Tobacco Harm Reduction Supports Public Health Goals
Based on a report from the World Health Organization (WHO) and the National Cancer Institute of the United States, it is highlighted that effective tobacco control measures are vital for safeguarding public health by addressing major causes of death, such as cancer and heart disease. Neglecting to tackle tobacco use can have significant economic consequences, resulting in healthcare costs and lost productivity amounting to more than USD 1 trillion annually. Although the report recommends policies to reduce the supply and demand of tobacco, it fails to acknowledge the potential of innovative cigarette alternatives in reducing healthcare expenses.
This article delves into the emerging movement towards tobacco harm reduction and its capacity to transform global public health strategies. In a recent article published in The Lancet, Robert Beaglehole and Ruth Bonita, former employees of the World Health Organization (WHO), expressed their criticism of the organization’s position on harm reduction. They pointed out that despite considerable technological advancements and growing evidence in support of harm reduction, the WHO and the Conference of Parties of the Framework Convention on Tobacco Control (FCTC) remain opposed to it. Beaglehole and Bonita argued that the resistance to harm reduction is largely influenced by vested interests that strongly advocate for nicotine abstinence, even at the expense of endorsing the continued use of cigarettes, which are known to be the most harmful tobacco products.
A growing number of nations are realizing the shortcomings of the WHO’s approach and are incorporating tobacco harm reduction as a crucial element of their tobacco control plans. Countries including the United States, Portugal, the United Kingdom, New Zealand, the Czech Republic, the Philippines, and Greece are diverging from the conventional path and actively embracing harm reduction strategies. These countries recognize the potential of reduced-risk products as viable substitutes for conventional cigarettes.
With the introduction of Heated Tobacco Products (HTPs), Japan witnessed a remarkable decrease in cigarette sales since 2016, without the interference of public health groups’ efforts. The American Cancer Institute funded a study that addressed the continuous deceleration in cigarette sales and attributed this phenomenon to the increased popularity of HTP’s. This evidence suggests that these modern alternatives can be a major contributor to decreased cigarette consumption without the intervention of public health campaigns.
Professor Francesco Morone from Brunel Business School will soon publish an independent paper titled “Does Switching to Reduced Risk Products Free Up Hospital Resources? A Reflection using English Regional Data,” in the British Journal of Healthcare Management. The study evaluates cost savings for health expenditure in England with the introduction of reduced-risk products like e-cigarettes and heat-not-burn tobacco as opposed to traditional cigarettes. According to Prof Moscone’s research, this transition could result in a decrease in health expenditures ranging from 2.5% to 13%, however these percentages are heavily reliant on the conversion rate. Prof Morone highlights the fact that this could help the UK achieve its target of eliminating smoking by the year 2030 while conserving hospital resources for other pressing treatments.
According to some critics, the WHO should be the main contributor in proposing solutions to eradicate smoking. The critics contend that the World Health Organization mainly relies on the FCTC treaty mechanism, and the MPOWER measures. They claim that both the FCTC and MPOWER have not been contributors in reducing the traditional cigarette consumption or tobacco-related mortality. To help achieve the target of eradicating smoking worldwide, a combination between implementing strong measures for smoked tobacco with support for less harmful options such as e-cigarettes is suggested.
The continuously evolving field of tobacco control is headed towards harm reduction strategies that prioritize innovative alternatives over traditional cigarettes. While a significant amount of criticism has surrounded the WHO’s approach, for its resistance to harm reduction, several countries have adopted reduced risk products as a contributor to their tobacco control policies. According to research, the mentioned approach can pave the way for achieving public health goals and can aid in witnessing significant reductions in healthcare expenditures.
As the entire globe struggles with issues of tobacco-related diseases, considering available alternatives can aid in protecting global health and implementing effective tobacco control strategies.