Need for removal of roadblocks for innovation to reduce tobacco-related harm

Asian consumer groups engaged with reducing smoking and tobacco-related harm charged that health authorities and western anti-tobacco lobby groups often got in the way of shifting consumers towards less harmful products. 

Speaking during the launch of a report titled ‘Tobacco Harm Reduction: A Burning Issue for Asia’, Joaqui Gallardo, Spokesperson of Vaper AKO in the Philippines said a common factor amongst Asian nations is the high prevalence of smoking and fear of innovative nicotine products spread by health authorities themselves. 

“In the Philippines for example, the WHO and anti-tobacco lobby groups such as Bloomsburg Philanthropies exert tremendous influence on local policies that make it difficult to promote Tobacco Harm Reduction (THR) as a public health strategy. This has resulted in policies that actually discourage the switch from combustible cigarettes to less harmful alternatives such as vapes and heated tobacco products. They are actually more restrictive than regulations for traditional cigarettes,” Gallardo said.

The World Health Organisation (WHO) statistics show that 60 percent of smokers live in Asia, alongside 90 percent of global consumers of smokeless tobacco products resulting in millions of deaths each year. Misinformation and anti-tobacco harm reduction propaganda is getting in the way of public health progress in Asia.

The report was authored by Harry Shapiro, Director of DrugWise in the UK and he opined Asia is the epicentre of the “smoking crisis”, as 90 percent of consumers use unsafe smoking and smokeless tobacco products. He asserted it is timely to begin looking at the objections against reduced harm products such as vape and heated tobacco products that are popular in other regions. 

During the discussion, its moderator, Jaggenath Sarenpani, from the Association of Vapers India, averred what Asia faces is neo-colonialism as western companies, governments and agencies such as Bloomberg, pump hundreds of millions of dollars to go against vaping, which is demonstrably a reduced harm product. Vaping has been adopted by the UK government as an alternative to smoking as it is up to 95 percent safer than smoking.

Chowdhery stated the interference is real and asked Shapiro what could be done to overcome such forces?
Shapiro replied, “I was interested to see politicians in the Philippines have begun to shed light on this and we are not at all happy that Federal Drug Administration has been taking money from Bloomberg to develop tobacco controls. Much of which I suspect are being used to promote anti-tobacco harm reduction policies. I think politicians should be encouraged to turn the stone on some of these stuffs.”

“Lots of people these days, because of COVID, have become interested in the evidence base. There’s a lot of focus now been put on the scientific clinical medical evidence base within public health. I think it is an opportunity to be pushing the evidence base on Tobacco Harm Reduction to wherever and whoever is prepared to listen. Of course, the WHO doesn’t help in this because they’re one of the apparent credible sources of information and action for COVID and Ebola and other diseases. So, it’s not surprising that people believe them when they start talking about misinformation on vaping. The WHO’s tobacco free initiative could hardly survive if it wasn’t getting philanthropic money. And that particular organisation has an anti-vaping agenda. There’s No question.”

Executive Coordinator for the Coalition of Asia-Pacific Tobacco Harm Reduction Advocates, Nancy Loucas, stressed the biggest challenge for tobacco harm reduction in Asia is the reach of “philanthropic colonialism”, with foreigners using private foundations and funding to influence governments in developing policies. 

“These people do not want safer nicotine products available. They do not want the concept of Tobacco Harm Reduction to be promoted or celebrated, as it doesn’t serve their personal economic agenda,” she charged. 
Speaking further, Loucas opined that countries like Japan and South Korea are leaders with tobacco harm reduction products embracing innovation, where vaping and safer heated tobacco products have picked up. She added that governments too have a stake in tobacco manufacturing in these countries but though this was also the case in countries like India, they have been completely anti-THR. 

“I’ve wondered perhaps maybe in Japan and Korea because it is more of a collective society, they are more about what’s the greater good for everyone as opposed to other countries where it may be more individualistic, materialistic and more capitalistic. That is probably the number one reason why it hasn’t been embraced in other countries in Asia I think.”

Director of AVI India, Samrat Chowdhery, pointed out that globally almost half of tobacco production is controlled by state-owned companies. But the WHO through its Framework Convention on Tobacco Control largely ignores this fact. Article 5.3 of the convention is strangely not applied by the agency to these countries, he remarked, which he said is a conflict of interest. 

Chowdhrey felt the focus must be brought back on health as opposed to the tobacco issue. He added there is a lot of discussion on the potential of reduced harm products to make its way to the hands of teenagers and he pointed out that THR products pose far less harm than cigarettes in the hands of minors and even adults.

“There are millions of smokers that could benefit from THR. I think the big challenge is to humanise or bring the focus back on people. Right now, all or most of the counter measures are supply side measures to reduce demand by going after these companies; little attention is being paid to the needs of the smokers and also the people who have transitioned. I urge these governments to also think about their sovereignty when it comes to tobacco control. Because a lot of policies are being led by foreign NGOs and foreign interests,” Chowdhrey remarked. 

Medical position carries significant weight in many countries and it is imperative to present the opinions and findings of medical professionals and science. This is in addition to presenting and promoting local information, as opposed to juxtaposing ideas from foreign markets. The issue of dangerous smokeless tobacco, which forms a huge portion of tobacco-related harm and a relatively untouched area is an aspect that needs urgent attention.

These products are in use because of the nicotine within. Therefore, if methods readily exist with which nicotine delivery can be achieved with significantly far less harm to human health, governments and regulators should be moving towards these innovative alternatives without restricting them further. 

“If you are talking about a war against smoking and tobacco, then you would want another big gun in the armoury. That other big gun is Tobacco Harm Reduction products and the tools that go with it. Many of these deaths are preventable if only tobacco consumers had access to safer nicotine products that are affordable, accessible, appropriate and acceptable, Shapiro asserted.”