Friday, October 12, 2018

Harm Reduction 2 : “Less harmful alternatives to tobacco”

Continuing our series on Harm reduction, we present the views of Jeannie Cameron, Founder and MD JCIC International, a UK-based strategic advocacy consultancy specializing in tobacco harm reduction. She also attended the seminar on “Harm Reduction” organized on 27th September at IIC, New Delhi.

When I spoke to her about tobacco harm reduction and e-cigarettes, this is what she had to say.

“There is a product called Swedish snus, which is like pasteurized smokeless tobacco product that you put in the mouth. Sweden has this product historically for 300 years. In Sweden, which is very good at its medical health and epidemiology, they have studied this for more than 50 years, and found zero or nil deaths from tobacco snus product.  Norway, next door in Scandinavia, also has started to use this product and also found zero deaths from it. When you compare that with a country like India which has significant use of oral and smokeless (tobacco) and you have huge deaths – 30-40% of tobacco related deaths are coming from that.

In Sweden, they were so wanting to ensure that they didn’t want to lose this product that when they joined the European Union (EU) in the 1970s, they have a special derogation in the law under the treaty to join EU to protect their use of this product. That’s how important it was for Sweden at the time. And the evidence everyone who is anywhere in the world, anyone would tell that it is less harmful than smoking.

I am not an expert on e-cigarettes so much because  when I did my legal dissertation at the time in 2007 on harm reduction and tobacco harm reduction, e-cigarettes were not even available. They were not really discovered then. So this information has come later.

The Royal College of Physicians and all the research that is coming in now – independent research, some research is coming from tobacco companies, but they put it out for independent scrutiny – it is all showing and the RCP saying that it is up to 95% less harmful than smoking.  

There are three products available now, which are less harmful than smoking.

One is Swedish snus, which is significant in Sweden. The other one is e-cigarettes; UK has now the fastest fall in smokers since they have been available because the UK allows them freely.

And, vaping is taking off all over the world as smokers find it’s a good replacement.

The third is the heated tobacco, which is launched in Japan only two years ago. It’s already something like 27% of Japanese smoking market. Japanese are known to be big smokers and they have switched over to using heated tobacco. Japan does not allow e-cigarettes, but they allow heated tobacco.

The way to think about is both these products are vaping because they are not producing smoke, whether it is a heated tobacco or whether it is an e-cigarette. They are producing vapor and vapor is not causing any harm to the lung like smoke is.

And as we know, it’s the nicotine they want … they smoke for nicotine, but they die from the smoke.

If we can provide people with something that is helpful to them in terms of their health, but still gives them the nicotine that they want, then that’s a much better thing. In India, that could make a huge difference.

All the time, there are new developments being made on nicotine, and nicotine is now being used to help cases of Parkinson’s, Alzheimer’s ... I think in the future there will be lot of emerging research, which will show that.  

But, I think, one of the big concerns also is the tax side and of the growers and economies which are dependent on tobacco should see it as potentially for future business opportunity in some respects because it is transitioning people. They don’t need to be afraid of it and in some parts of the world, where there are big growing places like Brazil or Indonesia and maybe a bit in India, they should see it as an opportunity.”

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