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Category: Also in TR

  • Bubbles of Bliss

    Bubbles of Bliss

    Splash’s objective was to develop a smoke-free and vape-free product that would integrate enjoyment and ritual.

    A German startup deploys foam to deliver nicotine.

    By Stefanie Rossel

    Klaus Hagen

    Until recently, users of noncombusted products had two ways of consuming nicotine: through an aerosol generated by e-cigarettes or heated-tobacco products (HTPs) or through direct absorption by the mucous membrane of the mouth, as is the case when using modern oral nicotine products. The Splash platform works with an entirely different medium: foam. According to its eponymous manufacturer, a startup company based in northern Germany, Splash is the fastest delivery system on the market, delivering the desired nicotine “hit” within seconds.

    The stimulants carrier is not an aerosol but a glycerin-free fine foam, similar to the froth on a cappuccino, which is consumed through a mouthpiece. The Splash device comprises a bottle filled with nicotine-containing liquid. A separate department at the top of the unit holds a mix of natural ingredients, including phospholipids and a vegetable emulsifier, that turn the liquid into a stable foam when released.

    “We wanted the particles to stay in the mouth longer than aerosols and be absorbed sublingually,” explains Klaus Hagen, chairman of Splash. “Foam moves slowly and remains in the mouth long enough for ingredients to be absorbed quickly. This way, it takes only a few seconds until the active ingredient arrives in the brain. In addition, the foam allows the aromas to spread in the mouth and create an intense taste experience.”

    To manage the air pressure within the bottle, the device is equipped with coated pills and a filter. “With Splash, we have found a way to substantially shortcut the road that stimulants usually have to take through the body via the stomach and the bloodstream,” says Hagen.

    Smoke-Free and Vape-Free

    Splash is a hybrid: a modern oral nicotine product in the form of a handheld device that mimics the hand-to-mouth motion associated with smoking or vaping.

    Hagen, who boasts a long career in the tobacco industry, most recently as head of next-generation products at a leading multinational, founded Splash in 2021. Development of the Splash platform, however, started as early as 2019. Hagen had just successfully exited his first startup, which had developed a battery-powered shisha.

    “A few weeks after the sale of our company, my team and I were contemplating what to do next,” says Hagen. “We knew that whatever we would develop now would only become relevant to consumers, the industry and regulators in three [years] to four years. When we started with Splash, vaping was already very popular, and it was all about generating big clouds of steam. Oral nicotine products at that time were either tiny niche or locally limited, such as snus in Sweden. The same was true for batteries and their potential hazard for the environment. Nevertheless—or because of that—we decided to create a natural alternative to aerosols and batteries.”

    The objective was to develop a smoke-free and vape-free product that would integrate enjoyment and ritual. “We aimed to be way ahead of a consumer trend we were anticipating,” says Hagen. “At that time, it was a mere gut decision, but it has turned out to be the right one.”

    The idea of using foam was inspired by the detergent capsules used in dishwashers. “We were immediately aware of the enormous potential ‘effervescent tablets’ would have as an energy source for use in inhalers,” says Hagen. “So we decided to develop a method to turn a liquid into a solid foam.”

    Facilitating Switching

    The result is a hybrid—a modern oral nicotine product in the form of a handheld device that mimics the hand-to-mouth motion associated with cigarettes, HTPs or vapes. Hagen calls it a vape 2.0 or “no heat, no burn.” The product can be offered with various nicotine strengths. Once activated, the device generates 25 puffs to 30 puffs.

    The company tested user acceptance at different points in the development process. “In the U.K., we had the product tested by many consumers in London, Birmingham and Manchester this May,” says Hagen. “They all immediately understood what Splash was about, which is on the one hand to maintain an essential ritual known from smoking or vaping and on the other hand to be discreet—i.e., not to emit smoke or vapor. We live in a fast-paced time where social acceptance of smoke[-generating] and vapor-generating products is getting ever more limited. Besides, for smokers or users of HTPs or vape products, the switch to a nicotine pouch is too big a step—they need certain key elements, including habits and satisfaction.”

    In researching the market, the company paid particular attention to two aspects: How do consumers experience the absorption of active ingredients, and how do they like foam as an administration tool? “We were surprised how well both were received,” says Hagen. “Consumers described the uptake of active ingredients as ‘very fast and effective.’ The foam, albeit a novelty, was experienced as extremely pleasant. We had numerous conversations with smokers who confirmed that nicotine absorption through Splash is not only exceptionally fast but also lasts for a long time so that the total consumption of nicotine—spread across a day—is lower than with the usual nicotine-containing products.”

    Splash is not only fast, but it also lasts a long time so that the total consumption of nicotine is lower.

    Klaus Hagen, chairman, Splash

    Low Risk Profile

    Splash’s comparatively low risk profile should help the product gain acceptance in a heavily regulated industry. The foaming agents contain emulsifiers that have been approved for use in the food industry. As a modern oral product, the device is not subject to the EU Tobacco Products Directive (TPD) yet; for the time being, member states can decide for themselves whether to permit the product category. Hagen is confident that the TPD will embrace new products such as Splash in the future.

    Being made of nicotine, the liquid in Splash does not contain harmful substances common in tobacco, such as nitrosamines. The product is also free from heavy metals. Since Splash works without heating or pyrolysis, it doesn’t create any byproducts, such as formaldehydes. What’s more, the absence of a battery means there is no risk of fire or malfunction. Other risks, such as leakage or accidental swallowing of the whole product, are ruled out as well, according to Hagen.

    In addition to equipping its device with a child-safety lock, Splash adheres to strict voluntary standards to prevent youth appeal. “Of course we stick to the legal caps for nicotine, but we also refrain from using sugar-loade[d] flavors or giving our flavors fancy names that are targeting children or youths,” says Hagen. “We don’t do lifestyle marketing, and we focus on age verification for online trade and retail.”

    Splash is a disposable product, planned to retail at $2 per unit and appealing to a mass market with its simplicity of use. However, sustainability has played an important part in its development. “We were motivated to make things better than existing products,” says Hagen. “In contrast to vape products, Splash contains no electronic components. Almost all its parts are made of recyclable plastic, hence the product can be returned into the recycling loop. With this, we are anticipating what is already imminent in some regions: the legally enacted ban of batteries in disposable products.”

    Platform with Potential

    The company believes its platform has potential beyond nicotine delivery. “Splash could be used for the administration of substances that provide users with new energy or a feeling of well-being and deceleration,” Hagen says. “It is also apt for administration of medicines. Our technology has a big advantage for beverage and pharma: the speed of absorption. While it takes about 10 [minutes] to 20 minutes for an energy drink or a painkiller to release its effect, Splash will take only a few seconds. We have already carried out respective tests in our labs, and there’s interest from the industries. Here, our technology could be licensed.”

    The company, which comprises a network of 14 people spread across several cities and continents, aims to become an expert in the administration of substances rather than an expert in the distribution of nicotine products, according to Hagen. For the time being, though, Splash is focusing on nicotine, which currently engages the majority of its staff. A second division, however, is working on other mood enhancers.

    The Splash device is developed in Germany and manufactured in China. For regulatory reasons and to distinguish it from use in other industries, the company in November rebranded the nicotine part of its platform under the name Voam.

    The company started to commercialize its patented technology as a nicotine product in the late summer of 2023, testing the product in several stores in close contact with consumers to be able to potentially make last adjustments. “We intend to keep this panel that exceeds traditional market research to test innovations, such as new flavors, in the future,” says Hagen.

    According to him, the industry has already shown significant interest in the product. The company has been in talks with representatives of the traditional tobacco business as well as the nicotine industries and leading distributors in several countries. “We are already negotiating the first larger volumes,” says Hagen. “In the selection of potential partners, it is especially important to us that the player shares our mission: to enable a smoke[-free] and vapor-free world with our product without forgoing enjoyment and rituals.”

    Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.
  • Unpacking the Pouch

    Unpacking the Pouch

    Photo courtesy of Broughton

    How we can better understand the toxicological risk of nicotine in modern oral and other nicotine products

    By Libby Clarke

    Nicotine may be acutely toxic via all routes of exposure if the dose is high enough, but determining the true extent of its toxicity is challenging because of the variation in data. In 2014, Bernd Mayer highlighted the discrepancy between the generally accepted lethal dose of nicotine and documented cases of nicotine intoxication. Examining these accidental oral ingestion case studies gives us another data point for consideration when determining nicotine toxicity.

    In this article, Libby Clarke, managing consultant for toxicology at contract research organization (CRO) and scientific consultancy Broughton, explains how manufacturers can understand the true impact of oral pouches and other nicotine-based products.

    The U.S. Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health, along with other sources, report an estimated lethal dose of around 60 mg when nicotine is ingested orally. While broadly accepted by the Food and Drug Administration and other regulatory bodies, this value is derived from a series of self-experiments conducted by two individuals in the 19th century, where non-fatal adverse effects were reported.

