Category: Harm Reduction

FDA Launches Online Vaping Resource Center

Image: Tobacco Reporter archive
The U.S. Food and Drug Administration has launched the Vaping Prevention and Education Resource Center, which provides free science-based, standards-mapped materials that teachers can use to help their students understand the risks associated with vaping and nicotine addiction. The Center for Tobacco Products also developed free materials for parents and teens.
Teachers will find lesson plans, interactive tools, infographics and videos with tobacco facts and tips about how to teach teens about the dangers of vaping.
Parents will find fact sheets, videos and resources to help them understand and recognize vapes, talk with their children and keep the conversation going over time.
According to the FDA, students will find real-life stories and relatable content to help them understand vaping, nicotine addiction, common myths about vapes and how to say no to vaping.
The resource center will be continuously updated, according to the FDA.
January 19, 2023
Mexico Tightens Tobacco Laws

Image: sezerozger | Adobe Stock
Mexico has banned smoking in public places, reports Mexico News Daily.
The country has also prohibited the advertising, promotion and sponsorship of tobacco products, which means that cigarettes cannot be displayed inside shops. E-cigarettes and heated-tobacco products are also facing tighter new restrictions, particularly indoors, as per BBC. Last year, Mexico banned the import, sale and distribution of vaping and heated-tobacco products.
Several other Latin American countries have also passed legislation to create smoke-free public spaces. Last year, for example, Panamanian President Laurentino Cortizo also signed legislation banning the sale of vapor products in his country.
However, Mexico’s legislation is considered to be the most wide-ranging in the Americas.
Critics have cautioned against unintended consequences. Given the prevalence of corruption in Mexico, they fear that some police officers will use the smoking ban as a pretext for demanding bribes.
January 17, 2023
Committed to Science

David O’Reilly (Photo: BAT)
David O’Reilly, director of scientific research at BAT, shares his views on the roles of science and nicotine in tobacco harm reduction.
TR Staff Report
Science is instrumental as the tobacco industry transitions from combustible products to less risky smoking alternatives. Tobacco Reporter spoke with BAT’s director of scientific research, David O’Reilly, about the roles of science and nicotine in tobacco harm reduction.
Tobacco Reporter: You have been with BAT since 1991. Could you please compare the role of BAT’s science department at the time when there were only combustible cigarettes to the role it plays today?
David O’Reilly: BAT has a long history of conducting scientific research and has had an R&D facility in the U.K. for over 60 years. Throughout this period, we have seen the science significantly change.
Originally, the majority of R&D we conducted was focused on cigarettes and tobacco plant science, but the more we learned about combustion and the harm that burning tobacco causes, the more we shifted our efforts to exploring new ways to provide consumers with less risky alternative products.
Initially, our focus was on reduced-toxicant cigarettes, but, utilizing the growing body of evidence and the Institute of Medicine report that highlighted the negative impact of combustion, we shifted our activities to the development of noncombustible products.
This is now where the majority of our R&D efforts are focused: generating new evidence to support our new category products but also developing new or improved products.
To ensure that we are using the latest scientific thinking and cutting-edge techniques, we have increased our investment in science and expanded the number of scientists within BAT. We have recruited people from a broad range of backgrounds, such as genetics, neuroscience and data sciences.
With so much focus on the development of reduced-risk products (RRPs), does BAT still conduct research on combustible cigarettes?
Our primary focus within R&D is our new category products, as we know that consumer preferences continuously evolve, but also that science and innovation continue to change at pace. However, we do undertake some R&D on our combustible products. This is essential to ensure that they are produced to high quality and manufacturing standards.
What are your thoughts on very low-nicotine cigarettes with regard to their role in tobacco harm reduction?
Our belief is that tobacco harm reduction is the best way forward to reduce the health impacts of smoking. The evidence shows that most of the harm from cigarettes is caused by combustion and the burning of tobacco, not by the nicotine.
In fact, nicotine plays an important role in tobacco harm reduction. Since it is one of the reasons why people smoke, nicotine’s presence in products that, though not risk-free and addictive due to the presence of nicotine, are designed to be reduced risk¹ compared to cigarettes. These products can help adult smokers to switch instead of continuing to smoke.
As Professor Michael Russell said in his 1976 pivotal paper, “People smoke for nicotine, but they die from the tar,”² and we know if you take the nicotine away or offer very low amounts, consumers may not be satisfied and revert back to cigarettes rather than switching completely to a reduced-risk alternative that is backed by scientific research, such as vaping.

