Heated tobacco does not qualify as risk reduction, according to MILDECA

The Interministerial Mission to Combat Drugs and Addictive Behavior (MILDECA) has just published its Interministerial Strategy for Mobilization against Addictive Behavior 2023-2027, which places great emphasis on protecting minors from sales of tobacco, alcohol, and gambling. On the subject of risk reduction, this document clearly states that heated tobacco devices cannot be products suitable for risk reduction in tobaccology, an argument that manufacturers do not hesitate to brandish.

The leading cause of preventable death in France with 75,000 deaths per year, smoking is one of the major topics of mobilization of the Interministerial Strategy for Mobilization against Addictive Behavior 2023-2027. The theme of tobacco is addressed from several angles, whether it is sales to minors, social marketing or risk reduction.[1]The objective of a Tobacco-Free Generation by 2032, i.e. fewer than 5% of young people smoke, is reaffirmed.

Enforcing the ban on sales to minors

It is perhaps on the theme of the protection of minors that this 2023-2027 strategy will make its mark. Noting, with mystery shopping studies to support it, that two thirds tobacconists sell tobacco to minors and 95% of minor smokers buy their supplies through the legal tobacconist circuit, MILDECA proposes to use this lever to achieve a significant reduction in smoking among young people. Vaping products are not directly mentioned, but it can be assumed that their sale to minors should be subject to the same provisions.

To this end, MILDECA not only recommends a significant strengthening of the training of tobacconists, but also plans to enforce the ban on sales to minors. "by a continuous and dissuasive control system, formalized by an interministerial protocol". Checks are now almost non-existent, since only 24 fines were issued for offences involving the sale of tobacco to minors in 2018.[2]. Tobacconists are thus only likely to be checked once a century for this type of offence. Compliance with this fundamental ban would be a counterpart to the many measures to support tobacconists and would be carried out "in application of the memorandum of understanding on support for the tobacconist network 2023-2027" which grants them substantial advantages.

Promotion of the “No Tobacco Month” social marketing operation

The advantages of social marketing are clearly highlighted in this 2023-2027 Strategy. The collective challenge of the "Smoke-Free Month" scheme should therefore be renewed every year, but the "Dry January" initiative, its equivalent for alcohol, still does not attract the attention of public authorities. The notion of denormalization - resulting from the fight against smoking and which consists of no longer displaying consumption to avoid the incentive effect - is also highlighted with the increase in smoke-free spaces, this principle being able to be applied to all psychoactive substances.

Addressing the subject of risk and harm reduction (HRDR) related to tobacco, MILDECA clearly states that heated tobacco cannot be part of this logic. It even specifies that "heated tobacco should in no case be an aid to quitting smoking, the substances inhaled during its use being the same as those in conventional tobacco, even if the concentrations of toxic substances are lower than in smoked tobacco." A major clarification, which invalidates the tobacco industry's discourse on heated tobacco. In the United States, the Food and Drug Administration (FDA) has granted heated tobacco the status of "modified risk product", but tobacco industry, particularly in Europe, persists in claiming to be part of the RDRD, an abuse of language that deserves to be clarified.

Keywords: MILDECA, Strategy 2023-2027, sale to minors, heated tobacco.

M.F.

[1] MILDECA, Interministerial strategy for mobilization against addictive behavior 2023-2027, March 2023, 56 p.

[2] Health prevention, Annex to the draft finance bill for 2021, Ministry of Budget.