    Mayer estimated that a dose of 60 mg of nicotine would give rise to a plasma concentration of approximately 0.18 mg per liter based on 20 percent oral bioavailability and assuming linear kinetics. Cases of fatal nicotine intoxication cited by Mayer suggest a much higher lethal nicotine blood concentration of approximately 2 mg per liter, corresponding to 4 mg per liter in plasma. Many existing case studies include data on accidental ingestion in children and infants, where the lethal dose is likely lower, as with nicotine naive adults.

    There is a significant disparity in the levels of nicotine that individuals can tolerate and a broad range in the upper level of nicotine that nonsmokers can consume without experiencing adverse effects. Research indicates that tolerance increases with repeated use of nicotine products, but the speed at which tolerance grows depends on the frequency of nicotine use, the amount absorbed systemically and individual genetics.

    Research Challenges

    Understanding nicotine toxicity is essential for determining the likelihood of adverse effects associated with certain products and concentrations, but research is limited. It is unethical to test nicotine toxicity in nonsmokers, and light or nondaily nicotine users are likely to have a lower tolerance, putting them at a higher risk of experiencing adverse effects such as dizziness, nausea and vomiting. On the other hand, established smokers have upregulated receptors in the brain, meaning many more nicotine receptors are available to bind nicotine than in nonsmokers. Therefore, the higher levels of nicotine that produce adverse reactions in nonsmokers are often required to satisfy the cravings of regular smokers.

    The wide range in tolerance among adult nicotine users makes it challenging for manufacturers to define a threshold for nicotine toxicity in their products. Meanwhile, attempting to extrapolate findings from children to adults is not recommended due to differences in metabolic capacity, which increases as people grow. There is also a vast difference in metabolic efficiency, even among adults, which limits extrapolation.

    Understanding the Effects of Nicotine

    One option is for manufacturers to review case studies, conduct postmarket surveillance (PMS) on the incidence of reported adverse effects and use surveys to understand consumer use and the subjective effectiveness of nicotine delivery. For example, Massen et al. (2020) evaluated case studies reporting the clinical symptoms and outcomes associated with accidental or intentional ingestion of nicotine-containing e-liquids, which are limited to 20 mg per milliliter in the EU. Gerdinique C. Maessen et al. reported that the highest nicotine plasma concentration in the surviving group was 0.8 mg per liter. In comparison, the lowest plasma concentration in the patients who did not survive was 1.6 mg per liter.

    Another approach is working with a CRO that can conduct dissolution, aerosol characterization for inhaled products and pharmacokinetic studies to inform on the nicotine levels being delivered to users. CROs can also conduct behavioral studies under controlled conditions to understand the use patterns for certain products and what products and strengths are used across population samples.

    When developing oral pouches, manufacturers must adhere to the regulatory guidelines that are starting to be brought in by some markets. The rate at which nicotine transfers from the pouch across the buccal membrane is one of the main factors associated with users experiencing adverse effects, so manufacturers should consider a range of nicotine strengths. Dissolution studies and clinical studies may provide useful data to inform nicotine exposure from pouches, and case studies and PMS may also provide valuable insights. Working with a CRO that can conduct such studies is an effective way of understanding a product’s safety profile and form part of a manufacturer’s product stewardship and duty of care responsibilities.

    Libby Clarke is managing consultant for toxicology at Broughton, a global scientific consultancy-based CRO across industries in pharmaceuticals, next-generation nicotine-delivery products and cannabinoids.
  • The Core of the Confusion

    The Core of the Confusion

    Photo: Westock

    The likely origins of the prevailing misperceptions about nicotine—and how that impacts tobacco harm reduction

    By Sudhanshu Patwardhan

    A widely prevalent misperception prevailing in society is that nicotine in tobacco products causes cancer. This myth and its widespread acceptance even among healthcare practitioners worldwide was recently highlighted by a survey among 15,000 doctors from 11 countries. Nicotine misperception may be the key reason preventing the world from becoming free from risky forms of smoked and smokeless tobacco products. The origins of this misperception may have something to do with south Asia and the nasty oral tobacco products sold there.

    The Basis of Tobacco Addiction

    To achieve a world free of risky tobacco product use, understanding nicotine’s role in tobacco addiction is crucial. Tobacco addiction—in lay terms, the harmful habit of consumers of risky forms of tobacco to continue consuming despite knowing the harms to themselves and society—is primarily driven by the psychoactive effects of nicotine. The hand-to-mouth action, the action of nicotine on brain receptors, the activation of reward pathways in the brain, the release of neurotransmitters during product use and their eventual depletion, the expectation of the kick of the drug on longer term use, the craving and withdrawal effects that are mitigated by further consumption (or dosing) of nicotine, the social and cultural cues—all these point to a complex interplay. Nicotine is central to this addiction. An addiction that kills over 8 million people worldwide every year, affecting millions more in bereaved friends and families, and sees another 1.3 billion people in the world struggling to quit.

    It Is the Smoke, Stupid … or Is It Just?

    Over nearly five decades of tobacco control, thought leaders in the West have been enamored by—and have generously quoted—Michael Russell’s statement, “People smoke for nicotine, but they die from the tar” (Russell, British Medical Journal, 1976). He was right in the context of smoked tobacco. Indeed, this insight underpinned the enlightening among some tobacco control researchers in the U.K. and across the Atlantic. That in turn manifested in ground-breaking publications, e.g., the 2001 National Academy of Sciences’ Clearing the Smoke report, the 2007 U.K. Royal College of Physicians’ report Harm Reduction in Nicotine Addiction: Helping People Who Can’t Quit and the 2014 U.K. Royal College of Physicians’ report Nicotine Without Smoke: Tobacco Harm Reduction.”

    Indeed, the U.K. medicines agency’s authorization of an additional harm reduction indication for nicotine-replacement therapy (NRT) products from 2010 onward established the world’s first class of licensed tobacco harm reduction products. This is often forgotten by tobacco harm reduction advocates as well as tobacco control enthusiasts around the world, with even lesser understanding of how and why the U.K. arrived at this fork on its journey in addressing tobacco-related harms (Patwardhan, Drug Testing and Analysis, 2022).

    Metaphorically separating nicotine from its toxic delivery system that burned tobacco allowed Russell and the subsequent generations of public health thought leaders to pave the way for nicotine in cleaner forms to be formulated in various delivery systems, starting with medically licensed nicotine gums, patches and lozenges and culminating in Hon Lik’s invention of the e-cigarette. Heated-tobacco products launched by large tobacco multinationals also entered the market, with companies keen to “unsmoke” the world and phase out combusted tobacco, just like electric batteries in place of combustion engines in automobiles. Or Coke Zero and Pepsi Max instead of Coke and Pepsi. Right? Wrong! This narrative ignores oral tobacco consumption by nearly 300 million tobacco users, living mostly in Asia and Africa, and the attending oral and pharyngeal cancer-related morbidity and mortality.

    Smokeless Tobacco’s Harms: A Collective Blind Spot

    One estimate suggests that nearly 10 percent of doctors in the U.K. are of Indian or Pakistani origin and a sizeable number from Africa and the rest of Asia as well. There is even a higher proportion of healthcare professionals from these continents in mental health settings. Training in south and southeast Asia or Africa inevitably exposes doctors to patients presenting with the harms of oral tobacco.

    Current medical curricula in these countries (or in fact anywhere else in the world) do not go into any level of detail when it comes to treating smoked or smokeless tobacco addiction. During medical education, it is quite common to simply identify the myriad diseases that tobacco is responsible for and to require trainee doctors to advise patients to quit. Which nicotine-replacement therapy to prescribe, why, how to provide behavioral counselling for tobacco de-addiction, the need for follow-up and relapse prevention, the impact of smoking on specific drugs’ metabolism and reduced efficacy are skills and knowledge that are not imparted at any stage of clinical training to doctors, dentists or nurses anywhere in the world.

    There are millions of healthcare professionals in Asia and Africa and hundreds of thousands of expatriate doctors and nurses from these continents in Europe, America and the Middle East who have seen oral cancer patients, most likely resulting from oral tobacco use. They have seen firsthand the harms from oral tobacco products.

    Unsurprisingly, telling them that tobacco harm reduction can be achieved by going smoke-free or by switching to “smokeless tobacco products” or giving “safer” nicotine alternatives will be perceived as fake news at best, disingenuous and dishonest at worst. Even licensed NRTs are not spared in this misperception, with many clinicians worried about nicotine causing cancer and NRT addiction with longer term use. This may result in inadequate NRT being prescribed for not long enough, thus making relapse more likely.

     

    The use and harm profile of south Asian and African smokeless tobacco products is often not mentioned when championing snus (and therefore smokeless tobacco) as harm reduction. This can only add to the distrust of the industry and tobacco harm reduction advocates by the public health community.