In RRP development, one of the most pressing challenges is youth initiation. To what extent can innovation help prevent underage consumption? Will it be necessary to sacrifice all nontobacco vaping flavors to achieve this goal?
We are clear that our products are for adult consumers only and that youth should never use any nicotine products, be it cigarettes or vaping products.
Our products are sold to adult consumers via reputable retailers that verify the age of consumers before sale and follow our youth access prevention standards, which include prominent 18-plus labels on the front of all packaging and on all communications.
This is in addition to robust age verification on our own e-commerce channels, our youth access prevention training and certification for retailers and our “iCommit” training for employees.
It is worth highlighting that alternative products need to be satisfying to prevent adult consumers from going back to cigarettes, and research has shown that flavors play an important role in encouraging adult smokers who would otherwise continue to smoke to switch to better alternatives. However, a priority for BAT is ensuring that our flavors and device colors are designed to appeal to adult consumers, not youth.
In order to switch away from combustibles, consumers need to like the alternative, less hazardous product. What still needs to be done to improve nicotine delivery and consumer satisfaction? Can you please give an example of how you improved one of your next-generation products in this respect?
When we develop any new product, we think holistically about the consumer experience, and we use science and consumer insights to guide our development programs and deliver products that consumers want and find satisfying. For example, when we think about a product, we think about many aspects, including the design, the feel, the power of the battery, ingredients of the liquids, taste, etc. BAT was one of the first companies to use nicotine salts, as we knew that consumer satisfaction is important to make vaping more acceptable to cigarette smokers. This is just one example of how science and consumer insights combine to enhance our products.
For tobacco harm reduction to succeed, product must be affordable, especially to customers in the low-income and middle-income countries where many of the world’s smokers reside. What solutions in addition to nicotine pouches are you researching in this regard?
Our purpose is to build “A Better Tomorrow” by reducing the health impact of our business. We are doing this by developing a wide choice of alternative products for adult consumers who would otherwise continue to smoke, tailored to meet their evolving preferences.
Two key components of every innovation program we undertake are sustainability and affordability. It is important that these aspects are considered from the outset and at every step of the way so that we deliver a product that consumers want. We continue to launch these in markets across the globe, and our aim is to switch 50 million consumers to our noncombustible products by 2030.
Sustainability is increasingly important. BAT has introduced a recycling campaign for its electronic nicotine-delivery devices and has begun replacing plastic elements of vapor products with pulp-based alternatives. However, vaporizers contain circuit boards, which in turn contain plastics and heavy metals, and they also use lithium-ion batteries. How is BAT tackling this issue?
Every product developed has sustainability as a key component of the development plan, and we are committed to carbon neutrality across our operations by 2030. In May 2021, Vuse became the first global carbon neutral vape brand due to our ongoing efforts, notably by offsetting its carbon impact.³
Also, in many markets where Vuse is available, there is a takeback scheme in place, which allows consumers to return products for responsible disposal.
As part of our ongoing Vuse “Cut the Wrap” initiative, Vuse Go packaging has no external plastic poly wrap. The initiative, which is our commitment to reduce single-use plastics in our packaging, has already saved approximately 250 tons of plastic, the equivalent to more than 10 million plastic bottles.⁴
Misconceptions about the relative risks of RRPs and misconceptions about the nature of nicotine also present major challenges to harm reduction. An increasing number of U.S. adult consumers believe that vaping is as hazardous or even more hazardous than smoking, for example, and there are also misperceptions in the scientific and medical world. Such misunderstandings are often fueled by flawed studies. What can the industry do to address this problem without being accused of lobbying and in an environment where many are skeptical about tobacco industry-funded research?
At BAT, we think that the solution cannot be delivered by industry alone. To the contrary, BAT needs to work together with the wider scientific community and other key opinion leaders to create a system that is clear about the harm caused by smoking yet recognizes, holistically and consistently, where real public health gains can be made. A system that encourages adult consumer choice. We want a “whole-of-society approach”—as referenced by the United Nations—to this important public health issue.
There is also a need for the ongoing generation of robust scientific evidence. BAT continues to invest in scientific studies and openly share the results to help build the evidence base that supports alternative tobacco and nicotine products and their potential role in tobacco harm reduction.
At BAT, we believe that adult consumers should have access to information that enhances their understanding and allows them to make informed choices based on the best available evidence.

