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Youth Smoking

WHO China launches smoke-free campaign targeting youth

The World Health Organization (WHO) started a “smoke-free generation” media campaign in Beijing Thursday targeting young Chinese.

http://www.china.org.cn/china/2017-06/03/content_40957899.htm

China is in the grip of a national tobacco epidemic, and children are most susceptible with cigarettes portrayed as fashionable and alluring in popular culture, said Bernhard Schwartlander, WHO Representative in China at the launch event.

According to WHO, over half of Chinese adult men smoke, two thirds of whom started as young adults. By 2014, 72.9 percent Chinese students had been exposed to secondhand smoke.

“There is nothing cool about smoking, but there is something empowering about choosing to live a healthy, smoke-free life,” said Schwartlander.

Since China ratified the WHO Framework Convention on Tobacco Control in 2005, the country has made a number of tobacco control efforts, including banning tobacco advertisements, increasing tobacco taxes and putting forward regional smoking bans.

As of 2016, 18 cities, including Beijing, Shanghai and Shenzhen, had implemented regional smoking bans.

China has set a target to reduce the smoking rate among people aged 15 and older to 20 percent by 2030 from the current 27.7 percent, according to the “Healthy China 2030″ blueprint issued by the central authorities last October.

WHO urges government to control tobacco use

The World Health Organisation (WHO) has urged the government to introduce policies to control the use of tobacco because it is a leading risk factor for some serious non-communicable diseases.

The Country Representative of WHO, Dr Owen Kaluwa, who made the call suggested, for instance, the imposition of high taxes on tobacco companies to deter them from going into production.

http://www.graphic.com.gh/news/general-news/who-urges-government-to-control-tobacco-use.html

In the event of the companies paying such taxes, he said, the revenue generated should be used to finance health delivery.

He was speaking at a public forum to mark World No-Tobacco Day (WNTD) in Accra last Wednesday.

Avoid tobacco

Dr Kaluwa said globally, tobacco kills about 7.2 million people every year, over 80 per cent of whom are from low or middle-income countries.

“In Africa, about 146,000 adults aged 30 years and above die every year due to tobacco-related health diseases,” he added.

He said the use of tobacco was a leading preventable risk factor for non-communicable diseases such as cardiovascular diseases, cancer and chronic lung disease.

“Up to half of all tobacco users will die prematurely from tobacco-related causes, and on average, tobacco users lose 15 years of their lives,” he said.

Mr Kaluwa added that the growing of tobacco had affected agricultural lands in some areas.

Public education

At her turn, a Deputy Minister of Health, Mrs Tina Mensah, said adequate public education was important in dealing with the problem of tobacco use.

She reiterated the fact that tobacco use was dangerous to human health and damaging to national economic development.

“Tobacco-related illnesses and premature mortality impose direct and indirect cost to individuals and government,” she said.

She noted that tobacco production companies tried to influence the young generation to become addicted to smoking, which was a national threat.

She applauded the Food and Drugs Board (FDB) for its intervention in combating the use of tobacco by preventing tobacco companies from advertising their products.

Mrs Mensah said the ministry, for its part, would continue to support the fight against the use of tobacco in the country.

Preventive measures

Outlining some measures that had been put in place to check tobacco usage, the Chief Executive Officer (CEO) of the FDA, Mrs Delese A. Darko, mentioned the prohibition of smoking in public places, advertising prohibition and sponsorship as examples.

She added that packaging, labelling and health warnings on tobacco packages were other ways of preventing and discouraging tobacco consumers from patronising the product.

“These prohibitions have shown to be effective in reducing the demand for tobacco,” she said, adding that public sensitisation and education would, accordingly, be increased to meet the target groups.

“As we get funding, we will continue to do more to inform the public about the harmful effects of the use of tobacco,” Mrs Mensah said.

In connection with the celebration, Smoking Cessation Guidelines and a declaration on WNTD 2017 were launched.

