Category: Harm Reduction

  • GSTHR Report Finds Vapes Help Smokers Quit

    GSTHR Report Finds Vapes Help Smokers Quit

    The latest Briefing Paper from the Global State of Tobacco Harm Reduction (GSTHR), a project from public health agency Knowledge·Action·Change (KAC), focuses on Aotearoa New Zealand’s remarkable journey towards “smokefree” status.

    “Pro-consumer laws and an endorsement for vaping: why smoking is disappearing in Aotearoa New Zealand” tells the story of the country’s rapid and growing embrace of vaping, which overtook smoking in 2022, and provides another vital case study showcasing the potential of tobacco harm reduction through the adoption of safer nicotine products (SNP), following recent GSTHR Briefing Papers on Japan and the United Kingdom. This country profile also features in The Global State of Tobacco Harm Reduction 2024: A Situation Report published last month.

    While Aotearoa, New Zealand, had been experiencing falling smoking rates for the last 50 years, this decline gathered pace following the widespread adoption and, in 2018, the legalization of nicotine vaping products. Thanks to the Government’s step change in vaping policy, Aotearoa New Zealand now has a considerable chance of reaching its “Smokefree 2025” goal, a designation indicating that smoking prevalence has been reduced to below 5%.

    David MacKintosh, a director for KAC, said the Briefing Paper explores the rapid trajectory of Aotearoa New Zealand’s progress in reducing smoking, the approaches that have underpinned this, and the lessons that can be learned.

    “By embracing vaping as a tool for smoking cessation, policymakers are accelerating the transition away from cigarettes and their associated harms,” he said. “More needs to be done in addressing high smoking rates in some groups, notably among Māori communities, which contributes significantly to health disparities in the country. However, the experiences and success of Aotearoa New Zealand provide food for thought for many other countries seeking to tackle smoking.”

    This would be a remarkable achievement given the smoking rate in 1976 was 40% for men and 32% for women. This has now fallen to the point where only 8.3% of adults smoked in 2023. In the same year 11.9% of adults vaped in the country, up from 1.4% in 2016. But while the overall smoking figures are low, they mask much higher rates within some communities. Daily smoking prevalence for Maori, who make up 16% of the country’s population, was 17.1% in 2022/2023, which is in stark contrast to the 6.1% rate for people of European descent.

    Alongside regulatory oversight of vaping products to ensure quality and safety, a key factor has been the proactive encouragement of vaping as a tool for smoking cessation by the Government. The Ministry of Health has provided official resources for people looking to stop smoking with the help of vaping. Smokefree New Zealand, a smoking cessation resource run by the country’s publicly funded healthcare service Health New Zealand, has stated that “using vaping products is a legitimate option for those people who are trying to quit smoking”.

    Through the Vaping Facts website, the Ministry of Health of New Zealand and Health New Zealand have also emphasized the Cochrane Review’s position that vaping is significantly safer than smoking.

    Aotearoa New Zealand’s attitude to vaping is in direct contrast to its neighbor Australia, which has heavily restricted the availability of SNP by making nicotine available only in pharmacies. Australia has sought to reduce significantly the availability of safer nicotine products, which has led to the proliferation of a thriving black market in the absence of a legal market. Meanwhile, with its broadly supportive public health messaging, Aotearoa New Zealand has enabled consumers to make positive changes in their own volition, enabling them to switch from smoking to safer products.

    These differences in approach have resulted in a marked difference in smoking rates between the two countries, with Australia’s smoking prevalence plateaued in recent years after many years of steady decline. Indeed, the current smoking prevalence for Australians aged 14 and over has only fallen slightly in the last five years, from 12.8% in 2018 to 11.8% in 2023.

    It should be noted that Aotearoa New Zealand’s attitude towards vaping is not mirrored for all SNP. While heated tobacco products are also legal, the sale of both snus and nicotine pouches is banned. Still, as this Briefing Paper shows, Government and public health organizations in Aotearoa, New Zealand, working with consumers, have highlighted the crucial role that vaping can play in reducing smoking.

    The country has demonstrated its ability to enact pro-consumer legislation effectively, and its consistent endorsement of some safer nicotine products has been a key component of its stop-smoking strategy. Central to this has been consumers, who have established a demand for safer products and proven to the Government that these products can and will exist despite initial legislative opposition.

  • Gateway to THR

    Gateway to THR

    The Middle East Vape Show will hold their next event in Bahrain in January.

