Knowledge-Action-Change - Tobacco Reporter

Survey Details Advocacy for Safer Nicotine

Knowledge-Action-Change (KAC) has released a global survey investigating the role and activities of consumer organizations advocating for access to safer nicotine products (SNPs) and tobacco harm reduction.

Carried out by KAC’s Global State of Tobacco Harm Reduction project, the research was published in Public Health Challenges.

It reveals that there are 54 active consumer advocacy groups working around the world to raise awareness about, and promote the availability of and access to, SNPs, which include nicotine vaping products (e-cigarettes), Swedish-style snus, nicotine pouches and heated-tobacco products.

The authors of the survey found that the vast majority of organizations (42) were operated entirely by volunteers, most of whom had successfully quit smoking with the help of SNPs.

Only seven of the groups had any contracted or paid staff (13 people globally), and for the last full year, the total funding for all organizations surveyed amounted to $309,810. This is in stark contrast to the millions of dollars spent on campaigns by actors, such as Bloomberg Philanthropies, seeking to limit access to SNPs, such as nicotine vaping products. The paper also notes that none of the consumer advocacy organizations reported receiving funding from tobacco or pharmaceutical companies.

This paper starkly demonstrates the major imbalance in resources available to consumer organizations advocating for access to safer nicotine products and those opposed to tobacco harm reduction, unfairly skewing the debate.

Gerry Stimson, director, KAC

Many of these organizations are members of four regional umbrella organizations covering Latin America (ARDT Iberoamerica), Africa (CASA), Europe (ETHRA) and Asia-Pacific (CAPHRA).

“This survey offered a unique opportunity to map these advocacy organizations for the first time and provide valuable insight into how they are operating all over the world,” said Tomasz Jerzynski, lead author and data scientist for the Global State of Tobacco Harm Reduction project. “The sustainability of these organizations is one of the main concerns that has come out of the data. All of these groups face challenges due to their small numbers of core workers and their dependence on volunteers.”

“This paper starkly demonstrates the major imbalance in resources available to consumer organizations advocating for access to safer nicotine products and those opposed to tobacco harm reduction, unfairly skewing the debate,” said Gerry Stimson, report author, director of KAC and emeritus professor at Imperial College London. “It also highlights why consumer groups must be recognized as legitimate stakeholders in the policy sphere.”

February 1, 2023

KAC: Seize Potential of Safer Nicotine

Knowledge-Action-Change (KAC) has published The Global State of Tobacco Harm Reduction 2022: The Right Side of History. The Global State of Tobacco Harm Reduction (GSTHR) publication charts the history of tobacco harm reduction and considers the future of a strategy that can hasten the end of smoking and drastically reduce smoking-related death and disease worldwide.

According to the report’s authors, the emergence of new safer nicotine products has caused substantial disruption to nicotine use, public health and tobacco control institutions and the traditional tobacco industry. However, mistrust and ideological opposition is hampering widespread adoption of a strategy that could help 1.1 billion adult smokers failed by existing tobacco control interventions.

“Technology helped smoking become one of the world’s biggest health problems,” said Harry Shapiro, author of The Right Side of History, in a statement. “Now, technological innovations from beyond both the tobacco industry and public health have combined to produce safer nicotine products, and millions of people who smoked have already chosen to switch. Yet progress is being hampered. Although disruption is not always comfortable, the genie is out of the bottle—these new technologies demand the development of new policies and new thinking.”

“A failure to recognize and exploit the potential of tobacco harm reduction will mean millions more avoidable deaths each year.”

Gerry Stimson, project lead, GSTHR

“A failure to recognize and exploit the potential of tobacco harm reduction will mean millions more avoidable deaths each year and contribute to an ever-growing burden of disease that disproportionately affects the most vulnerable countries and communities,” said Gerry Stimson, GSTHR project lead and emeritus professor at Imperial College London.

“Tobacco control’s lack of evolution, despite its very limited gains, means that many aspirational targets to achieve smoke-free status by 2030 or within the next generation are no more likely to be met than former aspirations for a drug-free world. Tobacco harm reduction offers us an historic opportunity. We must not let it slip away.”

The Right Side of History is the third in the biennial series of GSTHR reports, following No Fire, No Smoke in 2018 and Burning Issues in 2020. A summary of the most recent report is here. The GSTHR project is produced with the help of a grant from the Foundation for a Smoke-Free World.

November 16, 2022

KAC Solicits Scholarship Applications

Knowledge-Action-Change (KAC), with the support of a grant from the Foundation for a Smoke-Free World, is looking for the sixth cohort of scholars for its Tobacco Harm Reduction Scholarship Program (THRSP).

The application period closes on Nov. 30. Successful candidates will receive a 12-month bespoke mentoring program to undertake a THR-related project of their own design plus $10,000 in financial support. On completion of the scholarship, graduates of the THRSP potentially have access to up to a further three years of funded support from KAC.