    Nicotine Misperception: The Likely Origin Story

    There is an unprocessed wrong belief that most health experts and lay people have come to harbor: tobacco = nicotine = cancer. Toxicants, including carcinogens, are delivered during consumption of most tobacco products: from the smoke due to combustion of tobacco in the case of cigarettes/cigars/cigarillos and bidis, or added/formed in the manufacturing and storage of Asian and African oral tobacco products, e.g., chemicals, slaked lime, areca nut-specific nitrosamines and tobacco-specific nitrosamines (TSNAs).

    The exception to these is Swedish-style pouched smokeless tobacco (snus). Through decades of evolving manufacturing standards and innovation, concentrations of carcinogens such as TSNAs and other toxicants in Swedish-style snus have been engineered to be minimal. The population level effects of the “Swedish experience” with snus in enabling a transition to a smokefree nation with the attending lowest male lung cancer rates in the EU, are the darling of tobacco harm reduction advocates. However, the use and harm profile of south Asian and African smokeless tobacco products is often not mentioned when championing snus (and therefore smokeless tobacco) as harm reduction. This can only add to the distrust of the industry and tobacco harm reduction advocates by the public health community.

    In the absence of a curriculum that does not specifically distinguish nicotine’s psychoactive properties and dependence-causing potential from the toxicants formed or present in smoked or most smokeless tobacco products, healthcare professionals may easily conflate the tobacco products’ harms with nicotine.

    Furthermore, their experience with patients from south Asia and Africa makes it logical for them to unconsciously do so. There are already lazy parallels with other widely prevalent addictions afflicting the world: e.g., alcohol. The nuance, however, is lost, that unlike nicotine, ethanol is the psychoactive component as well as the chemical that harms the liver and brain cells.

    Lay media add to the confusion. Globally, tobacco control slogans and campaigns have run for decades now, most often using simple one-liner messages against nicotine. There was no need or place for nuance for those wanting to rid the world of the indirect harms of nicotine. It could even be justifiable for some to do so to achieve their utopian prize of a tobacco-free society (not to be confused with a society free from the harms of tobacco, a worthy goal).

    The problem arises when nicotine, the very chemical that is vilified in the prevalent anti-tobacco narrative, when delivered in clean systems is recognized as a key solution for the 1.3 billion users of risky smoked and smokeless tobacco products. E.g., the World Health Organization has NRT on its model essential medicines list for treating tobacco dependence.

    Nicotine: An Orphan Drug

    Eighty percent of the world’s users of risky tobacco products, nearly 900 million people, live in low-income and middle-income countries (LMICs). Most of them do not have access to affordable and appealing safer forms of nicotine-replacement products, including NRT. A majority of healthcare professionals in those countries wrongly believe that nicotine in tobacco products causes cancer. In these countries, tobacco cessation treatments are either unavailable or delivered by healthcare professionals who are not trained in the art and science of nicotine replacement and behavioral interventions.

    For too long, pharma and tobacco companies have shied away from owning nicotine, with pharma perhaps worried about the optics of selling a psychoactive substance with such global harms, albeit due to the dirty delivery system it is currently sold in. Tobacco companies care about their own brand and product and may prioritize brand building over broader product-agnostic market conditioning about nicotine. The result is that a large swathe of countries that lack the sophistication or the academic rigor and experience of the U.K.’s tobacco control community or the U.S.’ Food and Drug Administration find themselves accepting hand-me-down anti-tobacco-harm-reduction rhetoric.

    Light at the End of the Tunnel?

    A rush to launch new nicotine products globally without adequate disentanglement between tobacco and nicotine education will only lead to more knee-jerk reactions and bans. That shall slow down any ambition to make the world smoke-free, or to be more precise, free from risky tobacco products. Achieving nicotine literacy through education and practice may be the much-needed game changer. In theory, most countries, including LMICs, have NRT on their national essential medicines list.

    That does not necessarily translate into actual availability and affordability for cessation. Anyone truly invested in tobacco harm reduction should recognize that much groundwork needs to be laid first to get the new generation of healthcare students and future practitioners to be nicotine confident—starting with NRT. Tobacco cessation, underpinned by tobacco harm reduction principles, should be taught, practiced and experienced in LMICs through well-regulated healthcare ventures and partnerships.

    Consumers, healthcare practitioners and governments first need to see the success with cessation using conventional NRTs but also recognize the need for a wider choice of safer nicotine alternatives to wean off the 1.3 billion current tobacco users. Only then will the conditions be ripe for companies to responsibly market their nicotine innovations to adult tobacco users in such markets.

    Sudhanshu Patwardhan is a medical doctor, nicotine expert and health tech entrepreneur from India, based in the U.K. He works on projects around the world to reduce harm from tobacco, especially among the most disadvantaged tobacco user populations.
  • Persistence Pays

    Persistence Pays

    Photo: alisaaa

    Lessons from consumer advocacy groups that successfully fought for vaping regulation

    By Stefanie Rossel

    In the shaping of tobacco control legislation, the consumer is often ignored. Many governments find it easier to deny the health benefits of switching from combustible tobacco products to reduced-risk alternatives and simply ban less harmful nicotine-delivery systems. According to The Global State of Tobacco Harm Reduction, 37 countries currently prohibit the sale of nicotine vaping devices, and many others treat vapes like conventional tobacco products, which means restrictions on public consumption and bans on the promotion of e-cigarettes as safer alternatives to smoking.

    The consumer is typically denied a voice, as is the case at the Conference of the Parties to the World Health Organization Framework Convention on Tobacco Control (FCTC) (COP10), which will be hosted in Panama this November. Consumer advocates will not be allowed to participate in the event, not even as observers. The FCTC Secretariat, meanwhile, discourages treaty signatories from speaking with any group that is even remotely associated with the tobacco business, making interactions next to impossible.

    Despite such restrictions, recent examples show that with persistence, consumer advocacy groups can make a difference. For example, last year, the Philippines, a country with 19.9 million smokers, replaced its 2019 vaping ban with a sensible regulatory framework. Republic Act (RA) 11900, also known as “the vape law,” legitimizes vaping as a strategy for smokers to reduce their health risk, and it lowers the age at which vape products can be legally purchased from 21 to 18. Furthermore, the law moves the authority to regulate vapes and heated-tobacco products from the Philippines Food and Drug Administration (PFDA) to the Department of Trade and Industry. In 2021, the PFDA came under pressure after it was revealed that it had accepted significant funding from Bloomberg Philanthropies, a move that critics said subjected the Philippines’ health policy to foreign influence.

    The adoption of the vape law in the Philippines can largely be attributed to the persistent efforts of consumer organizations in countering misinformation.

    Peter Dator, president, Vapers PH

    Engagement is Key

    Tobacco harm reduction (THR) advocates consider the Philippines’ vape law “a minor miracle” as it prevailed in a region that is strongly influenced by Bloomberg Philanthropies and the WHO, both of which tend to favor prohibitionists tobacco control approaches. Many Southeast Asian countries, including Singapore and Thailand, have banned vape products in line with WHO recommendations.

    “The adoption of the vape law in the Philippines, despite the influence of anti-THR groups, can largely be attributed to the persistent efforts of consumer organizations in countering misinformation,” says Peter Dator, president of consumer advocacy group Vapers PH. “These groups have been instrumental in challenging misconceptions surrounding vaping, advocating for evidence-based harm reduction strategies and ensuring that accurate information reaches policymakers and the public.

    “Through their consistent and dedicated campaigns, consumer organizations have played a vital role in shaping a more informed and balanced perspective on vaping, thereby influencing the decision to overturn the ban and embrace a more pragmatic approach to tobacco harm reduction in a region where such legislation has often been swayed by ideologically driven influences.

    “Vapers PH actively engaged in the process of overturning the vaping ban in the Philippines by taking concrete steps, such as leveraging social media platforms to raise awareness and disseminate accurate information about vaping’s benefits and risks. Additionally, we participated in various forums and public consultations dedicated to the vape bill, providing expert insights and representing the interests of vapers. By actively contributing to public discussions and presenting evidence-based arguments, our group, alongside several other vaping consumer groups here in the Philippines, played a crucial role in influencing the reconsideration of the ban and encouraging a more nuanced approach to vaping regulation.”

    Manufacturers, distributors and retailers are currently working through an 18-month transitory period to comply with the new legislation. Recently, the Philippines released guidelines for flavors, which, according to Dator, focus mainly on preventing their marketing to minors. For example, e-cigarette companies may not give their flavors names that may appeal to children.

