Category: Harm Reduction

IEVA Launches Vaping Awareness Campaign

Dustin Dahlmann (Photo: IEVA)
The Independent European Vape Alliance (IEVA) has launched a new campaign aimed at educating smokers about the harm reduction potential of vaping compared to smoking combustible cigarettes.
Tobacco consumption is the single largest avoidable health risk and the most significant cause of premature death in the EU, responsible for nearly 700,000 deaths every year, according to the European Commission. Around 50 percent of smokers die prematurely.
Independent studies have shown that the switch to vaping is often an effective way to stop smoking completely, according to the IEVA.
“The developments in New Zealand and the U.K. are examples of progressive and enlightened public health policies. Political and public health leaders should take a close look at these results. Vaping can make a significant contribution to reducing smoking rates,” said Dustin Dahlmann, president of the IEVA, in a statement.
The European awareness campaign will take place over the coming weeks via the social media channels of the international members of the IEVA.
April 28, 2022
U.K. Acknowledges Vaping’s THR Role
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The U.K. Department for Health and Social Care’s (DHSC) has acknowledged the role of vaping in smoking harm reduction, according to the U.K. Vaping Industry Association (UKVIA).
In its review of the Tobacco and Related Products Regulations (TRPR) laws, which was published on March 25, the DHSC noted existing TRPR regulations “met their original objectives” and that they “could not be better achieved through alternative regulatory measures.”
The government has set itself a target of reducing the amount of U.K. smokers to just 5 percent of the population in the next eight years with the TRPR and other developments, such as the yet to be published Tobacco Control Plan (TCP), set to play a major role in helping to realize that ambition.
“While at first glance this appears to be ‘status quo,’ I see this as a win for the U.K’s vaping sector as the review clearly states the positive impact that vaping can have in helping people to quit smoking,” said John Dunne, director general of the UKVIA.
“As part of the TRPR consultation we submitted a whole raft of proposals aimed at creating a better commercial and regulatory environment to make it easier for the industry to help people trying to give up smoking and it is good to see those acknowledged.”

I see this as a win for the U.K’s vaping sector as the review clearly states the positive impact that vaping can have in helping people to quit smoking.
John Dunne, director general, UKVIA
The UKVIA, which promotes vaping as a much less harmful alternative to smoking and its significant impact in helping smokers quit, as well as dispelling the misinformation on vaping that exists, submitted a landmark package of recommendations to the TRPR consultation, including:
The use of government-approved expert health claims on products to address misinformation leading to misperceptions on vaping, and therefore encourage smokers to switch
Greater opportunities to engage with smokers, as current regulations restrict vaping’s ability to provide smokers with evidence-based knowledge to make informed decisions when looking to quit
The extension of certain regulations to cover additional vaping products, such as non-nicotine e-liquids, thereby ensuring a highly responsible and safe industry.
“What this tells me is that the industry is doing its job in bringing to the fore some of the things that have been holding back vaping’s ability to support the government’s smokefree targets to full effect,” said Dunne.
“We have to remember this is only a review of all points made and some initial positions the government is taking; our hope now is that those proposals and recommendations are carried forward and manifested in the Tobacco Control Plan.
“So, while in some respects it is disappointing that the government hasn’t taken forward the measured, evidence-based reviews put forward by the UKVIA, there is still positivity that in addition to forthcoming TCP, our recommendations can also inform and influence the Health Disparities White Paper and independent review into tobacco control policies.”
March 27, 2022
Imperial Launches Vaping Campaign

Photo: Tobacco Reporter archive
Imperial Tobacco Canada has launched a campaign called Let’s Clear the Smoke with the goal of educating Canadian adults on the facts about vapor products and the role these products can play in reducing risks compared to cigarettes, according to BAT.
Let’s Clear the Smoke provides information about the latest in vapor product science and aims to allow Canadian adults to take a more informed view when considering their stance on vaping products and other less risky alternatives to smoking.
This campaign is driven by a combination of mass out of home media placements and digital ads to drive awareness and website traffic. The campaign lasts for 10 weeks and will be the first of a range of initiatives to drive the acceptance of tobacco harm reduction in Canada.
“There is a lack of understanding out there about vapor products, especially when it comes to the positive role they can play in tobacco harm reduction,” said Ralf Wittenberg, president and CEO of Imperial Tobacco Canada. “I think this misunderstanding is due to the fact that the vast majority of people don’t have access to accurate, credible and independent information.
“The purpose of this campaign is to educate Canadian adults on the facts about vapor products by providing access to credible, factual and independent information.”
March 18, 2022
Australia Urged to Include Vaping in Smoking Strategy

