Blog

Connecting the Global Industry

Photo courtesy of Quartz Business Media

Get ready for WT Middle East

World Tobacco Middle East is set to return to Dubai Nov. 27–28, 2023, reasserting its position as the largest international B2B tobacco event beyond western Europe, drawing attendees from over 90 countries. As the premier event for the Middle East’s tobacco industry, it has become a cornerstone for professionals in the field, fostering vital in-person connections, networking and business.
Trusted by leading brands and manufacturers, WT Middle East is the flagship exhibition of the World Tobacco series, which annually gathers over 13,000 professionals. With established events in the Middle East, Europe and Asia, the WT Events portfolio will be further expanding into Africa next year with a conference and exhibition in Zimbabwe, reflecting its dedication to supporting clients entering new markets and stimulating business growth.
This year’s event in Dubai is poised to be its biggest yet, featuring over 250 exhibitors, welcoming over 7,000 visitors and showcasing thousands of products. Due to its impressive growth, the event show floor has expanded to another hall, the Trade Centre Arena, with stand space now completely sold out.
With new exhibitors from HTL Human Trust Lean, Khyber Tobacco Co., Multi Tabak, Ora Tobacco and Mind Spirit Designs & Works as well as returning companies such as Sopariwala, Kaane, ARD, Gulbahar and Premium Tobacco, the upcoming trade show promises to offer an even wider range of products and services for attendees.
To ensure a truly immersive experience, attendees can use the Lex Tobacco Smoking Lounge, an expansive 700-square-meter space designed for meetings, relaxation and product sampling.
At World Tobacco Middle East 2023, you can participate in the largest tobacco event outside Western Europe, avail yourself of exclusive offers from over 250 leading suppliers, connect with industry leaders, explore cutting-edge machinery and gain insights into regulatory matters. Such trade events are pivotal in nurturing personal and business relationships within the global tobacco industry.
For more information and registration details, please visit www.wtevents.com/middle-east.

November 1, 2023
Surprising Successes
Image: chokniti

The uncelebrated triumphs of tobacco harm reduction

By Cheryl K. Olson
U.S. smokeless tobacco users are no more likely to die from cancer than people who never touched tobacco products. This unexpected news comes courtesy of the National Longitudinal Mortality Study. Compared to those who never used tobacco, current users of smokeless products do not have elevated mortality risks from all cancers combined.
This was just one happy fact I ran across when writing articles for doctors summarizing alternative nicotine product risks and benefits. I felt a similar “Wow! Really?” writing recently for this magazine about today’s astonishingly low youth smoking rates.
It’s time to stop, notice and give a cheer for good news about tobacco harm reduction (THR) that doesn’t get enough attention. Interesting evidence from research studies, natural experiments and everyday life observations ought to be shared.
This is not just about raising smiles. The accumulated weight of these bits of information can change mindsets. They can influence how future studies are framed and which policies are proposed and implemented.
I asked colleagues involved in harm reduction to suggest examples to celebrate. They include:
reduced-risk options that knocked down smoking in a particular nation or subgroup;
unexpected positive shifts in behavior, such as people who try vaping and notice one day that they no longer smoke;
harmful behaviors we were worried about that, to our relief, don’t seem to be happening (i.e., vaping as a gateway to youth smoking);
and finally, personal observations about the effects of THR.
Transforming the Map

We can’t say it often enough: cigarette smoking is still the leading preventable cause of disease and death in the U.S. It kills millions worldwide every year. Preventing cigarette use and helping people who don’t quit to consider lower-harm alternatives are medical and moral imperatives.
As pioneering nicotine researcher Karl Fagerstrom has said, “Realistically, no single alternative nicotine product category will be able to reduce smoking rates and the associated disease burden.” Individuals and nations will find different options appealing and acceptable. His article “Can Alternative Nicotine Products Put the Final Nail in the Smoking Coffin?” highlights five nations’ successes. In the U.K., Sweden, Norway, New Zealand and Japan, higher uptake of alternative nicotine products has meant lower smoking rates compared to their neighbors.
According to the Associated Press, “Sweden, which has the lowest rate of smoking in the Europe Union, is close to declaring itself ‘smoke-free’—defined as having fewer than 5 percent daily smokers in the population.” As of 2022, they had reached 5.6 percent. Thanks in large part to snus, Sweden has the lowest tobacco-related mortality among men in Europe.
David Sweanor of the Centre for Health Law, Policy and Ethics at the University of Ottawa regularly monitors tobacco company behavior. When Japan Tobacco released their second-half results in July, he noted the “extraordinary” shift in Japan’s tobacco use.
“Overall, the cigarette market has declined by half since heated products were introduced,” Sweanor says. “It is important to note that Japan has achieved this dramatic decline in cigarette smoking without policies actively encouraging the change.”
Roberto Sussman of the National Autonomous University of Mexico UNAM challenges us to look at the inverse proposition. “In the last 20 years, is there one case—a country, a subpopulation—of a significant reduction in smoking prevalence in which any effect or influence from usage of noncombustible products can be absolutely ruled out?” he asks. “I doubt there is a single case.”
Natural experiments created by bans on e-cigarettes in some U.S. states offer added noteworthy support for vaping as an effective substitute for smoking. Compared to “control” states with no full or partial e-cigarette bans, the states of Massachusetts, Washington and Rhode Island saw increased cigarette sales.

Inadvertent Quitting

Personal stories and research have shown that taking up vaping can mean putting down cigarettes—for people who initially had no plans to quit. This includes analyses by Karin Kasza and colleagues of widely respected ongoing studies such as the Population Assessment of Tobacco and Health (PATH) and the International Tobacco Control Four Country Smoking and Vaping surveys (of the U.S., Canada, Australia and England).
A recent systematic review by Elias Klemperer and colleagues found little evidence that conventional smoking cessation methods induce quit attempts among those without plans to do so. “The optimal treatment (or treatment combination) for this population remains unclear,” the authors state.
“No one ever ‘quit by accident’ with a nicotine patch, nicotine gum, nicotine lozenges, nicotine inhalers, Chantix/Campix, bupropion or smoking cessation counseling,” says Charles A. Gardner of Harm Reduction Strategies. “But millions of smokers who had no intention to quit have ‘quit by accident’ with nicotine vapes.”
Gardner believes this point deserves more attention. “If 75 percent of smokers claim they want to quit, then obviously 25 percent have no intention to quit,” he says. “No approved smoking cessation intervention will ever reach them. Nicotine vapes do.”
A related finding that deserves notice: Researchers at the U.S. Food and Drug Administration’s Center for Tobacco Products published evidence that mint/menthol ENDS users were more likely to switch and quit than tobacco-flavored e-cigarette users. The authors refer to additional research that identified better switching odds with nontobacco-flavored products.