Cheaper cigarettes, roll-your-own tobacco slows smoking’s downward spiral

Yesterday morning, Australia’s tobacco industry woke to the latest chapter in the book documenting its inexorable decline.

https://theconversation.com/cheaper-cigarettes-roll-your-own-tobacco-slows-smokings-downward-spiral-78745

The Australian Institute of Health and Welfare released data from its 2016 National Drug Strategy Household Survey, which it has conducted every three years since 1985.

While it was always going to be hard to show even further decline in teenage smoking from what was an already very low level, it’s happened again.

The proportion of teenagers (aged 12-17) who have never smoked more than 100 cigarettes significantly increased between 2013 and 2016, from 95% to 98%. Smoking more than 100 cigarettes in a lifetime has long been used in Australia as a benchmark question to sort curious, experimental smokers from more committed and addicted smokers.

Younger people also continued to delay when they first smoked their first full cigarette. This increased in the 14 to 24-year-olds from 14.2 years in 1995 to 16.3 in 2016 (a statistically significant increase from 15.9 years in 2013).

Catch ‘em young

The tobacco industry knows it needs to attract and addict new consumers to replace those who stop smoking through quitting and death. As a 1981 report sent to the then vice-president of research and development at Philip Morris put it:

Younger adult smokers are the only source of replacement smokers … If younger adults turn away from smoking, the industry must decline, just as a population which does not give birth will eventually dwindle.

Australia’s plain packaging legislation, implemented in December 2012, was aimed at reducing teenage Australians taking up smoking. As the health minister who introduced it, Nicola Roxon emphasised in April 2010 when announcing the policy:

We’re targeting people who have not yet started, and that’s the key to this plain packaging announcement – to make sure we make it less attractive for people to experiment with tobacco in the first place.

As Australian young people have turned away from smoking, the tobacco industry is left scrambling for new ways to addict young customers to nicotine.

Total smoking levels remain level

The proportion of people of all ages who smoke was also not good news for the tobacco industry.

The percentage of people aged 14 and over who smoke daily is down from 12.8% in 2013 to 12.2% in 2016. While any decline is welcome, this was less than it should have been, and the first time in two decades that a statistically significant fall was not recorded.

There are several factors likely to be responsible for the previously brake-less downward slide in smoking.

Long-time campaigners Mike Daube and Todd Harper have set out nine strategies the Australian tobacco industry has used so it can keep earning from the deaths of two in three Australian smokers likely to die from using their products.

Two critical factors here are price discounting and the dramatic rise of roll-your-own tobacco.

How price discounting works

Plain packaging means brand differentiation is gone as all packs look the same, except for the written brand name. So, the ability of branding to convince gullible smokers that premium (expensive) brands are somehow “better” and worth spending more on than cheaper, budget brands goes out the window.

After plain packaging was introduced, there was an industry-wide decision to cut prices to compete with lower priced brands for market share. There were large tobacco tax rises in the run-up to plain packs being introduced (25% in 2010) and a further 12.5% each year from 2013 to 2016.

Again, the tobacco companies cut their margins by desperately trying to keep some brands below A$20 a pack, a price known to trigger quitting.

These practices may see renewed interest in floor pricing of tobacco products, when a price is set below which a product cannot be sold.

Rise in roll-your-own tobacco

Tobacco companies have also aggressively pushed cheaper roll-your-own tobacco by introducing loose tobacco with cigarette brand names. The tax in roll-your-own tobacco will rise from September 2017, which may see a further round of price discounting to try and stop people quitting.

The use of roll-your-own cigarettes has gone from 26% of smokers in 2007, to 33% in 2013 and to 36% in 2016. Lower price is one factor driving this, but so too are the quite erroneous beliefs that roll-your-own tobacco somehow contains fewer additives and is less harmful, an issue I will explore in my next column.

