COP10 ends with a missed opportunity for harm reduction. Despite calls, no workgroup was established. Emphasis on Article 18's environmental impact. Advocates stress inclusion and science-based policies for COP11.

**Day 5**

COP10 wrapped up on February 10th, with the member states mainly focusing on FCTC Article 18, concerning the protection of the environmental impact of combustible tobacco cultivation, manufacture, consumption and waste disposal. A missed opportunity was the failure of COP10 to appoint a workgroup on "tobacco harm reduction strategies", an integral part of Article 1(d) of the FCTC. The governments of several Caribbean countries urged parties to formally appoint such a workgroup, to "learn from the best practices of proven public health-oriented measures".

Similarly, COP10 failed to facilitate genuine multi-stakeholder engagement. Again, the "invisible" stakeholder group at COP10 was the 1,1 billion adult cigarette smokers worldwide. While the inclusion of youth groups in COP10 should be welcomed, Sweden, which is on the cusp of becoming smoke-free, has shown that it is possible to prevent young people from starting to smoke while also helping adults find a safer path away from traditional smoking.

COP10 was again about exclusion and non-differentiation of tobacco risk and harm. Yet, combustible tobacco-related disease, disability and premature death remain by far the world's most significant health problem, killing 8 million people per year. As Sweden has shown, sensible tobacco harm reduction measures have the ability to save millions of lives. For COP11, let's continue to advocate for inclusion, engagement and proper science-based risk differentiation, for responsible and effective policymaking.

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Delon Human's FCTC COP10 Insights

COP10 closes without appointing a harm reduction workgroup, despite calls for multi-stakeholder engagement. Focus on Article 18 environmental protection.

Missed Opportunities and Calls for Inclusion: Reflections on COP10's Focus on Tobacco Harm Reduction

World Health Day 2022

THR: A Historic Opportunity for Our Health & Our Planet

Seize COP10 delay for tobacco control innovation. Learn from Sweden and the UK, exemplary in harm reduction.

**For Immediate Release**

**Experts recommend to seize the COP 10 delay as a catalyst for tobacco control innovation**

**21st November, 2023 Stockholm, Sweden** – The Framework Convention on Tobacco Control must use the delays to its Tenth

Conference of the Parties (COP10) to consider smoke-free success stories like that of Sweden, leading experts have said.

Since the delay to COP10 was announced last week, Dr. Delon Human, leader of the Smoke Free Sweden movement, has emphasised the urgency of the moment: "_This is a critical time for the WHO to consider the compelling evidence and to do their own research on countries such as Sweden that have successfully implemented harm reduction strategies._"

Sweden, with its smoking prevalence nearing the 'smoke-free' threshold of 5%, serves as a model for effective tobacco control.

_"The Swedish approach has saved thousands of lives annually. If other countries adopted similar strategies, the potential for saving millions of lives is immense. It's about providing safer options, not just imposing bans,_" commented Anders Milton, a renowned Swedish public health expert.

Similarly, in the UK, where the NHS endorses vaping for smokers unable to quit, there has been a consistent decline in smoking rates. In 2021, the proportion of current smokers in the UK was 13.3%, equating to 6.6 million people, showing a [significant decrease](https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2021) of 6.9 percentage points compared with 2011​.

"_The rescheduling of COP10 should prompt a focused analysis of the tobacco control strategies implemented in countries like Sweden and the UK, or even Japan which is seeing lower smoking rates because of heated tobacco products use. Examining their substantial reductions in smoking rates through harm reduction methods will provide practical insights._" added Dr. Human.

Building on the need for detailed analysis, Dr. Human proposed an innovative approach to enhance global understanding of effective tobacco control. "_Hosting a future FCTC conference in Sweden would be a strategic move, offering global health leaders direct exposure to the successful implementation of Tobacco Harm Reduction (THR) policies, alongside traditional tobacco control._"

This proposal aims to showcase Sweden's pioneering approach to tobacco control, where a combination of accessible reduced-risk products and informed public education has led to one of the lowest smoking rates in Europe. A conference in Sweden would provide a tangible, real-life context for discussions, allowing policymakers to observe and learn from a country that has effectively balanced regulatory frameworks with public health objectives.

\*\*\*\*\*\*\*

**Notes to editors:**

About COP10

The Tenth session of the Conference of the Parties (COP10) to the WHO Framework Convention on Tobacco Control was supposed to take place from 20 to 25 November 2023, in Panama City, Panama. It is currently postponed and no location or dates are known for the moment.

About Smoke Free Sweden

Smoke Free Sweden is a campaign which encourages other countries to follow the Swedish model when it comes to Tobacco Harm Reduction. Sweden is about to become the first 'smoke-free' European country in 2023, with a smoking rate of below 5 percent. This is a huge achievement, and will be 17 years ahead of the 2040 EU target. This can be attributed to Sweden's open attitude towards alternative products.

For more information on Sweden's successful approach to becoming a smoke-free nation, please visit www.smokefreesweden.org.

Contact

Jessica Perkins

jessica@healthdiplomats.uk

www.smokefreesweden.org

COP10 twitter-03.png

Press Release: Experts recommend to seize the COP 10 delay as a catalyst for tobacco control innovation

Experts urge using COP10 delay for tobacco control innovation, citing Sweden and the UK as successful models.

COP 10 Delay Sparks Innovation in Tobacco Control

Leading harm reduction experts debunk the notion that vaping is a gateway to smoking, advocating for evidence-based harm reduction strategies

Recent claims by Otago University in New Zealand that vaping is a gateway to smoking have been disputed by leading global harm reduction experts Roberto Sussman, Konstantinos Farsalinos, and Gerry Stimson. These experts have highlighted the importance of harm reduction strategies in reducing the negative health impacts of smoking.

According to Dr. Roberto Sussman, "There is no evidence that vaping is a gateway to smoking. In fact, [studies have shown that vaping can be an effective tool for smoking cessation](https://www.cochrane.org/news/latest-cochrane-review-finds-high-certainty-evidence-nicotine-e-cigarettes-are-more-effective)." Dr. Konstantinos Farsalinos adds, "The vast majority of vapers are former smokers who have successfully quit smoking thanks to vaping."

Gerry Stimson, a public health expert and advocate for harm reduction, emphasizes that "Harm reduction [strategies like vaping are essential in reducing the negative health impacts of smoking](https://www.tobaccoharmreduction.net/thr). We need to focus on providing smokers with safer alternatives to cigarettes, rather than demonizing harm reduction strategies like vaping."

As Dr. Sussman notes, "We need to focus on harm reduction strategies that work, rather than relying on outdated and inaccurate claims about vaping being a gateway to smoking." Dr. Farsalinos adds, "The evidence is clear: [vaping can be an effective tool for smoking cessation and harm reduction](https://www.tobaccoharmreduction.net/benefits)."