Gateway or Diversion?

I previously reported on the unanticipated and little-lauded plunge in U.S. youth smoking rates (“Where’s the Parade?,” Tobacco Reporter, March 2023). The 2022 National Youth Tobacco Survey found that one in 10 (10.9 percent) high school students had ever tried a cigarette. Just 2 percent reported smoking in the past 30 days.
Although youth vaping is down from its 2019 peak, e-cigarettes are the most common nicotine product used by teens. Past-month use stands at 14.1 percent. Concerns have persisted among researchers and policymakers that vaping could lead youth who wouldn’t otherwise smoke to start.
Recently, more sophisticated assessments have challenged that connection. PATH study analyses by Kenneth Warner of the University of Michigan and colleagues show that few teens become established smokers regardless of previous e-cigarette use. When other known risk factors for youth smoking are taken into account, it turns out that ever-use of e-cigarettes makes a trivial difference.
Rather than leading teens down a path to smoking, e-cigarettes seem more likely to divert teens away. A new article by Christine Delnevo and Andrea Villanti of Rutgers University does a deep dive into national trends in high school student smoking since 1991. They found that “the most rapid declines in cigarette prevalence have occurred in the past decade, when e-cigarettes emerged as a popular product among youth.”

THR in Daily Life

A scientist who has worked in harm reduction inside and outside of industry points to an under-praised behavior shift in one important subgroup: people who work in nicotine product companies. At both the offices of a large e-cigarette maker and at a legacy multinational tobacco company, “I’ve never seen or known someone to smoke,” they said. “Even at a bar or outside of the office. But plenty of people vape or use other alternatives. And most, if not all, were former smokers.”
Their conclusion? “Reduced-risk product availability and a culture of acceptance actually change behavior.”
Christopher Greer, CEO of TMA and president of The GTNF Trust, described how tobacco harm reduction principles benefited his health in unexpected ways. “When I met my wife, I was very heavy—coming up on 260 pounds. I had a dependency on food for stress relief, and a stressful job.” He found that the typical advice from health professionals (e.g., cut out junk foods and fast food) didn’t fit his situation. Nor did a pharmaceutical option.
“Utilizing principles I knew from THR, I crafted a risk reduction plan for my eating,” Greer says. For example, he identified and targeted situations that put him at high risk for overeating. “It was incredibly difficult, but a decade later, I’m a much healthier, stable weight.”
Greer likens his transformation to transitioning to reduced-risk tobacco products: “another form of people finding agency in their own health decisions, when standard treatment isn’t working.”

Citations

Chang JT et al. (2023). Characteristics and patterns of cigarette smoking and vaping by past-year smokers who reported using electronic nicotine-delivery systems to help quit smoking in the past year: Findings from the 2018–2019 Tobacco Use Supplement to the Current Population Survey. Nicotine & Tobacco Research. https://doi.org/10.1093/ntr/ntac199
Delnevo CD & Villanti AC (2023). Dramatic reductions in cigarette smoking prevalence among high school youth from 1991 to 2022 unlikely to have been undermined by e-cigarettes. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph20196866
Fagerstrom K (2022). Can alternative nicotine products put the final nail in the smoking coffin? Harm Reduction Journal. https://doi.org/10.1186/s12954-022-00722-5
Kasza KA et al. (2021). Association of e-cigarette use with discontinuation of cigarette smoking among adult smokers who were initially never planning to quit. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2787453
Kasza KA et al. (2023). Associations between nicotine vaping uptake and cigarette smoking cessation vary by smokers’ plans to quit: longitudinal findings from the International Tobacco Control Four Country Smoking and Vaping Surveys. Addiction. https://onlinelibrary.wiley.com/doi/10.1111/add.16050
Klemperer EM et al. (2023). A systematic review and meta-analysis of interventions to induce attempts to quit tobacco among adults not ready to quit. Experimental and Clinical Psychopharmacology. https://psycnet.apa.org/doi/10.1037/pha0000583
Sun R et al. (2023). Association of electronic cigarette use by U.S. adolescents with subsequent persistent cigarette smoking. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802764
Sun R et al. (2022). Is adolescent e-cigarette use associated with subsequent smoking? A new look. Nicotine & Tobacco Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8962683/
Timberlake DS et al. (2017). A longitudinal study of smokeless tobacco use and mortality in the United States. International Journal of Cancer. https://onlinelibrary.wiley.com/doi/10.1002/ijc.30736
Xu Y et al. (2022). The impact of banning electronic nicotine-delivery systems on combustible cigarette sales: Evidence from U.S. state-level policies. Value in Health. https://doi.org/10.1016/j.jval.2021.12.006

Cheryl K. Olson is a California-based public health researcher who specializes in behavioral health issues and consults on tobacco product behaviors via McKinney Regulatory Science Advisors. She spent 15 years on the faculty of Harvard Medical School.
November 1, 2023
A Heady Mixture

Photos: AIR Global

AIR Global is revolutionizing shisha smoking with a mixture of technology and tradition.

By George Gay

As anybody who has tried it will be aware, dabbling with tradition is usually fraught, but it can be done successfully provided the rituals of the tradition remain largely the same and any changes introduced are aimed exclusively at improving the experience of taking part in the traditional activity. This idea came to mind while taking part in a Q&A with Ronan Barry, chief corporate and regulatory affairs officer at Advanced Inhalation Rituals Global (AIR Global), because the focus at one point turned to the company’s latest product, OOKA, which Barry described as the “future of shisha.”

Tobacco Reporter: Can you describe what sets OOKA apart and the philosophy behind it?