The concept of harm reduction has been widely accepted in fields such as substance abuse. Why does it face so much resistance when applied to tobacco, and how can this be overcome?
Firstly, it is important to recognize that there are some governments, such as the U.S., U.K., Sweden and New Zealand, who have adopted progressive public health policies that reflect the growing weight of evidence that supports the role of alternative tobacco and nicotine products in providing less risky alternatives to those who would otherwise continue to smoke. In these countries, although not all at the same stage, we see the continued decline in smoking rates and progress toward becoming smoke-free (under 5 percent of the population).
In other countries, many of whom have adopted policies that do not differentiate between cigarettes and alternative products, we see little or even a reversal in progress. Often the reason for such an approach is the “precautionary principle.” Essentially, in the absence of epidemiological data about alternative products, governments will not recommend them.
However, we believe, based on the already available evidence about alternative products and providing a complete switch, that these are reduced risk¹ compared to cigarettes. This is a view reflected through the work of independent organizations, such as Public Health England, who determined that based on current knowledge, vaping is at least 95 percent less harmful than smoking.⁵ However, it is important to note that these alternative products are not risk-free and contain nicotine, an addictive substance.
BAT has started to build an innovation hub in Trieste, Italy. What role will this hub play within the company’s global strategy for innovation and sustainability? What does this mean for your R&D site in Southampton?
The Trieste innovation hub will host a range of facilities, including a new manufacturing site for BAT’s New Category products, a digital boutique, innovation lab and Centre of Excellence for digital transformation and digital marketing. These activities, alongside the activities undertaken at our other R&D and innovation sites, complement and build upon the research and development work undertaken in Southampton, which is focused on generating the science needed to substantiate our products whilst ensuring they are produced to high standards.

What role should tobacco harm reduction play nowadays?
Tobacco harm reduction is one of the most important public health strategies. Science plays a critical role in delivering the alternative products that enable it but also allows us to measure the impact and outcomes of switching completely from cigarettes.
Work by scientific experts, using advanced computing and modeling, has shown us the potential for substantial life year gains and premature deaths caused by smoking-related diseases averted than can be delivered by switching smokers to vapor products.⁶ The longer these alternative products are on the market, the more real-world data we will be able to collect, which will be very powerful and reinforce our belief about the critical role they play in tobacco harm reduction and building “A Better Tomorrow.”
¹Based on the weight of evidence and assuming a complete switch from cigarette smoking. These products are not risk-free and are addictive.
² Russell MJ. Low-tar medium nicotine cigarettes: a new approach to safer smoking. BMJ 1976;1:1430–3.
³ Based on Vuse Go, [Vuse Go Max], Vuse ePod, ePen, eTankmini, Alto devices and consumables internal sales forecast (calculated March 2022) for 12 months starting from April 2022. Vuse will have reduced its carbon emissions by circa 55 percent (as of March 2023) through its internal sustainability initiatives since launched in 2019 and has now offset the remaining circa 45 percent.
⁴ Plastic saving was calculated from 2020 global sales volumes and 2021 forecasted sales, and the plastic bottles comparison was based on a 22.9 g bottle weight, representative weight of 500 mL commercially available soft drink bottles (May 2020).
⁵ Evidence review of e-cigarettes and heated-tobacco products 2018 (publishing.service.gov.uk).
⁶ Potential deaths averted in the U.S. by replacing cigarettes with e-cigarettes – PubMed (nih.gov).
January 1, 2023
Charting History