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Australia is lagging well behind many other countries in the Asia-Pacific region when it comes to successfully tackling smoking through vaping, says the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA).
The CAPHRA’s observation comes as Australia’s Department of Health seeks feedback on its Draft National Smoking Strategy 2022–2030, with public submissions closing on March 24.
“We encourage vapers and supporters of a progressive tobacco harm reduction (THR) approach to have their say. Australians desperate to quit smoking and those keen to stay off deadly cigarettes need all the help they can get,” says Nancy Loucas, executive coordinator of the CAPHRA.
On Oct. 1, 2021, Australia’s Therapeutic Goods Administration expanded its prescription-only model with customs clamping down at the border on personal imports of nicotine vaping liquids from overseas websites.
Not only does Australia’s draft strategy ignore the potential of safer nicotine products, it also lacks ambition, according to Loucas. The strategy aims for a smoking rate of 10 percent or less by 2025 while New Zealand is pursuing a 5 percent smoke-free goal and looks on target to achieve it. “Instead of banning vaping, New Zealand has regulated it, making it tough for minors to access but available to all adults keen to keep off the cancer sticks. New Zealand is seeing its overall smoking rate tumble, yet the Australian government fails to accept that the most effective smoking cessation tool available is staring it in the face,” says Loucas.
“Australia is well down the world rankings when it comes to adopting effective THR policies and is light-years behind the U.S. and U.K. Subsequently, Australia’s overall smoking rate has fallen very little over the past decade, and without reasonable access to vaping, Australia will struggle to even achieve its 10 percent smoking goal,” says Loucas.
March 11, 2022
Taiwan: Stakeholders Debate Policy Proposals

Photo: Andrii Yalanskyi | Adobe Stock
A demonstrative policy debate event on whether e-cigarettes should be regulated was held on March 8, 2022, in Taipei, showing how different public policy viewpoints can be rationally discussed, according to The Taipei Times. The debate was held by the Chinese Debate Promotion Association (CDPA) at the Taipei NGO House.
CDPA Chairman and Founder Chia Pei-te said that the Executive Yuan in January approved a draft amendment to the Tobacco Hazards Prevention Act proposed by the Ministry of Health and Welfare for legislative review. The proposed regulations on emerging tobacco products have sparked discussions, he said.
The amendment would classify emerging tobacco products as “tobacco-like products” and “designated tobacco products.” E-cigarettes would be classified as “tobacco-like products” and be fully banned while heated-tobacco products would be classified as “designated tobacco products” and be subject to regulation.
The reasoning behind banning e-cigarettes includes keeping curious teenagers away from the products, preventing consumers from adding nicotine to e-cigarette e-liquids and lowering the risk of teenage users turning to smoking.
The debate participants went back and forth discussing the pros and cons of regulating e-cigarettes versus banning them, bringing up subjects such as public health, tax revenue options and teenage use.
National Yang Ming Chiao Tung University (NYCU) College of Pharmaceutical Sciences Dean Kang Jaw-jou said that he was moved by opinions for and against e-cigarettes. He said the affirmative side proposed to directly manage e-cigarette use through regulations and an approval system while the opposing side stressed their attitude to life—banning a substance if the public consensus deems it harmful to society.
Many aspects of the topic can be argued, but e-cigarettes can cause negative health effects, and supporters and opponents must clearly present this fact to the public in further discussions, stated Wang Hsiang-tsui, NYCU Faculty of Pharmacy associate professor.
March 11, 2022
French Experts Call for Tobacco Policy Rethink

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Sixteen French doctors, researchers and medical professors have called for government support of vaping in response to a publication by the French High Council for Public Health last year, which was critical of the sector, according to the Independent European Vape Alliance.
The article, by addiction researcher Benjamin Rolland and pulmonologist Sebastien Couraud published in Le Monde newspaper, equates the High Council’s anti-vape position with unscientific anti-vaccination arguments.
The article evaluates public health policy developments to combat the Covid-19 pandemic and compares them with government measures to contain the tobacco “epidemic.” Vaccines have been available for more than a year to help reduce the number of infections and severe health damage.
Anti-vaxxers rejected these vaccines because there was the absence of information about the long-term effects despite the well-known significant risks of contracting Covid-19. Vaccines helped millions of people and saved a great many lives, but they could have saved many more had opposition to them not been as fierce, according to the article.
The authors see a parallel to this development in the tobacco epidemic:
“For many decades now, another pandemic has been raging—that of tobacco addiction. It is responsible for more than 8 million deaths per year (including 75,000 in France),” they write.
Citing information from the international scientific consortium Cochrane, Rolland and Couraud suggest that e-cigarettes are among the most effective tools to wean smokers off cigarettes.
However, opponents of vaping often deny the public health potential of reduced-risk alternatives. And their reasoning is reminiscent of the arguments of anti-vaxxers, according to the authors. “Some scientists, however, refuse to promote the vape because of the lack of perspective on the prolonged consequences of this new device in the name of the same precautionary principle as that mentioned above,” they write.
Pointing to the high relapse rates among smokers seeking to quit with medical cessation devices—an estimated 70 percent to 80 percent of users return to smoking—the authors call on healthcare professionals to recommend e-cigarettes to smoking patients as a significantly less harmful alternative.
March 10, 2022
THR Strategies Have Reduced Smoking Rates