Ronan Barry: With OOKA, we’ve successfully blended the rich traditions of shisha with cutting-edge technology, offering a shisha experience like no other. Our philosophy at AIR Global revolves around pushing the boundaries of traditional shisha experiences, with a particular focus on reducing toxicants in shisha aerosol while delivering cleaner, more consistent and higher quality inhalation rituals.

Before you go into the details of OOKA, could you briefly describe traditional shisha consumption?

Traditionally, flavored shisha involves the heating of the shisha mixture rather than burning, setting it apart from combustible tobacco products. Shisha itself is a moist mixture comprised primarily of glycerin and fructose and a relatively small amount of tobacco. The mixture heats to a temperature of about 200 degrees Celsius, creating vapor that is fundamentally different from tobacco smoke. However, the conventional heat source is charcoal, which does burn and emits toxicants such as carbon monoxide. These emissions can, depending on how the shisha is set up, penetrate the waterpipe device and also pollute indoor environments.

But your new product is different?

Very much so. Our latest innovation, OOKA, introduces a revolutionary concept. It is the world’s first pod-based, charcoal-free shisha device, which heats the molasses in a micro-oven powered by a rechargeable battery. Its innovative heating element, in collaboration with an integrated microchip, heats the shisha to its optimal temperature. This ensures users enjoy a consistent and pleasurable experience, drawing a parallel to the precision that coffee enthusiasts seek in achieving the perfect brew. Importantly, OOKA’s innovative design brings the traditional shisha ritual into the modern era by removing the need for charcoal to heat the shisha and, in turn, removing charcoal “smoke” from the experience. As such, OOKA provides the cleanest shisha experience available for both users and the environment. It offers, on average, a 94 percent reduction in a range of harmful chemicals and nondetectable levels of carbon monoxide.

Are there other advantages?

Certainly. The new system eliminates any inconvenience of preparation, ash and mess. It reduces the preparation time to five minutes—four times faster than conventional waterpipe devices on the market. The pods contain the prepared shisha, and OOKA’s smart technology monitoring system checks the temperature 25 times per second before it passes through the water for inhalation. This offers consumers the ease of a lounge experience at home at a drastically reduced price.

Would you describe your company briefly?

AIR Global, which was founded in 1999, is majority owned by London-based private equity firm Kingsway Capital. We are headquartered in Dubai, United Arab Emirates (UAE), with offices in the U.S., U.K., the UAE, [the] KSA [Kingdom of Saudi Arabia], India, Poland and Germany, and factories in Ajman, [the] UAE and Poland. Reinhard Mieck is the CEO of AIR Global, which he joined in May 2021, bringing with him a wealth of experience from a 19-year career in FMCG and nine years in the luxury industry.

Is AIR Global a profitable company?

Yes. Our growth over the years is a testament to our commitment to innovation, product quality and customer satisfaction. Partly by expanding our customer base to more than 100 countries today, we have consistently outperformed the market. We are currently the leading company in the global shisha market, with 47 percent market share. Beyond our current success, we envision significant long-term growth, reflecting the promising future of the entire shisha category. Presently, the global shisha market is valued at $19 billion, and by 2026, it is forecasted to rise to $22 billion, underscoring the potential for continued expansion and innovation.

Our philosophy at AIR Global revolves around pushing the boundaries of traditional shisha experiences, with a particular focus on reducing toxicants in shisha aerosol while delivering cleaner, more consistent and higher quality inhalation rituals.

Ronan Barry, chief corporate and regulatory affairs officer, AIR Global

What products do you offer beyond OOKA?

The most significant is Al Fakher, the world’s leading brand of shisha molasses. We have recently launched Shisha Kartel, the fastest-growing shisha brand in Europe, and we offer Zodiac, which is a non-nicotine, nontobacco tea-based product. Our influence extends to various aspects of the shisha industry, and through our online platforms, such as Hookah-Shisha.com in the U.S. and Shisha World in Europe, we sell a range of shisha devices and accessories. In particular, we promote the use of heat management devices in place of aluminum foil in the setup of a shisha session to deliver a cleaner shisha cloud with minimal toxins to every consumer.

Where, geographically, does AIR Global currently sell its products? Is that geographical spread increasing or decreasing?

AIR Global currently sells its products in more than 100 countries, showcasing our global reach and commitment to serving diverse communities. While the Middle East, the United States, Europe and Africa are our largest markets, our presence continues to expand.

Are AIR Global’s volumes increasing or decreasing, and is this increase or decrease driven by particular markets?

Our sales volumes have been on an upward path, reflecting the appeal of our innovative products such as OOKA. The launch of OOKA made a significant impact, with its charcoal-free and smoke-free design. In fact, OOKA achieved remarkable success in the UAE, where it quickly sold out within a month of launching due to its unique appeal. Our dedication to innovation and product quality continues to drive growth and customer satisfaction in various markets.

Are consumer preferences changing, especially perhaps in respect of shisha flavors?

Consumer preferences are evolving in respect of shisha, and our commitment to staying ahead of these preferences ensures that we continue to provide an exciting and evolving range of shisha flavors to satisfy our customers. Shisha enthusiasts today have a growing appetite for a wider range of flavors and experiences. This has driven us to expand our flavor offerings and introduce innovative options that cater to diverse tastes, such as Zodiac nicotine-free tea-based shisha flavors, which come in both the traditional shisha format as well as in pods designed for the OOKA system, making this shisha experience available to a wider audience. We anticipate substantial growth in the nicotine-free segment, similar to the trend toward alcohol-free beers, wines and spirits.

How does the regulatory landscape for shisha look?

The fundamental differences between shisha and other tobacco and nicotine products are increasingly appreciated by regulators. Recently, the state of California prohibited all flavored tobacco and nicotine products but created a specific exemption for shisha. The reasons for this were the social and cultural importance of shisha as well as the fact that it is not conducive to youth use and tends to be consumed occasionally rather than compulsively. The global average consumption frequency among regular shisha users is two sessions per week.

Do you have any idea of the age profile of shisha users?

External sources, such as data published by the CDC [Centers for Disease Control and Prevention] and FDA [Food and Drug Administration] annually in the United States, demonstrate that shisha is very much an adult-oriented pastime. For several years now, the rate of experimentation by minors with shisha has been in the low single digits and the lowest among tobacco and nicotine products. This is not surprising as shisha is a time-consuming ritual, usually enjoyed in social settings, and cannot be consumed inconspicuously or on the go.