    The Importance of Enforcement

    As a representative of consumer advocacy, Dator says he is pleased to see that the bill has taken steps toward regulating the vaping industry in a fairer manner than before. “However, while I appreciate the progress made so far, I believe that there is still more work to be done in terms of implementing these regulations effectively,” he says. “It’s important that the regulatory framework is comprehensive and well enforced, ensuring that manufacturers adhere to quality standards, provide accurate product information and refrain from targeting minors. Additionally, there should be measures in place to monitor and assess the long-term health effects of vaping products as this information is crucial for consumers to make informed decisions about their health.”

    Dator believes the rules should be strengthened to ensure the safety and well-being of consumers. “The ultimate goal should be to strike a balance between providing adults with a potentially safer alternative to traditional smoking while also preventing any unintended negative consequences, particularly among younger individuals,” he says.

    “While the bill has transformed into law, its true impact depends on how well the regulations are enforced and monitored. If the implementation process lacks rigor or faces challenges in terms of oversight and enforcement, there is a notable risk that the objectives of the law could be undermined. Therefore, the success of the law hinges on the commitment to robust implementation strategies that ensure compliance with the intended regulations and prevent any potential subversion of the law’s intent.”

    Sharing information, knowledge and strategies are key, especially in a regional context as what happens in one country may/will impact surrounding countries.

    Nancy Loucas, co-founder, AVCA

    A Resource of Information

    New Zealand, too, has been praised for its regulation of vaping. Unlike Australia, where vape products are available only on prescription, vaping remains legal as a smoking cessation tool under New Zealand’s Smoke-Free Aotearoa 2025 Action Plan, an amendment of the Smokefree Environments and Regulated Products Act (SFEA) from 1990.

    As in the Philippines, consumer advocates helped shape regulation in New Zealand. As the process to regulate vaping under the SFEA got underway, advocates contacted elected officials, health providers and community groups and offered to be a source of information. Members of the Aotearoa Vapers Community Advocacy (AVCA), for example, attended meetings to present science and research.

    “AVCA had an approved vendor list whereby the vendors agreed to equipment and liquid standards to self-regulate the industry,” says AVCA co-founder Nancy Loucas. “We gave this to the government to use as a template.”

    Loucas believes that New Zealand’s comparatively small size and progressive policies made it easier to help shape sensible, evidence-based regulation that recognizes the principle of harm reduction. “Because of the economies of scale, it is much easier to engage with officials here than in Australia, “ she says. “Australia is very conservative—authoritarian—comparatively.”

    Loucas is also executive coordinator of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates, an unfunded grassroots alliance among the THR advocates and their respective organizations in the region.

    She says collaboration among consumer advocacy groups from different countries is beneficial for consumers and consumer groups. “Sharing information, knowledge, strategies are key, especially in a regional context as what happens in one country may/will impact surrounding countries,” she says. “Commiseration and support is also important on a mental health level. Advocacy is not easy, and a burden shared is lighter.”

    The challenges we have been facing for almost a decade is the ignorance of a few control freaks.

    Asa Saligupta, head, ENDS Cigarette Smoke Thailand

    Educating People

    As the head of ENDS Cigarette Smoke Thailand (ECST), Asa Saligupta knows that consumer advocacy can seem like a Sisyphean task. Thailand has one of the world’s strictest vape laws, enacted in 2014. In the runup to the elections, THR activists had high hopes the new administration would lift the country’s ban on vaping. However, despite gaining the most seats in the House of Representatives, the progressive Move Forward Party was blocked from forming a government by allies of the monarchy and military in the Senate.

    Yet Saligupta remains optimistic. “My humble opinion is that no matter who will win the election and who will be our next Prime Minister, the vaping ban will be lifted. One of the delegates already proposed to set up a committee to look into it, and he was supported by enough votes that this bill is already waiting in line at the parliament.”

    While anti-vaping groups like to boast about Thailand’s harsh regulations, the country has a problem with enforcement. Bribery is a big issue. “The challenges we have been facing for almost a decade now is the ignorance of a few control freaks, plus you have to admit we are living in a social media era,” says Saligupta. “We don’t have enough resources to fight them. They kept coming with blatant lies after lies, along with misinformation. Fortunately, the ban does not include possession or the act of vaping unless you vape in a no smoking area. So, for us to go out to the public and tell them that vaping is safer than smoking is not against any laws, yet.” ECST is in touch with its counterparts in the Philippines and hopes to duplicate their accomplishments. “We have talked about copying their laws,” says Saligupta.

    Even as it maintained its ban on vaping, Thailand’s Food and Drug Administration July 2022 took cannabis off its narcotics list, legalizing possession, cultivation, distribution and consumption under certain conditions. Since then, thousands of cannabis shops have opened. However, there’s little support for similarly relaxing vaping restrictions, according to Saligupta. “But of course, we can point out the harm and addiction,” he says.

    ECST has done a lot to get the ban lifted. “We attended many seminars at the parliament; we sent a petition to the Ombudsman,” says Saligupta. “Now the hearing is over, and we are expecting results soon. I also host live casts at the weekend, with more than 100,000 followers, etc. I traveled worldwide to educate people on the situation of vaping in Thailand. Our next step is to wait and see who the government will be. For what it’s worth, I think almost all parties agree that vaping should not be banned but controlled.”

    Beating a Flavor Ban

    Meanwhile, in Europe, the EU is in the process of implementing its 2021 Beating Cancer Plan and preparing to review its Tobacco Products Directive (TPD). In 2022, THR proponents rejoiced when the European Parliament for the first time recognized the THR concept with the adoption of a report by its Special Committee on Beating Cancer (BECA).

    That success can at least in part be attributed to the work of consumer representatives. “Along with our 24 partner associations, I think we played a significant role,” says Damian Sweeney, a partner in the European Tobacco Harm Reduction Advocates (ETHRA).

    “From the beginning of BECA’s mandate in September 2020, we wrote and published articles on the BECA meetings to inform consumers about what was going on. As the meetings progressed and amendments were tabled and discussed, we could see that flavors were under threat. So, along with partners, we wrote to all members of the BECA Committee on three occasions to outline the importance of flavors in the success of vaping products as a harm reduction tool.

    “Another important recommendation to come from BECA—and something we also raised with committee members—was that risk assessments should compare the use of safer nicotine products [SNPs] to smoking. Although we don’t think the final report was specific enough as it said risk assessments should compare safer nicotine products to ‘consuming other tobacco products,’ this was still a positive, as it calls into question the validity of the Scientific Committee on Health, Environmental and Emerging Risks Opinion, which compared risks [of safer nicotine products] to nonsmoking.” 

    Cooperation among consumer advocacy groups is vital, according to Sweeney. “One of the founding principles of ETHRA was to coordinate and amplify the tobacco harm reduction voice in Europe, in support of millions of nicotine consumers,” he says. “One of our biggest strengths is our partner associations and how we work together to further the goals of THR.”

    The ETHRA has recently been busy with the revised TPD, which is expected to be adopted in 2024. “We have been actively involved at every stage of the evaluation,” says Sweeney. “We’ve taken part in numerous calls for evidence, public consultations, and been invited to participate in targeted stakeholder consultations and interviews. As the next iteration of the TPD will impact millions of consumers of safer nicotine products, it is essential that consumers have a voice, and it has been our mission to ensure consumers have that voice.

    “Our message has been simple—safer nicotine products are a popular and effective means to quit smoking and are proven to be substantially less dangerous. Policymakers should consider the opportunities safer nicotine products offer in reaching smoke-free targets and be acutely aware of potential unintended consequences of prohibitive policies, such as flavor bans or high taxation.”

    Recently, the ETHRA wrote to members of the newly formed EU Subcommittee on Public Health (SANT) ahead of the presentation of the Rapporteur’s Draft Report on noncommunicable diseases (NCD). “We highlighted that ‘tobacco use’ was erroneously identified as a risk factor when it should be ‘smoking.’ We also outlined the importance of safer nicotine products in reducing smoking and NCD prevalence. During the meeting, two members of SANT, who were also in BECA, asked that the BECA recommendations on SNPs be incorporated into the final SANT report. So, I’m quietly confident that those positives will be included.” 

    By continually challenging misconceptions, promoting accurate information and participating in public discussions, consumer organizations can help shape a more informed perspective on vaping and other harm reduction strategies, ultimately influencing policy decisions in favor of public health and individual choice.

    Damian Sweeney, partner, ETHRA

    Valuable Lessons

    So what can consumer organizations in other countries learn from their colleagues in the EU, the Philippines and New Zealand?

    “For me, political engagement is one of the most important parts of advocacy,” says Sweeney. “I would encourage other consumer groups to get in contact with their representatives at local, national and EU level to make them aware of the importance of tobacco harm reduction. It’s also important to participate in consultations when restrictive policies on safer nicotine products have been proposed. And, if you are part of a consumer group that is independent of industry, I’d highly advise joining ETHRA as a partner.”