Nancy Loucas, Executive Coordinator of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates ([CAPHRA](https://caphraorg.net/)), who compiled these comments, also disputed the recent claim by [Otago](https://www.otago.ac.nz/) [University](https://www.otago.ac.nz/) that vaping is a gateway to smoking. In her view, the recent claim by Otago University is not supported by the evidence and could discourage smokers from trying vaping as a tool for smoking cessation.

According to recent data, the smoking incidence rates in New Zealand have fallen significantly over the past 5 to 10 years. The current smoking rate of New Zealand adults is 8% in 2021/2022, which has decreased from 16.5% in 2015 and from 27% in both men and women in 1993. Vaping has played a significant role in the reduction of smoking rates in New Zealand over the past 5 to 10 years.

According to research published in the [NZ Medical Journal](https://journal.nzma.org.nz/journal-articles/an-evaluation-of-a-new-zealand-vape-to-quit-smoking-programme), the current vaping rate in New Zealand is 8.3% of adults being categorized as daily e-cigarette users, up from 6.2% in the previous year.

"We need to [focus on harm reduction strategies that work](https://www.tobaccoharmreduction.net/thr-products), rather than relying on outdated and inaccurate claims about vaping being a gateway to smoking. The evidence is clear: vaping can be an effective tool for smoking cessation and harm reduction," Ms. Loucas said.

Read more on [Tobacco Harm Reduction](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf). Follow us on [Twitter](https://twitter.com/Tobaccoharmred1) and [LinkedIn](https://www.linkedin.com/company/tobaccoharmreduction-net/).

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Leading harm reduction experts dispute claim that vaping is a gateway to smoking.

Harm reduction experts challenge the claim that vaping leads to smoking, emphasizing evidence of vaping's effectiveness in smoking cessation

Leading Experts Dispute Vaping as a Gateway to Smoking: Focus on Harm Reduction Strategies

Review written by **[Joseph Magero, of Campaign for Safer Alternatives / CASA](https://safer-alternatives.org/about-us/what-we-do)**

[**New research**](https://www.kcl.ac.uk/news/vaping-substantially-less-harmful-than-smoking-largest-review-of-its-kind-finds) from the [**Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London**](https://www.kcl.ac.uk/ioppn) has found that the use of electronic cigarettes rather than traditional cigarettes leads to a substantial reduction in exposure to toxicants that cause cancer, lung disease, and cardiovascular disease.

The [**systematic review**](https://www.kcl.ac.uk/news/vaping-substantially-less-harmful-than-smoking-largest-review-of-its-kind-finds), commissioned by the **[Office for Health Improvement and Disparities](https://www.gov.uk/government/organisations/office-for-health-improvement-and-disparities)** in the **[Department of Health and Social Care](https://www.gov.uk/government/organisations/office-for-health-improvement-and-disparities)**, represents the most comprehensive review of the risks of vaping to date. The findings were; while vaping is not risk-free (particularly for people who have never smoked), it poses a small fraction of the health risks of smoking in the short to medium term.

It is the eighth successive time that a review commissioned by the main **public health body in England**, the Office for Health Improvement and Disparities, has found that electronic cigarette use is far less risky than cigarette smoking. 

In the report, researchers expressed concern that “around two-thirds of adult smokers, who would benefit from switching to electronic cigarettes, have no idea that vaping is less harmful”.

Perceptions about the relative harms of tobacco smoking and vaping among smokers are out of line with current evidence. An exploration of the available studies found that levels of tobacco-specific nitrosamines, volatile organic compounds, and other toxicants implicated in the main diseases caused by smoking were significantly lower in e-cigarette users. Among e-cigarette users, overall levels of nicotine were lower or similar to cigarette smokers.

The levels of exposure to cancer-causing and other toxicants are drastically lower in people who use electronic cigarettes compared with those who smoke traditional cigarettes. Helping people switch from smoking to vaping should be considered a priority if Governments are to achieve a smoke-free world in our lifetime.
The evidence has strengthened and shows that e-cigarettes have the potential to reduce the harm caused by smoking. We must educate people about the reduced risk of alternative products such as electronic cigarettes.

![Kings College.png](https://media.thr.net/strapi/5f6ec56b9dce9d1a81caae2c657e7698.png)


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Vaping is substantially less harmful than smoking, Largest Review Finds!

Restrictions create black market for unregulated, mislabelled nicotine vaping products

Since 1 October 2021, nicotine liquid has been classified as a [**prescription-only medicine in Australia**](https://www.health.nsw.gov.au/pharmaceutical/Pages/nicotine-vaping.aspx#:~:text=From%201%20October%202021%2C%20all,4%20(prescription%20only)%20medicines.). Australia is the only country that classifies nicotine vaping products (NVPs) as such, in other Western countries nicotine liquid is seen as a consumer product.

The Australian model has been **an embarrassing failure**. Although the aim was to allow adults to access nicotine vapes with a doctor's support and prevent youth vaping, the opposite effect is the reality. It has created a thriving black market that sells **unregulated, mislabelled nicotine products** to adults and to children.

The [Australian Medical Association (AMA)](https://www.ama.com.au/) is pushing to increase NVP restrictions. This approach will:

- Fuel the black market by driving the sale of NVPs further underground
- Reduce adult access to vaping, as very few doctors are willing to prescribe NVPs
- Increase youth smoking, as vaping diverts young people away from smoking
- Lead to more smoking, as vaping is the most effective and popular quitting aid in Australia and worldwide

Watch [Dr Colin Mendelsohn's](https://colinmendelsohn.com.au/)full interview [here](https://www.youtube.com/watch?v=ZrZ6a91jEp0).

For more information about nicotine products and smoking cessation, [click here](https://www.tobaccoharmreduction.net/thr-products).

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AUSTRALIA'S PRESCRIPTION-ONLY MODEL FOR VAPING HAS BEEN AN EMBARRASSING FAILURE

Expert says Australia's prescription-only vaping model is a failure

Seize the Chance: Speak Out Against Restrictive Vaping Policies in Australia by March 24, 2022. Advocate for Harm Reduction and a Safer Future!

This is an opportunity for vapers to be heard before the anti-vaping policy is locked in for the rest of the decade.

The draft strategy lacks urgency. It sets a very modest goal of <**10%** adult daily smoking by 2025. In sharp contrast, [**New Zealand**](https://www.health.govt.nz/system/files/documents/publications/hp7801_-_smoke_free_action_plan_v15_web.pdf) recently set a target of <**5%** daily adult smoking by 2025 for all population groups including Maori and Pacifica groups. Vaping is a key element of this plan.

