On April 16, the Global State of Tobacco Harm Reduction (GSTHR) released its newest report—“Tobacco Harm Reduction: A Burning Issue for Asia”—detailing how countries in the region have largely failed to consider safer nicotine products (SNPs) to combat the smoking-related death toll.
While media and political focus on vaping tends to land on youth use in the United States and typically ignores the voice of tobacco harm reduction experts and consumer advocates, that leaves so much out. US smoking rates have steadily declined, and as of 2019, there were 34.1 million adult smokers in the country, according to the Centers for Disease Control and Prevention. Smoking still causes more than 480,000 deaths per year in the US.
Asia’s issues, though, are on a different scale altogether. The continent contains roughly 60 percent of the world’s smokers (around 743 million people), and suffers nearly half of the 7 million-plus annual toll from the leading cause of preventable death on Earth. The region also holds almost 90 percent of the planet’s consumers of the higher-risk smokeless tobacco products, which contribute to high rates of oral cancer.
All of this is why GSTHR, a Knowledge-Action-Change project primarily authored by Harry Shapiro, sees Asia as the major battleground for tobacco control. Alternatives to combustible cigarettes such as vaping and less dangerous oral nicotine products like snus have not yet been largely embraced. It’s a messy situation: Many countries have governments that own or have a stake in tobacco companies and usually bend to the influence of Western philanthropists like Michael Bloomberg, who advocates through his charity and other nonprofits to institute draconian, prohibitionist policies.
The report estimates that there are currently 19 million nicotine vapers in Asia—just one vaper for every 39 cigarette smokers. The consequences of a failure to scale up harm reduction are manifest. “By making it difficult, if not impossible, for current adult smokers to access SNP, governments are illegitimately interfering with an individual’s right to health,” GSTHR’s paper reads. (The authors do acknowledge outliers, like Japan, South Korea and Malaysia, which have made strides by fostering markets for less-lethal heat-not-burn products.)
The main argument of the report focuses on the lapses of the World Health Organization (WHO), and how it has not followed the tenets outlined in its own Framework Convention on Tobacco Control —which includes “a range of supply, demand and harm reduction strategies that aim to improve the health of the population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.”
There are reasons for the WHO’s omission of harm reduction in its approach, and the paper cites a number of factors: the profit-seeking motives of state-owned tobacco companies, misinformation that floods in about youth vaping and lung illnesses from the States, and vaping bans encouraged by billionaires in the West, most especially Bloomberg.
As a result, regulation and control of SNPs suffers—to the frustration of both THR proponents and vapers, who are beginning to speak out. In March, the International Network of Nicotine Consumer Organizations (INNCO) put out a letter condemning vape bans and the quit-or-die mentality seeping into lawmakers’ minds through institutions like the WHO.
“The WHO has made its position clear that SNP do not serve a purpose as an exit route from smoking,” the GSTHR paper asserts, echoing INNCO’s position. “This has had consequences around the world, as governments look for guidance and leadership on regulation or legislation to respond to new products, and consumers look to apparently credible sources of information on how to improve their own health outcomes.”
Knowledge-Action-Change has provided donations and scholarships (to support tobacco harm reduction reporting) to The Influence Foundation, which operates Filter. Both INNCO and The Influence Foundation have received grants from the Foundation for a Smoke-Free World.
Photograph of a man vaping in Japan by Curtis Simmons via Flickr/Creative Commons 2.0