    “Consumer organizations from other countries, like India [which prohibits vaping], can draw valuable lessons from the Philippines’ experience in vaping advocacy,” says Dator. “One takeaway is the importance of unwavering persistence in fighting against misinformation and advocating for harm reduction alternatives. The Philippine example shows that even small efforts, when consistently carried out by a collective of dedicated vaping advocates, can create a significant impact over time. By continually challenging misconceptions, promoting accurate information and participating in public discussions, consumer organizations can help shape a more informed perspective on vaping and other harm reduction strategies, ultimately influencing policy decisions in favor of public health and individual choice.”

    Loucas reminds consumer groups that elected officials work for them. “They should approach them with respect and integrity and present facts—but most importantly, their testimony,” she says. “Humanize the issue.”

    Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.
  • A Taste of ‘Terroir’

    A Taste of ‘Terroir’

    Photos: CTS
    Photos: CTS

    With its origin-focused approach, CTS has become a successful niche player in the French RYO category.

    By Stefanie Rossel

    “Shrinking” is the first word that comes to mind when thinking about the French tobacco sector. According to Statista, French tobacco sales are expected to decline by almost 1 percent annually between 2023 and 2028. In 2022, the tobacco market in France experienced its strongest value decline in a decade.

    With the country’s last cigarette factory in Corsica closing this December, cigarette manufacture in France will come to an end. Due to the phaseout of EU tobacco subsidies in 2006, the area dedicated to tobacco cultivation in France has decreased as well—from 3,149 ha in 2016 to 1,205 ha in 2021.

    Sadly, the only part of the tobacco landscape that continues to flourish is the illicit cigarette trade. According to a KPMG study commissioned by Philip Morris International, illegal smokes represented 32 percent of the French tobacco market in 2022.

    However, this dark environment conceals some remarkable success stories.

    One of them has been written by Collaboration Traditab Santele (CTS), an alliance of Traditab, a company run by small tobacco producers in southwestern France, and Santele, a Flemish family-owned manufacturer of traditional Belgian rolling tobacco.

    Considering the pressures from increasing regulation, the two companies felt it made sense to join forces. Traditab provided the raw materials and tobacco cultivation knowledge; Santele contributed roll-your-own expertise and manufacturing facilities.

    Established in 2016, CTS today is a medium-sized enterprise headquartered in Belgium with offices in France and Spain that currently manufactures and markets four brands of RYO tobaccos, focusing on the concept of “terroir.” The French term is used to describe the environmental factors that affect a crop’s phenotype, including unique environmental contexts, farming practices and growth habitat.

    CTS’ Vasconha RYO brand, an American-blend type, is made of 100 percent tobacco cultivated by farmers in Gascony, the Basque Country and Aragon, traditional tobacco cultivating regions on both sides of the Pyrenees. Wervikse Tabak b34, a fine-cut dark blend, comes from Wervik, a historical tobacco-growing region in Flanders. The tobacco for Veramia, a Virginia blend, is cultivated exclusively in the western Spanish region of Extremadura, where tobacco has been grown since the 16th century.

    Focus on Origin

    The company’s bestseller is 1637. In October 2023, the product was the third-bestselling RYO brand in France. Made of French tobaccos grown in the southwest, its name alludes to the year when tobacco was first planted in the region. The brand was created in 2008 by Traditab at the initiative of a cooperative of small tobacco growers, Tabac Garonne Adour (TGA), that sought to improve the price paid for local tobacco growers.

    Anne-Marie Bracq

    Marketing began regionally, with an emphasis on tobacconists. “At that time, there weren’t many such products on offer, as organic tobacco products were popular,” says Anne-Marie Bracq, director of CTS France. “We started out with 20 tons of tobacco and grew step by step, explaining to tobacconists that if they choose to sell our products, they support their country’s growers.”

    It’s a concept that works well in France, which takes pride in domestically produced cheese and wine varieties that derive their identities from clearly demarcated origins. The company has applied the same philosophy to the other two markets. In Spain, for example, it has a sales force of 17 people.

    CTS works with 120 tobacco farmers in France, who are organized in the TGA cooperative and cultivate almost 300 ha in the region between Bordeaux and Lot-et-Garonne. The farms are small, with tobacco representing only one of a variety of crops, typically planted on 2 ha to 4 ha.

    While in Belgium, CTS works with only one or two growers, it cooperates with 150 growers of a cooperative in Spain, which cultivates tobacco for CTS’ RYO brands on 550 ha.

    Jerome Duffieux

    “In France, tobacco growing is not as much a tradition as in Spain, and Burley is the main variety, with flue-cured Virginia [FCV] being more of a filler type,” explains Jerome Duffieux, director of Traditab. “Burley production is more mechanized whereas FCV production is more of a manual process in France. In Spain, where farms are bigger and more specialized in tobacco, it’s the other way around; Spanish FCV is more aromatic.”

    Like Traditab, CTS aims to preserve a centuries-old regional tradition. “Our objective is to promote tobacco culture, which involves paying farmers an adequate price,” says Bracq. “This is also important in Spain. Extremadura produces 95 percent of Spain’s tobacco, accounting for 1,900 jobs, and provides €91 million ($95.83 million) to the region’s gross domestic product.”

    CTS’s bestselling 1637 brand was named after the year that tobaccos were first grown in the southwest of France.

    Expansion Planned

    The tobacco growers cooperating with CTS face a challenge shared by farmers in other fields of agriculture: finding successors when they retire. “Maybe it’s more difficult for tobacco because it’s difficult to promote from a health perspective,” says Bracq. “But we still have the problem of economic viability. At CTS, we are looking at ways to maintain tobacco cultivation, trying to develop a future for growers and [figuring out] how to support them economically. We are also running a program to find new farmers.”

    CTS plans to expand its current portfolio by developing a new RYO brand, but it’s not easy, according to Bracq. Almost three years ago, France raised tobacco excise taxes to €6.61—substantially above the EU average of €3.34.

    The government has continued raising RYO taxes since, thus eliminating the buffer function RYO usually plays between factory-made cigarettes and cheap illegal smokes. “A pack of 20 cigarettes now costs €11 and a 30-gram pouch of rolling tobacco €15 to 20,” explains Bracq. “The RYO segment is now declining more heavily than the cigarette market.”

    CTS is presently also involved in a cigar project. “We are developing cigars that are made of tobacco from southern France and plan to launch them in the next three years,” says Bracq.

    Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.
  • Peace of Mind

    Peace of Mind

    Photos: Smoore Technology Indonesia

    With its first overseas production facility, Smoore has boosted the resilience of its operations.

    By Taco Tuinstra

    The site that houses Smoore Technology Indonesia in Malang used to be a tobacco factory, but there is little to remind the visitor of its illustrious past. The rattling conveyors have fallen silent, the leaf scraps have been swept away and the sweet scent of clove tobacco has long dissipated, giving way to a serene, almost sterile environment.

    Instead of the rumbling of cigarette-making machines, there is the hum of high-tech equipment. Sixteen automated production lines assemble, fill and pack e-liquid pods for the U.S. market, requiring only a minimum of human intervention. According to Smoore, the Indonesian facility is one of the most sophisticated and highly automated in the world.

    Though Indonesian plant manufactures nicotine products like its predecessor, the new establishment looks more like a pharmaceutical lab than a factory, with medical-grade standards of hygiene. Entering the production floor requires hairnets and shoe coverings along with a mechanical “wind shower” to remove any contaminants from visitors’ clothing. In addition to a wastewater treatment facility, the compound has its own power generator; in case of a network failure, production can continue for at least 24 hours.

    Considerate of the local culture—Indonesia is the world’s most populous Muslim-majority country—the Chinese firm has built multiple prayer rooms throughout the facility as well as a covered parking deck that can accommodate hundreds of motorcycles. Despite its high level of automation, the Indonesian affiliate employs thousands of local people, and two-wheelers remain by a large margin the most affordable and efficient vehicles for commuters to navigate the country’s bustling roads.

    Ensuring Business Continuity

    Clayton Shen

    Touring the 60,000-square-meter facility (30,000 of which are covered), as Tobacco Reporter did in early October, it is hard to believe that a mere eight months passed between the time that Smoore’s head office in Shenzhen authorized the project and when the first product shipment left the factory in May 2022.

    According to Clayton Shen, president director of Smoore Technology Indonesia, the new factory—Smoore’s first outside of its home country—is part of the company’s business continuity strategy, designed to strengthen the resilience of its global operations and guarantee customers uninterrupted supply regardless of geopolitics or other eventualities.

    As the world’s leading atomization company with a global market share of almost 20 percent, according to Frost and Sullivan, Smoore already has a formidable manufacturing footprint in China, featuring multiple highly automated production lines. In light of recent global developments, however, the company considered it prudent to expand globally and supplement its Chinese base with an additional site.

