Category: News This Week

Bhutan’s Tryst with Health Imperialism

The author standing with a local in front of a pharmacy stocking NRT gums adjacent to a grocery shop officially selling tobacco. (Photo courtesy of Sudhanshu Patwardhan)
Without offering locally relevant cessation tools, prohibition is doomed to fail.
By Sudhanshu Patwardhan
Bhutan, a country that measures its riches in terms of “gross national happiness,” may have become an unsuspecting victim of a new form of imperialism: health imperialism. A blind copy-paste of Western tobacco control policies, worsened by local gold-plating, may have landed Bhutan in a mess. A visit to the landlocked nation gave the author a unique insight into how prohibition of tobacco without offering locally relevant and innovative tobacco cessation tools threaten this Shangri-la.
The Forbidden Kingdom
A series of district-wide tobacco control measures in Bhutan from the 1980s culminated in the declaration of a nationwide ban on the sale of tobacco products in 2004 through a resolution of the National Assembly. Overnight, Bhutan became a poster child of global tobacco control, an emerging David against the Goliath of transnational tobacco companies. Nanny statists got a lifeline, and the “p” word—prohibition—was resurrected after successive failures of over 150 years in alcohol and drug prohibition movements. The Tobacco Control Act of 2010 further enshrined into law restricted access, availability and appeal of tobacco products and gave sweeping powers for arresting those selling or even possessing tax-unpaid tobacco for personal consumption. Bhutan was all set to become a tobacco-free society. A happy nation was also going to become healthier. In theory.
Market Forces Take Over
The roller-coaster ride between 2010 and 2019 is captured in the World Health Organization’s regional office’s 2019 publication The Big Ban: Bhutan’s journey toward a tobacco-free society. A big achievement in this period was visible reduction in public place smoking. Otherwise, the optimistic title belies the details of the failed ban confessed in the publication. It is a classic tale of good intentions scuppered by poor execution. A highlight of the data reported there is the difficulty in enforcing the ban, evidenced by availability of tobacco products below the counter in most shops in Bhutan. Tobacco use among 13-year-olds to 15-year-olds went up from 24 percent in 2006 to 30 percent in 2013 based on the Global Youth Tobacco Survey findings. The severe penalties required by the initial law resulted in more than 80 people being imprisoned between 2010 and 2013. There was growing discontent about the disproportionality of the penalties among the people of a nation gradually moving from a benevolent absolute monarchy to a democratic constitutional monarchy. Public furor and rethinking among the lawmakers resulted in amendments and milder punishments, and the law’s “claws (were) trimmed,” states the WHO report. Between 2010 and 2014, permissible quantity for personal possession was steadily increased for both smoked and smokeless tobacco products. The ban and its enforcement were proving ineffective and untenable. And then Covid-19 happened.
Reversal of a Failed Ban
The government was obviously losing revenue due to the flourishing black market of smoked and smokeless tobacco products smuggled from India and elsewhere. The fear of tobacco smugglers bringing in the Covid-19 virus was enough excuse to act decisively. In July 2021, the government amended the 2010 Act, thus lifting a decade long ban on local tobacco sales.
The pragmatism of the politicians who reversed the ban presents a sharp contrast to the previous prohibitionist policy. Today, sales and consumption continue, and based on the most recent (2019) WHO STEPwise approach to surveillance (STEPS) data, 24 percent of those between ages 15 and 60 currently use tobacco products. Sadly, the ban did not make Bhutan a tobacco-free society. Anecdotally, e-cigarettes are also available now in some grocery stores in the capital, Thimphu, and attracting use among smokers and never-smokers. These are not regulated nor used as smoking cessation tools, presenting another area of concern for public health. A ban may not be the answer for these products either. Regulation that balances current smokers’ needs for safer alternatives versus prevention of uptake by the youth and nonsmokers will be key.
Peering Through an ‘Addiction’ Lens
I first read about the ban’s overall failure in the 2019 WHO report and then heard about the reversal of the ban during the global Covid-19 pandemic. How did Bhutan land in this situation? There is, of course, economics at play: demand, supply and something to do with a genie being out of the bottle. When I put my doctor’s hat on, a key explanation stares at me: lack of quitting support for the existing 120,000 tobacco users. Reams of self-congratulatory publications and numerous WHO awards to Bhutan since the 1990s have focused on success in awareness-building and restricting access and use. The famous case of the Buddhist monk who was jailed for three years in 2011 for the possession of $2.54 worth of tax-unpaid tobacco misses the point that he was very likely addicted to tobacco and may have needed more than punishment to quit. In the absence of availability of tobacco products, it should have been a human right for him to have access to safer nicotine to manage nicotine withdrawals and achieve craving relief. This assessment should not be used to vilify tobacco users. Instead, it should be a reminder to those in tobacco control that preaching to nicotine-dependent users without offering alternatives is not enough and also unethical. A key demand-side reduction measure, to use Framework Convention on Tobacco Control (FCTC) vocabulary, is that of providing tobacco dependence treatment and services. This is covered under FCTC Article 14 but rarely implemented in low-income and middle-income countries (LMICs), Bhutan included. I saw firsthand recently the country’s struggles with rising tobacco use coupled with a lack of cessation products and services.
Tobacco Cessation: The Poor, High-Maintenance Cousin