The Asia Harm Reduction Forum 2021 attended by the leading experts in technology, public health policy and science met to discuss the tobacco harm reduction (THR) strategies deployed in various countries, according to a press release from the Canadian Vaping Association.
“We have known the risks from smoking for many decades. We have known that it is the smoke, not the nicotine, that is responsible. We also know that we can deliver nicotine in ways that have minimal risk,” said David Sweanor, chair of the Center for Health Law, Policy and Ethics and an adjunct professor of law at the University of Ottawa. “As a result, Sweden’s rates of tobacco-related illness and death are by far the lowest that you can see in the European Union. Their smoking rates are now low enough that many people would call it a smoke-free society. When Norway allowed snus products to be more widely available, cigarette smoking fell by half in just 10 years. When Iceland allowed both vaping products and snus into the market, smoking fell by about 40 percent in just three years.”
For decades, Canada has tried to curb smoking through education and taxation with limited success. Reductions in smoking prevalence had generally slowed, with modest annual declines prior to more mainstream adoption of vaping by smokers. Vaping experienced peak adoption in 2019, which lead to a 7.5 percent decline in cigarette sales.
“Harm reduction is one of the four pillars of Canada’s drug and substances policy. Policy that makes vaping less appealing to smokers, like flavor restrictions and taxation, is out of step with this policy. In effect, Canada has embraced harm reduction in name but not substance,” said Darryl Tempest, Government Relations Council to the Canadian Vaping Association.
March 4, 2022
Watch Your Mouth

