Category: Harm Reduction

COP10 to Reject Harm Reduction: Briefing

Photo: Alesmunt
Tobacco harm reduction will be absent at the 10^th Conference of the Parties (COP10) to the Framework Convention on Tobacco Control (FCTC), according to new briefing paper published by the Global State of Tobacco Harm Reduction (GSTHR).
Scheduled for Nov. 20-23 in Panama City, COP10 will have a significant influence how tobacco policies are implemented at a national level, which in turn will determine the future of safer nicotine products such as e-cigarettes, heat-not-burn products and nicotine pouches.
To determine the potential impact of the conference on tobacco harm reduction, the GSTHR analyzed the COP10 agenda and supporting documents.
The GSTHR’s analysis indicates that at present, tobacco harm reduction and its potential to reduce smoking-related death and disease are entirely missing from the proceedings. The publicly available documentation ahead of the FCTC COP10 presents safer nicotine products as a threat to tobacco control rather than as potential tools to support a switch from smoking and reduce high-risk tobacco use.
Parties to the FCTC are expected to be encouraged to classify and regulate nicotine vapes, snus, nicotine pouches and heated tobacco products in the same way as tobacco and combustible tobacco. This risks removing or reducing access to safer options from people who already use them and may return to smoking—and from people who smoke and have the potential to switch and improve their health, according to the GSTHR, which is a project of Knowledge Action Change (KAC).

The WHO and FCTC Secretariat’s refusal to engage with evidence from multiple countries that have witnessed accelerated declines in smoking rates is unscientific and unjustifiable.
Gerry Stimson, director, KAC
“Having observed the WHO’s activities on this issue for some time, many are unsurprised that the FCTC COP10 meeting papers reveal a concerning direction of travel,” said KAC Director Gerry Stimson in a statement.
“The WHO and FCTC Secretariat’s refusal to engage with evidence from multiple countries that have witnessed accelerated declines in smoking rates is unscientific and unjustifiable. Their repeated characterization of safer nicotine products as a threat to tobacco control runs directly counter to what should be the overarching goals of the Convention–to reduce smoking-related deaths and disease as rapidly and effectively as possible.
“People who use safer nicotine products are barred and have no voice at the FCTC COP10. Those Parties who have successfully adopted and supported access to these products as effective tools for smoking cessation must ensure that their own progress is not hindered by COP decisions—and that the potential for tobacco harm reduction is given due consideration by all Parties present in Panama next month.”
October 10, 2023
Center for Black Equity Calls for E-Cig Approval

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The Center for Black Equity (CBE) called on the U.S. Food and Drug Administration and the Center for Tobacco Products to grant broad approval to a full range of nicotine e-cigarettes, also known as vapes, in a major step toward closing the significant harm reduction and health equity gaps perpetuated by current FDA tobacco policies, according to a press release. The approval of vaping products would benefit Black and LGBTQ+ populations disproportionately impacted by the negative health effects of smoking, including cancer, according to the CBE.
The CBE’s call for expansive regulatory approval of e-cigarettes, including flavored vaping products, comes as the CBE released an econometric report that, for the first time, quantifies the benefits of switching from smoking to vaping in terms of lives saved, GDP benefit and healthcare savings.
The report was authored by Robert J. Shapiro, former undersecretary of commerce for economic affairs and advisor to former President Clinton, former President Obama and President Biden. Shapiro’s report found that between 2010 and 2022, shifting from smoking to vaping saved 113,000 lives, preserved $137 billion in GDP and saved $39 billion in healthcare costs—and that the availability of e-cigarettes reduced the number of smokers in the U.S. by 6.1 million during that same period.
“Championing meaningful harm reduction initiatives for Black and LGBTQ+ communities has been an elusive but essential aspect of effective public health advocacy for decades,” said Earl Fowlkes, president and CEO of the CBE. “If the Biden administration and the FDA are serious about health equity and harm reduction, especially when it comes to the president’s Cancer Moonshot initiative, the science is clear: Broad approval of flavored vaping products will save Black and LGBTQ+ lives, reduce smoking and drive meaningful progress in lowering preventable cancer rates in the U.S., especially among the most vulnerable populations.”
The report also reviewed existing academic and medical literature on vaping versus smoking to examine and verify the substantial scientific evidence that e-cigarettes have a drastically lower risk profile than cigarettes and can help individuals successfully reduce smoking or quit altogether.
“The single most effective way to help people stop smoking, which kills 480,000 people per year, is to encourage them to switch to vaping, which kills no people per year,” said Shapiro.
“The Center for Tobacco Products needs to be honest with American smokers—especially those in Black and LGBTQ+ communities who smoke at disproportionately higher rates—and proactively convey the substantial health benefits of shifting from smoking to vaping,” Shapiro said. “Future FDA policy on tobacco and nicotine products should draw on the well-established scientific evidence regarding the relative risks of e-cigarettes versus cigarettes and the utility of people using vaping to stop or reduce their smoking.”
The report also squarely examined the primary concern of critics of e-cigarettes, the supposed “youth vaping epidemic,” to which formal FDA approval of vaping products would allegedly contribute. “The supposed ‘youth vaping crisis’ narrative that has existed for some time in the media and, curiously, in public health conversations at the FDA is unfounded,” Shapiro continued. “The U.S. Centers for Disease Control and Prevention’s own data show that adolescent vaping has declined substantially in recent years—receding to 2014 levels, well below the 2019 peak—and that most young people who vape do so on an irregular or occasional basis without becoming dependent on nicotine.”
“The FDA and the Center for Tobacco Products have an obligation to follow the science, support harm reduction and health equity, and advance—rather than stall—President Biden’s Cancer Moonshot,” concluded Fowlkes. “The FDA must acknowledge the evidence-based benefits of switching from smoking to vaping and aggressively educate Black, LGBTQ+ and other smokers about those benefits. Failure to approve a wide range of vaping products is an abdication by the FDA of its public health responsibility to Black and LGBTQ+ individuals across the country who desperately want to access a way to quit smoking that actually works.”
October 5, 2023
EU Considering Ban on Tobacco-Free Snus