In Bhutan, like in most LMICs, overall tobacco control is run by public health experts, and tobacco cessation specifically (and separately) falls under the remit of psychiatrists. Neither groups are excited by tobacco cessation for a variety of reasons. Public health professionals often have little or no experience in treating individual patients and have increasingly been sold a unidimensional narrative that the tobacco epidemic is singularly driven by the commercial vested interests of tobacco companies (the “vector”). For them, the tobacco user is a victim of the tobacco industry, should be labeled an addict and then preached at to quit. Psychiatrists, on the other hand, are generally geared toward treating established mental health conditions and severe mental illnesses and even within the “de-addiction” field prioritize substance abuse treatment and alcohol de-addiction over tobacco cessation. Tobacco cessation with nicotine-replacement therapy and other pharmacological interventions are costly and need a level of training and qualification to prescribe—and are therefore cost-prohibitive to be offered at scale. They are also not without their failures, give around 20 percent quit rates at one year in controlled clinical studies and much less success in real-world settings. The success of quitting cold turkey is overrated and often drives policymakers’ wrong beliefs and attitudes about the ease of quitting. Public health tobacco control awareness campaigns and advocacy, on the other hand, are highly visible, scalable, inherently worthy endeavors, and most do not require impact assessment as proof of success. The FCTC’s Article 14 thus remains a neglected tool for reducing harms from tobacco globally and receives little or no funding from international donors and national governments nor any interest from pharmaceutical companies or tobacco companies to innovate in.
Safer Nicotine Not Widely Available in Bhutan
Nicotine illiteracy among healthcare professionals and lack of availability of safer nicotine alternatives can translate into poor quitting among tobacco user patients. From my field visits to pharmacies and discussions with frontline healthcare professionals in Bhutan, I noted that 2 mg and 4 mg nicotine gums have only recently become available in some pharmacies in Thimphu, but patches are not stocked. Patients come and buy these over the counter, but there is little record of how long they take it for, their quit and relapse rates and whether their doctors support them in their quit journeys. Varenicline or bupropion are not available for cessation. When called, the “national quitline,” contrary to the claim of the 2019 and 2024 WHO publications, do not deal with tobacco cessation support. Most of the healthcare professionals in Bhutan receive their undergraduate and graduate training in India, Sri Lanka and other nearby Asian countries. Similar to the rest of the world, doctors in Bhutan are not confident about prescribing nicotine-replacement therapy and may harbor misperceptions about nicotine itself. They have not received any tobacco cessation-related training in the past five years, and nicotine-replacement therapy is not available for free or at subsidized prices anymore, unlike other medications in Bhutan.
Navel-Gazing Time for All?
The backpedaling by Bhutan on the tobacco ban has not been reported or analyzed widely enough. Bhutan’s failure to rein in tobacco sales and increased use, despite a ban, should be a wake-up call for all parties involved. What was touted as a role model for other countries for eliminating harms from tobacco has instead become a cautionary tale for poor policymaking done to pander to international funders and organizations. The undue influence of a select few Western nations in national health policymaking for LMICs is also a matter of concern as the global geopolitical order rapidly morphs. Projects such as FCTC 2030, funded by the U.K., Norway and Australia, continue to churn out reports such as the Investment Case for Tobacco Control in Bhutan (WHO/UNDP, February 2024), ignoring lessons from the ban, mostly unaware of capacity issues on the ground and not addressing the need of current tobacco users for safer nicotine alternatives. Emergent strong economies such as China and India will no longer tolerate meddling by past colonial powers and imperialist nations in their health policies, but neither should other LMICs.
Toward Gross National Health
For a nation of around 750,000 people, tobacco use is claimed to kill between 200 people and 400 people every year—all preventable deaths (side note: the data for the same year varies dramatically between two WHO reports). Global tobacco control has failed Bhutanese tobacco users and their families. For a nation built on principles of sustainability, risky forms of smoked and smokeless tobacco products have no place in society. The mountains, the clean air, the happy smiles and peace-loving people of Bhutan deserve to own tobacco control initiatives, not be made to adopt hand-me-down Western ideologies or policies. That will require the doctors and pharmacists in Bhutan to understand the science of tobacco cessation and harm reduction and make quitting sexy. Availability of nicotine-replacement therapy products, innovation in safer nicotine alternatives and improved cessation services will need to be ensured and incentivized by the government. That has the potential to keep their nation happier and healthier for the coming generations.
Disclaimer: The author’s work here or elsewhere is dedicated to using ethical and scientific evidence-based approaches to eliminate harms from all risky forms of smoked and smokeless tobacco products. The article is based on the author’s personal conversations with experts and lay people in Bhutan and from shop visits and an analysis of two of the most recent WHO reports on this topic. The intent of this article is to shine a light on a vulnerable LMIC’s experience with unchecked health imperialism to create insight and debate on the impact and implications of such practices. The author holds utmost respect for the nation, the policymakers and the people of Bhutan.
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.