AIR Global says it has blended the rich traditions of shisha with cutting-edge technology.

Why do people consume shisha?

People consume shisha for various reasons, making it a multifaceted experience. Shisha is often a cultural and social ritual that brings people together. It serves as a means of relaxation, enjoyment of diverse flavors and a platform for engaging in conversations with friends and family. The rich heritage and centuries-old tradition associated with shisha contribute to its appeal, fostering a sense of connection and shared experience among enthusiasts.

Given the often strongly social aspects of shisha consumption, did the pandemic have a negative effect on sales?

Yes and no. On the one hand, social engagement was limited during the pandemic; shisha bars were closed in many countries, and that did have an impact. On the other hand, border closures had the effect of substantially cutting down smuggling, which was a boon to legally operating businesses and mitigated some of the negative impacts of the pandemic.

Are counterfeit products a major problem in respect of shisha markets?

Counterfeit products can be a concern in the shisha market, and we take this issue very seriously. The production of counterfeit shisha products creates multiple risks to consumers and can tarnish the reputation of legitimate manufacturers. We are committed to addressing this problem through a multifaceted approach to protect the health and safety of end users and uphold industry standards. For instance, the OOKA pod system incorporates patent-protected smart technology and a counterfeit-resistant design. It uses RFID [radio-frequency identification] technology for heating profiles, an NFC [near-field communication] chip to ensure only AIR Global-approved pods work with OOKA, 128-bit AES [advanced encryption standard] encryption to prevent counterfeit pods from functioning, and microchips for traceability.

How is shisha taxed relative to other tobacco products, and do taxation levels play any part in exacerbating the illegal trade?

Shisha is often unfairly taxed in relation to other tobacco products because of the outdated approach of taxation based on weight. This practice fails to consider the unique characteristics of shisha, which include a significantly lower presence of tobacco and toxicants compared to combusted tobacco. Shisha should be classified as a distinct category with its own taxation framework that doesn’t penalize the weight of nontobacco ingredients in the product. Adopting a more considered taxation system that aligns with the nature of shisha would not only protect consumers from unfair taxation but would also help address the issues of black market and counterfeit shisha products, ensuring the health and safety of end users while preserving government revenue.

Finally, are there going to be any major changes to AIR Global or the way it operates in the near future?

As a forward-looking company, we are continually exploring opportunities for growth and innovation. Our commitment remains unchanged—to deliver the highest quality products and services to our customers. Our focus continues to be on pushing the boundaries of the shisha experience, ensuring that we stay at the forefront of the industry and continue to offer unparalleled shisha experiences.

George Gay is Tobacco Reporter’s European editor, but his territory spans the globe. Based in London, George has covered the tobacco industry since 1982, initially for a U.K.-based publication and since 2004 for Tobacco Reporter. George’s understanding of industry issues, combined with his keen sense of observation and dry wit, have earned him a loyal following among Tobacco Reporter’s readers.

November 1, 2023
Changing the Conversation
Photo: Sayan

From Sept. 19 to Sept. 21, 2023, stakeholders from around the world gathered in Seoul to discuss the challenges and opportunities in the nicotine business, particularly as they relate to tobacco harm reduction. Attracting delegates from all parts of the globe, the event featured a wide variety of experts, including public health professionals, consumer advocates and financial analysts along with top regulators, such as the director of the U.S. Food and Drug Administration’s Center for Tobacco Products, Brian King. Below are highlights from the conference.

