Tag: Yach

  • Derek Yach: The Promise of Synthetic Nicotine

    Derek Yach: The Promise of Synthetic Nicotine

    As consumer demand for healthier and more environmentally friendly alternatives to combustible cigarettes increases, we should expect greater focus on the benefits of this man-made alternative.

    By Derek Yach

    Tobacco-derived nicotine has been the sole source of nicotine used by pharmaceutical and tobacco companies until recently. The naming of the sector (tobacco sector), the naming of companies (British American Tobacco for example) and the framing of public health policies as tobacco control all show how pervasive and deeply embedded the word tobacco has become despite its scientific name being Nicotiana.

    The dominance of tobacco plants started to wane when pharmaceutical companies developed nicotine-replacement therapies (NRTs) as cessation products. That highlighted the fact that while nicotine is addictive, it is not the source of death and disease caused by the products of combustion. The advent of a wide range of consumer-facing products that also use nicotine (especially e-cigarettes and nicotine pouches) to help smokers switch and/or quit has further increased the focus on nicotine.

    Initially, there was no debate about the source of nicotine since it was assumed to come from the plant. In recent years, several companies have started using patented laboratory processes to develop nicotine from scratch. Many, like Zanoprima, use green chemistry to convert plant-based molecules into synthetic nicotine. Other companies, such as Contraf-Nicotex-Tobacco (CNT), begin with plant-based molecules used in cosmetics and derived from vitamin B.

    Nicotine, like many molecules, exists in two orientations: S-nicotine and R-nicotine; however, nicotine that occurs naturally in the tobacco plant is entirely S-nicotine. Prior to the popularization of synthetic nicotine, this distinction had not been of great practical importance due to its naturally occurring form. Pharmaceutical-grade synthetic nicotine manufacturers such as CNT and Njoy therefore treat R-nicotine as a byproduct of the S-nicotine manufacturing process while Zanoprima’s patented process does not produce R-nicotine at all. Other manufacturers may use methods that may well not meet the high-quality standards of the pharmaceutical industry.

    What Benefits Does It Bring to Consumers and the Environment?

    Consumers increasingly demand information about the supply chain of end products. Leading food companies have led in being transparent about the source of all ingredients in their products with a shift toward those where labor conditions on the farm are known, addition of chemicals are reported, water and greenhouse gas use associated with products are made public and the traceability of food product ingredients is independently audited. Investors are more likely to invest in companies with sound records on these issues.

    So it will be for all future nicotine products.

    For many combustible users, the incentive to switch to a reduced-risk product usually starts with a desire to lower health risks. But for a considerable number, environmental issues are fast becoming reasons to switch, often independent of their health concerns. Again, this has its analogy in the food sector, where companies like Whole Foods have built their main value proposition on an environmental benefit, with health credentials being dubious.

    The tobacco industry emits 84 million metric tons of carbon dioxide (CO2) a year, which is equivalent to 0.2 percent of global CO2 emissions, according to researchers at Imperial College London. Of the total, 20.87 million tons of CO2 come from cultivation, and 44.65 million tons of CO2 come from curing, together amounting to 78 percent of all tobacco industry emissions. Synthetic nicotine has the potential to virtually eliminate these.

    Synthetic nicotine brings tangible benefits to consumers: A better sensorial experience, assurances about the absence of contaminants and a stamp of quality good enough for pharmaceutical companies, to name a few.

    The recent World Health Organization report Tobacco: Poisoning Our Planet paints a vivid picture of the harms of tobacco farming, curing and processing for the environment. More recently, the Foundation for a Smoke-Free World provided a qualitative summary of the potential sources of environmental harm associated with reduced-risk products. Both the WHO and the foundation advocate for the reduction in global tobacco farming, outlining the harms caused by tobacco growth and cultivation on arable land, workers’ rights and malnutrition. It is likely that products created with synthetic nicotine can mitigate many concerns in the product lifecycle. And as companies selling clean nicotine push harder to ensure their products are recyclable and/or reusable, the overall negative environmental footprint will decline further.

    Where Is It Likely to Grow Fastest?

    Today, synthetic nicotine is used in next-generation nicotine products by emerging nicotine pouch companies like NIIN and by mainstream vape companies like Njoy. This trend is set to continue and will gain traction as e-cigarettes and nicotine pouch companies seek medical licensing using synthetic nicotine.