Image: Andrii
In a tweet from Member of Parliament Charlie Weimers, news of a potential ban on snus in the EU has come to light.
“A secret report I shouldn’t have landed on my desk,” the tweet said. “In the report that will be presented to the EU member states this week, there are two notable writings: (1) praise for how successful the snus ban has been and (2) a recommendation that the EU should extend the snus ban to the tobacco-free white snus (nicotine portions).”
“That the EU snus ban is a success is completely wrong,” he wrote. “It is actually snus that makes Sweden the only country in the EU that is on the way to reaching the U.N.’s goal of a smoke-free society (defined as less than 5 percent smokers), which has saved many lives. A ban on nicotine pouches would have been a hard blow to the attempt to eradicate smoking in the EU.
“Unfortunately, the Swedish exception for tobacco snus does not apply to nicotine pouches. If the EU Commission and the member states accept the report’s recommendation, nicotine pouches will also be banned in Sweden. Men have largely opted out of smoking in favor of snus while women looking for less dangerous alternatives choose nicotine pouches more often. Therefore, such a ban would hit women extra hard.
“The report has been written by consultants who work for DG SANTE (the EU’s health bureaucrats), and the writings probably would not have crept into the report if they did not have the support of the bureaucrats. Most likely, this is a test balloon from the bureaucracy. If the proposal falls to the ground at the meeting with the member states, the bureaucrats can blame the consultants, and if the proposal does not meet resistance, the bureaucrats can interpret it as a clear support and work on with a sharp proposal. This is how you often work in the EU’s bureaucracy.
“The government must therefore already make it clear at the meeting this week that our country opposes a ban on white snus and work to ensure that citizens continue to have the opportunity to choose the least harmful way to use nicotine. Our negotiators are also welcome to raise the issue of the risks to public health of having too many do-gooding bureaucrats in DG SANTE.”
The news has left many angry, with calls for “SWEXIT” if the proposal passes—meaning, those against the measure are calling for Sweden to leave the EU if the ban passes.
October 4, 2023
UK to Raise Cigarette Consumption Age

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The U.K. prime minister, Rishi Sunak, wants to raise the legal age for consuming cigarettes, gradually increasing it one year at a time until the next generation is no longer legally allowed to purchase the products, reports Bloomberg.
According to Sunak, the move would make it so that “a 14-year-old today would never legally be sold a cigarette.” Sunak spoke on the age increase at a Conservative Party conference in Manchester Wednesday, where plans to restrict availability of vapes and look at packaging and flavors of vapor products were also discussed.
Simon Clark, director of smokers’ rights group Forest, responded to the move, saying, “These are desperate measures by a desperate prime minister.
“Raising the age of sale of tobacco is creeping prohibition, but it won’t stop young people smoking because prohibition doesn’t work. Anyone who wants to smoke will buy tobacco abroad or from illicit sources.
“This is the opposite of leveling up; it’s dumbing down. Future generations of adults who are considered old enough to vote, pay taxes, drive a car and drink alcohol are going to be treated like children and denied the right to buy a product that can be purchased legally by people a year older than them.
“This is now a conservative government in name only because the prime minister has just taken a wrecking ball to the principles of choice and personal responsibility,” Clark said.
October 4, 2023
PMI Joins We Card