Additional GTNF 2023 session summaries >>
Keynote: Kingsley Wheaton (given by Jonathan Atwood)
During GTNF 2023, BAT’s global head of business communications, Jonathan Atwood, told attendees how BAT’s five-step plan for regulation could support achieving the right balance between harm reduction and the unintended consequences of access, including underage use.
“As an industry, we stand at an important crossroads. There is much confusion as to the way forward. Consumers are slightly confused. Doctors are slightly confused. Regulators are slightly confused and are struggling to enforce the laws they have written,” said Atwood. “What’s too often missed is the opportunity that tobacco harm reduction presents. The opportunity for a more progressive environment where both tobacco harm reduction and the role of [vaping products] is far better understood.”
Speaking on behalf of Kingsley Wheaton, BAT’s chief strategy and growth officer, Atwood said that reckless players in the market need to be penalized when they do not abide by the rules. He said the five suggestions are the areas that regulators should explore and then establish “smart regulation” that is right for their market.
“When I talk about smarter regulation, I mean regulation that is evidence-based, concentrated by nature, and achieving its policy aims while also avoiding unintended consequences. Greater partnership is required to achieve this,” Atwood said. “We must join forces externally with regulators and policymakers to try and create catalysts for positive change if smoke-free ambitions are to be met. Sustained and lasting changes to consumer behavior are difficult. However, it is consumer choice that offers the greatest hope for making a cigarette obsolete.”
Atwood said that the five areas were where smarter regulation could be applied to the vapor category to build a “more progressive environment” for tobacco harm reduction. He said the recommendations would need to be applied to the entire market and combined with greater enforcement. The five steps Atwood outlined included:
On-device technology and functionality: Vapor products should be accessible only to adults. Both underage prevention and restriction is crucial. On-device technology, when applied and enforced across entire markets, could help in this regard.
Flavors: More recognition is needed that flavors are an important driver of adoption for smokers seeking alternatives. However, flavors in vapor products should not particularly appeal to anyone underage.
Manufacturing and import level: ensuring that noncompliant products cannot reach the market in the first place.
Right to sell: Where no restrictions exist already, regulators may want to look at who should be able to sell vapor products and where. Reasonable safeguards at the point of sale would help ensure these products are sold only to adult consumers. Solutions such as retail licensing and facial recognition technologies should be seriously considered.
Enforcement and penalties: Governments must wield their power and ensure consumers are purchasing legitimate products. Such measures should be rigorously enforced, and those who fail to comply should face meaningful sanctions.
Atwood said BAT was calling upon governments, regulators and industry peers to rally toward a sustainable and progressive environment in which vaping products are sold and marketed responsibly.
“The time for boldness is now. The time to change the conversation is now. The time to change the outcome is now. The opportunity for change is here. It is not about relaxing regulations. It’s about recalibrating them to align with the evidence and aspirations of millions seeking a better alternative to smoking,” said Atwood. “We have the opportunity to redefine the future of public health, and it begins with smarter regulation that reflects the reality of smoking alternatives and provides smokers the freedom to choose less risky products.”
Panel: Putting Consumers First
Toward the end of the Putting Consumers First panel held during September’s Global Tobacco and Nicotine Forum in Seoul, South Korea, Matt Drodge, research director at Walnut Unlimited, made the point that while nicotine consumers were all different, they all wanted to be able to make informed decisions about whether to continue smoking combustible cigarettes or when and how to make the transition to new nicotine products.
Of course, nicotine users can make such transitions only in countries where regulations allow them to do so, and the moderator of the panel, Nancy Loucas, public health policy expert and executive coordinator of the Coalition of Asia Pacific Harm Reduction Advocates (CAPHRA), made the point that the panelists represented countries forming a continuum of nicotine regulation.
Panelist Samrat Chowdhery, former president of the International Network of Nicotine Consumer Organisations, told participants that he felt unhappy about representing India, a country that had put consumers last by effectively banning vapes. Chowdhery said this is a pity because India does not have a strong or widely used public health network, so prevention, including through the use of safer alternatives, is vital, as it is in other parts of the developing world where 80 percent of tobacco users live.
Fiona Patten, leader of the Reason Party and former member of the Legislative Council of Victoria, who was unable to attend the GTNF in person and instead recorded a video message, apologized for representing Australia, a country that she said is leading the way on what not to do around tobacco harm reduction. Patten said that Australia’s “so-called medical model” of regulation is so onerous that 99 percent of Australians who are looking for a safer way to consume nicotine are being forced onto the black market.
Alex Clark, CEO of the Consumer Advocates for Smoke-Free Alternatives Association, who also did not attend the event, but appeared via a live link, said the premarket tobacco product application (PMTA) system in the U.S. appears to consumers to be acting as a very tight bottleneck on the products they have access to; no flavored products have been authorized through the system, only variations of tobacco. Beyond the PMTA system, there was also concern that a methodical state-by-state, municipality-by-municipality effort to severely restrict the availability of lower risk products would continue. Clark said that while he hopes that in the future people will be able to find products they can trust, he questioned why there has to be a delay. What is needed now is to disseminate the idea that nicotine users are not just data on a spreadsheet and to get that message out, elevating it up the chain to the regulator.
Clarisse Yvette Virgino, a Philippines-based member of the CAPHRA, had a more positive tale to tell because a “wild journey” that had seemingly been headed toward prohibition had ended with regulation. The regulations were somewhat burdensome, however. Retailers had a lot of rules to comply with, and there was a problem when it came to consumer choice because manufacturers had withdrawn certain products, such as juices, rather than go through the process of complying with what were stringent requirements.

Panel: Reinforcing Scientific Research
During the Reinforcing Scientific Research panel held as part of September’s Global Tobacco and Nicotine Forum in Seoul, South Korea, New Zealand-based Marewa Glover, director of the Center of Research Excellence on Indigenous Sovereignty and Smoking, made the point that the forum had heard many times how there is a need for tobacco and nicotine policies to be grounded in science and, therefore, evidence-based. There is, in fact, no disagreement on this point between tobacco control officials and tobacco harm reduction (THR) advocates, she said. However, care needs to be exercised because a form of evidence has been appropriated by some opposed to THR, and they are driving a broad social change agenda aimed at instituting a utopia where, for instance, no one would ever use drugs. They used scientific platforms loaded with people who shared their views to spread their ideology. They redefined the meanings of words so that unproven assertions became facts and facts became lies. To combat such views, she added, it is necessary for THR advocates to produce demonstrably robust research as part of a project that includes a communication strategy identifying stakeholders and how the information is to be gotten to them.
Glover had been asked three questions by moderator, Mark Littlewood, director general of the Institute of Economic Affairs: What needed to be done to reinforce scientific research into tobacco and nicotine?; who should form the audience for the research findings?; and how should the findings of junk science be challenged?—questions he also posed to the rest of the panel.
Kai-Jen Chuang, professor in the Department of Public Health at Taipei Medical University, explained that THR is not taught as part of medical degrees in Taiwan and therefore is not a well-recognized term, even though harm reduction principles are engaged in other areas. In fact, vapes were banned in Taiwan on March 22 this year. What is taught is health promotion and, more latterly as part of social-work courses, disaster reduction. He pointed out, nevertheless, that health promotion, disaster reduction and THR have similar goals, so those from outside Taiwan wishing to engage at conferences with public health officials over THR principles should present their papers, translated into Chinese, as health promotion studies. Nevertheless, he warned that it would be difficult, because of their training, to convince public health people of all stripes of the efficacy of using new technology to reduce the harm caused by smoking. The starting point for getting across messages about THR, he added, should be scholars with open minds, and from there, the focus could move to journalists and politicians.
Riccardo Polosa, professor of internal medicine at the University of Catania and founder of the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), said there is a need to reinforce quality science that has good repeatability. Repeatability, he added, is currently in crisis and not just in respect of tobacco control science, so the CoEHAR has established a comprehensive repeatability program pertaining to research into toxicity and biology in respect of combustion-free, nicotine-containing products. The program involves setting up and researching in seven laboratories with the same equipment and the same procedures to come up with super strong findings. Another thing that is needed, Polosa said, is to shift the focus from risk to harm. Relative risk has been studied for a decade now, and it is an easy win if combustible products are compared with combustible-free products. So now is the time to look at the absolute risk and show that it is low and that the level of harm is super low. This would provide a better position from which to convince governments, regulators and the public. Polosa had some good news on junk science, which he said is easy to debunk because it is junk, though this takes energy and time and requires a willingness to do it. A global network of scientists is actively rebutting junk science articles, though the challenge now is to speed up this process of rebuttal.
Picking up on an earlier comment about uncertainty, Konstantinos Farsalinos, research fellow at the Onassis Cardiac Surgery Center, made the point that uncertainty is inherent in science and essential to human progress. There is nothing wrong with uncertainty provided that it is not used to maintain the status quo, especially where the status quo has failed miserably. It is important, also, that uncertainties are not used as the basis for decision-making, which needs to be based on current knowledge. But one problem being faced today is that current knowledge is not being used to make decisions [about THR]; rather, decisions are being made on the back of the abuse of uncertainties [that the long-term use of THR strategies are unknowable at this stage]. Revisiting the 1986 Ottawa Charter for Health Promotion by the World Health Organization, Farsalinos said, it is obvious that it was basically talking about harm reduction in our everyday lives. Everything, even medicine itself, was a harm reduction science because it was not possible, probably, to cure any disease besides certain infections. We were treating diseases and reducing the adverse effects and consequences of diseases. This was all known. What is needed now is the reinforcement of the applicability of scientific data, of which there is a lot, on decision-making, something that has not happened in many parts of the world. Finally, Farsalinos said that he has had bad experiences in rebutting junk science even though he has been successful. Basically, he had run into a wall behind which people had decided what they believed and were casting around for the data to support their predetermined views. With science, you have to do the opposite of that, he said.

