In a public statement, the International Union Against Tuberculosis and Lung Disease calls for a ban on the sale of heated tobacco products and e-cigarettes in middle- and low-income countries, in order to combat the tobacco epidemic. This statement echoes that of the World Health Organization in 2019, stressing that there is “insufficient independent evidence to recommend the use of [e-cigarettes] as a large-scale smoking cessation method to help smokers quit,” and arguing that these products are “undoubtedly harmful.” In support of its position, the Union puts forward ten arguments that demonstrate the importance of legislation in middle- and low-income countries.
- Tobacco industry targets youth
Studies show an epidemic increase in e-cigarette use among youth in many high-risk countries, putting this population at risk of lifelong nicotine addiction. These new products, increasingly controlled by the tobacco industry, target youth through
social media advertising campaigns, event sponsorship, or fruity and sweet flavors. The targeting of young people by the tobacco industry is also the theme of World No Tobacco Day on May 31, 2020.
- The transition from electronic cigarettes to tobacco among young people
A risk of transfer of consumption should not be underestimated. Young e-cigarette users who have never smoked before and who appear to be at low risk of starting smoking later are two to four times more likely to smoke traditional cigarettes in their lifetime.
- Insufficient evidence of reduction of harm in smokers
Electronic cigarettes, when not used solely as a cessation tool, pose medium and long-term health risks. There are no independent studies to demonstrate any danger from heated tobacco.
- The negative net result in public health
The expected benefits of new products in terms of public health, which are very uncertain, will be less than the health damage caused by their consumption.
- Weaknesses in enforcement will be exploited
Middle- and low-income countries already face challenges in implementing and enforcing regulations on traditional tobacco products. New and evolving tobacco products will be more difficult to control. This is all the more problematic because the tobacco industry systematically takes advantage of regulatory weaknesses to advance its financial interests and block, delay, or circumvent public health measures.
- New products divert essential measures to be adopted and implemented
Tobacco control must be based on a solid foundation of evidence, and the rigorous implementation of coherent and proven policies. New, uncertain tobacco products must not ruin years of public health efforts.
- The new products will mobilize resources that would otherwise need to be allocated to tobacco control.
The establishment of regulatory frameworks requires the mobilization of new resources, which are already sorely lacking in the fight against tobacco.
- New products facilitate tobacco industry interference
The tobacco industry is seeking to improve its image through its new products presented as less harmful. In this way, cigarette companies are positioning themselves as a legitimate interlocutor on public health issues, in order to interfere in regulatory processes.
- It is important to distinguish the context of middle and low income countries from the context of the United Kingdom.
The UK situation is not transferable, particularly to middle and low-income countries. The weakness of the regulatory and financial resources specific to these countries and the distinct situation of development of the tobacco epidemic require that these countries remain focused on the full implementation of the measures of the FCTC and in particular the WHO MPOWER programme.
- Safety first
Public health practitioners and decision-makers must follow the precautionary principle and an evidence-based approach in defining public policies. These fundamental public health concepts call for preventive measures when science cannot draw conclusions.
©Generation Without Tobacco
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