    By Norm Bour

    Over the past year, I’ve shared insights to the vape markets in Southeast Asia, including Indonesia, Vietnam, the Philippines, Thailand and Malaysia. Though some of them are separated by just a few feet, the differences between their vape markets—if they even exist—can be a numbing chasm of uncertainty.

    Though the vape market started in China, it took off more quickly in the West, and the U.S. and Europe jumped on trend with a vengeance. Asia took longer, limited by religion, government restrictions and customs as much as anything, and even though these countries are still muddled and unpredictable, the Middle Eastern market is also trying to compete with the Western world and has matured impressively over the last few years.

    In 2021, I was fortunate to be a speaker in Dubai at the World Vape Expo, and as the Covid pandemic was finally allowing the world to return to “normal,” the exhibitors and attendees seemed impressed at the Middle Eastern presence.

    Now, three years later, the region’s vape market is slowly transitioning from a sinful (and unlawful) replacement to tobacco, to a viable (and profitable) alternative to cigarettes, and the Middle East Vape Show, MEVS 360, will demonstrate that at its Jan. 15–17, 2025, event in Bahrain. Last year, post-Covid, the organizers restarted their event in Cairo. The event will alternate between several locations, including Kuwait and Jordan.

    But, as this article was being written, there are even more changes in the works.

    This event, launched in 2019, has been recently purchased by Dallah Promotions, one of the biggest event management companies in Bahrain and Saudi Arabia. Dallah promotes everything from Comic Con to Ferrari Night, so it must see potential in the vape market, and since they specifically focus on B2C, that would be an enhancement to the show. With this new ownership, the old name, MEVS 360, will be replaced with International Vape Con (IVC) at the Bahrain show, which will be held at the beautiful Exhibition World Bahrain venue.

    The new owners recognize the growth trend of vaping throughout the Middle East, and their biggest targets are Saudi Arabia and Kuwait. As a member of the Gulf Cooperation Council (GCC), Bahrain charges a 100 percent tax on tobacco, vape products and energy drinks. Bahrain’s excise tax law was ratified in 2017 and is intended to equalize tobacco taxes and reduce the affordability of tobacco and improve public health. Even with the high tax rates (paid upon import), finding exhibitors for the MEVS 360 show has not been a problem, though the numbers are down from prior years.

    Arya Hakim, senior media and production manager with the organization, said it clearly: “The mostly Middle Eastern buyers want quality and are willing to pay for it. They like the disposables, won’t buy ‘junk,’ and they want innovation. This puts pressure to the Chinese exhibitors to bring their ‘best game’ and leave their knockoffs at home.”

    Due to restrictions, the IVC will showcase only vape-related products and e-liquids but no tobacco, hookah, shisha, etc. The relatively small show brings in fewer than 100 exhibitors. Its main problem is that the Middle East is still viewed as a small market. The competing World Vape Show in Dubai is the exhibition’s biggest competition in the region.

    Smoking is still a big business in the Middle East. Vapers account for almost 20 percent of Egypt’s 112 million population. Home to just 1.5 million people, Bahrain reported a share of about 15 percent in in 2020. In between is the affluent Saudia Arabian market of 37 million people, of which 10 percent are smokers.

    “Arabs love to smoke!” joked Hakim.

    But Bahrain does have a unique competitive edge in the Middle East. It is one of several countries that have a Free Trade Agreement with the U.S., primarily driven by the mutually beneficial military and naval presence there. Hardware is duty-free for Americans, but tobacco and vape liquids are not.

    Another positive change in the show is the partnership with Ecigclick, an independent testing organization that offers advice on the best vape products to buy, along with industry news. Since 2010, the organization has been a leader in the vape space and annually hosts its Ecigclick Vape Awards, which is judged by public vote. Also part of this new collaboration will be 2FIRSTS, a China-based vaping industry media outlet and consultancy, and Rifbar, a newer disposable supplier that has been very hot.

    No question, over the years, new collaborations, buyouts and mergers have fueled the growth of the vape industry, creating larger and larger entities, controlled by fewer players. This was predicted a decade ago, and that trend should continue going forward.

    Norm Bour is the founder of VapeMentors and works with vape businesses worldwide. He can be reached at norm@VapeMentors.com.

  • Qnovia Raises $16 Million in Series B Funding

    Qnovia Raises $16 Million in Series B Funding

    Qnovia has raised $16 million in Series B funding. The financing was led by Blue Ledge Capital, Evolution VC Partners, Vice Ventures and Gaingels.