Please make a submission before the deadline of **24 March 2022**. More information about making a submission can be found [**HERE**](https://www.health.gov.au/initiatives-and-programs/national-tobacco-strategy#:~:text=The%20draft%20National%20Tobacco%20Strategy%202022%E2%80%932030%20is%20being%20developed,closes%20on%2024%20March%202022.). 

***“The main element missing from the draft Strategy is tobacco harm reduction, ie the use of safer nicotine alternatives such as vaping, heated tobacco products, Swedish snus and nicotine pouches for smokers who are unable to quit with other methods”***

Vaping is supported by the [**Royal Australian and New Zealand College of Psychiatrists**](https://www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/e-cigarettes-and-vaporisers) and [**Royal Australian College of General Practitioners**](https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/supporting-smoking-cessation) for smokers who are unable to quit with conventional strategies. However, the draft strategy *ignores their advice*. In Australia it is easier to purchase a deadly cigarette than a far safer alternative.

Continuing the traditional 'quit or die' approach will result in a continuing sluggish decline in Australian smoking rates and another embarrassing failure to reach the smoking target. Smokers are being thrown under the bus. **We need to do better**.

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Australian Government Department of Health and aged care logo for Tobacco Harm Reduction

The Australian Department of Health is seeking feedback on how to reduce smoking in the draft National Tobacco Strategy 2022-2030.

Raise Your Voice for Safer Alternatives: Advocate Against Restrictive Vaping Policies in Australia by March 24, 2022. Let's Prioritize Harm Reduction!

Advocate for Tobacco Harm Reduction in Australia Before It's Too Late!

Oral Nicotine Delivery Systems such as vaping, nicotine pouches, and snus represent the next generation of smokeless, tobacco-free nicotine products.

Over the last two decades, vaping, nicotine pouches and a range of other less harmful products have completely transformed the nicotine space. Oral Nicotine Delivery Systems, or ONDS, represent the next generation in smokeless, tobacco-free nicotine products.

Scientific evidence surrounding the benefits of nicotine pouches and snus has been mounting. A recent [study](https://pubmed.ncbi.nlm.nih.gov/32466721/) from the [Karolinska Institute in Sweden](https://ki.se/en), which involved 400,000 participants and covered 9-million-person years, has shown that there is no association between snus use and oral cancer. A separate [study](https://www.linkedin.com/pulse/systematic-review-confirms-harmful-health-outcomes-from-cother-hajat/) conducted by the physician and epidemiologist, [Dr. Cother Hajat](https://uk.linkedin.com/in/cother-hajat-b912261a) shows that we should not classify all oral tobacco or nicotine products in the same risk camp, and that snus confers no excess risks for oral and many other cancers, cardiovascular disease, and chronic lung diseases. When taking the scientific evidence into consideration, it comes as no surprise that the US Food and Drugs Administration (FDA) has [authorised](https://www.fda.gov/news-events/press-announcements/fda-grants-first-ever-modified-risk-orders-eight-smokeless-tobacco-products) Swedish Match's snus as being appropriate for the protection of public health under its modified risk tobacco product (MRTP) guidance.

Regulators and international organisations continue to group [oral nicotine products](https://oralnicotine.com/oral-nicotine/what-is-it) with combustible tobacco products, ignoring [the evidence of their positive impacts](https://oralnicotine.com/publications). The WHO's [latest report](https://www.who.int/publications/i/item/9789240061484) on oral health fails to distinguish between [snus and toxic smokeless tobacco products](https://oralnicotine.com/oral-nicotine/benefits) and raises unscientific concerns about the [potential negative effect of nicotine from vaping on oral cancer.](https://oralnicotine.com/publications)

Sweden assumes the [Presidency of the Council of the European Union](https://www.consilium.europa.eu/en/council-eu/presidency-council-eu/) in January 2023, so right now is the perfect time to look at the role snus has played in allowing them to become the European leader in smoking cessation.

Sweden has the lowest smoking rate in the EU at [6%](https://www.folkhalsomyndigheten.se/the-public-health-agency-of-sweden/living-conditions-and-lifestyle/andtg/tobacco/), compared to the EU average of 23%. As a result of this, Sweden has the lowest tobacco mortality rate in Europe. Snus has been at the centre of the reduction measures, but in recent years, nicotine pouches and e-cigarettes have proven to be [useful additional tools for Swedish smokers aiming to quit.](https://oralnicotine.com/oral-nicotine/benefits) The progressive, pro harm-reduction Swedish model is clearly distinct from the tobacco control policies proposed by other EU Member States. Ensuring that [less harmful alternatives to smoking, such as nicotine pouches and vapes](https://www.tobaccoharmreduction.net/thr-products), are accessible will be paramount to ensure that other countries can replicate Sweden's success.

At [Tobaccoharmreduction.net](https://www.tobaccoharmreduction.net/) and the [Oral Nicotine Commission](https://oralnicotine.com/about-us), we have developed an advocacy instrument, which addresses public misconceptions surrounding tobacco harm reduction.


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The Swedish harm reduction approach reduces smoking rates

In a special episode for World Mental Health Day, Michelle Minton explores the connections between addiction, mental health, and tobacco control in a series of enlightening discussions. Dive into the video clips for valuable insights.

[**THR.net**](https://www.tobaccoharmreduction.net/thr) sat down with [**Michelle Minton**](https://twitter.com/michelleminton) of the [Reason Foundation](https://reason.org/) for the latest #WomenInTHR episode, in honour of [**World Mental Health Day in October**](https://www.mentalhealth.org.uk/our-work/public-engagement/world-mental-health-day). We discussed the topics listed below (click on each one to watch the clips):

> [Addiction and nicotine](https://www.youtube.com/watch?v=P70-EoQaKt8&t=1s)

> [Mental Health Disorders and The Benefits of Nicotine](https://www.youtube.com/watch?v=cyMOZXOu4jQ)

> [Anti Smoking Campaign Effects On Youth](https://www.youtube.com/watch?v=--axrVx7W4Q&t=249s)

> [Narratives Prevent People From Objectively Looking At The Evidence](https://www.youtube.com/watch?v=YOIk19p_Kso)

> [The Quit or Die Approach in Tobacco Control](https://www.youtube.com/watch?v=tYzi15IEUBw)

> [Work and research into nicotine](https://www.youtube.com/watch?v=xhlAml08MeU) 

> [The unspoken benefits of tobacco and nicotine](https://www.youtube.com/watch?v=3vCkdpV-m2k) 

Click on [**this link here**](https://www.youtube.com/channel/UCyHKweBxXVzcskK-HOo8PEg/featured) to access our YouTube channel with mini clips for small and digestible videos.

