Category: Harm Reduction

  • Consumer Group Warns Against State PMTA Registries

    Consumer Group Warns Against State PMTA Registries

    U.S. states must recognize the unintended consequences of passing laws requiring premarket tobacco product application (PMTA) registries for alternative nicotine products such as vaping devices, heaters, and nicotine pouches, according to the Consumer Choice Center, an organization claiming to represent consumers in more than 100 countries.

    In the first months of 2024, more than a dozen bills have been introduced in U.S. states calling for a state-based registry for alternative nicotine products. Such legislation has already been passed in Oklahoma, Louisiana and Alabama.

    “While the intention behind these bills is to manage consumer access to unregulated nicotine products on the illicit market, the reality is that the FDA is not approving enough new devices and products to create a competitive, regulated marketplace that meets consumer demand,” said Elizabeth Hicks, U.S. affairs analyst at the Consumer Choice Center.

    While 26 million nicotine alternative products submitted PMTAs to the Food and Drug Administration, only 23 have been approved. Of those 23 approved products, 12 are tobacco-flavored e-liquid refills.

    “The FDA is hiding the ball here on product approvals and how few new products are actually coming to market. If the goal is to improve public health across the country, then consumers deserve to choose from a variety of different nicotine alternatives,” said Hicks.

    The Consumer Choice Centers urges state legislatures to refrain from adding to counterproductive federal policies and instead advance tobacco harm reduction through a competitive marketplace.

  • FDA Urged to Follow the Science for Vaping Rules

    FDA Urged to Follow the Science for Vaping Rules

    Photo: Pixel-Shot

    The U.S. Food and Drug Administration’s Center for Tobacco Products (CTP) should open the marketplace for electronic nicotine delivery systems to products with varied characteristics so that those interested in alternative nicotine products can access them, according to R Street resident senior fellow Jeffrey Smith.

    In a recently published analysis, Smith critiques the FDA’s disregard for the current research on ENDS, diving into new data that he says represents a “tectonic-shift in the academic medicine community” regarding the safety of ENDS for smoking cessation. 

    ”As evidence grows for the utility of ENDS and other potentially life-saving alternative products, the CTP continues to limit Americans’ access to these products,” writes Smith.

    “Though the CTP has received millions of applications for ENDS products, it has only allowed a few to be marketed legally in the United States. Of those that have received marketing clearance, only older closed systems have been approved—with tobacco as the only permitted flavor.”

    Arguing that a diverse range of ENDS products available to those who smoke and want to quit is critical to reducing the health burdens associated with smoking, Smith urges the CTP to revise its processes and procedures, and allow more cigarette alternatives on the market. Continued delay by the CTP, he says, will only lead to more unnecessary deaths and disease in the United States.

  • Study: E-cigarette Harm Perceptions Worsening

    Study: E-cigarette Harm Perceptions Worsening

    Photo: Asier

    Harm perceptions of e-cigarettes have worsened substantially over the last decade among adult smokers in England, according to a study published by Jama Network Open.

    In 2023, most adults who smoked believed e-cigarettes to be at least as harmful as cigarettes. The timing of the changes in harm perceptions coincided with the e-cigarette, or vaping product, use-associated lung injury outbreak in 2019 and the recent increase in youth vaping in England since 2021.

    Researchers collected data from 28 393 adult smokers. In November 2014, 44.4 percent thought e-cigarettes were less harmful than cigarettes, 30.3 percent  thought e-cigarettes were equally harmful, 10.8 percent thought they were more harmful, and 14.5 percent said they did not know.

    However, by June 2023, the proportion who thought e-cigarettes were less harmful had decreased by 40 percent, and the proportion who thought e-cigarettes were more harmful had more than doubled.

    Changes over time were nonlinear: late 2019 saw a sharp decline in the proportion who thought e-cigarettes were less harmful and increases in the proportions who thought they were equally or more harmful. These changes were short-lived, returning to pre-2019 levels by the end of 2020.

    However, perceptions worsened again from 2021 up to the end of the study period: the proportion who thought e-cigarettes were more harmful increased to a new high, and the proportion who thought e-cigarettes were less harmful decreased to levels comparable to those in late 2019.

    As a result, in June 2023, the perception that e-cigarettes were equally as harmful as cigarettes was the most commonly held view among adults who smoke, with roughly similar proportions perceiving e-cigarettes to be less and more harmful.

