replace ideological pressures and the overemphasis on youth initiation but also clearly communicate that THR alternatives are [much less harmful than smoking](https://www.cochrane.org/news/latest-cochrane-review-finds-high-certainty-evidence-nicotine-e-cigarettes-are-more-effective#:~:text=Trusted%20evidence.-,Latest%20Cochrane%20Review%20finds%20high%20certainty%20evidence%20that%20nicotine%20e,in%20helping%20people%20quit%20smoking) and encourage the creative destruction of the cigarette by allowing innovation in smoke-free nicotine delivery systems.

Some of the world-renowned independent tobacco harm reduction experts at the event included:

- [Dr. Delon Human](https://www.tobaccoharmreduction.net/dr-delon-human)
- [Prof. Marewa Glover](https://www.linkedin.com/in/marewa-glover-3a427235/)
- [Dr. Kgosi Letlape](https://en.wikipedia.org/wiki/Kgosi_Letlape)
- [Dr. Konstantinos Farsalinos](https://www.linkedin.com/in/konstantinos-farsalinos-gr/)
- [Dr. Chris Russell](https://twitter.com/NicotineSurveys)
- [Prof. Heino Stöver](https://twitter.com/HeinoStoever)
- [Dr. Anders Milton](https://www.linkedin.com/in/anders-milton-6273292/)
- [Prof. Adriana Gioda](https://www.linkedin.com/in/adriana-gioda-059215174/)
- [Miguel Okumura](https://twitter.com/_aoshiz)
- [Juan Facundo Teme](https://twitter.com/JuanFacundoTeme)
- [Dr. Diego Verrastro](https://twitter.com/docverrastro)
- [Cíntia Leci Rodrigues](https://www.linkedin.com/in/cintia-leci-rodrigues-07b34232/)
- [Clive Bates](https://www.linkedin.com/in/clivebates/)
- [Dr. Derek Yach](https://www.linkedin.com/in/derek-yach-53369261/)
- [Federico N Fernandez](https://www.linkedin.com/in/federico-fernandez-936003187/)
- [Prof. Mihaela Răescu](https://www.linkedin.com/in/mihaela-raescu-a0601b24/)
- [Patricia Kovacevic](https://www.linkedin.com/in/patriciakovacevic/)

Follow us on [Twitter](https://twitter.com/Tobaccoharmred1) and [LinkedIn](https://www.linkedin.com/company/tobaccoharmreduction-net/).

Read more on [Tobacco Harm Reduction](https://www.tobaccoharmreduction.net/resources).

 

Watch the video to learn more about how THR can save lives in Brazil and Latin America:

PREVENTABLE DISEASES: TOBACCO HARM REDUCTION SEMINAR IN BRAZIL

Explore the South American Seminar on Tobacco Harm Reduction (THR) in Brazil, highlighting the potential to save millions of lives and the importance of embracing alternative nicotine products.