    While Smoore weathered the Covid-19 pandemic remarkably well, the crisis also exposed the risk of supplying customers worldwide from just one country. Travel restrictions disrupted global supply chains, causing shipping rates to skyrocket and containers to pile up in the wrong locations. China also locked down longer and more severely than many other countries, forcing suppliers to temporarily halt operations and leaving customers scrambling for their products.

    Meanwhile, rising political tensions between China—the world’s largest supplier of vaping liquids and hardware—and the United States—the leading destination for such products—resulted in new trade barriers, with Beijing and Washington slapping each other with tit-for-tat tariffs. E-cigarettes and many other Chinese-made imports are now subject to a 25 percent duty in the U.S., saddling buyers with considerable nonvalue-added expenses.

    Then, in April 2022, the State Tobacco Monopoly Administration, which had recently asserted jurisdiction over China’s rapidly growing vapor business, published new rules for e-cigarette manufacturing. While Smoore successfully applied for many of the newly required licenses, this development also gave pause to others planning to enter the industry.

    Selecting a Site

    The facility in Malang is conveniently located to one of Smoore’s key customers; BAT manufactures tobacco products at its Bentoel facility on the other side of the road.

    In July 2020, the company took its business public, raising more than US$1 billion on the Hong Kong Stock Exchange. The cash provided it with the confidence and financial flexibility to explore the possibility of strengthening its Chinese manufacturing base with a facility abroad.

    The immediate question was: where? The United States and Europe are Smoore’s biggest markets, but those places are also far from China, where many of Smoore’s suppliers remain based. And their regulatory environments can be intimidating for players unfamiliar with the local laws.

    Smoore decided to look closer to home, in Southeast Asia, which like China has a long tradition of manufacturing for exports. Industrial prowess was not the only criterion, however; Smoore also needed a location that was friendly to e-cigarettes. Thailand and Malaysia quickly disqualified as candidates because of their restrictions on vaping. Vietnam, by comparison, is a tolerant country for the nicotine business. It has a large domestic tobacco industry and a famously industrious workforce. However, the state requires foreign investors to not only team up with a local company but also give their Vietnamese partner a 51 percent stake in the business—an unappealing condition for Smoore.

    So the choice fell on Indonesia. According to Shen, the country offers multiple advantages. For starters, it is amiable to the nicotine business—a rarity at a time when hostility is the norm in many countries. Indonesia is a major producer and consumer of tobacco products. In 2022, the country’s tobacco growers harvested 225.58 million kg of leaf, and its cigarette companies produced more than 330 billion sticks, according to the Ministry of Agriculture and the association of white cigarette producers in Indonesia, Gaprindo. The tobacco industry and its supporting sectors employ almost 6 million workers and contribute nearly 11 percent of the country’s total tax take. E-cigarettes and tobacco-heating products (THPs) have been making steady inroads in Indonesia, too, lately, especially in urban areas.

    On top of that, Indonesia offers a conducive industrial environment for the e-cigarette business. The country is endowed with abundant natural resources, including nickel and copper, which are key materials in battery production. Keen to move beyond mineral extraction, the government has been pushing domestic production of power cells for electric vehicles and other applications.

    The economic significance of tobacco to Indonesia means not only that the country welcomes new initiatives in the sector but also that it has a workforce accustomed to handling nicotine products. What’s more, Indonesia offers good logistics and a favorable investment climate. According to Shen, the latter factors are important because Smoore is keen to localize its supply chain as much as possible. Encouragingly, Indonesia’s business-friendly environment is expected to endure regardless of who wins next year’s presidential elections, as none of the candidates running for office appear inclined to reverse the policies that have allowed Indonesia to become one of the world’s fastest-growing economies.

    Perhaps the only hesitation was the uncertainty of how Smoore, as a Chinese company, might be received in Indonesia, where throughout history there have been episodes of tensions between the Indonesian people and the country’s ethnic Chinese community. Smoore’s subsequent experience, however, demonstrated that people, regardless of their background, will generally treat you as well as you threat them: The company’s sincere effort to understand the local culture and respect local customs was reciprocated with fierce loyalty from a dedicated workforce. Local authorities, meanwhile, went out of their way to accommodate the investment. When Smoore inaugurated its facility in June 2022, Indonesia’s minister of investment attended as a guest of honor.

    Remarkably, labor cost did not feature prominently in Smoore’s decision to set up shop in Indonesia. While an affordable payroll is a nice side benefit, according to Shen, the company’s focus on automation made the price of labor a less important consideration than it might have been for a less advanced player.

    Smoore continues to enjoy a significant lead in this area, having set up its automation division in 2014, when manual production still prevailed in the sector. According to Shen, two developments accelerated automation—the debut of ceramic heating in 2016 and the U.S. premarket tobacco product application process. The first replaced the easily deformed wick with a more solid structure, which is easier to work with from a design perspective. The second made it cost-prohibitive to keep changing products for the all-important American market, resulting in a more predictable form factor.

    Smoore’s factory in Indonesia is one of the most sophisticated and highly automated in the world.

    The Yunnan of Indonesia

    Having decided on Indonesia, Smoore had to pick a city. Should it be Jakarta, Indonesia’s administrative and financial capital, or perhaps Surabaya, with its large industrial base and busy port? In any event, Smoore chose Malang, the capital of the larger Malang regency in the province of East Java. Though smaller than Jakarta or Surabaya, Malang is strategically located with good connections to the port of Surabaya and other key cities. In addition to reputable universities, the town has a strong tobacco heritage, with leading players such as Sampoerna, Djarum and Bentoel operating in the region. “Malang is the Yunnan of Indonesia,” says Shen, referring to China’s leading tobacco-producing province.

    The other consideration that made Malang an appealing choice was the fact that BAT had a piece of land available along with empty buildings that used to house a tobacco factory. This provided Smoore not only with suitable facilities but also placed it in proximity to a prominent customer. BAT’s Bentoel subsidiary continues to manufacture tobacco products on the other side of the road.

    The first team from China, which included the project leadership, construction specialists and human resource recruiters, arrived in Malang in November 2021, around the time that the Omicron Covid variant started doing the rounds. While Indonesian pandemic restrictions were less severe than those in China, employees among the first group still had to quarantine in Jakarta for up to 10 days. Shen was luckier. By the time he arrived as part of the second group, Indonesia had relaxed its isolation requirements.

    Nurturing Talent

    Initially, recruitment appeared to be a challenge. Although Indonesia has a large, well-educated workforce and plenty of experience with tobacco products, Smoore was the first e-cigarette company in the country, and there was no readily available workforce for that segment.

    “We found that the people here had good experience in other industries but no idea about e-cigarettes,” says Shen. In addition, getting people to relocate for work proved a harder sell in Indonesia than it is in China. “In China, it’s easy to convince people to leave other cities for job opportunities in Shenzhen,” says Shen. “Pursuading candidates to move from Jakarta or Surabaya to Malang turned out to be more challenging.”

    So Smoore decided to set up its own training programs. “We went to the local universities and recruited students who were about to graduate,” says Shen. Then we trained them not just in one department but allowed them to rotate based on their university major and their personal interests and capabilities. After one year of training, we sent them to the appropriate position, whether that be in engineering, quality control or in another department.”

    This approach not only creates well-rounded employees but also nurtures a pool of future leaders—an important benefit for a rapidly growing company like Smoore. “For many of our people, Smoore is their first employer; they will be heavily impacted by our culture, and they will grow up very fast,” says Shen. “We believe that, within three [years] to five years, many of them will move into key positions—an opportunity that is not always available in established companies where all the leadership functions have already been filled.”

    The investments in people appear to be paying off. When a delegation of senior Smoore officials from Shenzhen visited the Indonesia facility, they asked employees from various departments for honest feedback. According to Shen, 95 percent of respondents indicated that they felt proud and comfortable working for Smoore.

    Growing the Pie

    Such levels of employee satisfaction bode well as Smoore expands. While the facility across the road from Bentoel currently supplies BAT, the company is keen to serve other customers from Indonesia as well. For that purpose, it has been building a second factory at a different location, which at the time of writing was nearing completion.

    By spreading its geographical footprint, Smoore has boosted the resilience of it business. With manufacturing capabilities in both China and Indonesia, the company not only offers security of supply but also allows U.S. customers to avoid costly import duties. Other Chinese e-cigarette companies have taken note, and some have also started exploring the option of setting up shop in Indonesia. For the time being, however, most of Smoore’s competitors are limiting their activities to Bantam, a special economic zone just south of Singapore.

    Shen is unconcerned about such actions. “We never worry about competitors because we want to make the industry bigger,” he says. More e-cigarette manufacturing in Indonesia also makes it more interesting for suppliers to establish operations there, which in turn will benefit Smoore. In a testimony to the company’s strategic relationships, three of its Chinese suppliers also came to Indonesia when Smoore set up shop there—but there’s always room for more. “Ultimately, our goal is to grow the pie,” says Shen.

