The start of 2018 has seen a flurry of activity in the tobacco harm reduction sphere, with many potentially significant events taking place in relation to several different products. In light of this, it is worth revisiting the NNA’s stated aims to reinforce why we are central to this debate and supportive of Tobacco Harm Reduction in all its forms.
As our About Us page states, the NNA seeks to encourage “a mature public and organisational understanding of the potential of safer nicotine products for reducing cigarette smoking, including their safety and efficacy”. This is as true for tobacco-based solutions as it is for vapour-based ones and extends to other novel harm reduction innovations currently in existence or yet to come to market.
It is important to highlight this because there have been some who have been puzzled, for example, as to why the NNA were instrumental in a case challenging the EU’s ban on snus. The NNA is not, and has never been, solely devoted to promoting e-cigarettes and vaping even though many of our most prominent advocates have been drawn from that avenue out of smoking.
We have provided many updates to the snus challenge and are still optimistic that – with the snus case being merely one part of our work - we may be part of a sea change in attitudes towards harm reduction, a concept which is not new or confined to nicotine and tobacco, but instead has a long history of saving lives in HIV prevention, safer drug delivery and road fatalities amongst other areas.
Harm reduction relies on rejecting binary thinking and argues that often the best solutions are those which – although perhaps counter-intuitive – will deliver optimal results without heed to ideology or blind groupthink.
Our support for snus – undeniably a tobacco product – is based on the fact that it has been proven in jurisdictions where sale is permitted to provide a safer alternative to smoking and therefore to save lives. To reduce harm, in other words.
By the same token, heated tobacco has also been in the spotlight recently and the NNA also supports this increased activity to assess its efficacy. Early research suggests that it offers another promising alternative for those who have chosen to reduce their exposure to the risks of smoking but may not take to NRT or vaping.
In January, an application by PMI’s iQos for making a reduced risk claim was rejected by an FDA committee but it is expected that the right to market the product in the US will be approved. Market analysts are confident that claims of ‘heat not burn’ tobacco to be markedly less harmful than smoking will follow once the science has been evaluated, perhaps as soon as the end of this year.
Likewise, in keeping with the UK government’s commitment in its Tobacco Control Plan to assess evidence on novel nicotine delivery systems, the UK Committee on Toxicity reported at the turn of the year that heated tobacco is likely to be less risky than lit tobacco and exposes consumers to between 50-90% fewer harmful compounds. This is the essence of harm reduction which is why the NNA is supportive of further research to examine the potential in these products. Indeed, just last week the government’s Science and Technology Committee took evidence at Portcullis House about reduced risk products and included heated tobacco in its remit.
On the horizon are more opportunities for tobacco harm reduction, with novel products such as tobacco-free snus being available in some countries and rumours that these may be rolled out in the UK too. Other options such as dissolvables and nicotine films/strips may all contribute in the future to a diverse range of nicotine products which can deliver reduced harm while also satisfying what is a vast market for nicotine which is never going to go away.
The NNA exists to promote tobacco harm reduction - a term understood by governments, NGOs and even the WHO to describe ways of reducing harm from cigarette smoking without necessarily giving up the use of nicotine – and we will never shy away from that.
Anything from smoking fewer cigarettes through to total abstinence are harm reduction of varying degrees. There are no downsides if harm and risk are being reduced. To borrow a rhetorical turn of phrase from the Prime Minister, tobacco harm reduction means tobacco harm reduction, and the NNA is happy to add its support to anything which delivers that goal.