Click below to watch the part called > “[**Mental Health Disorders and The Benefits of Nicotine**](https://www.youtube.com/watch?v=cyMOZXOu4jQ)”


Michelle Minton Women in Tobacco Harm Reduction Coffee Chat

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Latest #WomenInTHR webinar with Michelle Minton now on YouTube

Michelle Minton of the Reason Foundation delves into the complex relationship between nicotine, mental health, and tobacco control.

Michelle Minton Discusses Nicotine and Mental Health

Women in THR: Coffee Chat with Michelle Minton | Mental Health Diagnosis & Nicotine

Implementing the Philippine nicotine products Regulation Act will save lives, says harm reduction advocates


![Clarisse Virgino (1).png](https://media.thr.net/strapi/f6e0f098db4b2b5d758009ad57d020e1.png)


"Any concerns about youth vaping are well covered in last year's landmark vape law. The Philippines has more than enough regulations and safeguards now in place, without a Senator trying to relitigate everything," says Nancy Loucas, Executive Coordinator of CAPHRA ([Coalition of Asia Pacific Tobacco Harm Reduction Advocates](https://caphraorg.net/)).

Her comments follow the Senate recently adopting a resolution denouncing the sale and marketing of e-cigarettes and other vape products towards the youth. It saw [Senator Pia](https://en.wikipedia.org/wiki/Pia_Cayetano) [Cayetano](https://en.wikipedia.org/wiki/Pia_Cayetano) deliver a speech where she claimed vape flavours and designs draw young people to the products.

Last year, smokefree advocates around the world celebrated the Philippines passing the Republic Act 1190, otherwise known as the 'Vaporized Nicotine and Non-Nicotine Products Regulation Act'.

Regulation of the importation, manufacture, sale, packaging, distribution, use and communication of vaping products such as e-cigarettes and heated tobacco products (HTPs) became law on 25 July 2022.

At the time advocates said the law strongly protects minors, helps to eradicate blackmarkets, ensures safety standards, and critically delivers adult accessibility to viable alternatives for smokers desperate to quit.

"Without doubt, the legislation and regulations are aimed at protecting youth, despite it not being expressly stated in the statute. For example, there are provisions that expressly provide prohibition on selling to minors.

She says there is also a provision where it is expressly stated that flavour descriptors that unduly appeal to minors are prohibited. This includes candy, fruits, desserts, and cartoon graphics.

Late last year, following the passing of the vape law, the Department of Trade and Industry (DTI) issued the Implementing Rules and Regulations (IRR).

"It's the DTI's mandate and responsibility to implement the new vaping laws. The Philippines doesn't need any more Senate speeches and resolutions. It just needs the regulator and retailers to work together to ensure young people are protected as was clearly intended," says Nancy Loucas.

Clarisse Virgino, Philippine representative to the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), agrees that any issues pertaining to the vape law now lie with the DTI.

"This is not a Senate issue but an issue around implementation. We must let the DTI do its job and positively work with the industry and retailers to make sure they're educated and compliant. Many parties, including consumer advocates, worked on the vape law in good faith. Let's continue that good faith," says Ms Virgino.

She says despite political argument at the edges the Philippines now leads the charge in Tobacco Harm Reduction (THR) among its Asian neighbours.

"Our country has endured a terrible smoking epidemic for decades, with nearly 90,000 Filipinos dying annually from smoking-related diseases. We've now adopted a successful THR strategy which will see smoking rates fall. Ours is landmark and leading legislation. It just needs time to bed in.

"The 2022 vape law will deliver real results and help eradicate smoking. Our focus now must be to ensure 16 million Filipino smokers have a viable path to switch to safer nicotine products," says Clarisse Virgino.

For a free digital media repository on tobacco harm reduction in Asia Pacific

- including media releases, images, and graphics - please visit [https://apthrmedia.org](https://apthrmedia.org/)

**About CAPHRA**

The Coalition of Asia Pacific Tobacco Harm Advocates is a regional alliance of consumer tobacco harm reduction advocacy organizations. Its mission is to educate, advocate and

represent the right of adult alternative nicotine consumers to access and use of products that reduce harm from tobacco use.

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Time to support Filipino vape law, not relitigate it

The UK's Health Secretary, **Sajid Javid MP**, believes it is a “moral outrage” that England’s richest people are living for up to a decade longer on average than the poorest.

To help tackle this disparity, he is plotting a **#vaping revolution**, writes **Caroline Wheeler** in yesterday's edition of **The Sunday Times.**

"England will become the first country in the world to prescribe e-cigarettes on the NHS to help smokers quit as part of plans to increase life expectancy for the poorest.

Sajid Javid, the health secretary, believes it is a “moral outrage” that England’s richest people are living for up to a decade longer on average than the poorest.

He will announce plans to address the root causes when he unveils his health disparities white paper this spring. It is understood this will include a “vaping revolution” that will allow GPs to prescribe e-cigarettes on the NHS."

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SAJID JAVID PLOTS VAPING REVOLUTION TO HELP POOR LIVE LONGER

Smoking rates among those with mental health issues are high, but quitting can improve both physical and mental health. Accessible cessation aids and harm reduction measures are essential to reduce this gap in life expectancy.

[**October is Mental Health Awareness Month**](https://www.who.int/campaigns/world-mental-health-day). We take this time of year to acknowledge the widespread concerns among the general public, including mental health which is a crucial piece of the puzzle that makes up an individual's overall health and wellness.

Of the general population, only a minority are smokers. In a population of those with a history of depression and a propensity for recurrent depression, a majority are smokers. 

[**Smoking rates among people with mental health disorders are disproportionately higher than average country smoking rates across the globe**](https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often). The association between cigarette smoking and mental health conditions becomes stronger relative to the severity of the mental health condition, with the highest levels of smoking found in psychiatric inpatients. 

[**Nicotine has mood-altering effects**](https://www.tobaccoharmreduction.net/updates#Nicotine_the_weirdness_of_harm) that put people with mental disorders at higher risk of smoking and nicotine addiction. Many of them associate smoking cigarettes with stress relief and relaxation.

Important to note, individuals with mental health conditions die on average 10–20 years earlier than the general population, and smoking is the single largest factor accounting for this difference.

One in every two people who smoke (including those with mental health issues) will die of a smoking-related illness. But many think quitting will worsen their mental health problems or impact their social lives and friendships.

In most cases, people with mental illness lack access to cessation aids to help them quit. This makes it even more challenging for them to quit smoking.