Photo: Shaiit
Are the experiences with harm reduction from the past applicable to the future?
By George Gay
Knowledge Action Change (KAC), the U.K.-based public health agency, published in the middle of November what it described as a landmark report, The Right Side of History. According to a press note, the report “charts the history of tobacco harm reduction (THR) to date and considers the future of a strategy that can hasten the end of smoking and drastically reduce smoking-related death and disease worldwide.”
The Right Side of History is the third in what has been a biennial series of Global State of Tobacco Harm Reduction (GSTHR) reports, following No Fire, No Smoke in 2018 and Burning Issues in 2020. Alongside the biennial reports, GSTHR Briefing Papers and other publications, a free-to-access global database enabling users to explore tobacco harm reduction and safer nicotine product use on a country-by-country basis, is available, also under the GSTHR brand.
There can be no doubt that these publications and databases comprise a tremendous resource from an organization that boasts a dedicated—I would say passionate—team of experts with long experience in various fields of harm reduction research and application. This was the organization that, in 2014, launched the annual series of forums that brought together a wide range of people with interests in, but not limited to, nicotine—people who, importantly but unusually for such events, included consumers. Under the name Global Forum on Nicotine (GFN), these events have been held mainly in Warsaw, Poland, though, during the period of Covid-19, when face-to-face meetings, especially international meetings, were difficult to organize, the GFN was moved rapidly to a partly online format.
And there is a lot more to what KAC has achieved through the application of innovative ideas. For example, the following is from the report’s foreword: “As an organization, we also wanted to help expand research capacity and understanding in relation to the principles and delivery of tobacco harm reduction. To achieve this, we established the Tobacco Harm Reduction Scholarship Programme (THRSP), … funded by the FSFW [Foundation for a Smoke-Free World]. Scholars from across the world have worked on a wide range of topics, helping improve professional and community understanding, with outputs including articles published in peer-reviewed journals, the establishment of regional networks, podcasts and films. Graduates of the THRSP will play vital roles in the ongoing struggle to expand and improve THR.”
Losing Sight
I have long been an admirer of KAC, its people and what it has achieved in a relatively short space of time, so I hope that I will be forgiven for being critical about its latest undertaking—for saying that I believe the latest report is a step in the wrong direction: backwards, where history always leads. To me, the latest report suggests that we are in danger of losing sight of our objectives, that the consumers, who were once championed, have been pushed aside while academics, experts and journalists on either side of the THR debate engage in an unseemly slugfest of recriminations.
But, before I go any further, I should declare an interest, or a lack of interest, perhaps. I am on the side of history that thinks history is bunk and largely a drag on moving forward. I find it impossible to see how history can play a positive role in promoting a disruptive technology. You cannot move fast and break things if you are dragging behind you the weight of history and all its petty grievances, real and imagined.
The Right Side of History is, of course, a brilliant title because it plays to the idea that history is written by the victors and so stakes a claim for THR advocates to be the victors and therefore to have written the one true history. But if we are going to move forward, we must accept that others have different versions of history with which we might disagree but with which we might have to engage. More importantly, we need to focus on the fact that it is the consumers who must eventually be the victors.
Perhaps it is because it is constantly reminded of its past that the tobacco/nicotine industry seems to me to have an unhealthy obsession with history and, especially, U.S. history, which is often presented as being universally applicable. Start talking about addiction and you will be transported back a quarter of a century to the testimony of the heads of U.S. tobacco manufacturers. Start talking about tobacco prohibition and you will be referred back 100 years to failed U.S. efforts with alcohol. And in chapter one of The Right Side of History, those interested in disruptive technologies are taken back perhaps a thousand years to what indigenous Americans got up to with tobacco.
I am not qualified to judge such matters, but, knowing the author, I feel certain that the history of tobacco and nicotine as presented in the KAC report is excellent and will be of much interest to historians, but I cannot see what relevance the ancient beliefs of indigenous Americans have to do with what the report refers to as safer nicotine products (SNPs). I struggle even to understand what relevance descriptions of early iterations of SNPs have on disruptive technologies, though I would concede that it would be wise to take note of, and keep in mind, any instances where products caused a disturbance in the forcefield of disruptive technology, either because the technology went in the wrong direction or it handed ammunition to anti-THR activists.