  • CoEHAR’s Replica 2.0 Team to Meet in Catania

    CoEHAR’s Replica 2.0 Team to Meet in Catania

    Photo: CoEHAR

    The Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) will hold the Annual International Meeting for its Replica 2.0 project in Catania, Italy, March 25–29.

    The Replica project is one of CoEHAR’s most successful projects, according to the organization. In the last couple of years, the research team replicated and validated the results from well-known international studies in the field of tobacco harm reduction.

    The project benefits from its collaboration with an international network of independent laboratories all around the world, which includes the Universitas Padjadjaran in Indonesia, the Institute of Research and Development Nosmoke in Greece, the Faculty of Medical Sciences, University of Kragujevac in Serbia, the Sultan Qaboos University in Oman, the Temple University-SHRO in the United States and Kazan Federal University, Russia.

    During the event, the Replica team will discuss lessons learned, harmonize standard operation procedures for the project and continue the laboratory training emphasizing critical steps for harmonization.

    On March 29, CoEHAR will host the ceremony for its Talent Research Award.

    Tobacco Reporter profiled CoEHAR in its January 2024 print edition and online (see, “Reviewing their Peers”).

  • Former WHO Officials Highlight Key THR Strategy

    Former WHO Officials Highlight Key THR Strategy

    Photo: Alexander Ovsyannikov

    Harm reduction should be a central strategy of the Framework Convention on Tobacco Control (FCTC) in addition to the measures for demand and supply reduction, according to Robert Beaglehole and Ruth Bonita.

    Writing in The Lancet, the two former World Health Organization directors argue that while the FCTC has been influential in encouraging a global response to tobacco control, it has been challenging to show a strong and consistent association between the implementation of FCTC measures and smoking prevalence and cigarette consumption outcomes.

    The FCTC does not prohibit harm reduction approaches but leaves it up to member states to decide how to regulate e-cigarettes and other novel nicotine products. The WHO’s lack of endorsement of tobacco harm reduction limits healthier choices for the 1.3 billion people globally who smoke and who are at an increased risk of early death, according to Beaglehole and Bonita.

    The authors note that there is no scientific justification for WHO’s position that e-cigarettes and other novel nicotine products should be treated in the same way as tobacco products. This position, they argue, overlooks a risk-proportionate approach.

    “We believe WHO needs to provide positive leadership and technical support to countries as they consider the use of e-cigarettes and other nicotine delivery devices,” the authors write. “WHO’s current approach to these lower-risk product is to reward countries, such as India, for banning e-cigarettes; thirty-four countries, primarily low-income and middle-income countries, now ban e-cigarettes.”

    Beaglehole and Bonita note that, in some countries, substantial reductions in smoking prevalence have coincided with the uptake of novel nicotine products. In New Zealand, for example, the prevalence of adult daily smoking plummeted from 13.3 percent in 2017–2018 to 6.8 percent in 2022–2023 after e-cigarettes became widely available, a 49 percent decline in five years.

    In the same period, and with the support of the government and regulation of vaping, the prevalence of adult daily vaping increased from 2.6 percent to 9.7 percent. New Zealand’s recent decline in smoking occurred in the absence of any other major tobacco control policy, apart from the annual cost-of-living price increases, according to the authors. “The decrease in smoking during this period in New Zealand shows what can be achieved, and exceeds the WHO smoking prevalence reduction goals of 30 percent over 15 years from 2010 to 2025,” they write.

    The New Zealand 2022 smoke-free legislation includes a “tobacco-free generation”, a 90 percent reduction in smoked tobacco retail outlets, and compulsory denicotinization of retail tobacco. The New Zealand government, elected in November 2023, is committed to reaching the Smokefree 2025 goal of 5 percent (or less) smoking prevalence for the adult population, but intends to repeal the 2022 smoke-free legislation.

    However, because of the implementation timelines, fears that this repeal would jeopardize the Smokefree 2025 goal can be allayed, according to Beaglehole and Bonita. This is because none of the three headline measures would be expected to have an impact before 2025 and might have had negative unintended consequences. “Based on recent progress, New Zealand’s Smokefree 2025 goal looks likely to be reached by consent rather than coercion and by further support for switching to smoke-free nicotine products,” the authors note.