Stopping smoking suddenly through willpower alone or cold turkey is the least effective way to quit. It’s a well-known fact that quitting smoking improves one’s physical health. A recent [**Cochrane systematic review shows that stopping smoking is linked to improved mental health. The review summarizes evidence from 102 observational studies involving over 165,900 people.**](https://www.cochrane.org/news/featured-review-stopping-smoking-linked-improved-mental-health)

Action to reduce smoking among people with mental health challenges should be a high priority, whether through nicotine replacement therapy or safer nicotine products. No other action would do more to reduce the life expectancy gap among this group. 

Pragmatic approaches are absolutely essential to improve outcomes. The lack of cessation services in many low and middle-income countries makes the scale of the task to reduce smoking among people with mental health challenges inherently complex.

With current tobacco control strategies showing meagre results and **NRTs unaffordable** to most smokers with mental health challenges, the introduction of accessible, market-driven harm reduction measures into the mix is a vital way forward. Reduced-risk products can significantly lower smoking rates among individuals with mental health challenges.

In line with the [**mental health awareness month**](https://www.who.int/campaigns/world-mental-health-day), smokers should quit smoking to protect their mental health. Looking to the future, an approach to reducing smoking among persons with mental health issues that includes a wide range of safer nicotine products would provide governments with the tools to significantly improve health outcomes at a minimal cost. 


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Illustration for happy and healthy mental health

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Mental Health Awareness Month: Smoking and Harm Reduction. New Article By Joseph Magero.

Explore the link between mental health and smoking, and the potential benefits of quitting for overall well-being.

Improving Mental Health Through Smoking Cessation

The 10th edition of GFN celebrated a decade of progress in tobacco harm reduction. Experts discussed challenges, opportunities, and evidence-based approaches to nicotine use

**13 June 2023**

*Written by: Joseph Magero*

In Warsaw this June, [The Global Forum on Nicotine (GFN)](https://gfn.events/) celebrated its 10th edition, with a packed program reflecting on the last decade in safer nicotine use. The event brought together over 400 researchers, public health professionals, policymakers, and advocates to share scientific findings and insights.

This year's theme centered on reflecting on the challenges and successes of tobacco harm reduction over the past decade and sought to identify the priorities for advocates, academics, scientists, policymakers, manufacturers, and distributors in the future.

As usual, the GFN tackled controversial subjects head-on, in respectful debates involving all stakeholders. Public health advocates who attended the forum emphasized evidence-based approaches to nicotine use and policy-making. They revisited the key milestones of the last ten years, assessed today's complex political, regulatory, and scientific environment, and discussed the challenges and opportunities of the future.

Dr. Alex Wodak, a retired physician, hosted a session on reducing the environmental impacts of tobacco harm reduction. The panel included Dr. Colin Mendelsohn, a medical practitioner, academic, and researcher in smoking cessation and tobacco harm reduction for 40 years; who said that 'disposable vapes cause environmental harm but far less than cigarette butts.'

Clive Bates, former Director of Action on Smoking and Health (UK), sought testimonies from the audience on how the last decade can influence and inform the next. Delegates expressed concern as the W.H.O. makes preparations for the [10th session of the Conference of the Parties](https://fctc.who.int/who-fctc/governance/conference-of-the-parties/tenth-session-of-the-conference-of-the-parties) to the [W.H.O F.C.T.C.](https://fctc.who.int/who-fctc/overview) in Panama City later this year. They called on the World Health Organization (W.H.O) to stop its opposition to the tobacco harm reduction approach and insistence on banning less harmful alternative products, and instead rely on scientific research to support evidence-based policymaking.

Experts were particularly worried about the W.H.O F.C.T.C.'s push for a ban on [vapes and other smoke-free alternatives](https://www.kcl.ac.uk/news/vaping-substantially-less-harmful-than-smoking-largest-review-of-its-kind-finds), which would deprive smokers, especially those from L.M.I.C.s, of [the most effective means to quit cigarette smoking](https://www.cochrane.org/news/latest-cochrane-review-finds-high-certainty-evidence-nicotine-e-cigarettes-are-more-effective). 'It is absolutely clear that consumers across the world are demanding lower-risk alternatives,' said Dr. Sud Patwardhan, co-founder of the Centre for Health Research and Education ([CHRE](https://chre-uk.com/)).

As GFN 2023 finally came to an end, the comprehensive discussions provided invaluable insights into the facilitators and barriers to smoking cessation and transitioning to low-risk tobacco and nicotine products. The take-home message was, by relying on scientific evidence, we can make more informed, rational, and evidence-based choices that are grounded in the best available knowledge and understanding of the world around us.

This year's winner of the prestigious 2023 [Michael Russell Award](https://gfn.events/michael-russell/awards/) was Professor Gerry Stimson.

Follow us on [Twitter](https://twitter.com/Tobaccoharmred1) and [LinkedIn](https://www.linkedin.com/company/tobaccoharmreduction-net/).

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Global Experts Convene in Warsaw For The Global Forum on Nicotine

The 10th edition of GFN celebrated a decade of progress in tobacco harm reduction. Experts discussed challenges, opportunities, and evidence-based approaches to nicotine use.

Global Forum on Nicotine (GFN) 2023: Reflecting on Safer Nicotine Use

A new study in Addiction highlights significant harm reduction by switching from smoking to vaping or dual use, based on a secondary analysis of 1,299 participants across multiple countries.

A [**new study**](https://onlinelibrary.wiley.com/doi/10.1111/add.16063) published in **Addiction** (by [**the society for the Study of Addiction**](https://www.addiction-ssa.org/)) has found significant harm reduction when switching from smoking to vaping or dual use. Following a [**systematic review**](https://ebn.bmj.com/content/14/3/64), this [**secondary analysis**](https://www.indeed.com/career-advice/career-development/secondary-analysis) incorporated nine studies from Greece, Italy, Poland, the United Kingdom and the United States. It features **1,299 adult participants** who smoked combustible cigarettes (CC), switched completely from smoking CC to electronic cigarettes (EC), or who switched to using both CC and EC (dual users). 

In a **secondary analysis**, researchers work with previously collected existing data (secondary data) to perform a new study. This allows researchers to work with large data sets, as they can work with data from multiple studies. A **systematic review** uses all the existing research and also secondary research (research on research). A high-quality **systematic review** is one of the most reliable sources of evidence to guide clinical practice, as it delivers a meticulous summary of the available primary research in response to a research question.

Measurements for the study were conducted using **carbon monoxide (CO) and other biomarkers**. [**Biomarkers (biological markers**)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3078627/) are biological molecules found in body fluids or tissues that signal a normal or abnormal process or a condition or disease. Measuring biomarkers enabled the researchers to indicate how biomarkers of harm change based on participants’ smoking/vaping behaviour. 