The increase in roll-your-own cigarettes since 2007 has been largest among smokers aged under 40 (increase of 82% for young adults and 70% for smokers in their 30s between 2007 and 2016). Between 2013 and 2016 roll-your-own use in smokers in their 30s jumped from 29% to 37%.

National campaign wheels fallen off

Sustained and adequately funded mass media campaigns are a vital component of strategies health authorities recommended to change health behaviours, like smoking.

And with smoking, one of the most obvious pieces of evidence comes from ex-smokers about why they stopped smoking. There are light-years between the answer that has always been given (concern about health) and everything else (cost, social unacceptability, pregnancy etc).

In this study of smokers in 20 US communities, 91.6% of ex-smokers nominated “concern for your own current or future health” as why they quit compared with 46.5% who nominated “pressure from family, friends or co-workers”.

Without large scale, on-going campaigns that reach large proportions of the population with unforgettable, motivating information about why smoking is so harmful, the core driver of quitting and not starting smoking may wane.

Regrettably, Australia’s world famous national tobacco campaign that started in 1997 and has been used by many other countries, has been mothballed since 2013 when the Coalition government took office.

Smokers still get sporadic small bursts of quit smoking ads on television in some states from state health departments. But they are not getting a fraction of the highly motivating exposures that were a big part of our earlier rapid declines. This absence is almost certainly a major factor explaining the slow down in people quitting smoking.

E-cigarettes

The latest stats show that while around 31% of smokers (ie 3.8% of the 14+ population) had ever tried e-cigarettes, 20% seemed to have done so out of curiosity (once or twice) with only 4.4% currently using them (the remaining 6.8% no longer use them). Just 1.5% of smokers were using e-cigarettes daily (0.8% of ex-smokers and 0.2% of never smokers).

There’s no evidence from these very small numbers that e-cigarette use is contributing to falling smoking in Australia.

Many are concerned that the tobacco industry (which has bought into vapourisers big time) has a business plan to have smokers vape and smoke, not vape instead of smoking. If that plays out, increases in vaping may in fact act to further slow people from quitting smoking. The next few years will provide important information on this important issue.

Smoking may cause bone degeneration, osteoporosis in youngsters

Smoking as a habit typically begins in high school or the college years, when bones are still developing. It also interferes with calcium and vitamin D absorption in the body.

http://www.hindustantimes.com/fitness/smoking-may-cause-bone-degeneration-osteoporosis-in-youngsters/story-loCO9GllLujrar6epnuDbI.html

Youngsters who smoke may be at risk of developing low bone density — a condition that may lead to an increased risk of developing osteoporosis, experts say.

“Smoking has a negative effect on the bones, causing loss of bone mass and, eventually, premature osteoporosis when young people take up smoking,” Raju Vaishya, senior orthopaedic surgeon, at Indraprastha Apollo Hospitals, said in a statement on Wednesday.

Smoking as a habit typically begins in high school or the college years, when bones are still developing. It also interferes with calcium and vitamin D absorption in the body.

Besides, in case of a bone injury, a person who smokes is more likely to have a longer period of recovery and greater risk of complication, doctors noted.

“Smoking during the years of bone-building puts you at risk of osteoporosis in later stage. Smoking after 30 will speed up loss of bone mass almost twice as faster,” Vaishya added.

Smoking kills over one million people in the India annually, according to The Global Adult Tobacco Survey (GATS) India report. The economic burden of tobacco consumption is around Rs 104,500 crore per annum.

In a study, recently published in the journal Annals of the American Thoracic Society, smoking was found to be an independent risk factors for low bone density among both men and women.

Each additional pack-year of smoking raised the odds of having low bone density by 0.4%. The participants with normal bone density had an average of 36.6 pack-year of smoking, while those with low bone density had an average of 46.9 pack-years of smoking history.