June 1, 2024
Heated Breakthrough

Greentank is at the forefront of innovation with the launch of its patented Heating Chip technology.
By Timothy S. Donahue
The vaping industry is in a constant state of innovation, primarily driven by advancements in hardware. A significant focus has been on enhancing battery quality as well as the electronics and circuitry within vaping systems. Notably, there have been substantial advancements in atomization technology. This includes the development from traditional wire coils and wicks to a more progressive adoption of ceramic materials.
Atomization technology is crucial because the heating element functions as the core of a vaping system. The coil’s role in atomizing e-liquid is pivotal; the more efficient the element, the better the aerosol production, consistency and flavor. Recently, a leading technology company announced its breakthrough in heating technology, set to revolutionize the market.
It has been seven years since a significant advance has been made in atomization technology. Enter Greentank: a company with a wholly new design representing a dramatic step-change from the conventional ceramic and wicked coil systems prevalent in many of today’s vaping products, promising enhanced safety, performance and experience.
Greentank is a business-to-business technology company that specializes in the design, development and manufacturing of precision-made inhalation devices and atomization technology, according to CEO Dustin Koffler. Greentank’s latest innovation in atomization is called Quantum Vape. It replaces cotton wick and ceramic heating elements with a state-of-the-art patented Heating Chip.
According to Koffler, the Heating Chip outperforms all other leading atomization products. For example, the Heating Chip performs better on key safety metrics such as harmful and potentially harmful constituents (HPHCs) and heavy metal testing than other leading technologies in the market. It also produces the “absolute greatest” release of flavor and the most consistent consumer experience from the first draw to the last, he says.
“With this breakthrough in inhalation science, we’ve catapulted beyond the current generation of atomization technology,” said Koffler. “Our Heating Chip is set to disrupt the global market. It’s a distinct departure from anything currently available. While many companies focus merely on tweaking the substrates and print materials used in ceramic-based systems, they remain bound to the same ceramic foundation.
“They’re refining ceramics—making components slightly smaller, slightly tighter, experimenting with new materials and formulations. Greentank, however, is pioneering an entirely novel approach that’s unlike anything witnessed in the industry before.”
The Heating Chip is small. It comfortably fits on a fingertip and is one-fifth the size of today’s heating solutions. However, Koffler said its high-performance standards are due to advances that have never been achieved before with atomization. Typically, in a ceramic heating element, over time, flavor starts to dissipate naturally. This is because there is caking or buildup inside the pores of the ceramic, causing the temperature throughout the ceramic to vary after each use, leading to thermal cycling. With the Heating Chip, there is zero potential for thermal cycling, according to Greentank; every puff tastes the same as the first.
“The Heating Chip employs a unique capillary action to draw the oil through the heating element, ensuring that each puff initiates a fresh cycle of material,” explained Koffler. “Many products boast consistent flavor throughout use, yet we’re all aware that the current market offerings fall short in maintaining this throughout the life of the product. In contrast, the Heating Chip integrates nanofabrication into its design.
“The entire manufacturing process is proprietary, involving novel methods to assemble materials into the Heating Chip that emits no ceramic particle emissions and contains the lowest levels of harmful and potentially harmful constituents. While it’s not feasible to claim complete absence, third-party testing and rigorous chemical analysis have found these HPHCs to be at undetectable levels.”
Additionally, Greentank only recently completed a longevity study using the Heating Chip in one of the company’s proprietary electronic nicotine-delivery system devices with a target of 15,000 puffs. “We easily achieved this target while demonstrating consistent vapor output from the first puff to the 15,000th puff,” explained Koffler. “Furthermore, we provided these same devices, along with new ones, to Labstat International to conduct aerosol analysis for both carbonyls and metals. The results showed that there was no difference in the safety efficacy from the first puff to the 15,000th puff.”