Keynote: Brian King
When Brian King speaks, people come to listen. The U.S. Food and Drug Administration’s Center for Tobacco Products (CTP) director’s keynote address was easily the best attended session of GTNF 2023. King’s speech served as an overview of the current state of the CTP and an outline of the center’s main priorities over the next few years.
King said that the CTP has made considerable progress in reducing combustible cigarette smoking in the United States, which he contends as one of the most remarkable public health achievements of the past century. He hopes that those declines continue, given that “we do know” that combustible smoking is responsible for the overwhelming burden of death from using combustible tobacco.
Tobacco use continues to cost the U.S. government a considerable amount of money—to the tune of $600 billion per year from both direct healthcare costs and lost productivity, according to King. He said there are important human health benefits as well as financial benefits for regulators to continue to focus on reducing combustible use in the United States. As a part of this focus, he said, the CTP is continuing to make inroads when it comes to premarket tobacco production application review.
“We have a new director of our Office of Science who has jumped in headfirst to continue to fiercely lead our 550-plus scientists on application review …. We have processed 99 percent of those and continue to finalize the remaining 1 percent. I’m hopeful that in the coming months and years, we will get back to what was intended to be a premarket approval process,” said King. “In the meantime, we have authorized 23 e-cigarettes, all tobacco flavored. So, it is possible. We have had successful authorizations. But again, I can’t reinforce enough the importance of providing that sound and robust science to inform on potential authorization.
“And it is possible, as you can see. There will be more authorizations in the future, but it’s important that we have that science to support those decisions. As I noted earlier, we also continue to fold in the nontobacco nicotine work into our broader portfolio around regulation. We did receive a million applications, which I don’t think anyone anticipated. I will say that we are making great numbers. We are 99.9 percent through with the review of those. I will say that 100 percent is very imminent.”
King said that when it comes to products that are illegally on the market (having received a marketing authorization and are not currently under review by the CTP), the CTP is mindful of the importance in exercising all authorities that it has to ensure that people are complying with the law. He said that the FDA has given retailers the information they need to comply with the law through a list of authorized products (the 23 products that have been authorized for sale). The CTP also continues to ramp up efforts in terms of training, education and outreach across the supply chain, particularly to retailers.
“We also continue to do surveillance inspection investigations. This is something that occurs on a daily basis. We have arrangements with all 50 states and territories to continue to do investigations. We have issued many warning letters for flavored disposable e-cigarettes, which we know are particularly popular for youth,” said King. “There’s been a variety of blitzes that have occurred monthly throughout the summer. I will say there are more to come. We are going to continue to conduct those blitzes and making sure that we are routinely monitoring, particularly with a focus on those products that we know have high youth appeal.
“On balance, we are also continuing to do work around issuing import alerts. I was a little tickled by all the attention that the import alert on Elf Bar got. That’s nothing new, folks. We’ve been doing that for many years. It was suggested it was something seismographic, but we’ve been doing import alerts for quite some time. And we do use those as, again, another tool in our toolkit to make sure that we are addressing not only the products that are already in the country but preventing illegal products from entering the country.”
As of Sept. 31, the FDA has issued over 1,200 warning letters for online investigations. For manufacturers, the CTP has sent more than 800 warning letters, with more than 750 letters for e-cigarettes. Beginning earlier this year, the FDA also issued the first civil money penalties against manufacturers for violations for illegal e-cigarette sales. He said civil money penalties will remain a part of the CTP’s tools to combat illicit sales.
“We also issued the first six injunctions in coordination with the Department of Justice. I got a lot of flak for that as well about enlisting the Department of Justice. And I will remind folks that the FDA doesn’t have an independent litigation authority. If folks do not comply with the law, we will escalate further, as has been evidenced by these actions, which again are going to be part of our broader portfolio moving forward,” said King. “Everyone is going to be held accountable across the supply chain. We do want to make sure that we address the bad actors in a meaningful way. We also continue to pursue no tobacco sale orders among retailers as well. This has traditionally been issued for underage sales. But again, we’re committed to using the full scope of our authorities granted through Congress.”
King added that education is also a priority for the CTP. The center is ramping up efforts to address misinformation in the continuum of risk for nicotine products. He mentioned that he recently wrote a commentary where he highlighted the importance of opportunities and considerations for addressing misperceptions in nicotine. “There is science that exists in that there are misperceptions around the continuum of risk and also nicotine. And so, we do have opportunities that are present, but we have to follow the data-driven pandemic-based approach,” he explained. “That said, I’m putting my money where my mouth is …. We’re working with the National Institutes of Health for a funding opportunity to get more data on public health communication messaging about the continuum of risk.
“And as noted in that funding announcement, we’re looking for data both for the target population, which is called smokers, but also unintended populations, particularly youth. This is several million dollars on an annual basis, and we look forward to that kickstarting and getting data to inform our work.”
King said the CTP will also continue to gather input from the industry and the public. The CTP is creating a new office within the Office of the Center Director and is looking to hire a new director for Policy and Partnerships. “That posting is public,” he said. “And I’m looking forward to seeing those who have applied and getting someone in that seat to meaningfully oversee the product regulation portfolio across the center, particularly as we get that strategic plan in place.”
During the closing of his address, King said that he continues to be big on communication and stakeholder engagement. He expects to provide the industry with more opportunities for communication with the CTP. “I know that you’ll see in the future an evolution of our messaging. Both through our press releases, our social media and our [overall] messaging to make sure that we are clearer, simpler and more digestible,” he said. “I’ve been a bureaucrat for many years, but that doesn’t mean that I can’t communicate effectively with the general public. I think we can do better. I know we can do better.”