Smokers Undeterred as Bills Keep Rising

Since the beginning of the past fiscal year (ended in March) the taxes collected on tobacco products are paid to the Health Ministry (50%), Education Ministry (25%) and Ministry of Sports and Youth Affairs (25%) for anti-smoking campaigns

https://financialtribune.com/articles/people/65335/smokers-undeterred-as-bills-keep-rising

Iranians spend $1-1.5 million (40 to 50 billion rials) on tobacco products each day and the cost of treating tobacco-related disease is almost three times more than the amount spent on tobacco consumption.

During the past five years, the rate of tobacco consumption has only slightly decreased, studies conducted by the Health Ministry indicate. The rate is still high among adolescents and young people (the peak age for first trying of smoking has decreased from 13 to 10). The figure has also increased dramatically compared to the past decade, the Persian language weekly ‘Salamat’ reported.

“In 2006, Iranians smoked 50 billion cigarettes (worth $33.3 million). The figure reached 60-70 billion cigarettes in 2016,” said Dr Mohammadreza Madani, head of the Iranian Anti-Tobacco Association (IATA).

Another concern is the high prevalence of hookah (water pipe) for smoking flavored tobacco among young people. One hour of smoking hookah exposes a smoker 100-fold to the amount of smoke inhaled from a single cigarette. Even those people around a hookah smoker inhale smoke equal to 10 cigarettes.

Every year on May 31, the WHO marks World No Tobacco Day (WNTD), highlighting the health and additional risks associated with tobacco use, and advocating effective policies to reduce tobacco consumption.

The theme for World No Tobacco Day 2017 is ‘Tobacco – a threat to development.’

But irrespective of the programs to create awareness on the harmful effects of smoking, statistics show that 14-15% of Iranians from the 80 million population are regular cigarette smokers (more than 3% are women, and 20% men).

“Though most of the cigarette smokers are men, hookah smoking doesn’t vary by gender; 21.3% of women and 21.7% of men are hookah smokers,” Madani said.

Dodging Taxes

Iran is one of the nations that has signed the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), by which a country is committed to reduce the rate of tobacco consumption every year (by implementation of both price and tax measures as well as non-price measures to reduce demand for tobacco).

Pointing to Article 8 of the National Comprehensive Law on Tobacco Control, Madani said, “According to the law passed in 2006, every year taxes on cigarettes should be increased by 10%.”

“However, there have been always obstacles in its implementation. For example, in 2010 the figure decreased to 5% due to ‘manipulative tactics’ by the powerful tobacco lobby. Tobacco producers said that high taxes on cigarettes would lead to an increase in cigarette smuggling, and thus managed to reduce the tax.”

However, in January this year, lawmakers passed cigarette and tobacco tax slabs to be implemented under the sixth five-year economic development plan (2017-22).

Based on the new law, the tax slab on locally-produced tobacco and cigarettes is 10%; for local brands jointly produced by domestic and foreign manufacturers, it is 20%; for domestically produced cigarettes with foreign brand names the slab is 25%; and for imported cigarettes and tobacco, it is 40%.

Lawmakers also mandated the Ministry of Industries, Mining and Trade to announce the retail prices of cigarettes and all tobacco products to the relevant authorities for taxation purposes and for printing the tax rates on cigarette packs.

“Since the beginning of the past fiscal year (ended in March) the taxes collected on tobacco products are paid to the Health Ministry (50%), Education Ministry (25%) and Ministry of Sports and Youth Affairs (25%). The Education Ministry is required to spend the money on increasing students’ awareness of harms associated with tobacco smoking,” Madani said.

Earlier, the tax money was given to the ministries of health and sports and youth affairs.

Facts About Tobacco

There are more than 7 million deaths from tobacco use every year, a figure that is predicted to cross 8 million by 2030 without effective and intensified action. Tobacco consumption is a threat to any person, regardless of gender, age, race, cultural or educational background. It brings suffering, disease, and death, impoverishing families and national economies.

Tobacco use costs national economies enormously through increased healthcare costs and decreased productivity. Some 80% of premature deaths from tobacco occur in low- or middle-income countries, which face increased challenges to achieving their development goals, the WHO website reports.