The study found exhaled CO (eCO) to be lower in participants who switched to EC completely than those who smoke CC or are dual users. eCO was also significantly lower in dual users than in CC only participants. 13 biomarkers were measured to compare EC versus CC – of these, 12 were lower in the EC groups. 25 biomarkers were measured when comparing EC to CC and dual use – of these, the results were lower for EC groups for 12 measures and for dual use groups for 5 measures. 

This secondary analysis confirms that exclusive EC use is associated with lower levels of biomarkers of harm than the exclusive use of CC or dual use. This supports the broad scientific consensus that the greatest health improvements come from ceasing the use of CC completely, and that (although not completely without risk) EC is a reduced-risk alternative that offers harm reduction benefits. An analysis such as this study not only informs debates concerning the potential harms and benefits of dual use but also illustrates the changes a smoker might expect if they switched completely to ECs or dual use.

Access [**www.tobaccoharmreduction.net**](https://www.tobaccoharmreduction.net/thr) to learn more about tobacco harm reduction.

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New study finds that switching from smoking to vaping or dual use significantly reduces potential harm

A recent study in Addiction highlights significant harm reduction in transitioning from smoking to vaping or dual use.

Switching to Vaping or Dual Use: Study Shows Significant Harm Reduction

Global health leaders urge Bangladesh to reject smoke-free alternatives ban, advocating evidence-based policies for 164.7 million citizens. The letter calls for government support in transitioning smokers.

A **letter** from an **international group of health leaders**, from the **EU**, **North and South America**, **Africa** and **Asia** has been submitted to the **Bangladesh Minister of Health**, calling for the Ministry to consider **not prohibiting** the use of smoke free nicotine-based alternatives to combustible cigarettes and to use evidence-based regulatory policy to do more to protect the health of Bangladesh's **164,7  million** people. In particular, the **34,7%** of adults in Bangladesh who still consume combustible cigarettes. The experts have called on the **Bangladesh government** to support smokers by encouraging a mass switch from high-risk cigarettes to low-risk ENDS and accelerating the end of the epidemic of smoking-related disease. 

Click [here](https://media.thr.net/strapi/5839390b594654146dcd9da3c8accd4c.pdf) to read the letter. 

![MoH Bangladesh.png](https://media.thr.net/strapi/ae1b796d04be9e11ce01ac6b5315951c.png)



Bangladesh Public Consultation on ENDS: Letter Submitted By Experts to Bangladesh MoH Offering Comments On The Smoking and Tobacco Products Usage (Control) Act, 2005 (Amended in 2013).

Health leaders worldwide plea with Bangladesh's Minister of Health to reconsider banning smoke-free alternatives, prioritizing evidence-based policies for the well-being of 164.7 million citizens, especially the 34.7% still using combustible cigarettes.

Global Health Leaders Urge Bangladesh to Embrace Smoke-Free Alternatives

In this interview, Dr. Marewa Glover, a prominent Māori behavioral scientist, discusses her advocacy for tobacco harm reduction and Indigenous sovereignty.

We sit down with [**Dr. Marewa Glover**](https://twitter.com/marewaglover), Director at the [Centre of Research Excellence: Indigenous Sovereignty & Smoking](https://coreiss.com/home). Dr. Glover is a Māori (New Zealand indigenous) behavioural scientist with over 30 years' experience in public health. She has written over [100 scientific papers](https://coreiss.com/publications) and is well known for her compassionate insight and **advocacy on tobacco harm reduction**. Dr. Glover was appointed as Tobacco Section Editor for the international [Harm Reduction Journal](https://harmreductionjournal.biomedcentral.com/about?gclid=Cj0KCQiAiJSeBhCCARIsAHnAzT_WapZOUObnh1u7UnkPUv6q6UOEHk9amGdjk0_66yR17cgn5cF4k3MaAqLaEALw_wcB) in 2019.

Click [here](https://www.youtube.com/watch?v=AsYMs8QLHCQ) to watch the **full episode** or on the topics below from the episode:

[Current Work](https://www.youtube.com/watch?v=etYzWcExHw0)

[SNUS was Never Illegal](https://www.youtube.com/watch?v=r3IATv2hIoE)

[NZ has Highest Priced Tobacco Relative to Income](https://www.youtube.com/watch?v=N0jC7wPGtyw)

[The Lack of Cessation Advice in NZ for Women](https://www.youtube.com/watch?v=s-PUOz8cDQc)

[There's No Good Basis to Deny Pregnant Women THR](https://www.youtube.com/watch?v=NLlpg7Ifpc8)

Click [HERE](https://www.tobaccoharmreduction.net/resources) to read more about tobacco harm reduction **RESOURCES.**

Click [HERE](https://www.tobaccoharmreduction.net/thr) to read our home page and access our **THR E - BOOK.**

Meet DR. MAREWA GLOVER in latest #WomeninTHR episode

Explore the insights of Dr. Marewa Glover, a Māori scientist advocating tobacco harm reduction and Indigenous sovereignty.

Dr. Marewa Glover: Championing Tobacco Harm Reduction and Indigenous Sovereignty

Women in THR: Coffee Chat with Dr Marewa Glover | Full Webinar

The draft strategy sets out the Welsh Government’s vision for a **smoke-free Wales by 2030**, this means achieving a smoking prevalence rate in adults of **5%** or less over the next eight years.

To support this ambition, they will be driving forward work across their three key themes of **Reducing Inequalities, Future Generations and a Whole-System Approach** for a Smoke-Free Wales.

The consultation will close on **31 March 2022**. They want to hear views and get feedback on their plans for tobacco control in Wales from everyone affected by tobacco in Wales, including the public, young people and stakeholders.

They are also planning engagement events during the consultation period. If you would like to be involved, please contact them at: **tobaccopolicy@gov.wales** for further details.

Government page to read more about the Consultation: [HERE](https://gov.wales/tobacco-control-strategy-wales-and-delivery-plan-html)

**How to respond**

Submit your comments by **31 March 2022**, in any of the following ways:
1. Complete our [**online form**](https://www.smartsurvey.co.uk/s/7KG7WK/)

2. Download, complete our [**response form**](https://www.google.com/url?q=https://gov.wales/sites/default/files/consultations/2021-11/consultation-questions_0.docx&sa=D&source=docs&ust=1647604864379064&usg=AOvVaw2cuT-gSLP4rqsf1VXA1zYY) 
 and email TobaccoPolicy@gov.wales

3. Download, complete our [**response form**](https://www.google.com/url?q=https://gov.wales/sites/default/files/consultations/2021-11/consultation-questions_0.docx&sa=D&source=docs&ust=1647604864379064&usg=AOvVaw2cuT-gSLP4rqsf1VXA1zYY) and post to:

Risk Behaviours Team
Welsh Government
Cathays Park
Cardiff
CF10 3NQ


![Welsh Post.png](https://media.thr.net/strapi/61e582c51141968c72ddf39b3776eb82.png)



The Welsh Government is seeking comments on the draft long term tobacco control strategy for Wales: A Smoke-free Wales and our first two year delivery plan: Towards a Smoke-Free Wales: Tobacco Control Delivery Plan 2022-2024.

