The Sunday Mail
Cathy Allison
Combustible tobacco products are harmful not only to smokers but their smoke has
prejudicial effects on non-smokers, says Professor David Nutt, an English scientist
specialising in drug research.
Prof Nutt made the observation in his presentation entitled “Estimating the harms of nicotine
products in the 21 st century” at the recent Global State of Tobacco Harm Reduction
(GSTHR)-Burning Issues virtual conference.
The neuropsychopharmacologist – who specialises in the research on drugs that affect the
brain and conditions such as addiction, anxiety and sleep – argues that smokers who cannot
quit should be encouraged to use other innovative sources of tobacco that reduce harm on
people’s health.
From the 14 nicotine products that were surveyed in 2014, only half – the combustible ones
– were found to affect non-smokers.
Prof Nutt added that smoking scored highly on the mortality rate (at over 8 million deaths a
year) through lung cancer.
Overall, he said, if people can use other non-combustible sources of nicotine such as e-
cigarettes or heated tobacco products, population harm can be much lower.
E-cigarettes (vaping) could be the answer for the next generation and the World Health
Organisation (WHO) should step forward and support this innovation, he said.
Recently, the United States Food and Drug Administration (FDA), after substantial scientific
assessment, found that a new smokeless tobacco invention, the ‘IQOS’, manufactured by
Phillip Morris International (PMI), managed to reduce exposure to harmful compounds.
The product delivers nicotine in a non-combustible way.
Research done on the PMI innovation shows that switching completely from conventional
cigarettes to the IQOS system significantly reduces the body’s exposure to harmful
chemicals that are found in cigarette smoke.
The IQOS system heats up tobacco but does not burn it and, according to the FDA’s recent
decision, this significantly reduces the production of harmful and potentially harmful
chemicals – consequently the user inhales reduced amount of toxicants.
Prof Nutt is the chaiperson of Drug Science, a non-profit organisation founded in 2010 to
promote independent, evidence-based information on drugs.
Until 2009, he was professor at University of Bristol (UK), where he headed its
psychopharmacologist unit.
Policy
In her presentation titled “Who should politicians listen to when developing policy?”,
Australian MP Fiona Patten said scientists should be listened to on harm reduction options
that should discourage people from combustible smoking by using tobacco harm reduction
(THR) products.
Covid-19 has shown how fickle politicians can be about evidence, science and medical
advice.
“When we are developing policy on tobacco we ask, how can we reduce harm? When we
are developing policy on alternative nicotine products we ask, is it safe? “We are failing to
change the question to ask how we can reduce harm,” she said.
“There has been some progress made at WHO, but not recognising harm reduction is
nothing short of deceptive.”
Speaking at the launch, director of Tobacco Harm Reduction (Malawi), Chimwemwe Ngoma,
said low- and middle-income countries (LMICs) are not sufficiently resourced to implement
and adopt THR and “the situation is further complicated in countries where the economy is
reliant on income from tobacco cultivation”.
“The challenges affecting THR in LMICs are that government policies and regulations are
being unduly influenced by flawed science and anti-harm reduction lobbying,” he said.
“Flawed public health information in many countries is confusing and misleading people who
want to switch away from smoking.
“In most low- and middle-income countries, THR products are either banned completely,
heavily taxed or there are no specific laws that govern them.”
He added that there not only is there lack of knowledge and limited access to THR in most
LMICs (such as Zimbabwe), but these less harmful products are very expensive compared
to the easily accessible combustible cigarettes.
“Though some smokers wish to quit, they are unable to do so because they are so addicted
to the nicotine and relapse rates are staggeringly high.”
In her presentation, “The Framework Convention on Tobacco Control (FCTC) –
accountability, policy and regulation”, Marina Foltea, founder and managing director at
Trade Pacts – a consultancy based in Geneva advising global companies and governmental
institutions on international trade agreements and economic organisations, as well as public
policy – said guidelines should not encroach on people’s rights but rather to help them to
make right choices on THR.
Martin Cullip, adviser to the Freedom Association’s Freedom to Vape campaign, similarly
said there was need to involve the consumer in the whole process of formulating and
determining policies.
“There exists a massive imbalance of a small number of well-funded groups that exercise
power (WHO, EU, national governments) and 98 million safer nicotine product users around
the world that are negatively affected,” he said.
All the speakers at the launch of “Burning Issues: The Global State of Tobacco Harm
Reduction (GSTHR) 2020” – the latest in a landmark report series from UK-based public
health agency Knowledge Action Change (KAC) – were in favour of tobacco harm reduction.
It is believed there are over a billion smokers in the world and the figure is not likely to
drastically drop soon, and the best solution is to offer the innovative scientific THR options.
According to WHO, over 8 million people die from smoking-related diseases such as lung
cancer every year and the unfortunate part of this public health crisis is that it also affects
non-smokers.
Thus, the encouragement on the use of THR products as campaign for good global health
practices.