Tobacco growing requires large amounts of pesticides and fertilizers, which can be toxic and pollute water supplies. Each year, tobacco growing uses 4.3 million hectares of land, resulting in global deforestation between 2% and 4%. Tobacco manufacturing also produces over 2 million tons of solid waste.

By increasing cigarette taxes worldwide by $1, an extra $190 billion could be raised for development. High tobacco taxes contribute to revenue generation for governments, reduce demand for tobacco, and offer an important revenue stream to finance development activities.

Current Tobacco Smoking and Desire to Quit Smoking Among Students Aged 13–15 Years

Download (PDF, 86KB)

Indonesian teachers group declares anti-tobacco stance

Ahead of World No Tobacco Day on May 31, Indonesia’s largest teachers group signed on Wednesday a declaration to underline the role of educators in supporting measures for tobacco control.

http://www.thejakartapost.com/news/2017/05/24/indonesian-teachers-group-declares-anti-tobacco-stance.html

Created by the Indonesian Teachers Association (PGRI), the declaration consists of six points, which include teachers’ commitment to “protect students from the dangers of smoking” and “oppose CSR [Corporate Social Responsibility] campaigns from the tobacco industry.”

Teachers also called on the government to create a comprehensive tobacco control regulations to curb cigarette consumption.

“Teachers have to be role models for their pupils by not smoking […] Exemplary acts by teachers are very strategic in the [anti-tobacco] campaign,” PGRI chairwoman Unifah Rosyidi said at the declaration’s signing event in Kuningan, South Jakarta, on Wednesday.

The event was organized by the National Commission on Tobacco Control (Komnas PT), a coalition of organizations that has been staunchly campaigning for tobacco related issues in Indonesia, one of the world’s biggest tobacco consumers.

Komnas PT chairman Prijo Sidipratomo welcomed the declaration, saying that it was in line with one of PGRI’s missions to support the country’s development.

“Some 25 percent of students’ daily time is spent at school, which highlights the role of teachers in shaping their way of life,” Prijo said. (rin)

Indonesia’s Child Tobacco Workers in Peril

In the next week, Indonesian President Joko (“Jokowi”) Widodo will decide whether to encourage parliament to move forward with a draft tobacco bill aimed at increasing domestic tobacco production. The bill would gut many important existing health regulations, like the requirement that companies include a health warning with a picture on the label of tobacco products.

Those are troubling proposals given that millions of children in Indonesia start smoking each year, and that 40 million more are “passive smokers” from secondhand smoke. The Indonesian Ministry of Health, 17 prominent health organizations, and many others have denounced the measure as an attempt to undermine Indonesia’s already weak tobacco control laws. Jokowi should reject the bill.

But the draft bill is not the only tobacco policy issue awaiting action by the Jokowi administration. Each year in Indonesia, thousands of children, some just 8 years old, work in hazardous conditions producing tobacco that ends up in products marketed and sold by huge Indonesian and multinational tobacco companies.

My colleagues and I published a Human Rights Watch report documenting hazardous child labor on Indonesian tobacco farms last May. Since then, another tobacco season has come and gone, but the child workers behind Indonesia’s tobacco industry remain unprotected.

We interviewed 132 children who worked on tobacco farms in four of Indonesia’s biggest tobacco-producing provinces. We found that child workers are exposed to nicotine and pesticides—toxins that can be especially harmful to children who are still growing and developing. Half the children we interviewed had experienced nausea, vomiting, headaches, or dizziness while they worked. Those symptoms are consistent with acute nicotine poisoning, which happens when workers handle tobacco plants and absorb nicotine through their skin. Many children said they also mixed and sprayed toxic chemicals on the plants with no protective equipment, and some became violently ill afterward.

The families we interviewed did not intentionally put their children in harm’s way. They were committed to helping their children get an education so they could have a better future.

Indeed, most of the children we interviewed attended school and worked in tobacco farming only outside of school hours.