It would be wise, but it probably wouldn’t happen because, as Georg Hegel pointed out, if we learn one thing from history, it is that we learn nothing from history.
Engaging Consumers
I get the feeling that we, the people involved in trying to nudge governmental policies in the direction of THR (as opposed to the technicians working on new products), have run out of ideas and come to accept that, as a number of famous people have been quoted as saying, history is “just one damned thing after another.” But this again runs against the grain of disruptive technology. It speaks to a determinism—a fatalism even; it suggests that it is time to throw in the towel and wait for events to overwhelm us.
I certainly worry that this is what is happening. The GSTHR-branded products are produced with the help of a grant from the FSFW, which is funded at arm’s length by Philip Morris International, though I should add that the GSTHR project and all its outputs are editorially independent of the foundation, under the terms of the grant agreement.
It is interesting to note here that the foundation also funds the Tobacco Transformation Index (TTI), the second biennial report of which was launched in September. That report presented details of the findings of two further years of research into the efforts made by the world’s 15 largest tobacco companies to reduce the harm caused by the consumption of their products. The 2022 TTI report evaluated the tobacco companies’ actions across six business functions, designated “categories,” and 35 underlying indicators that are said to cover “measures indicative of harm reduction …”
As I understand things, the TTI is supposed to harness analysts and investors to use their influence to encourage the 15 tobacco companies to beef up the transformation of their portfolios from high-risk products to low-risk products and thereby accelerate the reduction of harm caused by tobacco use. The idea is that investors can be harnessed in this way by ranking the tobacco companies on their relative progress or the lack thereof in transforming their portfolios. A system of Naming and Faming/Shaming.
But the way I see it is that the new KAC report and the second TTI report are so far from the consumer coalface, so far from real-world THR, as to be largely irrelevant. These reports are certainly not meant to engage with smokers. Few, I would assume, are likely to read the 130-page KAC report and even fewer the 140-page TTI report and its 80-page methodology.
Of course, it might be said with some justification that these reports are not meant for consumers but for the experts who know best and who are battling hard to make THR a reality around the world. But this seems to run foul of a principle recognised in the foreword to the KAC report: “nothing about us, without us.”
Success Stories
Surely there must be more direct and efficacious ways of using the important foundation funding. Perhaps it is time to recognize that one of the problems with the foundation is the word “World.” Perhaps those of us who support THR have to admit that we have bitten off more than we can chew in aiming for a world revolution.
What if, for the time being, we forget about the world, large swathes of which are under the anti-THR influence of the World Health Organization? What if, for the time being, we concentrate on a handful of countries that have already proved amenable to THR by helping their SNP industries to prosper? If we are right and THR can be achieved through encouraging the switch from high-risk products to SNPs, then the countries chosen will become exemplars for the rest of the world—health and economic success stories that cannot be ignored or brushed aside by the WHO.
Of course, it could be argued that these exemplars will arise anyway, even if the emphasis is on the whole world. Again, there is truth in this, but I would argue that we are talking about time here. Take the U.K.; it has been relatively successful in encouraging the switch from high-risk products to SNPs, but the progress could be much faster, perhaps with an injection of cash.
Anybody who attended the U.K. Vaping Industry Association’s conference in November could not, I think, have failed to have been impressed by the practical nature of some of the panel sessions at which compliance issues were discussed. It occurred to me, though, that some of these sessions would be even more helpful if, with the right level of funding, they were staged as stand-alone educational workshops.
I use the U.K. and compliance as examples, but there are other THR-progressive countries where other issues, such as the illegal trade, could probably use some help if they are to become exemplars.
But if such ideas are not seen as worthwhile or are unworkable under FSFW protocols, at least the next KAC report should turn to more practical matters by looking at the environmental impact of SNP use against that of smoking combustible cigarettes. It cannot be right that neither the KAC report nor the TTI report mentioned environmental matters in any meaningful way. Some SNPs, such as snus, probably have a very low environmental impact while vaping devices and heat-not-burn products probably have high impacts. Either way, we need to know, and we need to know whether the high-impact products can be improved. It is no good extending the lives of individuals by a few years if we are seriously polluting the world for everybody.
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.