    “This Series B financing marks a meaningful milestone for Qnovia as it provides validation for our RespiRx proprietary platform, our progress in the regulatory process and the potential for our inhaled drug delivery platform to improve patient outcomes. We are grateful for the partnership with our investors, who are committed to our vision of advancing the development of inhaled therapeutics for areas of high unmet need, starting with our focus on bringing innovation to medicines to support smoking cessation,” said Brian Quigley, CEO of Qnovia.

    “Our recent infusion of capital will advance QN-01 beyond our Phase 1 clinical trial in the U.S. and support an MAA submission to the MHRA in 2026. We believe that the data we have generated for QN-01, which includes our positive first in-human clinical data and our nonclinical findings, significantly derisks our clinical development plan and accelerates commercial validation to support our MAA submission for an expedited path to revenue generation in the U.K. Overall, this financing brings us one step closer to our vision of transforming the treatment paradigm for smoking cessation for a population who has not had access to any new treatment options in several decades.”

    Since its inception, Qnovia has raised $50 million to advance its proprietary inhaled drug delivery platform. Qnovia will use the proceeds from the recent financing to support the clinical, regulatory and commercial development of its RespiRx Nicotine Inhaler (QN-01) in the U.K. QN-01 has demonstrated clinical proof-of-concept in a first-in-human, Phase 1 study and received U.S. Food and Drug Administration clearance of its Investigational New Drug application. In addition, the company will use the Series B funds to evaluate the feasibility of additional therapeutic indications in their pipeline.

    “We are impressed by Qnovia’s agility and speed in navigating the complex regulatory framework for the development of novel smoking cessation therapies,” said Andy Roche, founder and managing partner at Blue Ledge Capital. “We are confident that their groundbreaking platform will revolutionize smoking cessation as well as drug delivery broadly as a result of its dose-to-dose consistency and favorable pharmacokinetic profile. We are honored to share that journey with the Qnovia team.”

  • Cigarette Smoking Drops to Record Low in Spain

    Cigarette Smoking Drops to Record Low in Spain

    Smoking rates in Spain have dropped to a record low, reports Euro Weekly News.

    In 2024, 25.84 percent of the population smoked, down from 33.1 percent in 2022. Health advocates credit successful government initiatives, including higher taxes on tobacco products, stronger restrictions on tobacco advertising, the expansion of smoke-free zones to include public outdoor areas, and increased funding for smoking cessation services.

    Despite these recent declines, tobacco remains a major public health issue in Spain. The Spanish Ministry of Health attributes nearly 50,000 deaths annually to smoking-related illnesses, accounting for nearly 15 percent of all deaths in the country.

    Meanwhile, the decline in cigarette smoking has been accompanied by a surge vaping. The number of e-cigarette users has doubled in the past four years, with 19 percent of Spaniards having tried them. Over half of e-cigarette users are opting for nicotine-free versions.

    In response to this shift, the Spanish government is introducing new regulations to curb e-cigarette usage, including banning e-cigarettes in indoor public spaces, restricting flavored e-liquids, and limiting them to tobacco flavors. It is also considering plain packaging for e-cigarette products, and discussing the introduction of taxes on e-liquids to mirror tobacco taxes.

  • CoEHAR: Vape Products Most Effective Quitting Tool

    CoEHAR: Vape Products Most Effective Quitting Tool

    Image: CoEHAR

    A recent review conducted by the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) at the University of Catania found that e-cigarettes are more effective than other treatments for smoking cessation.

    Published in Drug and Alcohol Dependence, the study represents one of the most comprehensive analyses to date, evaluating 16 systematic reviews and encompassing data from 24 randomized controlled trials (RCTs).

    According to the authors, e-cigarettes outperformed other cessation treatments in eight out of 11 meta-analyses. No evidence was found to suggest that e-cigarettes are less effective than any alternative treatments. And while mixed results emerged when comparing ENDS to traditional nicotine replacement therapy, the overall trend favored ENDS for cessation efficacy.

    “The data from our umbrella review can support the integration of harm reduction strategies into public health policies in many countries,” said Renée O’Leary, lead author of the review, in a statement. “However, the review highlights a critical gap in existing cessation strategies, with long-term success rates for e-cigarettes remaining modest at 10 percent-12 percent and the effect of relapse has not been sufficiently studied. New treatments and approaches are urgently needed”.

    Despite these promising findings, the study also emphasizes the need for greater scientific rigor in the field. According to the authors, the analysis exposes significant reporting biases in many studies.

    “This study provides robust evidence supporting the potential of ENDS as an effective cessation aid, but it also calls for enhanced clinical guidelines and further exploration of long-term outcomes,” stated Riccardo Polosa, co-author and founder of CoEHAR.