But direct contact with tobacco in any form is hazardous work for children because of the nicotine in the leaves. Most of the families we spoke with had never received comprehensive information about the hazards for children of work on tobacco farms, so they did not know the risks to their children.

We urged the Jokowi government to take action to protect children from danger in tobacco fields. We called on the Health Ministry to work with other ministries to develop a public education campaign to raise awareness of the dangers to children of work on tobacco farms. In recent meetings with Human Rights Watch, government officials have said they need additional support and resources to get the campaign underway this year.

Indonesia already prohibits children under 18 from work “with harmful chemical substances.” The Ministry of Manpower and Transmigration should explicitly prohibit children from working in direct contact with tobacco in any form and increase labor enforcement efforts to make sure government inspectors check for workers’ safety, especially on small tobacco farms where children might be in danger.

In our meetings with government officials, we have heard many times that the tobacco industry is powerful in Indonesia, and that it is difficult to achieve policy changes the industry opposes. Surely eliminating child labor in tobacco farming is an issue tobacco companies also want to address.

The UN Guiding Principles on Business and Human Rights make clear that companies have responsibilities for addressing human rights abuses in their supply chains. We shared our findings with the largest tobacco companies operating in Indonesia—Djarum, Gudang Garam, Philip Morris International (which owns Sampoerna), British American Tobacco (which owns Bentoel), and others. The large multinational tobacco companies have policies to prevent children from doing the most dangerous tasks on tobacco farms, but their policies are not strong enough, and they should do more to monitor for child labor when they buy Indonesian tobacco on the open market through traders.

The largest Indonesian companies—Djarum and Gudang Garam—do not appear to be taking any steps to prevent or address child labor in their supply chains. They have never responded to our many requests for information and meetings, and they do not make any information publicly available about their child labor policies.

These companies should not be profiting off the backs of Indonesian child workers.

Two months from now, the next tobacco-growing season will be underway, and children will be heading to the fields again. The controversy around the draft tobacco bill likely will not be resolved by then. But with decisive action, the Jokowi administration and tobacco companies could take steps to protect children from dangerous work in tobacco fields. Their futures depend on it.

Curbing teen smoking ‘must go beyond raising minimum age’

Teens below the age of 18 have been barred from smoking legally since 1993 – but the data two decades later tells a different story.

http://www.straitstimes.com/singapore/health/curbing-teen-smoking-must-go-beyond-raising-minimum-age

In 2013, the average age when smokers took their first puff was just 16, according to the National Health Surveillance Survey.

Said Mr Vincent Tng, 21, a non-smoker serving full-time national service: “I have friends who started smoking as young as 14 or 15 – they just got their friends to buy cigarettes for them. There are contraband cigarettes around, so you don’t even have to go to a proper shop.”

Experts said the discrepancy shows that efforts to curb teen smoking must go beyond raising the minimum legal age. Issues such as raising awareness and enforcement cannot be sidelined.

Said Sata CommHealth chief executive and anti-smoking advocate K. Thomas Abraham: “We should have a slew of measures that go concurrently with raising the minimum age. How are these young people able to get cigarettes? How do we plug the existing loopholes?”

Last week, the Ministry of Health (MOH) said it plans to raise the minimum legal smoking age from 18 to 21. In Singapore, these are the years when nearly half of smokers become regular smokers. The idea is to put cigarettes out of the reach of underage smokers, who tend to obtain them through their social circles.

A town in the United States known as Needham is often held up as a success story of how this measure can reduce smoking rates.

In 2005, it increased the legal smoking age from 18 to 21. Smoking rates among under-18s dropped by nearly half within five years – from 13 per cent in 2006 to 7 per cent in 2010. At least 215 other locales in the US have followed suit in recent years, including New York City, Boston and California.

Dr Chia Shi-Lu, who chairs the Government Parliamentary Committee for Health, said: “I don’t think that in itself will be enough… but raising the age would help interdict further access to cigarettes amongst the young.”