Discover how biomarkers are challenging conventional wisdom in tobacco control. Researchers Derek Yach and Gerhard Scherer introduce a groundbreaking approach to evaluating the harm reduction potential of tobacco alternatives like e-cigarettes. 

[A new research paper](https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/10.1002/dta.3567) is challenging a long-standing belief in the tobacco control community. For too long, potentially less harmful alternatives like e-cigarettes have been dismissed due to "lack of evidence." Now, researchers Derek Yach and Gerhard Scherer present a promising tool that could change this narrative: biomarkers.

"The reluctance to accept less harmful nicotine products, such as e-cigarettes, has always been rooted in the fear of the unknown and the desire for long-term evidence. Our research now showcases a robust method to bridge this knowledge gap sooner than previously imagined," said Derek Yach, one of the authors of the study.

Biomarkers are measurable substances in our bodies – present in fluids, tissues, and cells. They give information about our exposure to certain compounds and potential physiological effects. The use of these biomarkers could revolutionise the way we evaluate the harm reduction potential of new generation tobacco and nicotine products (NGPs). Instead of waiting for decades to understand the long-term effects of these products, we can rely on these indicators for quicker assessments.

"The future of public health depends on us embracing modern methodologies. Biomarkers offer a real-time snapshot of exposure levels, eliminating the traditional waiting period of 40-50 years to understand the effects of new products on our health," Gerhard Scherer, the research co-author commented.

A critically important application of this technology is in the life and health insurance industry. Currently, most insurers do not recognise the drastically reduced risk posed by smokefree alternative nicotine products, in comparison with combustible cigarettes.

“Insurers and their clients stand to gain by better quantifying and reducing smoking risk, using new technology such as biomarkers”, remarked Derek Yach.

With over a billion people globally facing health risks due to combustible cigarette consumption and a staggering eight million deaths linked to such cigarettes annually, the urgency for safer alternatives cannot be understated. NGPs like e-cigarettes and heated tobacco products hint at a future with reduced harm from tobacco. This study could be the key to unlocking that future.

[Watch the webinar here](https://www.youtube.com/watch?v=sWxc8Lrg0S0&ab_channel=TobaccoHarmReduction) on the breakthrough research paper, held Wednesday 13 September 10 AM EST.


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Revolutionizing Tobacco Control: Biomarkers Pave the Way for Safer Alternatives

Discover how biomarkers are revolutionizing tobacco control, providing a quicker and safer way to assess alternatives like e-cigarettes. Learn more here.

Biomarkers: A Game-Changer for Assessing Harm Reduction in Tobacco Alternatives.

Local legislators are making it harder for citizens who smoke to switch to safer nicotine options, say tobacco harm reduction advocates. 

[**APTHR M**](https://apthrmedia.org/)[**edia**](https://apthrmedia.org/) **Press Release.**

 "Raising the legal age for buying cigarettes to 20 is a good move, but effectively banning e-cigarettes is disappointing from Taiwan," says Nancy Loucas, executive director of the [Coalition of Asia Pacific Tobacco Harm Reduction Advocates](https://caphraorg.net/) (CAPHRA).

"We're all for getting tougher on cigarettes but only if smokers and those desperate to quit have a viable, accessible alternative. Taiwan's legislators are sadly only making it harder for the 19% of citizens who smoke to switch to safer nicotine options," she says.

In January, lawmakers approved the third reading of the [Tobacco Hazards Prevention Act](https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=L0070021#:~:text=No%20person%20shall%20provide%20tobacco,in%20form%20of%20tobacco%20products.), banning e-cigarettes and requiring [heated tobacco products (HTPs)](https://www.tobaccoharmreduction.net/thr-products) to comply with the law.

Amendments place e-cigarettes in the 'cigarette-like product' category, effectively banning their use as well as the sale, provision or manufacturing of their necessary components. The amendments take effect a month after their publication by the Government.

People who use HTPs or e-cigarettes that are not approved by authorities would face fines as would those who manufacture, import, provide or advertise tobacco products, or non-approved HTPs.

Taiwan is an island nation 100 miles off the east coast of mainland China. It has a population of about 24 million, of which about 19 percent of adults are believed to smoke.

"Sadly, Taiwan now joins some other countries in Asia which have outright vaping bans in place. The [World Health Organization (WHO)](https://www.who.int/) and its Bloomberg Philanthropies - funded allies will no doubt be pleased. Their meddling and pressure have worked again.

"The move, however, goes against growing international science and public outrage that such bans are an affront to human rights and improving public health outcomes," says [Ms Loucas](https://nz.linkedin.com/in/nancy-loucas).

She says the fact that a relatively progressive nation like Taiwan can be convinced to ban vaping is the talk of the global [Tobacco Harm Reduction (THR) community](https://www.tobaccoharmreduction.net/community).

All eyes will be on [COP10 in Panama](https://fctc.who.int/newsroom/news/item/17-11-2022-panama-host-upcoming-cop10-mop3) this coming November - hosted by the [World Health Organization's Framework Convention on Tobacco Control (FCTC)](https://fctc.who.int/who-fctc/overview) which continues to press for signatory states to adopt ever more restrictive policies, including outright bans.

Recently, [CAPHRA](https://caphraorg.net/) wrote to its delegates from around the world, noting that two high-profile studies, which have been quoted by tobacco controllers regarding the dangers of nicotine and vaping, have since been retracted and removed from significant medical journals.

'Consumers' rights to choose to use less harmful products to switch from smoking remain under tremendous threat from FCTC's continuing failure to address scientific evidence, democratic processes and human rights,'  [CAPHRA](https://caphraorg.net/) wrote.

[Ms Loucas](https://nz.linkedin.com/in/nancy-loucas): "Taiwanese lawmakers say their amendments help ratify their commitments to WHO's FCTC. However, the FCTC has a mandate to pursue harm reduction as a core tobacco control policy - a position it has singularly failed to acknowledge or implement since its inception. Taiwan is conveniently overlooking that.

"Taiwan's smokers have the right to avoid adverse health outcomes and to access less harmful nicotine products as alternatives to smoking. It is very disappointing Taiwan's lawmakers are buying into WHO's discredited position," says Nancy Loucas.

