Experts have called for tobacco manufactures to develop safer solutions for people living in poor countries who constitute the majority of smokers.
Speaking at the Global Tobacco and Nicotine Forum held virtually last week, the experts also implored governments to embark on evidence-based policy making in order to reduce the number of smokers worldwide.
“I would like to use this platform to request manufacturers to focus on developing safer solutions for people living in (low-to medium income countries) LMICs, will account for 80% of the world’s tobacco users, and who would benefit the most from risk reduction, given that they have mere means to deal with the consequences of tobacco use,” Indian tobacco harm reduction expert, Samrat Chowdhery, said.
Tobacco is a main revenue earner for southern African countries such as Zimbabwe and Malawi. The majority of farm workers in the two countries smoke untreated tobacco, which has grave health consequences.
Laura Leigh Oyler, a regulator at a US company said nicotine was, by and large, a drug that poor people use primarily in the form of cigarettes and called for policies that purposely marginalize and stigmatise smokers.
The experts noted that although the World Health Organisation has been promoting anti-smoking messages, research has actually shown that few smokers are quitting smoking, or transitioning to e-cigarettes that are nicotine free.
But another tobacco harm reduction expert, James Glassman said it was possible to get smokers to switch to less harmful practices, and eventually in many cases, quit tobacco altogether.
“Certainly, new technology is not the only means to ending smoking,” Glassman said.
“Misinformation is as deadly for tobacco as it is for COVID-19. For companies to play an increased role, they must show increased responsibility.”
He added: “There’s no greater global health challenge than the millions of deaths and the trillions of dollars wasted because of smoking. We can reignite the fight. The best evidence is about 70% of smokers say they want to quit, and they are not able to do that.”
But Simon Clark, director of a smokers lobby group, Forest, said a survey of over 600 smokers by the Centre for Substance Use Research in Glasgow found that 95% respondents to a recent survey gave pleasure as their primary reasons for smoking.
Many of those surveyed, 77% expected to smoke for many years, with only 5% envisaging a time in the near future when they could stop.
More than half the respondents, 59% had used alternative nicotine delivery products such as e-cigarettes. Few, however, were persuaded to switch permanently from cigarettes to vaping.
South African doctor, Delon Human who has a history of collaborating with British American Tobacco (BAT) on tobacco harm reduction, said there was ‘absolute consensus’ that evidence-based policies was the way to go.
“We have just heard that the risk continuum is being confirmed and practiced within the FDA. And we would hope in most other countries who are members states of the world health organization,” Human said.
Vice-president, Global Scientific Engagement at Philip Morris International (PMI), Gizelle Baker said successful harm reduction requires that adult smokers have access to information and alternative products for them to be able to switch.
“When you have contradictory information, conflicting findings, an ever-changing evidence pool coming out there,” Baker said.
“Anything that drives uncertainty, it leads to a consumer base that is completely confused. And when you have confusion, you drive indecision, you drive in action and you drive ultimately people wondering what does it mean for these products and even more confusing, what does it mean to me?”
PMI, which has been conducting wide research on tobacco harm reduction, has produced a reduced risk tobacco product, the Iqos that allows for smokeless consumption.
“Well, at PMI, we started doing studies on this and we have a most recent study, a multinational study that was just conducted looking at how does misinformation lead to misunderstandings? And we did it in tobacco world” Baker said.
“So let us look at misunderstandings of risk. In this multi-country over 29,000-person survey, we found that over 45% wrongly believed that smoke-free products are equally or more harmful than cigarettes. And actually, when we broke it apart, it was 45% for e-cigarettes 46% for heated tobacco products; almost 60% misunderstand what causes smoking related disease.”