Prohibitive policies on nicotine alternatives deprive consumers of their rights, say advocates

Consumers will become the “collateral damage” should prohibitive policies against alternative nicotine delivery systems, such as e-cigarettes, heated tobacco products (HTPs) and snus will be put in place, said tobacco harm reduction (THR) advocates.

They call instead for reasonable, fair, and humane regulations to strengthen public health policies during 7th Global Forum on Nicotine last June 11 to 12 which was held virtually due to COVID-19.

“It’s a sad thought that in this ruckus, consumers become the collateral damage, the one that, in the end, will suffer, if prohibitive policies will be put in place,” Clarisse Virgino, the Philippine representative to the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) said in her presentation during the annual event organized by Knowledge Action Change Limited. This year’s edition focused on the role of smoke-free products, such as e-cigarettes, HTPs or heat-not-burn (HnB), and snus in reducing smoking-related harms

“Prohibiting THR products such as e-cigarettes or vape, HnB devices, and snus will not just affect people who have already made the switch. This will affect people who are still trying to quit regular combustible cigarettes, depriving them of their right to do the switch, or basically, just to choose. A person’s right to choose is not just a consumer right, but it’s a basic human right,” Virgino said.

“Consumers and their rights should be protected under these policies. I think it’s just unfair and wrong, in so many levels, to disregard consumers in creating policies surrounding THR. As they say, there is nothing about us, without us,” she said.

Smoke-free nicotine products are considered a part of THR — a public health strategy that aims to provide alternatives to reduce risks caused by smoking cigarettes.

It has been known that the combustion or burning of tobacco and the release and inhalation of smoke causes diseases, not nicotine. Though not risk-free, nicotine is not considered a carcinogen, according to health experts.

THR products deliver nicotine by heating, and not burning tobacco. Without combustion, they do not produce smoke unlike combustible cigarettes that are linked to 20,000 deaths a day globally.

“Tobacco harm reduction is good public health. It starts with the people who matter— people who smoke, and people who have switched to a chosen alternative—and it fosters and encourages change. Tobacco harm reduction is not antithetical to tobacco control. It should be part of it,” GFN conference director Professor Gerry Stimson, emeritus professor at Imperial College London and a former honorary professor at the London School of Hygiene and Tropical Medicine said.

Citing recent data from Japan, Prof. David Sweanor of the Centre for Health Law, Policy, and Ethics at the University of Ottawa, said the cigarette market in Japan shrunk by a third since IQOS, a heat-not-burn product, was introduced in 2014.

“Imagine what would happen if people get access to a broad range of low-risk alternatives to cigarettes if they get information on relative risk, and if they’re nudged toward those options through intelligent, risk-proportionate regulation? The opportunity we have is to fundamentally change the course of public health history, relegating cigarettes to history’s ashtray,” Sweanor said.

Virgino said it is high time to embrace THR and what it entails, noting that there is a ton of data that supports it.

“Coming up with and implementing prohibitive policies goes against the very essence of tobacco harm reduction, that is, smoking cessation, and evidently, saving lives” she said.

“I remain hopeful that our policymakers, not just in Southeast Asia, but all over the world, truly take into consideration the plight of consumers, as well as their welfare, so that consumers will not serve as collateral damage, whether now, or in the long run,” she added.