Technically Speaking
To a scientist, it’s a micro channel-based aerosol generator that delivers sub-micron particles according to its proprietary design. To the average consumer, it’s a smoother experience with maximum flavor intensity in a less-risky delivery than currently marketed e-cigarette and cannabis vape products. The Heating Chip isn’t anything like ceramics, said Koffler. Porosity isn’t inconsistent. It’s a chip with thousands of small holes and microchannels that allow for a superior level of precision and control in the atomizing process.
One of the major challenges in designing the Heating Chip was finding the right talent to help develop the manufacturing process, said Koffler. The manufacturing of the Heating Chip requires specialized equipment, and bringing together a system that worked was incredibly complicated. The manufacturing of the Heating Chip can be compared to producing semiconductors.
“By adapting pioneering techniques from other advanced industries and tailoring them to meet our specific requirements, we’ve enhanced our technology’s performance,” Koffler revealed. “The expertise of our global team, the precision of the equipment we utilize and our methodical focus on perfecting one aspect of the process at a time has been instrumental in overcoming the challenges we faced.”
The next generation of atomization technology is moving away from ceramics, according to Koffler. The Heating Chip technology avoids all heavy metal leaching and ceramic particle emissions and ensures the lowest HPHCs all while permitting an unprecedented taste and consistency over a longer lifetime.
It also offers a smoother experience and better mouth dispersion. Interestingly, the device is also able to create particulate matter small enough to reach lower lung absorption levels for nicotine, much like combustible cigarettes. This could be a giant innovation in getting smokers to adapt to less risky nicotine-delivery systems.
“Utilizing microfluidic channel technology, we’ve engineered a system that precisely controls aerosol nucleation and optimizes particle size, enriching the sensory experience while maximizing intensity without any harshness,” Koffler detailed. “Our design includes independently arranged channels and a thin film interface that safeguards against chemical reactions and thermal decomposition. This architecture not only enhances flavor fidelity and ensures consistent temperature but also elevates safety standards and reduces potential harm significantly. From the outset, our goal was to achieve unparalleled performance and safety.”
The size of the Heating Chip is incredible. It’s tiny. It’s one-fifth the size and 100 times the precision of any ceramic atomizer on the market today, according to Koffler. Its reduced size creates greater design flexibility and quicker response times. The Heating Chip is produced on sophisticated micro- electromechanical systems (MEMS) machinery. MEMS is a general term for forming a micron-level three-dimensional structure on a support substrate such as a silicon wafer and integrating functions such as electronic circuits, sensors and actuators.
“Unlike the broad, imprecise methods typical of ceramic manufacturing, our approach from start to finish is meticulously controlled and exact,” explained Koffler. “This precision is why developing the right equipment for producing the Heating Chip was an extensive process. The level of control we achieve with the MEMS technology not only enhances consistency but also opens up revolutionary possibilities in precise dosing for pharmaceutical applications. This capability to finely tune dosages is a game changer in both vaping and medical fields.”