To complement the move, experts suggested increasing the size of graphic health warnings on cigarette packets, introducing plain packaging to make cigarettes look as nondescript as possible and even raising the tobacco tax.

According to the World Health Organisation, increasing tobacco prices in high-income countries by 10 per cent is estimated to reduce consumption by 4 per cent, said Professor Chia Kee Seng, dean of the Saw Swee Hock School of Public Health at the National University of Singapore.

Tobacco taxes were last raised in 2014, from $352 per kg to $388 per kg of tobacco, or 1,000 cigarettes. It was reported that out of the $12 for an average pack of cigarettes, $8.50 goes to the Government as tax.

Prof Chia said tobacco taxes should be raised further if smoking remains a serious issue, even after the age limit is raised.

At the same time, said Dr Abraham, even more work needs to be done to drive home the anti-smoking message among young people, as “the long-term effects of smoking are not always immediately apparent to a young smoker”.

Nee Soon MP Louis Ng, who used to smoke, said enforcement needs to be stepped up to ensure cigarettes are not sold to underage teens, and more has to be done to change the image of smoking.

“They think it’s cool to smoke and we need to tackle that mindset with a series of public awareness campaigns,” he said.

Management executive Catherine Ruth Jeyaseelan, 34, suggested involving parents too. “Sometimes parents smoke at home and kids will get curious, they might try it when their parents are out.”

When Public Health and Big Tobacco Align

Nobody trusts the tobacco industry, and it’s easy to understand why. For decades, industry executives knew that smoking caused cancer and heart disease yet publicly denied the dangers of cigarettes. It relentlessly attacked its critics. Documents that emerged in the 1990s showed that the industry targeted teenagers, knowing that the earlier someone became addicted to cigarettes, the more likely they would be lifelong smokers. And so on.

https://www.bloomberg.com/view/articles/2017-03-09/when-public-health-and-big-tobacco-align

In the 1980s and 1990s, the public health community went to war with the tobacco industry. Though the war largely ended in 1998 with Big Tobacco agreeing to a multi-billion-dollar settlement with the states, it remains a powerful memory for public health.

To this day, most tobacco-control advocates view the cigarette companies as being every bit as duplicitous and evil as they were in the bad old days. Some years ago, I asked Stanton Glantz, perhaps the leading anti-tobacco scientist in the U.S., what his ultimate goal was. He didn’t say it was to eliminate the scourge of smoking. He said: “To destroy the tobacco industry.”

What brings this to mind is an excellent cover story in the upcoming issue of Bloomberg Businessweek about the efforts of the tobacco industry to devise and market so-called reduced risk products like electronic cigarettes — products that give users their nicotine fix without most of the attendant carcinogens that come with combustible tobacco.

Although the tobacco companies have done decades of R&D on smokeless products, the business was dominated early on by startups like NJOY, which is today the largest independent e-cigarette company in America. From the start NJOY has said that a big part of its mission was “to end smoking-related death and disease.” And from the start, messages like that have been scorned by the public health community.

Ingesting nicotine in some smokeless fashion is vastly safer than smoking a combustible cigarette. (In the words of the late South African tobacco scientist Michael Russell, “People smoke for the nicotine but die from the tar.”) Last year, the Royal College of Medicine issued a report saying that e-cigarettes were some 95 percent safer than cigarettes.

Even so, the public health community in the U.S., led by the Centers for Disease Control and Prevention, has done everything it can to demonize smokeless products. Some of this has been with good reason: to try to keep kids from picking up an addictive habit. But this effort has also helped to create the impression that smokeless products are as dangerous as cigarettes. One result, sadly, is that many long time smokers have refused to try them, even though they could save their lives.

My sense in talking to tobacco-control officials over the years is that too many of them simply don’t believe in a reduced-harm approach. We give heroin addicts methadone not because methadone is good but because it is better than heroin. With cigarettes, however, the public health mindset appears to be all or nothing — that the only “right” thing for smokers to do is to go cold turkey.