    One example is SMOOD, an up-and-coming next-generation e-cigarette and NRT company based in New York City. SMOOD creates its products as a comprehensive approach to address both health and environmental issues simultaneously. Synthetic nicotine, recyclable hardware and design features to support smokers to quit may well be a signal of what is to come. “We always used nontobacco nicotine due to the absence of minor tobacco alkaloids and metals, both of which are inherent in agricultural production,” says Martin Steinbauer, chief engineer of SMOOD. “Together with repeatable pharmaceutical production processes, nontobacco nicotine improves the toxicological safety of our devices and eliminates carbon emissions, water use and deforestation from tobacco growing. Most importantly, it offers a clean break of nicotine from tobacco finally.”

    Snus and heated-tobacco products are unlikely to shift away from tobacco in the medium term but are lowering the health risks of the tobacco they use through processing changes in the case of snus and by eliminating combustion in the case of heated-tobacco products. For decades to come, tobacco plants will be used in these products as well as in combustibles like cigarettes and cigars where a significant demand from consumers is likely to remain even as overall demand declines.

    Most major tobacco companies already support farmers to diversify. It will be interesting to watch the dynamic within companies with large and growing reduced-risk portfolios who will continue to sell combustibles even as they shift to reduced-risk products to a greater extent in later numbers for several decades. Altria’s purchase of Njoy, Philip Morris International’s acquisition of Swedish Match and BAT’s dominance in the U.S. vape space all signal that these companies will take a twin track approach to nicotine sourcing.

    Who Makes It and How Do They See the Future?

    CNT has stated that synthetic nicotine is currently a niche product with enormous potential. “We see enormous demand there and the capacity for the synthesis of chemical is unlimited.”

    Zanoprima, the only company to use myosmine as the starting material believe that in time synthetic nicotine will become the main source of nicotine in pharmaceutical products as well as in products likely to be sold as both medically approved cessation products, and as recreational products for ex-smokers to use.

    Isn’t It Expensive To Use?

    No—prices have been dropping recently and will continue to do so as demand increases.

    Conclusion

    Health and environmental consumer demand combined with benefits in terms of quality and safety, suggest that synthetic nicotine is set to meet its potential in the coming years.

  • Yach: Ukraine Offers Chance to Transform Tobacco

    Yach: Ukraine Offers Chance to Transform Tobacco

    Photo: Hugo

    The crisis in Ukraine offers an opportunity to transform tobacco use across eastern and central Europe.

    By Derek Yach

    Vladimir Vorotnikov, writing Vapor Voice‘s sister publication in Tobacco Reporter’s August 2022 issue, outlined how Russia’s invasion of Ukraine has upended well-established supply chain and business relationships that have been in effect for decades. In fact, a careful read of Balkan Smoke by Mary C. Neuberger traces the roots of these relationships way back to Bulgaria in the 1920s. Vorotnikov discussed the impact of sanctions on Russian tobacco production, the emergence of illicit trade in the region, and more recently, the reestablishment of cigarette production in Ukraine.

    He does not discuss the massive growth over the past few years in new reduced-risk nicotine products—led by IQOS—across eastern and central Europe. The editor makes the point that Russia is (was) one the largest markets for IQOS. My own observations during a visit to Kyiv in late October 2021 were that a range of vape products and heated-tobacco products were readily available across the city despite posters funded by Bloomberg Philanthropies near the Parliament proclaiming that they were dangerous.

    An anti-vaping poster in Kyiv
    (Photo courtesy of Derek Yach)

    This is a time of profound transition for the region. Amid the horrors of war and the human tragedies it continues to bring to the people of Ukraine are opportunities to reduce future deaths from the single largest cause of premature death in the region—and especially among men—combustible tobacco products. As rebuilding begins—as it inevitably will—government, business and health professionals need to grasp the chance to avoid rebuilding the tobacco industry in the image of the past and rather take the high ground of health and make reduced-risk products the easily available option while phasing out combustible sales.

    For governments, this means adopting risk-proportionate regulations that build on the approaches proposed by the recent Javed Khan report for the United Kingdom, and on the authorizations of a range of reduced-risk products by the U.S. Food and Drug Administration. Ukraine and the neighboring countries relied on FDA guidance in relation to Covid vaccine advice—now is the time to draw upon their guidance to accelerate access to reduced-risk products, citing the FDA’s comments that they are deemed “appropriate for the protection of public health.”

    Tax and other regulatory approaches could be applied to accelerate the transition. Further, governments of the region need to step up investments in customs and excise oversight to stop large-scale illicit trade taking hold—as it has in the occupied territories of Georgia following Russian invasion in 2008.