Future Markets
Based in Toronto, Canada, Greentank doesn’t produce nicotine. It doesn’t manufacture e-liquids or cannabis products. At its core, Greentank is a technology and product development company with a focus on safety, performance and reliability. The Heating Chip is not made from ceramics. While the material is proprietary, Koffler insists the technology is something new and its application in inhalation products is only scratching the surface of its potential. It is designed specifically for multiple verticals, predominantly electronic nicotine-delivery systems but also pharmaceuticals and wellness products.
“We have expanded to over 100 employees across Canada, the U.S., the U.K., Singapore and China, with the majority focused on research and development,” Koffler detailed. “We’ve assembled a highly skilled manufacturing team to produce our innovative chip and have strengthened our engineering and material science capabilities. Last summer, we acquired Numerical Design, a company specializing in microfluidics and microfabrication, boasting an extensive portfolio of patents that further strengthen our intellectual property. This strategic expansion underscores our commitment to leading the edge in technology and manufacturing excellence.”
Greentank spent over three years developing and testing the technology surrounding the Heating Chip and its manufacturing process. Additionally, it has been created with a robust intellectual property portfolio involving more than 50 patent families to bring forward a variety of advancements. The company’s technology is manufactured in ISO-certified labs, and all products undergo third-party testing.
The technology is completely different from what exists in today’s inhalation devices. It gives Greentank the flexibility to be adopted into various inputs and varying viscosities. For example, it works well with both low-viscosity water-based e-liquids and high-viscosity resin oils from cannabis materials.
In March of 2023, Greentank announced that it successfully closed a $16.5 million Series B financing round led by a strategic investor group with more than 15 years of manufacturing experience. The total investment in Greentank to date is now reported at $38.5 million.
“Our Series B funding was a strategic move to elevate our operations from industrial prowess to global commercialization,” said Koffler. “We’ve established a 20,000-square-foot cutting-edge R&D and manufacturing facility, a project that spanned 18 months to build and equip with the most advanced technology needed to scale our Heating Chip.
“This facility not only pushes the limits of what’s possible with specialized equipment and expertise but is also designed with flexibility in mind. Our vision was to create a model that can be replicated anywhere in the world, preparing us to expand into any other market as we continue to grow our business.”
The expansion of the business is about phases, and Koffler said that during the next phase, whether that be the medical or wellness industry, Greentank needs to be able to produce chips to meet global demand with scale in mind. Koffler said this means that the company will look to leverage automation.
Koffler emphasized that the real measure of Greentank’s success will be seen as the next generation of inhalation devices hits the market. He highlighted that numerous devices are on the cusp of being launched, with the Heating Chip poised to redefine industry benchmarks for safety and efficiency. Currently, Greentank is aiming to influence tobacco harm reduction significantly.
“At Greentank, our commitment extends beyond mere compliance with regulatory standards; we are dedicated to establishing new paradigms of transparency and consumer safety,” said Koffler. “We are not just participating in the market—we are leading it toward a safer and better future.”
Timothy Donahue is the assistant editor of Tobacco Reporter. Since joining our team in January 2013, he has become not only an expert on the traditional tobacco business but also a well-respected voice in the rapidly developing vapor industry. Tim spends much of his time on the road, attending conferences and interviewing industry representatives. His networking skills, work ethic and quick mind are valuable assets to our diverse audience.

June 1, 2024
BAT Still Committed to Smokeless Future
Josh Fett (Photo: BAT)
On World Vape Day (May 30), British American Tobacco outlined a strategic vision to accelerate progress toward building a smokeless world, especially for the Asia-Pacific region, to encourage adult smokers to switch to smokeless alternatives such as vapor products.
The smoking prevalence among adults in the Asia-Pacific region is amongst the highest in the world, though it continues to fall each year in some markets. However, with various governments setting goals to be “smoke-free” (defined as smoking prevalence falling to 5 percent or less), BAT says that more must be done to realize their ambitions.
In its vision, the multinational sets out four principles that it believes should be applied for effective and impactful regulation relating to smokeless tobacco and nicotine products:
Access to consumer relevant products: regulations in all countries where cigarettes are sold should also allow a wide range of smokeless alternatives to ensure that consumers can access these alternatives and make informed choices about switching based on the best available scientific evidence.
Adult-only consumer: the use and sale of smokeless tobacco and nicotine products by and to the underage should be prohibited by law.
Product quality and safety: robust and properly enforced quality and safety standards should be at the heart of regulation, to protect consumers.
Robust enforcement: Regulation should provide enforcement authorities with the necessary powers to apply penalties and sanctions to those who fail to comply with regulations, particularly those who supply non-compliant products and provide product to those who are underage.
“More than 1 billion people globally continue to smoke despite the serious risks,” the company wrote in a statement. “According to population modelling studies, a significant reduction in premature deaths could be achieved if smokers switched exclusively to reduced-risk alternatives.
“To capitalize on the public health potential offered by smokeless products, appropriate regulation is required to encourage adult smokers to switch, protect consumers with stringent safety standards and prevent underage access and use.”
BAT noted that countries that embraced this approach have witnessed significant reductions in smoking rates as smokers opt for noncombustible products. The multinational cited the experience of New Zealand, where daily smoking rates have plummeted to 6.8 percent in 2023 from 8.6 percent the previous year, and 16.4 percent in 2012. The U.K., U.S. and Japan too are reporting their lowest smoking rates on record, while Sweden is on track to declaring itself smokefree this year, 16 years ahead of the 2040 EU target.
According to BAT, the success of these nations in reducing cigarette consumption is largely a result of widespread awareness, availability and usage of smokeless alternatives, such as vapor products, heated products and nicotine pouches.
“The migration of smokers to these alternatives is crucial both for countries looking to reduce their smoking rates and for global public health more broadly,” said Josh Fett, BAT’s head of corporate and regulatory affairs in the Asia Pacific Region. “Whether or not governments are able to take advantage of these products and maximize their harm reduction potential depends as much on the implementation of progressive, risk-proportionate regulation as it does on changes in consumer behavior.”
June 1, 2024
Retailers Fined for Selling Elf Bar