    Taco Tuinstra is Tobacco Reporter’s editorial director. Based in Raleigh, North Carolina, USA, he coordinates the work of staff writers and contributors. On his watch, Tobacco Reporter has won several awards for editorial excellence. Since joining the magazine in 1997, Taco has visited more than 75 countries to meet industry representatives in their markets and to report tobacco news firsthand.
  • A Pipe Dream?

    A Pipe Dream?

    Photo: Filipa

    Britain’s plan to create a smoke-free generation could be momentous if implemented properly—and herein lies the problem.

    By George Gay

    The Guardian newspaper on Oct. 6 published a trenchant cartoon by Ben Jennings that showed an angry-looking U.K. prime minister driving or stuck in traffic on a road heavily polluted with vehicle fumes. But it is not the vehicle fumes that are making Rishi Sunak angry. He is shouting at a pedestrian student choking on the fumes as he makes his way to school: “Maybe you should stop smoking.”

    For readers not based in the U.K., I should explain that, two days earlier, the prime minister’s office had issued a news bulletin titled, “Prime Minister to create ‘smoke-free generation’ by ending cigarette sales to those born on or after 1 January 2009,” while, previously, we had been told that Sunak was considering taking away the powers of local governments to protect children by preventing cars being driven right up to school gates.

    I hope that the Jennings cartoon was seen by those public health officials who are quoted in the bulletin as not only supporting the policy, which is a reasonable stance for them to take, but as heaping praise on the prime minister for looking after the interests of young people. They might like to ponder the way Sunak, as chancellor under prime minister Boris Johnson, resisted calls for extending the provision of free school meals to needy children; the way he has served in a government that has allowed more than 100 schools to become structurally unsound; the way he remained in government while it rolled out a chaotic pandemic-period education program, possibly ruining the life chances of countless children; the way he has in mind to prevent local governments from introducing lower speed limits and car-free zones, both of which have positive consequences for children; the way he has condoned the placement of lone asylum-seeking children in hotels, despite the high court’s having found the practice unlawful; and, possibly most heinous of all, the way he condoned the painting over of cartoon murals at other centers housing children seeking asylum lest the centers became too welcoming.

    I hope the public health people concerned do think about these matters, which are by no means exhaustive, and each of which will negatively affect the mental and physical well-being of children under the care of Sunak, a committed fossil fuel aficionado. And I hope that, in the future, before being drawn into the political sphere, they bear in mind that politicians regularly use children much as conjurors use their assistants.

    I should let it be known also that Sunak heads a party that has been in government for 13 years, that is deeply divided and unpopular and that faces an election next year. In fact, his situation puts me in mind of Maynard Keynes, who apparently once made the point that when something momentous was at stake, the last things you needed in the mix were politicians trawling for votes.

    The success or otherwise of this policy will hinge on satisfying, clean nicotine products remaining available even to young adults who will not be able legally to buy cigarettes.

    Objections

    Having said all that, I must admit that I think the proposed policy could be important, if not momentous. Nevertheless, I am conflicted because whereas I think the policy could offer huge advantages, it will do so only if it is implemented properly, and herein lies the problem. It is being rolled out in its initial phase by politicians trawling for votes.

    One of the objections put forward by those opposed to such a policy is that it amounts to a creeping prohibition that aims eventually to disallow smokers from obtaining the products they seek. But is this correct? I can sympathize with those who worry about how such a policy might lead to a “creeping” overreach that takes in current smokers, but I wonder whether this could be described as “prohibition.”

    Look at it this way: If there is one message that most tobacco harm reduction advocates have been keen to get across in recent years, it is that smokers smoke for the (benign) nicotine while being laid low by inhaling the tar that is a product of tobacco combustion. So, in fairness, while granting that the government is not proposing that current smokers should not be allowed to obtain cigarettes, it must be conceded also that it is not even proposing that they, or future generations of people, should not have access to nicotine, the substance that smokers want. And even if there is policy creep, the way things currently stand, smokers will not be subjected to a true prohibition because they will have access to nicotine. The proposal seems to my way of thinking to be only about stopping future generations and, given a bit of creep, current generations from inhaling tar, which, apparently, is not what smokers want but the thing that masks the otherwise unpalatable taste of nicotine and harms them.

    Meanwhile, some people believe that a major issue with the proposed policy is that it simply won’t work—that those who are underage will be able to obtain cigarettes through family members, friends and retailers who turn a blind eye to the law. There is clearly truth in this because the underaged can obtain cigarettes now, but I cannot see that this matters a great deal, at least at a societal level. In fact, it might provide something of a safety valve for the policy. We have vehicle speed limits in the U.K. that are broken by most people on most days, but those limits nevertheless tend to reduce the speed at which people would otherwise drive. People might drive at 35 mph in 30 mph areas, but few do 45 mph. That such a system works can be seen from the fact that few outside of those on the lunatic fringe of libertarianism would agree to speed limits being abolished, allowing petrol heads to drive through cities at 150 mph. And so it is that the tobacco purchasing age law, along with the continuing availability of satisfying, cleaner nicotine products, would have the effect of reducing the number of people taking up smoking. But, of course, it would not stop it.

    The way things currently stand, smokers will not be subjected to a true prohibition because they will have access to nicotine. | Photo: VPZ

    Offering Alternatives

    Nevertheless, as suggested above, the policy does raise concerns in my mind to do with the timing of it and the commitment to it of the current government and even a future government of a different stripe. Also as suggested above, the success or otherwise of this policy will hinge on satisfying, clean nicotine products remaining available even to young adults who, because of their age, will not be able legally to buy cigarettes. This is fundamental to me. I cannot imagine, as others apparently can, a future unchanging utopia where no one uses recreational drugs. And given I am correct in my assumption, cleanly delivered nicotine should have its place in the future. It is a popular and relatively safe drug, especially when compared with something such as alcohol, which, for reasons I can only guess at, is given a free pass by most public health people even though its consumption is a bigger drain on society than tobacco consumption.

    But I digress. The reason I am not convinced the policy will be implemented in a coherent way is that the government, as part of its Oct. 4 news bulletin, said it was planning “a further major crackdown on youth vaping by announcing an intention to consult on plans to reduce the appeal and availability of vapes to children.” The consultation is to take in flavors and product descriptors, disposable vapes, point-of-sale displays, and packaging and product presentation.

    It doesn’t take a genius to know which way this is going. The government says it wants to ensure it gets the balance right between protecting young people and supporting adult smokers to quit, but this is politics, and the “child epidemic” lobby will be allowed to have its finger pressing down on its side of the balance. And if the appeal to adults of clean nicotine products is significantly reduced, then it’s game over. The policy will simply pass the ball to those waiting to fuel the illegal trade in vaping devices and, probably, cigarettes.

    Rushed Policies

    But having said that, the policy could work in theory even though satisfying, cleaner nicotine products were not available, though it would take an investment in policing, the judiciary and the prison service to which no government would commit. The news bulletin said that “[e]nforcement activity will also be strengthened, with an investment of £30 million ($36.42 million) to support agencies such as local trading standards, HMRC [tax collection] and Border Force to take action to stop underage sales and tackle the import of illicit tobacco and vaping products at the border.” You would have to be terribly naive to believe that this amount would be guaranteed, and, in any case, it would be nowhere near enough and would probably not even make up for the disinvestment made in respect of these agencies during the Conservative governments’ 13 years of austerity. The major reason why young people are currently able to obtain vapes so easily is that the funding of trading standards was hugely undermined.   

    Another reason why the policy, though not without merit, is likely to fail is that it probably has not been thought through properly. The U.K. currently is awash with policies rushed out in order to make it appear, ahead of the election, that the government has a purpose. A recent announcement on railway investments was shot through with errors and failed even to place Manchester, the U.K.’s third-most populous city, correctly on a map.

    The tobacco news bulletin is a rambling, repetitive affair that apparently aims to make up with quantity what it lacks in quality. Consequently, we are told on seven occasions that smoking costs the country billions. There are 77 references to smoke or smoking, but you could be forgiven for missing the point that the ban on sales will apparently apply to tobacco products, not just combustible products, because this gets only two mentions. It is full of the usual platitudes that don’t stand up to any sort of scrutiny, such as “[n]o parent ever wants their child to start smoking.” It appears to include one glaring error in saying, “It is already illegal for children to vape.” And it quotes the chief executive of Cancer Research U.K., Michelle Mitchell, as saying, “[t]he prime minister deserves great credit for putting the health of its citizens ahead of the interests of the tobacco lobby,” without adding a caveat to say that if the government had listened to Philip Morris International years ago, the country would already be a long way down the track to being a smoke-free nation.

    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.
  • Roads to Rome

    Roads to Rome

    The MC Cosmic uses airflow technology to heat tobacco. | Photo: HNB Center

    There are multiple ways to heat tobacco without burning it.