    The Russian government also has an obligation to protect the health of its people and take regulatory steps to ensure that the progress made by Philip Morris International, Japan Tobacco International and BAT is increasing their revenue from heated-tobacco products at the cost of combustibles. Slippage with regard to these gains will translate into a return to the very high smoking rates, and associated death rates, of the past.

    Government actions will be limited, though, unless the three leading tobacco companies (PMI, JTI and BAT) active in the region commit to take concerted efforts to accelerate their transition out of combustibles and publicly clarify what “withdrawing from Russia” means. Are they continuing to profit from Russian cigarette sales albeit through local companies? Are those companies obliged to push ahead with reduced-risk products, or will they revert to cigarettes?

    Outside of Russia, leading tobacco companies could communicate the benefits of switching, take measures to clamp down on illicit trade and tighten youth access to all nicotine products, through joint action. Such bold actions would give them a chance to show their seriousness to transformation—something investors should reward.

    United Nations agencies have a role to play at this time. Evidence emerging from inside Ukraine suggests that smoking rates have increased among those in the military and possibly among displaced peoples. This is understandable given the unprecedented stress to which people are exposed. The current U.N. response has been to ignore this reality and simply continue to support policies that ban cigarette sales during conflicts—something that is probably ignored. A far better way forward is to support people who smoke or seek nicotine to have ready access to nicotine-replacement products and approved reduced-risk nicotine products. This would mean that a generation of people may well emerge from the war with lower overall risks to their health.

    War and tobacco use are intimately linked and currently interacting in dangerous ways to the health of populations. We should not wait for the transition to peace and health to begin before taking steps to accelerate the transition of smokers away from combustibles.

  • Foundation for a Smoke-Free World Changes Leadership

    Foundation for a Smoke-Free World Changes Leadership

    From left to right, Derek Yach, David Janazzo and Heidi Goldstain

    Foundation for a Smoke-Free World today announced that Derek Yach will no longer serve as president and board director. Heidi Goldstein, general counsel, and David Janazzo, chief financial officer and executive vice president of operations and finance, will serve as interim co-presidents, effective immediately, while the board conducts a search for a new president to lead the foundation and its vital mission forward.

    “After careful consideration, the board has determined that now is the right time for a new leader to guide the essential efforts of the Foundation, its team and its work with partners around the world,” said Pamela Parizek, chair of the Foundation’s board of directors, in a statement. “As we continue to take urgent action to accelerate progress toward ending smoking in this generation, we look forward to this opportunity to take the Foundation to the next level of achievement.

    “The Foundation remains squarely focused on its mission to improve global health by reducing death and disease caused by smoking, and Heidi and David, together with the rest of our talented team, will continue advancing our global research grantmaking, range of innovative programs and powerful public health collaborations without interruption.”

    Parizek continued, “On behalf of the board, I want to thank Derek for helping to establish and build the Foundation. We deeply appreciate the contributions he has made to this team’s work and to communities around the world through decades of ground-breaking efforts in tobacco control and public health. We wish him all the best.”

    “The Foundation’s ongoing work to end the world’s largest single preventable cause of death could not be more needed today,” said Yach. “I leave the Foundation with deep satisfaction that we now have an emerging cadre of hundreds of researchers, advocates and industry scientists dedicating themselves to this goal. My future efforts aim to complement them.”

  • Health Experts: WHO Must Embrace Vapor to Save Lives

    Health Experts: WHO Must Embrace Vapor to Save Lives

    New Year resolutions always include commitments to quit smoking. Most people fail not for want of trying but for want of options that can help them. Our interventions to date are not good enough.  Will the World Health Organization’s (WHO) campaign to help 100 million people quit tobacco (WHO News Release Dec 8, 2020) make a difference? Is the WHO willing to embrace new methods and emerging scientific data to course correct and in the process save millions of lives?

    stop smoking guy
    Credit: Martin Budenbender

    The WHO depends upon “new contributions from partners” to help smokers quit (WHO News Release Dec 8, 2020), Derek Yach and Chitra Subramaniam write in an opinion for Business Insider. They are as diverse as Amazon Web Services, Facebook, and Google. These digital giants are not known for their solutions to help people quit. Worse, WHO has turned to Allen Carr’s Easyway that has published studies of dubious quality and has a strong opposition to the use of nicotine even in nicotine replacement therapy (NRT Allen Carr, BMJ 2006). 

    Unfortunately, most of the countries listed as priorities for this campaign have yet to include NRTs in their national drug formularies despite WHO having included it in the Essential Drug list way back (Application for Inclusion of Nicotine Replacement Therapy (NRT) in the WHO Model List of Essential Medicines, WHO, 2009). 

