reduction of tobacco damage: is the context still unfavorable for its global implementation?

On 4 November 2020, the British health organization Knowledge Action Change, which focuses on the promotion of health through the concept of harm reduction, publishes a report entitled: Burning Issues: The Global State of Tobacco Harm Reduction and also organizes two discussions on the state of reducing tobacco damage worldwide.

The organization, which focuses on reducing harm as a key public health strategy, has addressed the fact that 1.1 billion people worldwide smoke, according to the World Health Organization (WHO). Experts reminded participants that this figure had remained unchanged for two decades and that it was urgently needed to reduce tobacco damage to save lives.

Experts have also revealed updated figures regarding the consumption of smokeless tobacco such as e-cigarettes, heated tobacco and pasteurized tobacco. Worldwide, only 9% of smokers use these alternatives, mainly in high-income countries when most smokers are located in low- and middle-income countries (LMICs).

The topic of the first session of the conference was: The context and importance of reducing tobacco harm to global health. They are a key guest speaker in the UK, professor and neuropsycho-pharmacologist David Nutt has made a strong point about the importance of data and science:
“My work, which led to a multi-criterion analysis on the harm of various nicotine products in 2013, has contributed to the understanding that e-cigarettes are about 95 percent less harmful than traditional cigarettes. Yet many so-called ‘experts’ refute scientific evidence on vaping or snuff safety and deny relative harm data, while scientists like me are insulted and insulted. The chance of reducing tobacco damage is perhaps the worst example of scientific denial since the Catholics

Church banned the works of Copernicus in 1616. ”

Professor David Nutt points to the responsibility of the WTO for public health and criticizes the fact that they do not distinguish between smokeless tobacco and traditional cigarettes: ‘I think the credibility of the WTO is at stake if it is not a clear change or development of an evidence base. ”

It was his assertion that the UN agency was steadfastly adhering to its outdated position, even against contradictory scientific evidence. According to the official WHO statement: “There is currently insufficient evidence to conclude that HTPs are less harmful than regular cigarettes. In fact, there are concerns that users may be exposed to lower levels of some toxic substances than regular cigarettes, but that they are also exposing users to higher levels of other toxic substances. ”

In addition, all countries that have ratified the WHO Framework Control Convention (FCTC) must prohibit all forms of tobacco advertising, promotions and sponsorships that promote a tobacco product in any way that is false, misleading or misleading or likely to give a false impression. create about its characteristics, consequences for health, dangers or emissions »

What is the current situation in low and middle income countries (LMIC)

A large number of scientific reports have mentioned that these alternatives to conventional tobacco are potentially less harmful and that the use of these devices can improve health and reduce death due to the absence of the flammable smoke and the carcinogens it causes and causing diseases. 80% of tobacco users are in LMICs. Yet regulations and policies are drastic against innovative tobacco systems. In most of the countries, products are completely banned, heavily taxed, or there are no specific laws to regulate them and are therefore treated in the same way as traditional cigarettes.

For Malawian social scientist and advocate Chimwemwe Ngoma of tobacco harm reduction, it is a denial of human rights: ‘The concept of harm reduction is not new in Africa and millions of people should not be denied access to products that can help them achieve poor quality to avoid. of life, disease and premature death. Preventing access to these products through bad policies deprives people of their right to health. The policy should include issues related to access to credible information / science and the availability of tobacco harm products.

According to the Burning Issues report, 98 million people worldwide use safer nicotine products. Of these, 68 million are vapers, with the largest population groups in the United States, China, Russia, the United Kingdom, France, Japan, Germany, and Mexico. 20 million users of heated tobacco products; with most users in Japan; and 10 million are non-smoking or “snuff” (pasteurized product) users.

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