The THRSP was launched to increase research and practice capacity in tobacco harm reduction in target locations and populations where current activities and resources are limited. The THRSP has a particular focus on low-income and middle-income countries (LMICs), where the need for new approaches to tobacco-related harms are especially acute. It aims to introduce new thinkers, new ideas and new methods to tobacco harm reduction as well as increasing the use of social media and new technologies to disseminate accurate information about the potential for safer nicotine products to reduce the global number of smoking-related deaths, which currently total 8 million every year.

The THRSP achieves its goals in a number of ways. Applicants to the program must devise a project that will improve understanding of, or communication about, tobacco harm reduction appropriate for their country, region or personal area of expertise. Current and former scholars have published original research in peer-reviewed scientific journals, created national and international tobacco harm reduction networks, developed toolkits for smoking cessation or healthcare practitioners, and produced new media resources ranging from articles and films to radio shows and podcasts.

“The impact of the program to date has been immense,” said THRSP manager Jon Derricott. “It has helped to shape and challenge thinking, practice and policy in many areas of the world, particularly in LMICs. The biggest influence is yet to come to full fruition, but this will be a growing cohort of well-informed and highly capable THR professionals who will continue to speak up for the benefits of THR and robustly challenge misinformation wherever it occurs. This really matters because at the root of all this is people’s right to a healthy life, even if they continue to use nicotine. THR enables that goal to be an attainable reality.”

“Being part of the THRSP as a scholar, a mentor and then becoming the THR scholarship manager has been a life-changing journey,” said Chimwemwe Ngoma, a graduate of the program from Malawi. “The THRSP has opened new and exciting doors for me, and I am confident that many people have also benefited through what I have been able to offer. This has been the biggest opportunity for me to give back to the community and impact lives.”

For more information about the program, visit https://thrsp.net.

November 4, 2022

Sub-Saharan Africa Urged to Embrace THR

With more than 200,000 smoking-related deaths each year in sub-Saharan Africa, there is an urgent need for the region to embrace tobacco harm reduction, according to a new briefing paper published by Knowledge Action Change (KAC).

KAC argues that tobacco harm reduction could generate significant public health gains for the countries in sub-Saharan Africa and is particularly crucial at a time when the number of tobacco users across the continent as a whole is set to increase to 62 million by 2025.

“Many people either cannot or do not want to quit nicotine use, but smoking is deadly,” KAC wrote in a press note. “Tobacco harm reduction offers smokers the choice to switch from combustible cigarettes to safer nicotine products that pose fewer health risks, including nicotine vapes (e-cigarettes), tobacco-free nicotine pouches, Swedish-style snus (an oral tobacco) and heated-tobacco products.”

Authored by THR Malawi founder Chimwemwe Ngoma, Tobacco Harm Reduction in Sub-Saharan Africa investigates the current status of tobacco harm reduction in the 48 countries of sub-Saharan Africa.

As well as considering the economic role of tobacco in the region, the paper provides a country-by-country guide on the availability and legal status of safer nicotine products. It notes progress is being made with tobacco harm reduction across sub-Saharan Africa, highlighting the work of consumer advocacy groups offering tobacco users accurate information about combustible cigarettes and safer nicotine products.

However, the availability and accessibility of products such as nicotine vapes remains poor in many countries while appropriate regulation is needed for product safety. Many smokers cannot access smoking cessation support. Some governments are unable to meet basic requirements for a robust healthcare system, and there is a lack of funding to prevent the noncommunicable diseases linked to smoking.

There is also widespread and deliberate misinformation circulating about safer nicotine products, and many consumers, healthcare institutions and governments in sub-Saharan Africa remain unaware of tobacco harm reduction’s potential.

“To become smoke-free, sub-Saharan Africa needs safer nicotine products that are locally feasible, affordable, appropriate, accessible and culturally acceptable, supported by sensible product regulation,” says Chimwemwe. “For this to happen, governments in Africa should strive to remain independent, conduct their own social economic impact assessments and make science-based policies that embrace tobacco harm reduction.”

The new briefing paper is part of KAC’s Global State of Tobacco Harm Reduction project, funded by a grant from the Foundation for a Smoke-Free World.

September 16, 2022

New Papers On Tobacco Harm Reduction

Knowledge Action Change (KAC) has launched the latest in a series of briefing papers as part of its Global State of Tobacco Harm Reduction project. Titled What is Tobacco Harm Reduction?, the publication provides a detailed introduction to the principles, history and evidence for this vital public health strategy.

For the 1.1 billion people across the world who smoke combustible cigarettes, tobacco harm reduction is a potentially life-saving approach. Like other forms of harm reduction, it recognizes that simply quitting isn’t possible for all smokers. People smoke for the nicotine, but nicotine itself does not cause smoking-related death and disease—it’s the chemicals inhaled in tobacco smoke. Removing combustion reduces the risk. For those people who can’t or don’t want to quit nicotine, tobacco harm reduction offers a chance to switch to safer nicotine products including nicotine vapes, tobacco-free nicotine pouches, Swedish-style snus, many U.S. smokeless tobaccos and heated tobacco products.