Keynote: Hiroya Kumamaru
Hiroya Kumamaru, vice director at Japan’s AOI Universal Hospital, gave a 15-minute overview of the current status of harm reduction in Japan.
Quoting 2019 figures, Kumamaru said that, as in many other countries, smoking is the biggest cause of death in Japan, though high blood pressure is not far behind and is catching up, probably because of the aging of Japanese society.
On top of this, he put forward the economic argument for reducing smoking, which, he said, while having a positive annual impact on the economy of ¥2.8 trillion ($18.76 billion), mainly through taxation, had a negative impact of ¥4.3 trillion mainly due to loss of labor because of smoking-related diseases, the medical costs associated with smokers and passive smokers, cleanups and fire-related expenses.
Kumamaru told how, about 15 years ago, he had started working in a small clinic in the center of Tokyo, where he became involved in a national smoking cessation program that was based on a three-month-long series of five visits by smokers to doctors. Although a lot of effort was put into the program, and nearly 60 percent of the participants at his clinic went on to complete the five outpatient visits, nine months after the end of the program, nearly half of those who had appeared to have quit started smoking again, a result he described as “disappointing.”
He then compared this with what had happened after the start of sales of heated-tobacco products (HTPs) from 2016. By 2019, almost one-third of male and one quarter of female tobacco consumers were using HTPs, a result that he described as “amazing.” As a result, total cigarette and HTP consumption was heading down while HTP consumption was increasing.
In part, his amazement sprang from the fact that while this was happening in Japan, it appeared not to be happening at the same level elsewhere, and he didn’t know why this was the case. For example, Japan’s smoking rate was decreasing at a faster rate than that of Australia, which had introduced very strict smoking restrictions but banned the sales of HTPs.
Notwithstanding Japan’s success with lowering smoking rates, many people in Japan remained skeptical about HTPs and raised issues about the unintended use of these products: dual usage, initiation, relapse and what is called in Japan the gateway effect of youth initiation. But these turned out not to be significant issues. Kumamaru said about 20 percent of smokers use HTPs and cigarettes, which is not that many. And initiation or re-initiation has been at a very low level, with two years of surveys recording a 2 percent factor in the first year and 1.3 percent in the second. In particular, youth initiation is low, and there has been no increase in initiation among younger people due to the launch of HTPs.
Kumamaru said that interesting data from Italy, Korea and Japan pointed to the fact that consumers of HTPs have better outcomes than smokers in respect of chronic obstructive pulmonary disease and cardiovascular disease while the exposure to carcinogens associated with HTP use is just 3 percent of that of smoking.
He ended his presentation by saying that Japan could look forward to a better future because of HTPs, though it is necessary to keep carrying out surveys and probably starting a long-term clinical study.

Additional GTNF 2023 session summaries >>
November 1, 2023
KT&G Celebrates Korea-Indonesia Ties

KT&G celebrated the 50th anniversary of South Korea-Indonesia diplomatic relations by organizing various global CSR activities, including support for university student startups, cultural festivals and improvements in the education environment.
On Sept. 28, KT&G selected the finalists in a competition for business ideas at UNTAR University’s Imagination Entrepreneurship School in Jakarta, Indonesia. A day earlier, the South Korean cigarette maker hosted a similar event at the State University of Jakarta.
Meanwhile, the KT&G Welfare Foundation finished renovating an elementary school in the Bogor region, transforming an old building into a new educational facility with an earthquake-resistant construction.
In 2014, KT&G established the KT&G Korean Language Institute in Indonesia, providing approximately 2,800 people with opportunities to learn Korean. In addition, the company operates Imagination University, which supports the development of the capacity and cultural experiences of Indonesian youth. In 2021, it established the KT&G Vocational Training Center at Malang’s UKCW University, teaching marginalized youth sewing, computer technology and other skills.
“We are taking the lead in promoting communication between the two countries through cultural exchanges in celebration of the 50th anniversary of Korea-Indonesia diplomatic relations,” said a KT&G representative. “We will continue to make efforts to spread Korean culture and enhance exchanges through various platforms.”
Indonesia is an important market for KT&G, which aims to earn half of its sales from overseas business by 2027. The company operates a tobacco factory in Indonesia and recently announced the construction of a second manufacturing facility.

October 31, 2023
Disposable Vape Waste a Problem for Cities

Photo: bennyrobo

Disposable e-cigarettes are creating a new waste management challenge for U.S. local governments. One of the main issues is that the battery-powered products are classified as hazardous waste.
The devices, which contain nicotine, lithium and other metals, cannot be reused or recycled. Under federal environmental law, they shouldn’t go in the trash.
“We are in a really weird regulatory place where there is no legal place to put these and yet we know, every year, tens of millions of disposables are thrown in the trash,” Yogi Hale Hendlin, a health and environmental researcher at the University of California, San Francisco, told the Associated Press.
In late August, sanitation workers in Monroe County, New York, packed more than 5,500 e-cigarettes into 55-gallon steel drums for transport to a giant industrial waste incinerator in northern Arkansas, where they would be melted down. Local officials said it’s the only way to keep the devices out of waterways and landfills.
“These are very insidious devices,” said Michael Garland, director of the county’s environmental services. “They’re a fire risk, and they’re certainly an environmental contaminant if not managed properly.”
Elsewhere, the disposal process has become both costly and complicated. In New York City, for example, officials are seizing hundreds of thousands of banned vapes from local stores and spending more than $1 each for disposal.
Vaping critics say the industry has skirted responsibility for the environmental impact of its products while federal regulators have failed to force changes that could make vaping components easier to recycle or less wasteful.
Disposable e-cigarettes currently account for about 53 percent of the multibillion U.S. vaping market, according to U.S. government figures, more than doubling since 2020.