Photo: Gevorg Simonyan
The U.S. Food and Drug Administration is seeking civil money penalties (CMPs) from nine brick-and-mortar retailers and one online retailer for selling Elf Bar products.
The FDA previously issued warning letters to these retailers for selling unauthorized tobacco products. However, follow-up inspections revealed that the retailers had failed to correct the violations.
The agency is now seeking a CMP of $20,678 from each retailer.
“The $20,678 CMP sought from each retailer is consistent with similar CMPs sought against retailers for the sale of unauthorized Elf Bar products over the last few months, including February and April of this year,” the FDA stated.
The retailers can pay the penalty, enter into a settlement agreement, request an extension to respond or request a hearing. Retailers that do not take action within 30 days after receiving a complaint risk a default order imposing the full penalty amount.
May 31, 2024
Tobacco-Paid Science Still in Medical Journals

Photo: Tada Images
Tobacco-funded research is still appearing in highly cited medical journals despite attempts by some publications to cut ties, according to an investigation by The Investigative Desk and the BMJ.
The researchers checked the tobacco policies of 10 leading general medical journals and 10 journals in three therapeutic areas especially affected by smoking.
Of those 40 journals, only eight (20 percent) had policies prohibiting studies wholly or partly funded by the tobacco industry. Of the 10 journals in the field of respiratory medicine, six had a tobacco policy, but in oncology, only one did, and in cardiology, none had one. Among the 10 general medicine journals, only the BMJ had such a policy.
But even among the journals that have a policy, the editors struggle to identify subsidiaries or organizations associated with the tobacco companies, according to the researchers. Last year, one of BMJ Group’s titles, BMJ Open, retracted a paper after it became clear that the listed funder receives sponsorship from the Foundation for a Smoke-Free World, a group supported and fully funded by tobacco company Philip Morris International.
(The Foundation for a Smoke-Free World ended its PMI funding agreement in October 2023. More recently, the group rebranded as Global Action to End Smoking and adopted a policy to not seek or accept funding from any industry that manufactures tobacco products or nonmedicinal nicotine products.)
The investigation cites the case of Dutch researcher Wytse van den Bosch, who had a research grant from pharmaceutical company Vectura when the company was bought by PMI in 2021. Nevertheless, his study was still published in the European Respiratory Journal, which said the research was not in breach of its policy as the grant from Vectura was initiated in 2018.
Ruth Malone, professor of social behavioral sciences at the University of California and former editor-in-chief of BMJ Group’s Tobacco Control journal, said that institutions, professionals and scientific journals should refuse involvement with the tobacco industry.
“Anyone who understands the history, extent and nature of the epidemic and the tobacco industry’s strategic efforts to divide the public health community knows that industry money should be rejected,” she said in a statement.
Nicholas Hopkinson, professor of respiratory medicine at Imperial College London, notes that given the industry’s “long-standing history of dishonesty,” it is “very straightforward” that researchers should cut ties to companies after they are acquired by Big Tobacco, as otherwise they would be “working with the tobacco industry” and contribute to their profits.
On May 30, BMJ updated its 2013 tobacco policy. In addition to excluding research funded by the tobacco industry, BMJ journals will also exclude work where authors have personal financial ties to the tobacco industry.
“The updated policy is one action BMJ journals can take to reduce the publication of content which downplays the harms of smoking or hinders the creation of a world free from the harms of smoking,” the publisher wrote in a statement.
“Creating a stronger firewall between the tobacco industry and BMJ content will provide space for editors to curate and publish content that is more independent and trusted and contributes to a healthier world.”
May 31, 2024
John Miller Resigns from 22nd Century