Image: Tobacco Reporter archive
Philip Morris International has joined the We Card Program, a national nonprofit serving the nation’s retailers of age-restricted products. The company’s Swedish Match affiliate will serve on We Card’s manufacturer advisory council.
Independent retail establishments and large retail chains utilize We Card’s educational and training services for their compliance efforts with federal, state and local laws aimed at preventing age-restricted product sales to minors.
National and state retail trade associations, government officials, community groups and others also support We Card’s ongoing efforts to raise awareness of responsible retailing and age verification requirements and to educate and train retail employees to identify and prevent underage attempts to purchase age-restricted products.
“As we enter the U.S. market, our ambition is twofold: to be the market leader across America for innovative smoke-free products that are a better choice than continued cigarette use and to ensure that youth cannot access these products, which are intended only for adults who smoke or use another nicotine product,” said Stacey Kennedy, president of the Americas and CEO of the PMI U.S. business. “Joining We Card reflects the commitment shared by PMI and Swedish Match to further enhance youth access prevention programs in close cooperation with our retail partners.”
“The We Card Program has long been a vital tool for retailers, and we look forward to working with them to expand the program’s suite of tools to reflect the growing range of innovative nicotine products, including oral pouches,” Kennedy added.
“We Card is pleased to have Swedish Match join our manufacturer advisory council. This will help us further our mission to prevent underage access to nicotine products and work to address the problem of the social sourcing of those products,” said Doug Anderson, president of the We Card Program.
October 3, 2023
BAT Outlines Five-Step Vapor Rules Plan

BAT has released a blueprint for how regulators and governments could better regulate vapor products and help smokers switch to less risky products.
During DTNF 2023, held from Sept 18-20 in Seoul, BAT’s global head of business communications, Jonathan Atwood, told attendees how BAT’s five-step plan for regulation could support achieving the right balance between harm reduction and the unintended consequences of access, including underage use.
Speaking on behalf of Kingsley Wheaton, BAT’s chief strategy & growth officer, Atwood said that reckless players in the market need to be penalized when they do not abide by the rules. He said the five suggestions are the areas that regulators should explore and establish “smart regulation” that is right for their market.
“First, on-device technology and functionality: vapor products should be accessible only to adults. Both underage prevention and restriction is crucial. On-device technology, when applied and enforced across entire markets, could help in this regard.
“Second, more recognition is needed that flavors are an important driver of adoption for smokers seeking alternatives. However, flavors in vapor products should not particularly appeal to anyone underage.
“Third is at the manufacturing and import level: ensuring that non-compliant products cannot reach the market in the first place.
“Fourth, where no restrictions exist already, regulators may want to look at who should be able to sell vapor products and where. Reasonable safeguards at the point-of-sale would help ensure these products are sold only to adult consumers. Solutions such as retail licensing and facial recognition technologies should be seriously considered.
“Lastly, enforcement and penalties: governments must wield their power and ensure consumers are purchasing legitimate products. Such measures should be rigorously enforced and those who fail to comply should face meaningful sanctions.”
Atwood said BAT was calling upon governments, regulators, and industry peers to rally towards a sustainable and progressive environment in which vaping products are sold and marketed responsibly.

September 19, 2023
Activist Group Touts THR Benefits

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Citizens Against Government Waste (CAGW) released a new issue brief, “Tobacco Harm Reduction Products Should Be Promoted Not Prohibited,” co-authored by CAGW President Tom Schatz and Director of Health and Science Policy Christina Smith, which details the benefits of tobacco harm reduction (THR) products.
“CAGW’s issue brief continues CAGW’s longstanding work on the benefits of THR products. Despite the evidence of their effectiveness in saving lives, state and federal bureaucrats have instituted regressive taxes, strict regulations and outright bans on harm reduction products, Schatz and Smith wrote in their statement.
“Restrictions on THR products have led to the creation of a dangerous and unregulated market that puts consumers at risk. And even with a crackdown on these products, the number of unique e-cigarette devices sold in the U.S. has tripled to more than 9,000 since 2020, driven mainly by unauthorized disposable vaping products from China. Instead of continuing and expanding strict laws and regulations, government officials should approach the issue of harm reduction products with evidence-based data and logical reasoning and promote policies that have helped millions of adult smokers quit.”
CAGW is a nonpartisan, nonprofit organization dedicated to eliminating waste, fraud, mismanagement and abuse in government. The organization is based in Washington, D.C.
September 5, 2023
FDA Urged to Prioritize Harm Reduction