  • South Korea Expands Vape-Only Smoking Lounges 

    South Korea Expands Vape-Only Smoking Lounges 

    Credit: Sayan

    With the growing popularity of e-cigarettes, South Korea is increasingly accommodating users by introducing dedicated smoking spaces, reflecting a broader shift in attitudes toward smoking alternatives.

    E-cigarette-exclusive lounges have emerged in places like Incheon International Airport and major commercial hubs, catering to smokers who wish to avoid the strong odors and cramped conditions of traditional smoking booths.

    Incheon Airport, for instance, has operated three e-cigarette lounges since June—one each in Terminals 1, 2, and a concourse. These facilities, converted from existing smoking areas, have been redesigned to eliminate ashtrays and mitigate lingering odors from conventional cigarettes.

    According to the airport, these lounges serve an average of 4,000 users daily, with a 4.2 out of 5 satisfaction rate, as measured by a September survey, state media reports.

    The rise of e-cigarette smoking parallels shifting smoking trends in South Korea. While overall tobacco product usage increased marginally from 21.6% in 2019 to 22.2% in 2023, e-cigarette usage has grown significantly.

  • CAPHRA Calls on Mongolia to Adopt THR Policy

    CAPHRA Calls on Mongolia to Adopt THR Policy

    Credit: Zero Photo

    The Coalition of Asia Pacific Harm Reduction Advocates (CAPHRA) has called on the Mongolian government to reassess its stance on tobacco harm reduction (THR) products. CAPHRA cites evidence from Japan that demonstrates significant health and economic benefits from embracing safer alternatives to smoking.

    A recent study published in the journal Healthcare indicates that if 50 percent of smokers in Japan switched from combustible cigarettes to heated tobacco products (HTPs), it could prevent 12 million patient cases and save JPY 454 billion ($2.95 billion) in healthcare costs. This data underscores the immense potential of THR strategies in countries with high smoking rates.

    Nancy Loucas, Executive Coordinator of CAPHRA, stated, “The Japanese example clearly illustrates that safer nicotine products can be an effective harm reduction tool in nations where smoking prevalence remains high and other safer nicotine products are unavailable.”

    Mongolia, which faces significant tobacco-related health issues, could greatly benefit from adopting a more progressive approach to THR. Despite the adoption of a Tobacco Control Law in 2005 and a ban on indoor smoking since 2015, enforcement remains weak. Cigarettes are still sold near schools without regulation, and there is no violation monitoring or fines.

  • Study: No Major Respiratory Symptoms for Vapers

    Study: No Major Respiratory Symptoms for Vapers

    A groundbreaking international study conducted as part of the Veritas cohort project has provided crucial insights into the respiratory health of exclusive e-cigarette users with no established history of smoking. Published in Scientific Reports, the study assessed respiratory symptoms among adults who had never been habitual smokers but used e-cigarettes, offering a rare glimpse into the health effects of vaping in this specific population.

    Led by researchers from CoEHAR and their global collaborators, the study compared respiratory symptoms between a cohort of e-cigarette users and a control group who had never smoked conventional cigarettes. The results indicate that individuals who have never smoked but exclusively used e-cigarette devices do not exhibit clinically relevant respiratory symptoms. Moreover, the study highlights the importance of distinguishing between statistically and clinically significant results when evaluating the health impacts of e-cigarettes.

    “Veritas lays the groundwork for longitudinal research to further assess the long-term effects of e-cigarettes on respiratory health. These findings are essential for shaping public health policies based on scientific evidence, especially as we work to differentiate the effects of vaping from those of traditional smoking,” said Riccardo Polosa, founder of CoEHAR.

    “What makes the Veritas project unique is not only its reach across six geographically diverse areas,” said Jeffrey Zamora, the study’s lead author, “but also its ability to provide data on the real-world use of e-cigarettes, including the most commonly used device types (refillable, disposable, pod-based) flavor preferences, and variations across different socio-cultural groups.”

  • THR Group Asks Kazakhstan to Reassess Policies

    THR Group Asks Kazakhstan to Reassess Policies

    Credit: Zero Photo

    The Coalition of Asia Pacific Harm Reduction Advocates (CAPHRA) today called on the government of Kazakhstan to reassess its stance on tobacco harm reduction (THR) products, citing compelling evidence from Japan demonstrating the significant health and economic benefits of embracing safer alternatives to smoking. 

    A recent study published in the journal Healthcare reveals that if 50 percent of smokers in Japan switched from combustible cigarettes to heated tobacco products (HTPs), it could prevent 12 million patient cases and save JPY 454 billion in healthcare costs. This data underscores the immense potential of THR strategies in countries with high smoking rates. 

