Tobacco Control Discussions Cannot Ignore Harm Reduction Products

More than 1 billion people smoke globally, and more than 7 million people die each year from smoking and using other tobacco products. This is unacceptable. Efforts must be accelerated to eliminate smoking and save lives.

Harm reduction products can serve as powerful and effective smoking cessation tools. They provide smokers with reduced-risk alternatives to cigarettes and other forms of combustible tobacco. However, smokers still have misperceptions about HRPs that cloud their understanding of these products. Furthermore, one-sided, biased narratives driven by global health organizations are limiting the progress of ending smoking and reducing the harm caused by combustible tobacco worldwide.

Recently, the World Health Organization Framework Convention on Tobacco Control held the eighth session of the Conference of the Parties to discuss its 2018 Global Progress Report and the future of tobacco control. The provisional report of the COP8 to the FCTC emphasized the importance of tobacco control strategies like taxation, plain packaging and pictorial warnings, and public smoking bans. Progress achieved by the implementation of these measures by some countries has been slow and not highly effective at ending smoking.

It’s been projected that 1 billion people will die from smoking this century despite the FCTC’s efforts. The report states that a WHO representative announced that a forthcoming report would provide evidence on the effectiveness of electronic nicotine delivery systems as a smoking cessation tool.

We look forward to that report. However, the FCTC declared at the COP8 that harm reduction was linked to “unproven claims.” Such disregard constrains the potential impact of tobacco control and the like-minded organizations working to end smoking.

A new report entitled “No Fire, No Smoke: Global State of Tobacco Harm Reduction 2018,” published by Knowledge-Action-Change in October, aims to build awareness of harm reduction and the potential benefit it can bring. It emphasizes that HRPs such as e-cigarettes, heated tobacco products and Swedish snus have been notably successful at reducing global smoking rates. We cannot ignore the promising evidence that HRPs may be effective smoking cessation tools.

Of course, more research is required to fully understand the long-term impacts of HRPs. Smoking cessation techniques have been stagnant; we need to invest in innovative research that could drive effective solutions and shed light on the long-term health implications of HRPs.

Progress is often constrained by limited access to policymakers and partners on the international stage, especially in developing countries. Low- and middle-income countries have significantly fewer resources to implement the tobacco control measures recommended by the FCTC. Approximately 80 percent of the world’s 1.1 billion smokers live in LMICs.

As the global demand for tobaccogrown particularly by LMICs — is declining, tobacco farmers will be negatively impacted. The COP8 report encouragingly states, “Parties were urged to increase support for tobacco farmers seeking economically viable alternative livelihoods (Article 17).” It adds, “In respect of Articles 17 and 18, Parties expressed their support for studies and economic modelling of potential alternative crops and for measures to support vulnerable groups involved in tobacco-growing, especially women and children.”

With limited public funding for research, organizations that are seeking to eliminate smoking globally must collaborate and form partnerships to support and lead smoking cessation research. The Foundation for a Smoke-Free World, of which I am the president, has both the financial resources and the international relationships to partner with the WHO on its identified barriers to advance progress toward our shared vision — a world with no smoking.

FSFW has the capacity to support research and innovation to drive real change and to educate smokers about effective tools to quit. Additionally, our Agriculture Transformation Initiative aims to diversify tobacco-dependent economies by preparing smallholder tobacco farmers for an era of reduced demand for tobacco leaf.

The time is now. We must move beyond exclusion and focus on engagement to help solve this global health crisis.


Derek Yach is the president of the Foundation for a Smoke-Free World, which seeks to end smoking in this generation, and previously Yach was a World Health Organization cabinet director overseeing tobacco control policy.   

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