Photo: New Africa
The R Street Institute is urging the U.S. Food and Drug Administration to prioritize harm reduction in its approach to tobacco regulation.
In a letter to FDA Center for Tobacco Products’ (CTP) Director Brian King, the organization suggested the agency should evaluate its past achievements, define its mission statement clearly and develop a science-based tobacco and nicotine policy. Additionally, it recommended applying product standards consistently across all tobacco and nicotine products.
The R Street Institute expressed concerns that the FDA’s proposed strategic goals may not address more immediate issues that could have a significant impact on public health. The group argued that the CTP should reflect on its initial goals and whether they have been achieved, such as setting clear standards for tobacco/nicotine products and effective enforcement processes.
The comments also stressed the importance of communicating the strengths and weaknesses of past CTP goals, defining the mission statement with clear measurables, and establishing evidence-based policy goals for tobacco harm reduction. The R Street Institute advocated for transparent and consistent education on tobacco harm reduction.
Lastly, the group urged the CTP to close gaps and loopholes in regulating tobacco and nicotine products, ensuring that all products are held to the same scientifically determined standards.
The R Street Institute is a nonpartisan organization dedicated to limited government.
September 1, 2023
CoEHAR Concerned About South African Bill
The Center of Excellence for the acceleration of Harm Reduction (CoEHAR) has urged the South African government to use risk-proportionate regulation in its tobacco control efforts.
In a reply to a public consultation on the Tobacco and Electronic Nicotine Delivery Systems Control Bill, CoEHAR raised concerns that the current draft will restrict less risky options for people who would benefit from using these products to quit smoking.
“The primary goal of the South Africa tobacco policy should be to prevent and control tobacco- related excess mortality and morbidity. In practice, this means reducing smoking as deeply and rapidly as possible,” wrote Riccardo Polosa and Giovanni Li Volti on behalf of the CoEHAR in their letter.
“Tobacco harm reduction provides a fast-acting, market-based strategy for reducing smoking and eliminating most smoking-related risks. The regulation of combustion- smoke-tar-free products should always be considered as part of a regulatory system that covers all the nicotine delivery products. The aim should be to encourage the migration from high-risk to low-risk products and support positive behavior change. Regulators should take great care to avoid the perverse consequences of prohibitions and use risk-proportionate regulation instead.”
Based in Catania, Italy, CoEHAR is a multidisciplinary center focused on the study of tobacco harm reduction.
September 1, 2023
FDA Tobacco Chief Discusses Relative Risk
Brian King (Photo: FDA)
In an article published in Addiction magazine, Brian King, director of the U.S. Food and Drug Administration’s Center for Tobacco Products (CTP), explores the chances and considerations for informing adults who smoke cigarettes about the relative dangers of tobacco products, including e-cigarettes. He collaborated with Benjamin Toll, director of the Medical University of South Carolina Tobacco Treatment Program and co-director of the Lung Cancer Screening Program.
The commentary highlights the findings of a recent survey about misperceptions of tobacco product harms, including cigarettes and e-cigarettes. The survey found that only about 20 percent of adults who smoke cigarettes believed e-cigarettes contain fewer harmful chemicals than cigarettes. While there are no safe tobacco products, the available scientific evidence indicates that tobacco products exist on a continuum of risk, with cigarettes being the most harmful.
The commentary notes that opportunities exist to educate adults who smoke about the relative risks of tobacco products, including e-cigarettes. However, these efforts should be accompanied by efforts to prevent youth tobacco product use; encourage first-line use of FDA-approved cessation therapies; and for adults who both smoke and use e-cigarettes, reinforce the importance of completely transitioning to e-cigarettes.
The commentary further emphasizes that any education efforts on the relative risks of tobacco products must be evidence-based. In particular, it is important to assess the benefits among the intended population (i.e., adults who smoke) and risks among unintended populations (e.g., youth). Currently, FDA is in the early stages of a research effort to assess messaging about the continuum of risk of tobacco products among adults who smoke.
Last week, the FDA announced a virtual listening session opportunity to verbally provide open public comment on the development of the new strategic plan, including proposed strategic goals. After introductions, the center will begin the listening session with an overview of the process used to develop the CTP’s strategic plan, including proposed goal areas.
Registration is open for the virtual listening session on the development of the CTP’s five-year strategic plan, which will take place on Aug. 22 beginning at 10 a.m. EDT.

August 15, 2023