Harm reduction holds the key to finally beating tobacco
The issue of tobacco harm reduction (THR) is not new to Europe, but it has now received support from an unlikely direction: German dentists. Several doctors associated with the medical center and clinics of the University of Leipzig in Cologne are call for integrating tobacco harm reduction strategies into dental care, citing the immediate health benefits that can be derived from stopping the use of combustible tobacco products. A dentist has even started keeping new nicotine products in his clinic to show them to patients who have trouble quitting conventional cigarettes.
This urgent appeal from dentists – who as health professionals see themselves as ‘on the front lines’ of harm reduction efforts – underscores the need for serious discussion on harm reduction, especially in light of the fact that completely weaning millions of people from nicotine is an unrealistic and impractical public health goal. In practice, much more advised The policy would be to empower health professionals to encourage the switch from tobacco to alternative nicotine products such as electronic cigarettes, which carry much less risk to the user.
Several studies have already shown that the use of vaping devices contributes to a decrease in smoking. In France, 80% of vapers have reduced their cigarette consumption. a British to study over 370 users have found that vaping helps to significantly reduce the rate of relapse to smoking in individuals, especially those who first use a vape pen or tank. In the UK, Public Health England found that more than 50,000 smokers were able to leave in 2017 using a vaping product. In light of this, calls for policy change would appear to be a viable and sustainable public health initiative to be implemented across Europe.
However, this message clashes violently with the overly dogmatic approaches that dominate within the World Health Organization (WHO) and among many European decision-makers. EU Cancer control plan, for example, has been widely criticized for failing to include harm reduction approaches, a sort of oversight given that it aims to reduce the number of smokers by around 90 million.
“[The EU’s plan is] very disappointing and a lack of imagination, innovation and courage in policy making ”, lamented tobacco harm reduction advocate Clive Bates, former UK action tobacco and health director. Several MEPs voiced also their reviews, suggesting that electronic cigarettes and tobacco products should not be treated the same. As Greek MEP Maria Spyraki pointed out, “the goal is to win the war against cancer. One in five patients in the EU suffers from lung cancer, so we must help smokers by giving them the opportunity to quit gradually ”.
Such criticism easily spreads to the WHO, which, like many policymakers in Brussels, continues to put vaping in the dark. same corner like smoking tobacco, despite overwhelming scientific evidence to the contrary. A recent WHO report even referred to the “dark impact of e-cigarettes” – a dangerous fear campaign that risks rolling back the fight against smoking. Indeed, WHO communications have regularly spread a disinformation double whammy: first, that vaping devices will increase the number of smokers, and second, that electronic cigarettes pose an equal or greater risk to public health as combustible tobacco products.
Fortunately, the data speaks for itself. Several studies have found that electronic cigarettes are considerably safer than combustible tobacco products, with Less than 1% carcinogenic emissions from tobacco smoke. A British government review of all available evidence, almost all of the 2.6 million UK adults using e-cigarettes are current or former smokers, and the vast majority of users rely on these devices to help them avoid smoking combustible cigarettes.
What the British review also revealed, however, was a to augment the number of people who have been misled into believing that electronic cigarettes are “as or more harmful” than smoking. In 2013, only eight percent of people were concerned about “electronic tobacco products”. By 2015, that figure had jumped to more than 22%. The situation is even worse in continental Europe, where a survey found that a staggering number of 59% of Europeans mistakenly believe that vaping is just as dangerous or more dangerous than smoking, which could set Europe back several years in its efforts to create a smoke-free generation.
By unnecessarily sounding the alarm on e-cigarettes, WHO is effectively blocking the success of its own anti-smoking Strategies and miss the bigger story: vaping is a much less risky alternative to consuming combustible tobacco, and the language around it needs to be adjusted accordingly. This is especially important for WHO, an organization that sets global health standards that to guide regional and national policy all over the world, including in Brussels.
Not all governments are oblivious to the public health benefits of a harm reduction approach. Last month the UK Department of Health announcement that the state-funded National Health Service (NHS) may soon begin offering e-cigarettes to smokers seeking to quit. Contrary to language used by the EU and WHO, the ministry said these products were “very effective” in helping people quit smoking.
Although the UK has one of the the lowest Smoking rates in Europe, there are over six million smokers in the UK, with much higher smoking rates in poorer areas. The unemployed are almost twice likely to smoke and, depending on the region, between 10 to 25 percent of pregnant women smoke during childbirth. In 2019, more than 64,000 people died from smoking-related illnesses.
Across the Channel, the EU is facing a smoking epidemic even larger proportions. Despite large-scale health policy efforts, smoking was responsible for one-fifth of cancer cases in 2018 and remains the number one The most important cause of premature death in the region. In this case, Brussels might do well to take a page from the London book for once.
Picture: Vaping by Mike Mozart / Flickr