    Beaglehole and Bonita also highlight the success of other high-income countries in reducing smoking prevalence in association with the use of a range of lower-risk nicotine delivery devices to complement FCTC demand and supply reduction measures.

    Sweden, with a long tradition of snus use, has the lowest prevalence of adult daily smoking in the world, down to 6 percent in 2022, accompanied by low mortality from tobacco-related diseases.

    Norway has had similar success with reducing smoking prevalence in the context of increased use of snus and e-cigarettes, and in England vaping is helping adults to quit smoking. The substantial decline in cigarette consumption in Japan is associated with the rapid uptake of products that heat, rather than burn, tobacco.

    Less progress has been made in low-income and middle-income countries where tobacco control capacity and political will to advance tobacco control measures are weaker, and the potential of tobacco harm reduction is not being realized, according to the authors.

    Beaglehole and Bonita say two concerns suggest why tobacco harm reduction is not more actively embraced, despite its association with reduced smoking prevalence. The first is that, compared with cigarettes, where the damage has been known for more than half a century, the long-term effects of e-cigarettes are unknown.

    Although vaping may not be risk-free, especially for people who do not smoke, the risks of there being substantial long-term harm from the constituents of e-cigarettes are likely to be low, especially when compared with the damage caused by smoked tobacco, the authors point out.

    The second concern is that the widespread availability of e-cigarettes in the absence of adequate controls and regulations encourages youth nicotine dependence and enables the vaping industry to act unethically. Beaglehole and Bonita say there is little evidence to suggest that vaping leads to smoking among youth, and although the proportion of non-smoking youth who vape is increasing, it remains at a fairly low level.

    Stricter regulations, including enforcing sales restrictions, and appropriate health promoting campaigns are needed to prevent vaping by young people, according to the authors, but these measures must be balanced with the health needs of older adults who smoke and require support to quit.

    Beaglehole and Bonita acknowledge that there is understandable skepticism about the motives of the tobacco industry in selling smoke-free products while continuing to expand tobacco markets in low-income and middle-income countries. To remain profitable, they say, the tobacco industry will eventually need to migrate its global business to less harmful alternatives since cigarettes will no longer monopolize the delivery of nicotine.

    The authors express concern about the recommendations, found in COP10 background papers, to treat nicotine products as equivalent to cigarettes and regulating them in a similar way. This approach, they argue, is a retrograde step because they are not comparable products in terms of the damage they cause; after all, it is the burning of tobacco that causes harm, not nicotine. Worse, such a strategy would ultimately favor the global cigarette market and may discourage vaping, according to Beaglehole and Bonita.

    The focus, they insist, must remain on the central public health problem—the damaging health effects of tobacco consumption. “Reducing cigarette smoking is the most effective way to prevent tobacco-related deaths and tobacco harm reduction is the fastest and fairest way to lower smoking prevalence,” the authors write.

    “WHO needs to embrace these innovations in nicotine delivery. Countries that are reaping the benefit of tobacco harm reduction, such as New Zealand, Sweden, Norway, England and Japan, should encourage participating countries at COP10 to support proposals that will quickly reduce smoking rates. The world’s 1.3 billion people who smoke, half of whom will die early, deserve this leadership.”

     

  • Taxpayers Group Holds ‘Counter COP’ in Panama

    Taxpayers Group Holds ‘Counter COP’ in Panama

    Photo: TPA

    Concurrent with the 10the Conference of the Parties (COP10) to the World Health Organization Framework Convention on Tobacco Control (FCTC), which takes place in Panama City this week, the Taxpayers Protection Alliance (TPA) is hosting an event at the Central Hotel Panama under the name “Good Cop/Bad Cop.” The event will be livestreamed on TPA’s YouTube channel.

    Good COP will feature nearly two dozen tobacco harm reduction experts, representing 14 different countries and highlighting some of the leading experts on consumer issues, national and global policies, and the science surrounding harm reduction.

    Throughout the event, TPA and the Good COP participants will be monitoring the WHO’s meeting and providing running commentary via livestreams, media interviews, blogs, and social media.

    “The taxpayer-funded WHO ignores science and puts billions of smokers at risk of not having access to life-saving technology to quit smoking,” said TPA’s President, David William in a statement.

    “The participants of Good COP will hold the WHO accountable for denying life-saving access to tobacco harm reduction products and denying access to the public and media to these meetings. “In real time, harm reduction experts from around the globe will be fact-checking and providing commentary on the WHO’s anti-science agenda at COP10.”