October 31, 2023
BAT Taps Arvato for German Vape Logistics

BAT Germany has selected Arvato as its logistics and fulfillment partner for its e-commerce operations encompassing e-cigarettes and heated tobacco products.

Since the end of June, BAT Germany online orders have been processed centrally from the site in Marienfeld, Guetersloh district. At this site, Arvato, a leading supply chain and e-commerce service provider, operates a state-of-the-art distribution center spanning approximately 32,000 square meters, serving multiple clients in the technology sector, according to the American Journal of Transportation (AJOT).

The comprehensive logistics services provided for BAT Germany at the facility encompass goods receipt, storage, order picking, packing, and shipping, as well as returns management.

“BAT’s goal in awarding the e-commerce logistics contract was to guarantee the most efficient and fastest delivery service for its customers. Our customer-centric approach allowed us to accommodate BAT’s specific processes and requirements,” says Thomas Becker, executive vice president at Arvato.

The logistics service provider commits to delivering within a 48-hour timeframe. To optimize warehouse operations for efficiency and speed, Arvato heavily integrates automation technology. Automated carton setup and closure processes significantly enhance the speed of operation. Moreover, product information is automatically included with orders through flyer dispensers.

“With its experienced team, Arvato provided us with very flexible and reliable support in setting up our logistics and distribution concept,” confirms Robert Juhnke, distribution manager at BAT Germany. “Even throughout the offer and final negotiation phase, the collaboration has been exceptionally cooperative.”

Sustainability is a growing trend in the vaping industry. Arvato is dedicated to doing its part, according to the AJOT story. In an effort to reduce plastic waste, the company adopted wet adhesive tape made from recycled paper, resulting in the annual saving of approximately 16 tons of plastic, as an alternative to polypropylene adhesive tape. Arvato’s approach to optimizing shipment sizing and processing minimizes the consumption of packaging materials.

October 31, 2023
JT Ups Forecast on Strong Quarter

Photo: JT Group

The JT Group reported revenue of ¥2.16 trillion ($14.29 billion) in the third quarter of 2023, up 7.4 percent over the comparable 2022 quarter. At constant currency exchange rates, core revenue increased 5.9 percent to ¥2.05 trillion. Adjusted operating profit at constant exchange rates jumped 5.9 percent to ¥675.5 billion. On a reported basis, the adjusted operating profit was ¥664.4 billion, up 4.2 percent from the 2022 quarter.
“The JT Group posted another set of strong results for the third quarter. In particular, the tobacco business reported solid growth across its indicators, driven by continued market share gains and robust pricing,” said JT Group President and CEO Masamichi Terabatake in a statement.
“We are accelerating investments in HTS to establish the foundation of our future growth, and these investments are progressing as planned. The market share of Ploom X in the HTS segment in Japan is steadily increasing with share exceeding 10 percent in the periods of July to September 2023, despite a competitive business environment.
“In addition, since July 2023, we have launched Ploom X in Switzerland, Poland, Hungary, Romania and Greece, and plan to roll it out in Kazakhstan in early November. We expect to continue the geographical expansion of Ploom X, to reach 28 markets by year end 2024.
The JT Group increased its full-year forecast for adjusted operating profit at constant currency by ¥34 billion to account for the stronger year-to-date top-line growth of the tobacco business.

October 31, 2023
Egypt Approves New Cigarette VAT

Photo: alexlmx

Egypt will impose a new value-added tax of EGP0.50 ($0.02) on locally sold tobacco products, reports Ahram Online.
On Oct. 29, the House of Representatives approved an amendment to the 2016 VAT law to allow for the new duty, which will apply to both “hot” tobacco (cigarettes) and “liquid” tobacco (vapes), according to Fakhri El-Fiqi, head of the House’s Planning and Budget Committee.
Egypt’s tobacco market has been in turmoil in recent months, with consumers facing cigarette shortages and price hikes, among other challenges.
“The new amendment will also encourage tobacco companies to increase production in a way that shall stem the rise in cigarette prices and satisfy consumers,” said El-Fiqi, who predicted the next tax would generate up to EGP8 billion in revenues for the state budget.
Some lawmakers praised the measure as method to discourage smoking in line with World Health Organization recommendations.
“There is no question that the hike in cigarette prices will push more citizens, particularly young people, to give up smoking,” said Hesham El-Hosary, chairman of the House’s Agriculture and Irrigation Committee.
Despite the recently announced tax hike, cigarettes in Egypt are still cheap compared to other countries. In France, for example, some brands of cigarettes sells for the equivalent of EGP600 per pack, according to Ayman Abul-Ela, deputy chairman of the House’s Human Rights Committee.

October 30, 2023
Altria Urges Action Against Illegal Vapes

Photo: Malcolm Griffiths

A booming illegal disposable flavored vape market is hurting sales of Altria Group’s authorized products, according to Altria Chief Financial Officer Sal Mancuso.
Speaking during a call with media and financial analyst, Mancuso noted that traditional cigarette sales had dropped even more than usual in the third quarter of 2023. The decline, he said, was caused by inflation and economic issues influencing customers as well as the heightened usage of illegal flavored disposable e-cigarettes.
Mancuso also observed that there appeared to be more switching between different categories than initially assumed and that e-cigarettes alone were causing a 1.5 percent to 2.5 percent reduction in traditional cigarette industry volumes.
R.J. Reynolds Vapor Co. leads the U.S. vapor market with a 41.8 percent share, per the latest Nielsen convenience store report released Oct. 7.
Njoy, which Altria purchased for $2.75 billion in June, has struggled to increase its No. 3 market share.
“The current state of the (vaping) market is intolerable for both legitimate manufacturers and consumers,” Altria CEO Billy Gifford said during the call. “The regulated market is being overrun by illegal flavored disposable e-vapor products made and distributed by companies violating virtually every rule and guidance FDA has issued since 2016. A lot of these products are imported. They’re imported illegally and then they’re sold illegally.”
Saying a “strong course correction is needed,” Gifford noted that Altria has filed federal lawsuits in California against 34 organizations that include manufacturers, distributors and online retailers.

October 30, 2023