Tobacco Asia

Tobacco Asia 21 from 15% to 5.6% of the population in 15 years, putting it on track to achieve smoke-free status (below a 5% smoking prevalence rate) in a matter of months and 17 years ahead of the European Union's 2040 target. Sweden also has the lowest percentage of tobacco-related diseases in the EU and a 41% lower incidence of cancer than other European countries. A report commissioned by Health Dip- lomats, an international organization working to improve access to healthcare, encourage innova- tion and the use of harm reduction to minimize the negative impact of alcohol, food, nicotine, and drugs, highlighted the fact that Sweden's approach benefited from employing tobacco control mea- sures to make combustible cigarettes less attrac- tive while facilitating the use the of less-harmful alternatives, making them accessible, affordable, and acceptable to the population. Smoking prevalence in the three most pop- ulous EU countries, namely Germany, France, and Italy, show a smoking prevalence of 23.8%, 25.5%, and 24.2%, respectively, despite the adop- tion of EU-wide tobacco control measures and a concerted public health anti-smoking effort. The current average smoking rate in the EU is 23%, which is almost five times higher than Sweden's. Other countries that saw their smoking prevalence drop after consumers had access to less-harmful alternatives include Japan, where heat-not-burn products entered the market in 2014 and the smoking rate drop by 10% between 2016 and 2019. Even New Zealand, the first in the world to introduce a generational tobacco ban, suggests vaping as a smoking alternative for those looking to quit and saw its smoking rate drop to 8%, the lowest it has ever been, with the number of adults vaping daily rising to 8.3% in 2022. It is noteworthy that the key to success here is not complete prohibition of all tobacco prod- ucts, but rather embracing less-harmful tobacco products. Or, as James Murphy, director of re- search and science at British American Tobacco (BAT), described THR at a recent conference, it's "zero combustion, not zero nicotine use." Enter health practitioners and policymakers Health practitioners and policymakers play influ- ential roles in THR simply by the fact that the out- comes of their actions directly effect consumers. A recent survey released by Altria Group found two-out-of-three Americans support THR, with 79% saying that if certain tobacco products have been scientifically shown to be less risky than cigarettes, physicians have a responsibility to com- municate this information to their patients who are adult tobacco consumers and have not successfully quit smoking by using traditional cessation therapies. In addition to general population adults, the survey asked primary care physicians about their views on tobacco harm reduction. Of those sur- veyed, 89% support tobacco harm reduction as a public health concept and 85% believe it is im- portant for FDA to focus on making smoke-free tobacco products available to adult smokers to help them switch from cigarettes to less harmful alternatives. Policy professionals were also surveyed and overwhelmingly believe that harm reduction is a better approach for FDA to focus on than prohi- bition (78%), that tobacco products should remain legal so they can be properly regulated (77%) and that FDA has a responsibility to accurately inform adult tobacco consumers about the different levels of risk associated with tobacco products (96%). FCTC COP10 With that being said, it should be interesting to see what comes out of COP10 this November in Panama. THR was conveniently removed from COP9's agenda, postponing to COP10. However, if COP10 continues in the tradition of previous sessions where only a few select groups of like- minded, prohibition-keen people with anti-to- bacco blinkers on are allowed to attend, it would probably be safe to say it'll be the same old, same old as usual. Snus has been instrumental in Sweden's harm reduction success story, along with other less harmful alternatives. Sweden, where snus is available, has the lowest percentage of tobacco-related diseases in the EU, where snus is banned.

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