John Miller (Photo: Swisher)
John Miller has resigned as 22nd Century Group’s president of tobacco, effective Aug. 2, 2024.
“I want to thank John for the pivotal role he played in the launch of VLN, leveraging his decades of industry experience to help us achieve national-scale distribution and establishing a retail presence in more than 5,000 stores across 26 states,” said Larry Firestone, chairman and CEO, in a statement.
“He also played a key role in expanding our CMO business, including our exciting Pinnacle launch as a store brand for one of the top convenience store chains in the country. We are now well positioned to continue building on this incredible footprint as we work to achieve our company objectives.”
May 31, 2024
Flavor Bans Threaten Smoke-Free Ambitions

Image: Arcady
The Tholos Foundation has launched three white papers exposing the risks of banning flavors in vaping products at an event in Brussels hosted by Parliament Magazine and featuring contributions from Swedish MEP Johan Nissinen. The reports cover the impact of flavor bans in the real world and best practices to educate adult smokers and restrict underage usage and analyzes the public response to the European Commission’s 2023 public consultation.
Surveys commissioned by the Tholos Foundation and conducted by Ipsos in multiple countries have shown that a significant majority of vapers use flavors other than tobacco to help reduce and quit smoking. Notably, 83 percent of vapers in Germany stated that flavors are crucial in their decision to vape, with similar high percentages reported in Belgium, the Netherlands and Sweden. The research also showed that, in countries where flavors were banned, many vapers went back to smoking or for black market alternatives and references numerous scientific studies confirming that flavors are essential for the effectiveness of vaping products in smoking cessation.
With European elections due to take place shortly, the Tholos Foundation believes it is imperative policymakers take heed of voters’ concerns and reject extensive restrictions on smoking alternatives.
“The evidence is clear: Flavors in vaping products are critical to helping smokers quit,” said co-author Tim Andrews in a statement. “Banning flavors will create a black market and drive people back to smoking. Our reports offer an evidence-based approach that combines rigorous law enforcement, education and technological innovations to reduce underage experimentation while preserving the benefits for adult smokers.
“With the European elections approaching, it is crucial for policymakers to understand the importance of harm reduction strategies. Our findings support a balanced approach that protects public health and helps smokers transition to safer alternatives.”
The Tholos Foundation is an international nongovernmental organization, affiliated with Americans for Tax Reform, dedicated to advocating for consumers.
May 31, 2024
Yields Up in Bangladesh

Photo: Tobacco Reporter archive
Tobacco yields per hectare in Bangladesh have increased more than 20 percent over the past five years thanks to improved agricultural practices, reports The Daily Star.
In 2018–2019, growers harvested an average of 2.04 tons per hectare. By the 2022–2023 season, the figure has increased to 2.46 tons per hectare, according to the Department of Agricultural Extension (DAE). In 2009–2010, per-hectare production was only 1.41 tons, according to World Bank data, which means per-hectare tobacco production has gone up by about 73 percent in 14 years.
The gain has been achieved by the introduction of high-yielding varieties and the application of chemical fertilizers and pesticides, according to experts.
Tobacco is a major cash crop in Bangladesh, the world’s 12th largest tobacco grower as of 2020, according to the University of Bath. In 2022–2023, the country grew 65,227 tons of tobacco on 26,475 hectares, representing roughly 1 percent of the total arable land in the country, DAE data show.
The domestic tobacco industry generated more than BDT325.02 billion ($2.77 billion) in revenue from cigarette sales in the most recent fiscal year, an 8 percent increase from the previous year, according to NBR data. Bangladesh also exports a significant volume of unmanufactured tobacco. In 2022, Euromonitor International estimated the Bangladeshi tobacco market to be worth nearly BDT420 billion.
According to a study by the Policy Research Institute of Bangladesh, tobacco farmers earn around 30 percent more than nontobacco farmers. The return from tobacco is about 18.6 percent higher than that from rice and about 33 percent higher than that from jute.
Critics blame tobacco production for its impact on soil, water and air. According to the World Health Organization, each cigarette emits nearly 14 grams of CO2 over its life cycle. Producing 300 cigarettes requires about one tree for curing leaf and making cigarette papers. In the case of Bangladesh, tobacco farming accounts for over 30 percent of annual deforestation, according to a study by PATH Canada.
May 31, 2024
WVA Raises Alarm About Misperceptions