    WHO should conduct an independent review of the evidence of each partners’ interventions in the very diverse set of countries where they will be tested. Such a review is a basic requirement for making global recommendations. It must be as rigorous and science-based as the processes that were put into action to approve COVID 19 vaccines. (WHO News Release Dec 31, 2020)

    Florence, WHO’s robotic digital health worker was launched with this campaign to help smokers quit. Dr. Yach tried it (see Speak to Florence) but found Florence true to its name – robotic and unable to answer simple questions and clearly out of depth when asked real world questions outside of the algorithm. A gimmick of this nature is disrespectful as it mocks those seeking to quit.

    It seems that WHO is far more interested in ending the use of tobacco harm reduction products than in saving lives.

    The latest Global State of Tobacco Harm reduction (GSTHR) report (GSTHR, Burning Issues 2020) indicates that almost 100 million people are now using a range of such products with most completely off combustible cigarettes and toxic smokeless tobacco products. This report provides convincing evidence that harm reduction products, including snus, e-cigarettes and heated tobacco products, are more effective means of quitting than the use of NRTs, and substantially lower exposure to harmful products of combustion seen in cigarettes and bidis. 

    In contrast, WHO’s latest report from their expert committee on Tobacco Product Regulation, released December 23rd, recommends banning and prohibiting e-cigarettes and heated tobacco products. This echoes a call by the Union, a Bloomberg Philanthropy financed NGO, to all low and middle income countries (LMICs) to ban such products to “avoid being distracted” by them  (WHO Expert Committee Meeting Report, Dec 23, 2020). 

    Distraction from what one may ask? 

    This “expert” report did not address snus. That may be because WHO accepts the EC ban as being the basis for its policies despite the recent USFDA decision that led to it being the first class of tobacco harm reductions products to pass its rigorous evaluation process (FDA News Release, Jul 2020). 

    Before the FCTC negotiations began 20 years ago under Dr. Yach’s leadership of the Tobacco Free Initiative (TFI) WHO invited tobacco industry scientists to present to the fledgling Tobacco Products Regulation Expert Committee on their progress in developing safer tobacco products. The presentations were not useable then for any specific harm reduction recommendations to be made. The hope remained that in time scientific progress would follow. For that reason – and in good faith – harm reduction found its way into the very definition of tobacco control used in the FCTC (WHO FCTC 2004).

    Decades have passed and tobacco consumption continues to kill people mainly in LMICs. Science and innovation have permeated every sector of society. Dirty legacy industries are now leaders in driving sustainable development. This is underway in the oil and gas, transport, mining and food sectors. And as the GSTHR and our Tobacco Transformation Index (https://tobaccotransformationindex.org/) bears out, such transformation is underway in the tobacco sector as well. This transformation should be embraced by the WHO not shunned. 

    Instead of looking into the future and enabling global leadership, the United Nation’s (UN) top health agency is digging into its past with a ferocity that is difficult to comprehend.  Ignoring decisions by the United States Food and Drug Administration (FDA), Cochrane Collaborating Centers and other regulatory and science oversight groups indicating the power of THR to increase quit rates more effectively than NRTs for example, or the potential to sharply reduce risks associated with combustible cigarettes or toxic smokeless products. 

    One hopes that as 2021 unfolds, WHO will take a fresh look at the power of THR to accelerate an end to smoking. A good way to start would be to summon the leading scientists from tobacco and e-cigarette companies to present to the WHO Tobacco Product Regulations Expert Committee in a series of open sessions. The aim could be simple: to assess whether industry has made material progress in developing products able to end smoking in order to truly judge whether the unilateral bans and prohibitions are warranted.

    From what we know, the answer is yes. WHO’s unambitious aim of helping 100 million of the 1.1 billion tobacco users quit could be revised upwards dramatically if they were to open up to rapid progress underway in the very companies we rightfully condemned 20 years ago.

    Knowledge that ignores science cannot help public health. We are seeing it with the COVID 19 crisis. We are seeing it differently in tobacco control. Time is not on our side. 

    The views expressed in the above opinion are those of the authors’ and do not necessarily represent or reflect the views of Vapor Voice or its parent organization.

    Derek Yach is president of the Smoke Free Foundation, USA. He has spent four decades advancing global public health especially chronic diseases. He was a key architect of the WHO’s FCTC.

    Chitra Subramaniam is the founder of CSD consulting Switzerland. A journalist by training and a media entrepreneur she writes on public health, development and trade