    By Stefanie Rossel

    With the multinationals dominating the global market for heated-tobacco products (HTPs), one could easily think there are only two heating solutions—resistive heating with a blade or pin and induction heating. For years, Philip Morris International, which established a whole new category with its IQOS device, had been working on a third method—carbon heating of tobacco—but the company has since discontinued this platform. Recently, however, more heating solutions have entered the market. In their quest to optimize the user experience, independent manufacturers have resorted to other heating technologies.

    At the InterTabac trade fair, which took place in Dortmund, Germany, in late September, HNB Center of the Netherlands presented its MC Cosmic consumable. The associated device is powered by airflow technology. Also known as convection heating, it generates a stream of hot (350 degrees Celsius) air that flows through the heating chamber, surrounding a consumable that is filled with loose tobacco granules instead of a tobacco plug. A membrane at the end of the heat stick prevents the granules from falling out and contaminating the device.

    The granule-filled sticks are the first of their kind, says Gert Gorter, head of export at HNB Center. “The granules consist of 100 percent tobacco derived from tobacco leaves. Together with the heating device, the taste experience is very good.” The airflow technology, he adds, heats the stick more effectively and evenly than a pin, which tends to heat the tobacco immediately surrounding it to higher temperatures than leaf at a greater distance.

    We cannot add any flavors, but we can play with different sorts of tobacco and blends as well as with the number of grams of the granules in the stick.

    Gert Gorter, head of export, HNB Center

    More Like Smoking

    A subsidiary of VCT International, HNB Center began to work with granule-filled consumables provided by Yunnan Tobacco, which holds the patents for the sticks and corresponding device, almost two years ago, first trying them on a traditional device. “The taste was already better,” says Gorter. “You can smoke the sticks with a blade device, but this of course will perforate the membrane and create waste. We didn’t want that, so we thought of using airflow.” While airflow has been around for some time, the technology has improved considerably in recent years, according to Gorter.

    Gorter believes that airflow-heated granule-filled sticks provide consumers with an experience that is closer to traditional smoking than other systems. “Two years ago, we did a survey with smokers on our traditional heat sticks and included two packs of the granule-filled prototypes,” he recalls. “These instantly went to No. 1 in the perception of the participating consumers. The taste is fuller. It’s also our answer to the flavor ban on HTPs, which will be effective in the European Union from May 2024, allowing only tobacco flavor. We want to provide a heat stick that comes close to traditional tobacco smoking. We cannot add any flavors, but we can play with different sorts of tobacco and blends as well as with the number of grams of the granules in the stick; a higher grammage will result in fuller flavor.”

    The device, which is called My Choice NOVA, has a battery capacity of 15 sticks, making it suitable for the average smoker, who typically consumes 13 cigarettes a day. Gorter is convinced that his technology will make a significant change. “You can also put any stick in this device; the whole system of airflow is giving you a better smoke experience.”

    The company started its business in 2019, when it obtained the European distribution rights for the heat sticks from Yunnan Tobacco. HNB Center created the brands, designed the packaging and developed a marketing narrative. “At that time, PMI was the only HTP manufacturer in the European market,” says Gorter. “In 2019, we launched MC, which is the heat stick brand, and My Choice, which is the device. We started with traditional heat sticks similar to PMI’s Heets. What makes us different in this market dominated by the big four is that we work with independent players—distributors, wholesalers and agents who do the sales and marketing in the countries where we are present.”

    Currently, the company sells its products in seven countries, including Italy—Europe’s largest HTP market—Portugal, Spain and some Eastern European countries, and it aims to expand into new markets.

    Due to the flavor ban, Gorter expects the entire EU HTP market, where flavored heat sticks account for 70 percent of sales, to change. Flavored sticks also represent a big share of HNB Center’s business. The company is betting that its tobacco-flavored granule-based consumables will help offset declining sales of flavored products following the EU ban.

    HNB Center plans to launch its MC Cosmic consumables and device in several countries, starting in Italy, where HTP consumption currently stands at 6 billion sticks annually.

    Fast and Precise

    NVX Labs heats tobacco with an alternating electromagnetic field, not unlike that generated by a microwave oven. | Photo: NVX Lab

    Meanwhile, in Switzerland, NVX Labs is developing an HTP device using radio frequency (RF) technology. The concept is similar to that of a microwave oven: A radio frequency generator generates an alternating electromagnetic field within a cavity that holds the consumable. The tobacco plug inside the consumable comprises primarily tobacco and flavor, especially VG, PG and water molecules.

    These molecules absorb the radio frequency energy at a frequency of 2.45 GHz. Their inherent dielectric loss properties cause them to rotate and align with the oscillating field’s opposite pole, similar to how a bar magnet behaves in a fluctuating magnetic field. The molecular movement in turn generates heat.

    Ralf Dummler | Photo: NVX Lab

    NVX Labs’ technology allows for contactless, precise heating of the tobacco plug and distinct flavor profiles, according to Ralf Dumler, founder and chairman of NVX Labs. It also effectively manages the release of nicotine. “The flexibility of the radio frequency energy, adjustable within milliseconds, guarantees exceptional precision in heating the tobacco plug and aerosol release,” he says. “This technology eliminates the need for any metal pieces, metal foils or a heating blade within the tobacco plug, signifying a major advancement toward sustainability in line with the U.N. 2030 agenda for sustainable development.”

    The device operates within the ISM band, a universally accessible frequency range that doesn’t require users to obtain a license. Upon activation, the device prepares the consumable within 4 seconds to 5 seconds for the first puff. What’s more, the technology can achieve equivalent aerosol production at temperatures below 210 degrees Celsius.

    “Thanks to our technology, tobacco companies can now develop a consumable similar to PMI’s Terea, with a closed end of the tobacco plug but without the need for a metal component inside the tobacco plug,” says Dumler. “In our latest product developments, we’ve harnessed the power of cutting-edge materials science to eliminate the need for traditional tobacco or reconstituted tobacco in the tobacco plug or filling. This sustainable approach not only promotes an eco-friendlier solution but also enhances aroma and provides an elevated consumer experience—all without relying on substrates derived from the tobacco plant.”

    Apt for Medical Use

    Initially collaborating with a multinational pharmaceutical company, NVX Labs is the pioneering patent holder for RF HTP technology, according to Dumler. The intellectual property provides protection beyond reduced-risk products to both medical and recreational cannabis applications.

    Furthermore, the device can function as a conventional pharmaceutical inhaler tailored for the pharmaceutical industry.

    A chemist by training with a strong background in the pharmaceutical industry, Dumler had previously ventured into RF heating through his initial startup company. The inspiration to use the technology for HTPs, he says, was a natural progression.

    NVX Labs first crafted a handheld prototype demonstrating the feasibility of RF heating for commercially available HTP consumables. Additionally, the company offers its own commercially available evaluation and testing device, enabling tobacco companies to assess RF heating technology and develop their own RF heating products.

    Alberto Torreno, co-founder and managing partner of NVX Labs, is optimistic about advancing his HTP device to the preproduction phase within approximately 18 months. He believes that the vast HTP market might intrigue the semiconductor industry because his device relies on GaN and LDMOS solid-state semiconductors.

    Simultaneously, NVX Labs is developing a pharmaceutical product, a thermal metered-dose inhaler. The company is researching the potential of this inhaler for administering Salvinorin A, a compound that has shown promise for addressing treatment-resistant depression and substance use disorders.

    Although Salvinorin A has yet to be approved by the U.S. Food and Drug Administration or the European Medicines Agency, Dumler proactively included its potential applications in his patent. “Our pulmonary drug delivery device offers the unique benefit of heating a drug product with pinpoint accuracy and without excipients, which enables new applications of drug delivery within the pharmaceutical industry,” he says.

    A Ray of Light

    Sixhill, the HTP division of First Union Technology of Shenzhen, China, presented several devices using its Breelight heating technology at InterTabac. According to Sixhill, Breelight is the first infrared heating technology for tobacco. The company says it can effectively stimulate the release of tobacco aroma and nicotine due to the absorption peak characteristics of different flavors, thus achieving unique flavor styles.

    In this technology, infrared radiation travels through air or space until it hits an absorbing surface where it is partially converted to heat and partially reflected. But rather than warming the ambient air, this heat warms its object directly.

    Used in an HTP, Sixhill says, the technology heats tobacco more evenly and efficiently, improving the utilization rate of a stick to 90 percent. According to the company, IR heating improves the aroma quality, intensity and sustainability of tobacco. It also releases nicotine more effectively than other technologies.

    Sixhill’s Aurr device reportedly has a nicotine release rate of 95 percent and a nicotine transfer rate of 45 percent.

    Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.
  • Connecting the Global Industry

    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.

  • Surprising Successes

    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.