It was widely reported at the end of June that the European Commission, the European Union’s executive branch, is proposing to amend its existing Tobacco Products Directive to prohibit the sale of flavored heated tobacco products in all EU member states.
In announcing the measure, Stella Kyriakides, the EU commissioner for health and food safety, explained that this was “another step towards realizing our vision under Europe’s Beating Cancer Plan to create a ’Tobacco Free Generation’ with less than 5 percent of the population using tobacco by 2040.” She offered this justification: “With nine out of 10 lung cancers caused by tobacco, we want to make smoking as unattractive as possible to protect the health of our citizens and save lives.”
Considering that combustible tobacco is the overwhelming cause of those cancers, it is difficult to imagine a more counterproductive anti-cancer measure than one which obstructs a safer alternative to cigarettes.
Heated tobacco products are demonstrated to be direct competitors to combustible cigarettes—and have reduced cigarette sales at astonishing rates.
Contrary to Kyriakides’ implication, heated tobacco products (HTP) do not involve smoking. Instead, these recent innovations heat a tobacco-based “stick,” rather than burning it, to create an aerosol that is inhaled. This process avoids vast amounts of the harmful elements of combustion which cause smoking-related diseases, as research has shown.
The UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment estimates heated tobacco products’ aerosols to contain up to 90 percent fewer “harmful and potentially harmful compounds” compared to cigarette smoke. And even the US Food and Drug Administration, hardly a champion of tobacco harm reduction, has authorized one HTP brand to be marketed as ”modified risk” —recognizing that it presents reduced exposure to harmful elements and is “expected to benefit the health of the population.”
In real-world scenarios, heated tobacco products are demonstrated to be direct competitors to combustible cigarettes—and have reduced cigarette sales at astonishing rates in markets where they are legally sold.
For example, in Japan, sales of cigarettes have plummeted by 47.5 percent since the introduction of popular HTP in 2016, as smokers switch en masse. Such a large, rapid rejection of cigarettes is unprecedented in the history of tobacco control.
Researchers seem confident that HTP are the cause. An American Cancer Society study in 2020 concluded that heated tobacco products “likely reduced cigarette sales in Japan.” Another 2020 study published in the International Journal of Environmental Research and Public Health came to a similar conclusion, stating that “the accelerated decline in cigarette-only sales since 2016 corresponds to the introduction and growth in the sales of heated tobacco products.”
There is emerging evidence, too, that the harm reduction potential of these products could be starting to translate into public health benefits. Investigations into recent Japanese population medical data have shown a significant downward trend in hospitalizations attributable to chronic obstructive pulmonary disease (COPD) and ischaemic heart disease from 2017 onwards, which correlates closely with the proliferation of HTP.
Neighboring South Korea has also seen its traditional cigarette industry losing customers at an unprecedented rate after the introduction of HTP, and is observing similar health trends. A 2021 study by the Seoul National University College of Medicine found that compared to smoking, switching to reduced risk-products—which, in South Korea, almost exclusively means HTP—was associated with 23 percent lower risk of developing cardiovascular disease.
Back in Europe, we’ve been seeing signs that things could head in a similar direction. Industry figures show that HTP now account for more than 20 percent of the entire nicotine market in Rome and Athens, a quarter in Budapest and a whopping 37 percent in Vilnius, Lithuania.
It’s like reacting to the environmental harms of the combustion engine by banning certain types of electric vehicles.
You might accept the evidence for the reduced risk of HTP, but still question why the EU banning just flavored forms of HTP would be a big deal. But as with vaping, flavors may be vital to adults who switch from smoking to HTP. Because providing smokers with safer alternatives that they prefer to cigarettes is the whole point.
If the goal is truly to beat cancer, it makes no sense to protect the combustible cigarette trade by imposing arbitrary restrictions on far safer products which significantly reduce harm. It’s like reacting to the environmental harms of the combustion engine by banning certain types of electric vehicles.
Why, then, is the European Commission embarking on this bizarre plan to protect the cigarette trade from competition? Either it has been woefully misinformed by tobacco control activists about the nature of HTP, or else its own ideology and puritanism outweigh its concerns for health and beating cancer.