January 1, 2023
GPS-Based App to Launch in India

Image: PixPaf | Adobe Stock
India’s Tobacco Control Cell will soon launch its GPS-based app “StopTobacco” that the population can use to lodge complaints of smoking in public places, reports The Hindu.
The Cigarettes and Other Tobacco Products Act 2003 (COTPA) was initiated to reduce smoking in public places and protect nonsmokers from involuntary tobacco smoke exposure. Anyone violating the COTPA can now be turned in using the new app—users simply upload a picture of the public place where the smoker is located and the state’s anti-tobacco squad will respond to the area and issue a penalty to the violator.
“We cannot be waiting for the police or municipal enforcing agency to be overburdened. This app will give us the opportunity to increase awareness about COTPA law and rules in public places, increase social responsibility for the citizens and impact positive health. This app draws a fine balance for awareness and enforcement,” said Vishal Rao, member of the state’s High Power Committee on Tobacco Control.
A similar pilot system was launched in 2019, allowing COTPA violations to be lodged via email in 10 districts. It could not be implemented across the state, however, due to the pandemic.
“After downloading the app, the photo of the public place where the violation is happening, such as a shop, bakery, hotel, school/college, bus station, railway station, playground, etc., can be clicked and uploaded. Then there will be an option to enter the district, taluk and mobile number of the complainant. The photo will reach the district tobacco control unit and be forwarded to the taluk tobacco control unit. As the app is GPS-based, the location from where the complaint has been lodged will be highlighted on the map, and the squad will rush to the spot,” said a senior official, adding that seven-member squads have been set up in every taluk to act on the complaints.
December 15, 2022
Study Shows Velo Offers Reduced Risk

Photo: BAT
Users of BAT’s Velo modern nicotine pouch showed significant reduced risk of smoking-related diseases compared to smokers, according to a new cross-sectional clinical study published in Biomarkers.
The study included participants who had been using Velo exclusively for over six months as well as current smokers, former smokers and never-smokers. For the Velo consumers and current cigarette smokers, usage patterns and overall consumption were not controlled under the study protocol as the aim was to assess the impact among people using the products in their “normal” way rather than in a controlled way. Four different groups were enrolled and studied.
The results showed that the levels for the biomarkers of exposure, based on priority toxicants as defined by the World Health Organization, were substantially lower in Velo consumers compared with smokers. The data also showed favorable differences between the Velo consumers and smokers in the majority of the biomarkers of potential harm, with four achieving statistical significance and the others having similar levels across the Velo consumers, former and never smoker groups.
A single set of samples of blood, urine and other clinical measurements was tested for certain toxicants and a range of biomarkers thought to be linked to the development of diseases such as cancer and cardiovascular disease.