Many of these products have only been developed in the past 10-15 years, but they are proving increasingly popular. Research published in March by the GSTHR estimates there were 82 million vapers worldwide in 2021. This represents a 20 percent increase on the figure for 2020 (68 million), meaning safer nicotine products are now being used by 112 million people worldwide. A striking example of tobacco harm reduction’s potential can be found in Scandinavia. Sweden now has the lowest rate of tobacco-related disease in Europe, thanks to Swedish men switching from smoking to snus, and in Norway, 12 percent of women aged 16-24 use snus daily while only 1 percent smoke.

In England, tobacco harm reduction can play a key role in the government’s bold ambition to make the country smoke-free (defined as a prevalence rate of under 5 percent of the population) by 2030, according to KAC. The uptake of vaping has been accompanied by a rapid decline in smoking. Vapes are the most popular way to stop smoking, with 3.6 million people vaping in Great Britain, of whom 2.4 million have completely quit combustible cigarettes. But tobacco is still the single largest cause of preventable mortality in England with nearly 75,000 smokers dying from smoking in 2019 and figures show nearly one in 10 pregnant women are smoking at the time of delivery.

An end to smoking is possible—but the widest range of harm reduction products, from nicotine vapes and heated tobacco products to non-tobacco nicotine pouches and Swedish-style snus, should be available, accessible, appropriate and affordable to all.

Gerry Stimson, director, KAC

Continuing to drive down smoking rates is crucial if the U.K. government is to tackle the health disparities caused by smoking that currently see a disproportionate burden falling on the most disadvantaged families and communities. Smoking rates vary significantly across the country—for example in Blackpool about one in five people smoke (19.8 percent), compared to about one in 20 in Richmond upon Thames (6 percent). Rates are also very high among people who experience drug and alcohol problems (56 percent of those entering treatment smoke), people who are homeless (of whom 77 percent in England smoke) and people who live with mental health problems (of whom 26.8 percent in England smoke).

But adopting tobacco harm reduction will not just help the U.K. counter the impacts of smoking, according to KAC. It has huge potential as a global public health solution. Smoking is responsible for 7.7 million deaths a year and current tobacco control measures are failing to reduce the death and disease caused by smoking fast enough.

Translated into Spanish, Russian, Mandarin, French, Portuguese, Indonesian, Swahili, Japanese, German, Polish, Hindi and Arabic, this GSTHR briefing paper is intended to start conversations in countries across the world where harm reduction has yet to be recognized.

“An end to smoking is possible—but the widest range of harm reduction products, from nicotine vapes and heated tobacco products to non-tobacco nicotine pouches and Swedish-style snus, should be available, accessible, appropriate and affordable to all,” said Gerry Stimson, director of KAC and emeritus professor at Imperial College London.

“Strong government support is also needed to ensure access for marginal and vulnerable groups. The gains will be evident in the lives saved and the communities protected. Crucially, tobacco harm reduction is an extremely low cost yet effective strategy—a rare example of a health intervention that doesn’t require significant government expenditure, as consumers bear the cost. An end to smoking is possible—and tobacco harm reduction is the key.”

May 27, 2022

KAC: Number of Vapers up Significantly

The number of vapers worldwide increased by 20 percent from 2020 to 2021, according to the latest research by the Global State of Tobacco Harm Reduction (GSTHR), a project from Knowledge Action Change. The organization estimates that there are now 82 million vapers worldwide.

The updated calculation was made possible by the release of a range of new data, including the 2021 Eurobarometer 506 survey, and is revealed in a new GSTHR briefing paper. The figure is based on 49 countries that have produced viable survey results on vaping prevalence.

To address the problem of missing data, the GSTHR used an established method of estimating vaper numbers in countries that currently have no information by assuming a similarity with countries in the same region and economic condition for which data points were available.

This estimate considers three factors—sales regulation status, World Health Organization regions and World Bank income groups—along with the Euromonitor data on vaping product market size from 2015 to 2021.

This [increase in vapers] is in spite of prohibitive policies in many countries who follow the World Health Organization’s anti-scientific stance against tobacco harm reduction, thanks to Michael Bloomberg’s billions and his personal zeal for a war on nicotine.”

Gerry Stimson, director, KAC

“As well as the substantial growth in the number of vapers globally, our research shows there has been rapid uptake of nicotine vaping products in some countries in Europe and in North America,” said Tomasz Jerzynski, data scientist at GSTHR. “This increase is particularly significant, because in most markets, these products have been available for only a decade.”

Indeed, the rise in the number of global vapers comes despite the GSTHR’s database showing nicotine vaping products are banned in 36 countries, including India, Japan, Egypt, Brazil and Turkey.

The new data also shows the U.S. is the largest market for vaping at $10.3 billion, followed by Western Europe ($6.6 billion), Asia-Pacific ($4.4 billion) and Eastern Europe ($1.6 billion).

“As this updated data from the Global State of Tobacco Harm Reduction shows, consumers find nicotine vaping products attractive and are switching to use them in increasing numbers worldwide,” said Gerry Stimson, director of KAC and emeritus professor at Imperial College London. “This is in spite of prohibitive policies in many countries who follow the World Health Organization’s anti-scientific stance against tobacco harm reduction, thanks to Michael Bloomberg’s billions and his personal zeal for a war on nicotine.”

March 9, 2022

Tag: Knowledge-Action-Change