Photo: WVA
The World Vapers’ Alliance (WVA) marked World Vape Day with a protest in front of the World Health Organization’s in Geneva today. Participants in the event urged the global health body to listen to consumers and acknowledge the scientific evidence supporting vaping, nicotine pouches and similar products as valid harm reduction tools.
The consumper group says it is concerned about the rampant “misperception epidemic” surrounding tobacco harm reduction. Recent research by Ipsos for the think tank We Are Innovation shows that 74 percent of smokers worldwide wrongly believe that vaping is as harmful or more harmful than smoking. This misconception, fueled by misinformation, is preventing millions from switching to a scientifically proven less harmful alternative, according to the WVA.
“The WHO [World Health Organization] has turned World No Tobacco Day into a propaganda day,” said WVA Director Michael Landl in a statement. “Sweden is about to become smoke-free thanks to alternative nicotine products.
“The WHO needs to stop fighting alternative nicotine products and start backing them as keys to a smoke-free future. The WHO’s false claims are fueling a deadly misperception epidemic. Smokers deserve the truth: Vaping is significantly less harmful than smoking. Accurate knowledge could save millions of lives.”
May 30, 2024
UKVIA Warns Against Vape Taxes

Photo: VPZ
The U.K. Vaping Industry Association (UKVIA) has warned that the Conservative Party’s proposal to tax vapes based on nicotine strength, predicted to increase the cost of some products upward of 300 percent, threatens to undo the work that the category has already done in saving millions of smokers’ lives.
In its submission to the government’s vaping duty consultation, the association argues that by making higher strength vaping more expensive, the proposed tax regime will place an unfair financial burden on nicotine-dependent smokers who are trying to quit. The UKVIA points to the fact that smokers are already significantly overestimating the risks of vaping compared to smoking and that a measure that discourages the use of sufficient nicotine to facilitate a quit attempt is likely to have the effect of decreasing the rate of successful quit attempts.
The association also argues in its submission that as smokers are disproportionally from lower socioeconomic backgrounds, the effect of introducing an excise duty for nicotine-containing vapes, the most appealing form of e-cigarette for smokers, will be dramatic and potentially fatal.
This conclusion is supported by HM Revenue and Customs (HMRC) Research Report Number 740, Understanding the Vaping Market, which found that less affluent adults were “more likely than average” to report being current vapers and revealed that 32 percent of current vapers are motivated to use these products over cigarettes due to cost savings. The same HMRC report also highlighted that the doubling of the prices of vaping could result in 62 percent of current users reducing how much they vape.
The UKVIA is calling for the proposed taxation of vapes to be based on e-liquid quantity and not based on nicotine strength. It believes a specific sales tax on all vaping products and nicotine levels at the rate of £1 ($1.25) per 10 mL would be far more effective in achieving the duty’s stated objectives.
Smokers who smoke more or are more nicotine reliant need higher concentrations of nicotine, at least initially, according to the UKVIA. The association feels they should not be deterred from quitting by having to pay an extra premium to buy the higher concentration nicotine e-liquids that they need.

While a tax on vapes may be inevitable, it does need to be effective and not counterproductive.
John Dunne, director general, UKVIA
“While a tax on vapes may be inevitable, it does need to be effective and not counterproductive,” said UKVIA Director General John Dunne in a statement. “In recent years, millions of smokers have managed to quit through using vaping products, and discouraging others from making the switch would have disastrous, and in many cases fatal, consequences.
“The industry therefore urges the government not to unfairly discriminate against nicotine-containing vapes, which are the most popular devices for a reason. It would be far more valuable for the government to instigate a vape licensing scheme, for which we have long been calling; such a scheme would deter rogue retailers, protect our children and help a heavily under-funded Trading Standards to police retailers by raising £50 million a year from the industry.”
May 30, 2024