“These results add further evidence that supports the important contribution Velo can make to tobacco harm reduction.”
David O’Reilly, director of scientific research, BAT
“These results are very important for Velo and the modern oral nicotine product category,” said David O’Reilly, director of scientific research at BAT, in a statement.
“They build on the extensive scientific evidence, including epidemiological data, that already exists for oral tobacco and add to the weight of evidence that supports our belief that Velo is a reduced-risk product for smokers who completely switch from cigarettes as compared to continued smoking. We have already generated data that shows Velo has a toxicant profile better than snus and comparable to nicotine-replacement therapy. These results add further evidence that supports the important contribution Velo can make to tobacco harm reduction.”
Based on the biomarkers measured, compared to smokers, Velo consumers who had been using the product exclusively showed significantly lower levels in biomarkers of exposure to priority tobacco toxicants; significant favorable differences in a biomarker of potential harm relevant to lung cancer risk; significant favorable differences in a number of biomarkers of potential harm relevant to cardiovascular disease; and significant favorable differences in a biomarker of potential harm relevant to general inflammation.
For the biomarkers that showed no significant difference between the Velo consumers and smokers, similar levels were observed between the Velo and former and never-smoker groups.
Participants were based in Denmark and Sweden, aged 19–55 years old and in good general health.
December 13, 2022
COP10 Urged to Consider Harm Reduction

Photo: lovelyday12
The Coalition of Asia Pacific Tobacco Harm Reduction Advocates’ (CAPHRA) nine member organizations have written to Framework Convention for Tobacco Control (FCTC) delegation heads from around the world, urging them to review the evidence that supports a tobacco harm reduction (THR) approach ahead of COP10.
With governments sending delegates to COP10 in November 2023, CAPHRA was keen to send leaders comprehensive reference material for their COP10 planning, submission writing and deliberations.
COP10 will be held in Panama and is hosted by the World Health Organization’s FCTC.
“We do this on behalf of the 4 million current users of safer nicotine products in the wider Asia-Pacific region. As you are aware, our region bears the brunt of the harm and death from combustible and unsafe oral tobacco globally,” said the letter.
The CAPHRA representatives reminded the health leaders that the FCTC has a mandate to pursue harm reduction as a core tobacco control policy.
“It has been known for decades that tar and carcinogens found in tobacco smoke cause the death and disease associated with smoking, not nicotine. Research has proven that nicotine, while usually mildly addictive in the same way as caffeine, is not a health issue,” they wrote.
The letter also called on delegates to deplore the FCTC’s policy to conduct COP10 sessions behind closed doors.
“Delegates to COP10 should be representing the rights and aspirations of the citizens whose taxes are paying for their attendance, who expect them to speak on their behalf, acknowledge the science underpinning the harm reduction benefits of ENDS and maintain democratic principles,” they wrote.
The CAPHRA representatives asked countries to take into account, when making their COP10 submissions, that consumers have the right to make choices that help them avoid adverse health outcomes. What’s more, people who smoke have the right to access less harmful nicotine products as alternatives to smoking.
The evidence-based documentation was wrapped up in a recently released white paper, titled “The Subversion of Public Health: Consumer Perspectives,” which was presented by CAPHRA executive coordinator Nancy Loucas at the fifth Asia Harm Reduction Forum.
December 8, 2022
Sweden Approaching ‘Smoke-Free’ Goal

Delon Human | Photo: Taco Tuinstra
Smoking in Sweden has fallen to 5.6 percent, making Sweden the only European nation close to reaching the smoke-free goal set by the EU ahead of the 2040 target, Swedish authorities confirmed, according to BusinessWire.
According to participants in an event organized by the Oral Nicotine Commission in Stockholm, Sweden is about to become the first country in the world to be defined as “smoke-free,” representing a share of less than 5 percent of the population smoking.
Sweden’s smoking rates have plunged since the 1980s from 35 percent to below 6 percent. The next lowest smoking rate in Europe is double that of Sweden’s, with the EU average sitting around 23 percent, four times higher than in Sweden.
“If all smokers in the world, some 1.1 billion people, would switch to one of [the] less harmful alternative smoke-free, nicotine-based products, it could prevent disease and save millions of lives worldwide. Sweden has found the fire escape for smokers. We need to work together to repeat the Swedish experience globally to save lives,” said Delon Human, president of Health Diplomats and organizer of the Oral Nicotine Commission event.
“The upcoming Swedish EU presidency is a great opportunity to share their 5 percent success story to other EU countries,” said Karl Fagerstrom, professor, at the event. “We hope that Sweden will be generous with sharing this know-how internationally.”
Speakers at the conference emphasized the need for sound evidence-based policy interventions in tobacco control.
December 7, 2022
European Support for Smoke-Free Technology