But the lingering distrust of the tobacco industry has also had a lot to do with public health’s unwillingness to acknowledge the potential benefits of alternative products. Matt Myers, the president of the Campaign for Tobacco Free Kids, has often complained, for instance, about the marketing of e-cigarettes, saying that companies are using the same tactics to hook teenagers that Big Tobacco once used.

With the e-cigarette market clearly established, the four big tobacco companies — BAT, Reynolds American, Altria (formerly Philip Morris) and Philip Morris International (spun off from Altria) — have proclaimed themselves all in.

Philip Morris International is an especially interesting case: Not only does it have an array of e-cigarettes and other smokeless products, but as the Bloomberg Businessweek story points out, it has publicly proclaimed that its goal is to lead the world into “a smoke-free future.” The home page of its website asks, “How long will the world’s leading cigarette company be in the cigarette business?”

As astonishing as it is that a company with $26 billion in tobacco revenue last year would be calling for the end of cigarettes, I believe Philip Morris is sincere. It has spent around $3 billion in research. Its new flagship product, called IQOS, heats tobacco but doesn’t burn it — which the company believes will be more satisfying to smokers than vaping. IQOS already has 7 percent of the tobacco market in Japan, and is being rolled out in other countries.

Philip Morris recently asked the British government that tobacco products “be taxed according to their risk profile.” In other words, it wants the government to impose higher taxes on cigarettes to encourage smokers to move to reduced-risk products. What tobacco company has ever done that before?

In the U.S., Philip Morris has done something extraordinary: It has made a submission to the Food and Drug Administration to get the right to market IQOS as a reduced risk product. The expensive submission consumed 2.3 million pages and is backed by a great deal of research, including several clinical trials. So far, none of the U.S. e-cigarette companies have attempted to get such a designation, and it is a big problem. How do you sell a reduced risk product when you can’t tell anybody it reduces risk?

The business case for diving into this market is that it’s a product category that’s growing, while the cigarette market is shrinking. Philip Morris doesn’t want to be left behind. But there is no particular need for the company to set out such a transformative agenda, at least not yet. The small smokeless companies are not much of a threat. NJOY filed for bankruptcy last fall. And under a 2009 law, every company in the e-cigarette industry will have to file something called a premarket tobacco application with the FDA by August 2018. The submissions will cost, on average, over $450,000, and the companies will have to show that their products have some public health benefit. There is a legitimate chance that some small companies won’t be able to clear the hurdle.

No, Philip Morris is pushing as hard as it is, I believe, because it wants to get on the right side of the issue, finally — to be viewed as a good corporate citizen. When I spoke to Glantz the other day about the company’s new anti-smoking agenda, he said, “I don’t believe them.” (He added, “If they were serious, they would stop marketing cigarettes right now.”)

No doubt many others in the tobacco-control community feel the same way. They still loathe Big Tobacco, and view Philip Morris’s new strategy as just another deception. But the truth is, if there is ever going to be a serious move from cigarettes to less dangerous products, it will have to come from Big Tobacco. They have the R&D resources, they have the marketing apparatus — and, it appears, they have the will.

Public-health advocates don’t have to trust Philip Morris, or any other tobacco company. They don’t have to believe what I believe in order to arrive at the same conclusion: that the advocates should be rooting for the companies’ innovations — pushing them, double-checking their data, making sure regulations are in place to prevent their products from being marketed to kids. The advocates should also be spreading the word that there is an alternative to cigarettes. Who really cares whether it’s Big Tobacco or some other entity that reduces smoking deaths? What matters is that it happens.

The tobacco wars are long over. Continuing to fight the cigarette companies may bring a certain satisfaction to the veterans on the public-health side. But joining forces is the way to save lives.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Joe Nocera at jnocera3@bloomberg.net

To contact the editor responsible for this story:
Philip Gray at philipgray@bloomberg.net