  • VTA Buys Ads Targeting Senator Over Zyn Comments

    VTA Buys Ads Targeting Senator Over Zyn Comments

    vta-logo-square

    The Vapor Technology Association (VTA) announced the launch of a cable news ad buy targeting Sen. Chuck Schumer and his proposed ban on Zyn nicotine pouches. The ad runs this week on FOX News and FOX Business during key programming slots, including “FOX and Friends,” “Kudlow,” and “The Five.”

    Sen. Charles Schumer

    The ad connects a proposed ban on e-cigarettes with a ban on all less harmful, tobacco-free nicotine products, such as Zyn nicotine pouches. The ad also calls out entrenched bureaucrats at the Food and Drug Administration’s Center for Tobacco Products (CTP), led by Brian King, for repeatedly blocking access for millions to e-cigarettes as harm reduction tools that the science has proven are the most effective product on the market to help people quit smoking cigarettes, according to an emailed press release.

    “Sen. Schumer and the FDA are simply wrong: wrong on e-cigarettes, wrong on Zyn, and wrong on the science,” said Tony Abboud, executive director of VTA. “Rather than give adult smokers broader access to a greater number of lower-risk alternatives, the FDA and CTP have instead imposed a de facto ban on e-cigarettes – and Zyn is next.”

    The ad states that Schumer’s proposed Zyn ban precisely mimics his attempts to eliminate e-cigarette use nationwide, amounting to an assault on Americans’ personal freedom to choose lower-risk, tobacco-free nicotine products that overwhelming scientific and medical data demonstrates are effective at helping adults quit smoking.

  • Activists Criticize Exclusionary Tactics at COP10 

    Activists Criticize Exclusionary Tactics at COP10 

    Photo: Alexey Novikov

    The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) today issued a sharp critique of the World Health Organization’s Framework Convention on Tobacco Control (FCTC) for its exclusion of consumer groups and harm reduction advocates from the 10th Session of the Conference of the Parties (COP10).  

     “CAPHRA argues that this exclusionary practice is in stark contrast to the successful, pragmatic approaches of countries like New Zealand, the Philippines and Malaysia, which have embraced vaping as a harm reduction tool,” said Nancy Loucas, a public health policy expert and passionate advocate for tobacco harm reduction and executive coordinator of CAPHRA. 

    The press release condemns the COP10 meetings for silencing the voices of those who advocate for harm reduction strategies, such as vaping, which have been shown to significantly reduce smoking prevalence in countries where they are available and regulated. 

     CAPHRA points out that the prohibitionist approach of countries like Australia, which recently banned vaping products, is not in the best interest of public health. 

     “CAPHRA calls on FCTC officials to open their minds to harm reduction and to consider the evidence from countries like New Zealand, where smoking rates have decreased due to the availability of regulated vaping products,” said Loucas. 

    The organization stresses the importance of including consumer groups in the decisionmaking process, as they provide essential insights into the needs of smokers and how alternative products can be used effectively. 

  • WVA: EU Harm Reduction Approach ‘Out of Touch’

    WVA: EU Harm Reduction Approach ‘Out of Touch’

    Vapor Voice Archive

    The European Commission’s approach to tobacco harm reduction is out of touch with EU citizens’ views, according to the World Vapers’ Alliance (WVA)

    A recent public consultation on the EU Tobacco Products Directive (TPD), analyzed by Snusforumet, reveals a substantial consensus among citizens, NGOs and scientific institutions on the effectiveness of harm-reduction products in assisting smokers to quit.

    A striking 77 percent of respondents recognize these products as helpful smoking cessation tools, while a mere 9 percent of EU citizens disagree. Furthermore, an overwhelming 82 percent of respondents refute the notion that new nicotine alternatives pose a risk to public health, with only 6 percent perceiving them as a threat.

    “The EU Commission’s current stance on harm reduction is not just out of touch; it’s a blatant disregard for consumer opinions and scientific evidence,” said WVA Director Michael Landl in a statement. “It’s high time the Commission responds to the reality that harm-reduction products are not the enemy but a vital ally in the fight against smoking.”

    According to the WVA, countries like Sweden serve as living proof of the success of a consumer-friendly harm reduction approach, significantly outpacing the EU in reducing smoking rates. The EU Commission’s reluctance to embrace this approach is not only perplexing but also detrimental to public health efforts, the organization says.