Photo: trodler1
Smoke-free technologies should complement the EU’s existing tobacco control measures, according to participants in a survey commissioned by Philip Morris International, according to Eureporter.
Carried out Nov. 10–15 by Povaddo and presented in Brussels on Nov. 17, the poll surveyed 13,000 adults spread over 13 European countries.
Among the participants, 73 percent said that industries should be incentivized to develop innovative products that are better for consumers and the environment. Sixty-nine percent said interested adult smokers should be encouraged to switch to scientifically substantiated, smoke-free alternatives by taxing these products at rates that are lower than cigarettes but high enough to deter youth and nonsmokers. Additionally, six in 10 respondents agreed that government endorsement of innovative tobacco products would have a positive impact on smokers.
“We know the potential to do better for adult smokers exists, as several member states have carried out similar policy approaches in, among others, energy, cars and alcohol,” said PMI Senior Vice President for External Affairs Gregoire Verdeaux during the presentation of the survey results.
“Pragmatic policies have the power to improve people’s lives, incentivizing companies to innovate for the better and provide equitable access to technological advances, especially in a time of economic instability.”
Povaddo Research President William Stewart said he hoped the results would encourage EU and national authorities to assess the results of current policies and consider other approaches, including “sensible regulation and taxation, while creating an environment that fosters innovations.”
November 21, 2022
Cochrane: Quitting Easier with Vapes
Photo: Rain
Quitting combustibles is easier with e-cigarettes, according to the most recent Cochrane Review on e-cigarettes. An update to the think tank’s ongoing review of the topic, the latest research includes 17 additional studies that conclude that smoking cessation works significantly better with e-cigarettes than with other nicotine-replacement therapy (NRT) products.
“Electronic cigarettes have generated a lot of misunderstanding in both the public health community and the popular press since their introduction over a decade ago,” lead author Jamie Hartmann-Boyce said. “For the first time, this has given us high-certainty evidence that e-cigarettes are even more effective at helping people to quit smoking than traditional nicotine-replacement therapies, like patches or gums.”
The total Cochrane analysis of e-cigarettes now includes 78 studies with over 22,000 participants. The body of evidence overwhelmingly supports the current update’s findings.
The just-released Cochrane review also indicates that e-cigarettes containing nicotine are more effective than e-cigarettes without nicotine or smoking cessation without aids containing nicotine. However, there is less data for these comparisons, which is why the authors rate the reliability of the evidence as only moderate.
Co-author Nicola Lindson from the University of Oxford and managing editor of the Cochrane Tobacco Addiction Group said that while not risk-free, e-cigarettes containing nicotine only pose a fraction of the risk of smoking.
“However, due to the lack of data on possible harmful effects from long-term use of nicotine-containing electronic cigarettes, i.e., over a period of more than two years, questions remain about the long-term effects,” Lindson said.
According to the authors, the study’s key messages include:
Nicotine e-cigarettes can help people to stop smoking for at least six months. Evidence shows they work better than nicotine-replacement therapy and probably better than e-cigarettes without nicotine.
E-cigarettes may work better than no support or behavioral support alone, and they may not be associated with serious unwanted effects.
However, more evidence is needed, particularly about the effects of newer types of e-cigarettes that have better nicotine delivery than older types of e-cigarettes, as better nicotine delivery might help more people quit smoking.
The Cochrane Review already found in 2016 that e-cigarettes were more likely to help smokers quit than nicotine patches or gum, but the available body of evidence at that time was slimmer.
“This comprehensive evidence review confirms, once again, that nicotine e-cigarettes help smokers to quit smoking and that these products are more effective than medically licensed nicotine-replacement therapies,” said John Britton, emeritus professor of epidemiology at the University of Nottingham. “All smokers should therefore try vaping as a means to end their dependency on smoking tobacco.”
November 18, 2022