    Nancy Loucas, the executive coordinator of CAPHRA, stated that the Japanese example clearly illustrates that HTPs can be an effective harm reduction tool in nations where smoking prevalence remains high, and other safer nicotine products are unavailable.

    “Kazakhstan, with its significant gender disparity in smoking rates and tobacco-related health issues, could greatly benefit from adopting a more progressive approach to THR. Kazakhstan’s current policies treat all nicotine products, including less harmful alternatives, the same as traditional cigarettes,” Loucas explains in an e-mailed release. “This approach, coupled with the recent ban on vapes and high taxes on smokeless alternatives, demonstrates a concerning lack of acceptance for harm reduction strategies. 

    “By ignoring the potential of THR products, Kazakhstan is missing a crucial opportunity to save lives,” Loucas added. “Our analysis suggests that embracing harm reduction policies could prevent 165,000 premature deaths in Kazakhstan over the next four decades.  

    The government must reconsider its stance for public health, stated Loucas.  CAPHRA urges Kazakh policymakers to: 

    1. Review and revise current regulations to differentiate between combustible cigarettes and less harmful alternatives. 
    2. Following Japan’s successful model, the introduction of HTPs should be considered as a harm reduction tool. 
    3. Engage with public health experts and THR advocates to develop evidence-based policies. 
    4. Implement a tiered taxation system encouraging smokers to switch to less harmful products. 

    “The time for Kazakhstan to act is now,” Loucas stated. “By embracing tobacco harm reduction, the country can significantly improve public health outcomes, reduce healthcare costs, and potentially narrow the life expectancy gap between men and women. We stand ready to support Kazakhstan in developing and implementing effective THR policies.” 

  • Report: Transition to Safer Products Underway

    Report: Transition to Safer Products Underway

    VV Archives

    A new report from Knowledge Action Change (KAC) describes the extent to which safer nicotine products (SNP) are replacing and substituting for combustible and risky oral tobacco products.

    Co-authored by experts in harm reduction, data science and economics, The Global State of Tobacco Harm Reduction 2024: A Situation Report (GSTHR 2024) considers what is driving these changes, how different regulatory environments have developed, and the complex interplay between products, consumers, and policy and regulation.

    The latest market data shows that while sales of combustible tobacco remain significantly higher than sales of SNP, two key shifts are occurring in the tobacco and nicotine market: first, the total market share of SNP is increasing, and second, inflation-adjusted combustible tobacco sales are declining, while SNP sales are experiencing rapid growth.

    Although the nominal value of combustible tobacco sales increased from $752 billion in 2015 to over $1 trillion in 2024, when adjusted for inflation (and assuming a constant currency value), combustible tobacco sales actually decreased to $685 billion in 2024—an 8.9 percent decline. Meanwhile, inflation-adjusted SNP sales grew nearly sixfold from 2015, reaching, in non-adjusted terms, $96 billion in 2024.

    Further analysis shows, however, that Chinese data skews these figures. China’s tobacco market accounts for an astonishing $344 billion of the $1 trillion global combustible tobacco market. Despite being the global center of production for nicotine vapes, the Chinese market for all SNP is extremely small, at less than 1.2 percent of its market for combustibles. GSTHR analysis removing China from the calculations reveals the true scale of the acceleration in the global SNP market: it has reached 12.3 percent of the total tobacco and nicotine market in 2024, up from virtually zero in 2004.

    The evidence from this report shows that when safer products are appropriate, acceptable, accessible and affordable—people will switch.

    Gerry Stimson, founder, KAC

    According to KAC, legal access to a range of SNP will be essential for the billion people who smoke worldwide to benefit from tobacco harm reduction (THR). Research undertaken for GSTHR 2024 shows that more than two-thirds of the world’s adult population can now legally access at least one form of SNP. Access to combustible tobacco products, by contrast, remains legal for 100 percent of the world’s adult population. The report also reveals that the global number of vapers has increased from 58 million in 2018, to reach an estimated 114 million in 2023. With 30 million people using other safer nicotine products, this means the GSTHR estimates there are now around 144 million users of SNP worldwide.

    “Harm reduction is often thought about as policies and strategies, driven by public health. But it isn’t only this. It’s also what people do themselves to reduce risks and improve their own health,” said KAC Founder Gerry Stimson in a statement. “Governments and both international and national health organizations, need to help create an environment in which people can be informed and empowered to make those safer choices. And the evidence from this report shows that—when safer products are appropriate, acceptable, accessible and affordable—people will switch, in fact they are already switching, in their millions.”