Image: martialred
What the industry can’t (and could) say about harm reduction
By Cheryl K. Olson
Surveys show that the public perceives nicotine as the devil behind most of the cancer and heart disease caused by smoking. E-cigarettes and nicotine-replacement therapies alike are misperceived as relatively risky by many smokers. Even physicians are likely to believe nicotine is dangerous. The now entrenched view of nicotine as public health villain is the predictable result of years of emotion-based anti-vaping campaigns from government and advocacy groups and a steady drip of media reports on the latest perceived danger or deception from the nicotine industry. This includes coverage of the e-cigarette or vaping use-associated lung injury crisis that wrongly linked deaths from THC vaping to nicotine vapes.
The hundreds of thousands of deaths from smoking take place out of sight; they’re old news, not worth mentioning. When I was a public health graduate student in the 1990s, there was much conversation about how to make those deaths newsworthy. Advocacy groups looked for vivid imagery and metaphors to make their case: Hey, deaths from smoking are like a jumbo jet crashing in flames every day! Those deaths are still happening; the campaigns are not.
The Real Cost media campaign, run by the U.S. Food and Drug Administration since 2014, now targets vaping instead of smoking. Creativity in advertising is now focused on fanciful brain worms and similarly unsupported high-fear imagery.
Over drinks at the 2021 London GTNF meeting, I heard conversations bemoaning the passing of those government antismoking efforts and wondering how the FDA or Centers for Disease Control (CDC) could be persuaded to target nicotine misperceptions. In the “before times” (pre-FDA regulation and pre-Tobacco Control Act of 2009), as an academic who consulted to the industry, I headed a multi-year stop-smoking campaign funded by Philip Morris USA. QuitAssist was created to expand upon and encourage the use of existing smoking cessation materials from government and nonprofit organizations. This naturally made me wonder whether, even in this changed regulatory environment, the industry could find a way to pick up the dropped baton and lead a new communications effort.
What stops nicotine product companies from pushing back against this tide of misinformation and misperceptions? You’d think there would be a strong incentive for companies to educate the public. After all, if everyone believes that the health danger in cigarettes comes from the nicotine instead of the byproducts of combustion, why would smokers who can’t or won’t quit even consider switching to vastly less dangerous alternative nicotine products?
Since the GTNF meeting, I’ve talked with people from legacy and upstart nicotine product companies working with these issues from various corporate communications, regulatory and legal angles to try to understand the “carrots and sticks” that shape how the industry responds.
Companies reflexively blame the FDA regulations for their inaction. This has merit. To prevent new outbreaks of old Big Tobacco deceptive practices, the wording of the law can block companies from speaking obvious truths. But there are also surprising hidden disincentives to educate the public about nicotine. Will it upset shareholders? Will it upset regulators? Is it worth the money? Will it create litigation risk?
What makes nicotine product makers watch their mouths when it comes to public education? It’s complicated. If we envision the forces blocking industry communication as an iceberg, let’s start with the visible tip: what the law says that you can’t say.
The Rules
The most commonly cited roadblock to correcting misperceptions about nicotine harm reduction is Section 911 of the Family Smoking Prevention and Tobacco Control Act of 2009.
Without a specific modified-risk claim pre-authorized by the FDA, a product’s label or advertising can’t state or imply it carries lower risk of disease or harm than another commercially marketed tobacco product. That’s pretty straightforward. But what’s next is not: you can’t even say the product “or its smoke contains a reduced level of a substance or presents a reduced exposure of a substance” or that the product “does not contain or is free of a substance” even when those statements are empirically true.
Based on this language, a company could not repeat facts from published research. It could not share the grudging admission from the CDC’s website that “E-cigarette aerosol generally contains fewer toxic chemicals than the deadly mix of 7,000 chemicals in smoke from regular cigarettes.”
This seemingly outrageous restriction on factual speech should be understood in historical context. The Act initially only covered cigarettes, cigarette tobacco, roll-your-own tobacco and traditional smokeless tobacco. With the language about advertising and communications, its authors were thinking about “light” cigarettes and similarly implied health claims that were misleading or taken out of context—not novel nicotine products that might be truly and even massively less risky. The FDA was empowered to issue regulations deeming other tobacco products to be covered by the Act, adding e-cigarettes in 2016.
The Risk/Benefit Calculation
Now, let’s look at the larger underwater part of that iceberg: the less visible factors that block companies from taking action.
Shareholders. Legacy tobacco companies like to focus publicly on their novel nicotine products and the transition away from combustibles. But there’s no denying that traditional tobacco products, especially cigarettes, are where the money is. Shareholders expect companies to act conservatively when it comes to their primary source of income. And some of the profits from combustibles support the massive R&D costs of transitioning to less dangerous products. However desirable the transition to the future world of reduced consumer harm and reduced litigation risk … as one person told me, it’s a good ESG (environmental, social and governance) story, but the incentives aren’t there.
Litigation risk. Despite the 1998 Master Settlement Agreement and FDA regulation, multinational tobacco companies remain in near-constant litigation on the cigarette front. Today’s tobacco industry is stuck with the legacy of decades of bad behavior; every action is scrutinized for intent to addict and harm fresh generations of users. So, an attempt to partner with a physician for public education conjures up images of 1930s Lucky Strike ads with smiling white-coated pitchmen. And as one insider explained, it becomes a cost to the business if it gets interpreted in court as evidence of further bad acting.
Cost. Section 911 of the Tobacco Control Act does allow the option of seeking authorization through the modified-risk tobacco product (MRTP) pathway to make a modified-risk claim. In 2019, Swedish Match was first to earn this status, allowing claims of lower risk of mouth cancer and five other ills if used instead of cigarettes to appear on eight General Snus products.
Unlike Europe, which takes a category approach to regulation, the U.S. regulates products one by one, even for very similar products with low youth use, such as vaping liquids. One person estimated that the cost of research to support an MRTP claim would be equivalent to what their company spent to support that product’s PMTA for marketing authorization: millions of dollars for claims that may not even be relevant or understandable to the average smoker.
Regulator pushback. Especially in the current regulatory environment of low trust, confusing guidance, pending legal cases and thousands of products in regulatory limbo, few companies want to risk further antagonizing the FDA. When I raised hypotheticals of education efforts that could be undertaken by nicotine product makers, I heard stories of wonderful might-have-been campaigns nixed by lawyers. A collaboration between the industry and respected researchers and their university, based on extensive focus group testing with smokers? Add a catchy slogan and creative messaging plus incentives and prizes to encourage smokers to try reduced-risk products and to stay off cigarettes? The FDA is lukewarm on the plan. Big Tobacco dollars that could have supported a huge smoking cessation effort go unspent.
The Right Audience and the Best Messenger
A final concern among industry insiders is a frank understanding of their own lack of credibility. Does it make sense to spend money on messages that won’t be believed? They point to research showing that government agencies and health professionals are the most trusted sources of information.
It’s noteworthy that recent research suggests that government agencies are less trusted by groups that disproportionately suffer from smoking, such as racial/ethnic minorities and lower income persons. And the FDA’s actions speak loudly: When smokers see their favorite vaping products removed from websites or store shelves while very low-nicotine cigarettes are authorized, what message does that send to consumers?
The industry’s best hope for correcting nicotine misperceptions likely comes from indirect public education, through health professionals and consumer advocacy organizations. But industry folks might also consider how to educate regulators, who may not know many or even any smokers, about the realities of their lives and needs.
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 Associates. She spent 15 years on the faculty of Harvard Medical School.