    “Sweden’s success story is a testament to what can be achieved with a sensible harm reduction policy,” said Landl. “It’s baffling and frankly irresponsible for the EU Commission to continue its hostile approach towards these life-saving products. The Commission needs to align its policies with the clear evidence and public opinion, rather than clinging to outdated and ineffective methods.”

  • Quit for Good President: WHO Report ‘Unscientific’

    Quit for Good President: WHO Report ‘Unscientific’

    Lorenzo Mata Jr. (Photo: Quit for Good)

    A public health advocacy group based in the Philippines has criticized the latest report of the World Health Organization on the use of electronic cigarettes, saying the global body undermines the significant progress made in public health over the past two decades as smokers transitioned to smoke-free products.

    Lorenzo Mata Jr., president of Quit for Good, said the WHO’s continued demonization of e-cigarettes disregards the wealth of scientific evidence demonstrating that smoke-free alternatives such as e-cigarettes, heated tobacco and snus have helped millions of smokers in countries like the United Kingdom, the United States, Japan and Sweden successfully quit smoking.

    “The best available clinical and population studies consistently show that vaping has led to adult smoking cessation. While it is necessary to monitor youth vaping, a complete ban on e-cigarettes will only exacerbate the smoking epidemic and its associated serious health conditions,” Mata Jr.  said in a statement.

    As a Filipino physician, Mata said the WHO’s failure to differentiate between the risks of e-cigarettes and combustible tobacco is unscientific.

    Last month, the WHO issued a statement calling for urgent action to safeguard children and prevent the adoption of e-cigarettes based on what Quit for Good insists is a misrepresented account of the scientific evidence to fit its predetermined conclusion to ban e-cigarettes or regulate them as strictly as far more dangerous cigarettes.

    Additionally, the WHO provided data indicating that the global market for electronic cigarettes grew from $7.81 billion in 2015 to $22.35 million in 2022. Between 2018 and 2022, the disposable e-cigarette market expanded by 116 percent, encompassing over 550,000 different products.

    Mata said the WHO’s diagnosis of the situation is flawed, as it fails to acknowledge the significant decline in harmful substance exposure resulting from smokers switching to e-cigarettes and other smoke-free alternatives, or the fact that smoke-free products work for many smokers better than traditional smoking cessation therapies.

    “E-cigarettes do not threaten public health but provide smokers with an exit from smoking, which is the real problem. Labeling these innovative products an emerging threat to public health is worrisome because the WHO essentially tells smokers that continuing smoking is better than switching to e-cigarettes. This is patently wrong,” he said.

    Quit for Good highlights that countries that banned e-cigarettes did not eradicate vaping but instead inadvertently created an unregulated underground market that poses risks to public health due to the absence of regulatory standards.

    Mata said these bans only benefit unscrupulous criminal gangs that are happy to sell these products to anyone, including children, without any controls as to what’s in them or how they’re made.

    According to independent public health experts, e-cigarettes and other smoke-free products offer an opportunity to combat smoking-related diseases such as cancer, heart disease and lung disease by transitioning to nicotine products with significantly reduced risk and no combustion.

    Commenting on a similar WHO report published earlier, Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London, said: “Given the tremendous benefits this transition would bring to public health, it is paradoxical that the WHO has adopted such a strident anti-vaping stance that risks impeding this progress. This new report perpetuates this tradition, calling for a ban on less risky alternatives while freely allowing the sale of tobacco. The report misrepresents evidence and should come with a prominent health warning.”

    John Britton, an emeritus professor of Epidemiology at the University of Nottingham, said the WHO still fails to differentiate between addiction to tobacco smoking, which leads to millions of deaths annually, and addiction to nicotine, which does not.

    “The WHO appears content with the inconsistency of recommending medicinal nicotine products for treating smoking addiction while advocating the prohibition of consumer nicotine products that serve the same purpose, but more effectively. The WHO is correct in discouraging non-smokers, particularly children, from using any nicotine product. However, for over a billion tobacco smokers worldwide, electronic nicotine delivery systems are part of the solution, not the problem,” Britton said.

    Mata said many countries, including the Philippines, have in fact chosen to embrace scientific evidence and regulate the use of innovative smoke-free products such as e-cigarettes to provide smokers with better options to quit.