Tobacco-free nicotine products could be a public health game changer, experts say

Tobacco-free nicotine products could be a public health game changer, experts say
The event was held in Stockholm on 11 and 12 October.

Finding safer alternatives to potentially harmful tobacco products is one of the biggest health challenges currently facing society.

This was a key message to emerge from the two day international hybrid event earlier this week in Stockholm about the future of “recreational” nicotine. The event was live streamed by The Brussels Times with the support of EPHI who organised the event.

Speakers came from three continents and included scientists, regulators and representatives from the business community.

All agreed the issue is one of the biggest policy conundrums facing the EU and wider international community and that it is imperative that more and safer tobacco alternatives are made available.

There are, currently, a whole range of existing products on the market aimed at tobacco cessation but one key question is: can smokers who want to quit do so in a “sustainable” way so as not to create a whole new set of problems?

The live streamed conference heard that while there has been a steady decline in tobacco use in Europe and globally there are still tens of thousands using “risky” tobacco products.

There has been huge growth in tobacco alternatives but this too has sparked concern, for instance, about a youth “vaping epidemic.”

Society, it was said, seems more tolerant about alcohol use among the young that it is of tobacco use in the same age group.

Former Swedish centre right MEP Christofer Fjellner, now Managing Director at EPHI, said his key message was: “We can win the war against tobacco-related disease.”

Sweden, he noted, has very low levels of smoking and this had resulted in low levels of cancer and heart disease.

What he called the “Swedish experience and the Swedish example” might inspire others and provide “lessons” for the tobacco-related industry.

The conference focused on four themes – market development and trends; regulatory development; health implications and investment and sustainability.

It also looked in detail at assorted other topical issues, ranging from strategies for tobacco control and harm reduction policy to European to national legislation.

Chris Snowdon, head of Lifestyle Economics at IEA, was once a “prolific” smoker but, in 2011, had taken up vaping, a transition that was, he reflected, thanks to a wide range of products and flavours on the market at the time.

The Briton told the audience that the UK, around that same time, had an “innovative and competitive” vaping industry and that the smoking rate in the UK had since fallen dramatically by as much as one quarter.

He said, “There is now greatly increased awareness of the risks involved with nicotine and knowledge about tobacco alternatives.”

But there was also concern over what has become known as the “youth vaping epidemic”.

Clive Bates, Director of Counterfactual Consulting, spoke about various innovations taking place in the tobacco industry, some of which had been met with “incredible hostility.”

It is not nicotine in cigarette smoke that causes cancer but the tar content, he said, adding that the fact that there were now various nicotine products without tar on the market, such as e-cigarettes, should be welcomed.

The implications of current trends could be “profound”, said Bates, because such tar-less products “can counter the 20 year domination of nicotine.”

There had been a one third reduction in smoking in England in recent years and the number of people vaping in the country now numbers about 3m. This compares with 8m smokers, he said.

But it is not just the UK where things have changed as there’s also been a “structural shift” in Norway away from nicotine use, he said.

However, “there is still concern, and for good reason, about vaping and other such products. This has led to headlines about a youth vaping epidemic, sparking something of a moral panic.”

Why so much opposition to vaping and similar products?

He replied by saying, “One reason is cultural inertia – there has been a rise in informed choice by informed consumers but, sadly, this is seen as counter cultural. There is a class dimension to this too. We are much more tolerant about alcohol use among the young than we are of tobacco use among the same age group. But if you wanted a dangerous and damaging drug for the young it is alcohol, not tobacco.”

Economist David Sunden, also an expert on market regulation, said he wanted to “bust a few myths” including the assertion that people who use snus, a moist oral tobacco product, will inevitably start smoking.

This is untrue, he said.

He was clear, he argued, that harm reduction measures, on their own, were not sufficient.

In Sweden, it was noted that no tobacco advertising takes place and there are severe restrictions on packaging and colour limitations.

“Compared to the alcohol market,” he said, “we don’t have any licensed sellers of tobacco here in Sweden.”

Sunden said, “We need more clarity on the risk of nicotine use. Is it harmful or is it not? There is just too much noise going on around this issue at present without us having full knowledge of all the facts.”

In Norway, there has been a huge fall in smokers and a big increase in people using snus.

This change, it was argued, is market driven, and not the result of regulation.

“The message?,” Sunden said, “It is this: don’t ban these alternative products: if you do you may end up with a problem because these new products present a clear opportunity for us to improve public health. That is very clear.”

Sudhanshu Patwardhan, MD and Director of Policy for the Centre for Health Research and Education, wanted to dispel another “myth”: that nicotine and tobacco products causes cancer.

“It does not,” he said.

“Tobacco is not the issue here but, rather, the range of toxins in unburned tobacco.”

The line between “recreational use” and addiction was “very fine” and, he said, one of the key questions is: Can nicotine products be consumed relatively safely?”

“The answer, I believe, is yes.”

The event, on 11 and 12 October, was held in Stockholm and broadcast live by to an EU-wide audience.

The Brussels Times

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