March 1, 2022
EU Parliament Endorses Harm Reduction

Photo: VanderWolf Images
The EU Parliament has adopted, by a margin of 652 votes to 15, a report on Cancer prevention and Treatment that recognizes the potential contribution of vapor products to smoking cessation. The report notes that “electronic cigarettes could allow some smokers to progressively quit smoking.”
In adopting the report, the EU Parliament has become the world’s first elected chamber to endorse tobacco harm reduction, according to the Independent European Vape Association (IEVA).
“This is a landmark declaration by the European Parliament, which should go a long way to reassuring smokers of the health benefits that a switch to vaping can bring,” said IEVA President Dustin Dahlmann in a statement. “We now encourage the other EU institutions—and in particular, the European Commission—to take this on board and ensure that policy follows science, not the other way around.”
In addition to measures to reduce cancer incidence, the committee’s report places a special focus on the serious health effects of smoking.
The report also stresses the need for further research on vaping to be viewed in relative terms, given that tobacco smoking kills and vaping does not.
The final text of the report also includes a mention of further assessment of flavors “particularly attractive to minors and non-smokers” and a possible ban on them in the context of the review of the Tobacco Products Directive.
The IEVA says its crucial to avoid a flavor ban because the variety of flavors is one of the top reasons for adult smokers to switch to e-cigarettes and for vapers not to return to smoking.
“Research into the impact of flavor bans shows that many vapers return to smoking as a result [of a ban],” said Dahlmann. “This must be prevented. We agree that steps must be taken to curtail inappropriate marketing, while recognizing the crucial role flavors play in helping smokers quit.”

February 18, 2022
U.K. Vaping Hits Record High as Smoking Drops

Photo: Rain
The number of people who vape in the U.K. has risen to its highest level since records began while the number of U.K. adults who smoke has fallen below 14 percent for the first time in years, according to just released government figures.
The Office for National Statistics (ONS) has published its annual report into smoking prevalence in the U.K., which includes figures on the number of adults who vape, just one month after the Department of Health’s announcement that vaping devices could soon be prescribed to smokers through the National Health Service.
In 2014, when data on the number of U.K. vapers started being collected, 3.7 percent of the population reported using e-cigarettes. In 2020, that had risen to 6.4 percent, equivalent to around 3.3 million people.
The report also reveals that the number of adult smokers in the U.K. currently stands at 13.8 percent of the population—its lowest percentage since at least 2015.
“This is a hugely welcome announcement as everyone on the side of harm reduction knows that vaping is far less harmful than smoking—by as much as 95 percent, according to the former health protection watchdog Public Health England [now part of the U.K. Health Security Agency]—so more people vaping and less smoking can only be cause for celebration,” said John Dunne, director-general of the U.K. Vaping Industry Association, in a statement.

This is a hugely welcome announcement as everyone on the side of harm reduction knows that vaping is far less harmful than smoking.
John Dunne, director-general, UKVIA
The ONS Smoking Prevalence Report highlighted that the number of ex-smokers who now vape had risen from 11.7 percent in 2019 to 12.3 percent while the number of smokers who also vape increased from 15.5 percent in 2019 to 17.8 percent in 2020.
However, according to the ONS monthly data, smoking rates rose sharply during the pandemic and national lockdown to a peak of 16.3 percent in August before slowly decreasing to 13.8 percent by the end of 2020.
“While this rise in smoking prevalence during lockdown could be attributed to increased anxiety because of the pandemic, I would also point toward the fact that specialty vape shops were not granted ‘essential retail’ status and therefore had to close their doors as another significant contributing factor,” said Dunne.
December 9, 2021