On 4 December, the global public health platform Quit Like Sweden hosted an event in London, Westminster, focusing on the global case for embracing new approaches to tobacco harm reduction.
Experts from various fields focused on three key areas essential in helping people to switch to safer nicotine alternatives: affordability, access and acceptance. These innovative approaches, adopted by Sweden, have allowed the country to enjoy the world's lowest smoking rate of just 5.31%.
To ensure an open discussion that looked at all perspectives, THR advocate, Clive Bates, from Counterfactual, took on the role of THR sceptic, providing probing questions and robust debate.
Founder of QLS, Suely Castro, introduced the event which aimed to be academic, practical, global and urgent. If safer alternatives can save lives, Castro said, what responsibility do we have to science, to fairness and to the people we serve?
Access
Martin Cullip from Taxpayers Protection Alliance spoke of the importance of consumers voices being present in the decision-making process of tobacco control, giving the example of COP11, where the World Health Organisation made concerted efforts to keep the voices of those with lived experience out. How can you have a treaty which is dealing with people's lives that is not inclusive, he asked.
Acceptable
Pharmacologist, Professor Bernhard Mayer, discussed the BfR's 16.6mg limit as a global standard and how the war against cigarettes has transferred to a war on nicotine. Mayer spoke about the importance of satisfying nicotine levels on SNPs products that help deter relapses. One size does not fit all, he explained, and varying nicotine levels helped consumers identify and tailor SNPs to individual needs.
Discussing the crucial role flavours play in helping smokers switch to safer nicotine products was Dr Garrett McGovern. Flavours, he said, ensured SNPs were satisfying, made the harshness of nicotine palatable and allowed smokers to disassociate with smoking more successfully. Answering Bates' stance that flavours simply hook a new generation to nicotine, a belief adopted by tobacco control enthusiasts, McGovern was clear. A clear balance between adult harm-reduction benefits with youth-prevention must be made - without restricting choice for adult consumers. He concluded that flavours need to be managed responsibly and enforcing laws that already exist on age limits are sufficient in helping youth vaping, if they are robustly enforced.
Risk-based taxation could drive one of the biggest public health transformations of our time.
Affordable
David Sweanor, Chair of the Advisory Board, Centre for Health Law, stated taxes on SNPs should be risk-proportionate. Aligning taxes on SNPs with taxes on deadly combustibles gave the message that both products were comparable in the risk they posed to consumers. He explained we can use rational economic taxation sense to help facilitate what would be one of the greatest transformations in public health history. Bates put forward the idea there should be a blanket tax on all nicotine products in order to stamp out all consumption. Sweanor explained, what was important here was to be clear on what is the desired outcome. If the goal is to reduce nicotine, then high tax and more law enforcement would be the way forward. But, if the goal is to reduce death and disease, lower taxation on SNPs was essential in changing behaviour that would not encourage workarounds and a thriving black market.
Event Highlights
Speakers
Suely Castro
Director, Quit Like Sweden
A long-standing harm-reduction advocate who has spent nearly two decades assessing global Tobacco Control efforts, and promoting accessible, acceptable, and affordable alternative nicotine products, inspired by the Swedish experience.
Clive Bates
Director, Counterfactual
Former Director of Action on Smoking and Health (UK) (1997-2003). A public health advocate with senior background in the UK Prime Minister's Strategy Unit and UN (Sudan), now advancing pragmatic solutions for sustainability and health.
Martin Cullip
International Fellow, Taxpayers Protection Alliance Consumer Center
Former Chair, New Nicotine Alliance (UK). As a consumer of alternative nicotine products, he provides a veteran voice for harm reduction in domestic and global policy forums.
Professor Bernhard Mayer
Pharmacologist, University of Graz
Former Chair, Dept. of Pharmacology and Toxicology, Univ. of Graz. Authored 300+ papers on molecular pharmacology and cardiovascular signaling. Corresponding Member, Austrian Academy of Sciences.
Dr. Garrett McGovern
Medical Director, Priority Medical Clinic
Clinical Lead, HSE Addiction Services. A GP specializing in substance misuse (MSc, King's College London; ISAM Diplomate). Member of the Irish Medical Council health committee and Int'l Doctors for Healthy Drug Policies.
David Sweanor
Chair of the Advisory Board, Centre for Health Law
Chair of the Advisory Board, Centre for Health Law, Policy & Ethics, University of Ottawa; Adjunct Professor, Faculty of Law, University of Ottawa; Global Leadership Council, Boston University School of Public Health; Legal Counsel, Non-Smokers' Rights Association, 1983-2005.