For a free digital media repository on tobacco harm reduction in Asia Pacific - including media releases, images, and graphics - please visit [https://apthrmedia.org](https://apthrmedia.org/)

 **About CAPHRA**
  The [Coalition of Asia Pacific Tobacco Harm Advocates](https://caphraorg.net/) is a regional alliance of consumer tobacco harm reduction advocacy organizations. Its mission is to educate, advocate and represent the right of adult alternative nicotine consumers to access and use of products that reduce harm from tobacco use.

You can also find further information on [tobaccoharmreduction.net](https://www.tobaccoharmreduction.net/thr) regarding advocacy and resources for consumers and health professionals.

Taiwan vaping ban disappointing for its many smokers

Discover the unique risks smoking poses to women's health on Women's Day. Learn why harm reduction and cessation are crucial for everyone's well-being.

While it is well known that smoking contains many, severe health risks, we wanted to take this Women’s Day as an opportunity to highlight some risks that are unique to women - and why it is so important for everyone to embark on a harm reduction or cessation journey.

1\. [Cancer](https://women.smokefree.gov/quit-smoking-women/what-women-should-know/smokings-impact-on-women): While smoking in general increases the risk of various cancers, it is particularly associated with an increased risk of cervical cancer. Additionally, smoking is the leading cause of lung cancer in women, and there are more cases of young female smokers (30-49) developing lung cancer than male smokers.

2\. [COPD](https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_women_smoking_508.pdf): Women who smoke, within certain age groups, are up to 38 times more likely to develop chronic obstructive pulmonary disease (COPD) than never-smokers. COPD also kills more women than men and develops more severely in women at an earlier age.

3\. [Cardiovascular Disease](https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_women_smoking_508.pdf): When compared to men who smoke, women smokers over 35 are more likely to die from heart disease.

4\. [Reproductive Health](https://women.smokefree.gov/quit-smoking-women/what-women-should-know/smokings-impact-on-women): Aside from the known complications that arise from smoking while pregnant, smoking can also lead to pain and irregularity during periods, a decrease in estrogen levels and an increase in the risk of infertility. Smoking may also worsen menopausal symptoms in women, including an increased risk of early menopause and related health issues.

5\. [Bone Health](https://www.lung.org/quit-smoking/smoking-facts/impact-of-tobacco-use/women-and-tobacco-use#:~:text=Women%20who%20smoke%20may%20develop%20more%20severe%20COPD%20earlier%20in%20life.&text=Women%20who%20smoke%20also%20have,for%20developing%20coronary%20heart%20disease.): Relatedly, post-menopausal women who smoke may have decreased bone density and an increased risk of hip and spine fractures.

Amidst all these negative health consequences, the good news is that it is never too late to quit. You can use this Women’s Day as an opportunity to encourage yourselves and the women in your life to prioritise their health and quit smoking by using [tobacco harm-reduction](https://www.tobaccoharmreduction.net/thr) strategies. These strategies, which help offset the varied and gendered consequences of tobacco smoking, are an important tool on the journey to smoking cessation.

You can learn more about tobacco harm reduction here: <https://www.tobaccoharmreduction.net/thr>

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Smoking and Gender: Health Risks of Tobacco for Women

Explore how smoking affects women's health uniquely on Women's Day. Prioritize harm reduction and cessation for a healthier future for all.

Women's Day: Smoking Risks & Harm Reduction

Dr. Lars Ramström argues that snus, a tobacco alternative, has dramatically cut tobacco deaths in Sweden and could save 2.9 million EU lives. He emphasizes reevaluating snus's risks to combat smoking.

In a recent commentary piece titled "[Snus: A Lifesaver in Sweden – And Beyond,](https://www.qeios.com/read/FUX4PH)" Dr Lars Ramström sheds light on the impactful role of snus in significantly reducing tobacco-related fatalities in Sweden. Highlighting Sweden's potential to become the first European Union country to achieve a smoking rate below 5%, a benchmark set by the World Health Organization for being 'smoke-free,' Dr Ramström emphasises the importance of alternative smoking products. Snus, a less harmful tobacco product, has been instrumental in this achievement.

Dr Ramström's analysis compares mortality rates in Sweden with those in countries where snus is less available, revealing that snus has saved approximately 4,000 lives annually among Swedish men. This finding underscores the necessity for health authorities to clearly differentiate the risks associated with cigarettes and snus. Misleading perceptions about snus's dangers may hinder the shift away from cigarette smoking.

Supporting Dr Ramström's insights, [research from Smoke-Free Sweden](https://smokefreesweden.org/wp-content/themes/smokefreesweden/assets/pdf/reports/Report%20The%20Swedish%20Experience%20EN.pdf) illustrates Sweden's lower cancer incidence and mortality rates compared to its European neighbours—41% and 38% lower, respectively. The ["Saving Lives Like Sweden"](https://smokefreesweden.org/wp-content/themes/smokefreesweden/assets/pdf/reports/Report_SAVING%20LIVES%20LIKE%20SWEDEN.pdf) report by Smoke-Free Sweden proposes that adopting Sweden's approach to tobacco harm reduction could potentially save 2.9 million lives across the EU. This evidence suggests that by promoting safer alternatives like snus, we could pave the way for a healthier future for millions of smokers worldwide.

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Snus is key to lowering tobacco-related death rates, says Swedish health expert

Explore how snus is pivotal in reducing tobacco deaths in Sweden, as Dr Lars Ramström highlights its role in achieving a smoke-free status.

Discover Spain's smoking statistics and the debate on tobacco harm reduction in Clive Bates' latest blog post and video.

Approximately 30% of adults between 15-64 are current smokers in Spain - shows the latest available data. There is a well-funded and vocal abstinence-only tobacco control establishment in Spain, and it seems to do its utmost to fight tobacco harm reduction. 

Clive Bates’ latest blog post with text, commentary and a 2 minute video explaining THR is well worth a read/listen and can be found here: [**A powerful declaration makes a compelling case for tobacco harm reduction**](https://clivebates.com/a-powerful-declaration-makes-a-compelling-case-for-tobacco-harm-reduction/). His [**tweet is here**](https://twitter.com/Clive_Bates/status/1585542869720469505). 

The international letter can be found here: [**Less Harm: international declaration for a smoke-free Spain (PDF)**](https://clivebates.com/documents/SpainInternationalLetterOct2022EN.pdf)

“So this is a call for the government to pay a little less attention to them and to reflect more on the opportunity to do better through THR.” says Clive. “Tireless work and energy from [**Carmen Escrig**](https://twitter.com/EscrigCarmen) to pull this together and kudos to the [**Plataforma para la reducción del daño por tabaquismo**](https://www.porlareducciondedanoportabaquismo.org/).”

![Spain Declaration.png](https://media.thr.net/strapi/9f1056f874fce92d60fae6e9ffade330.png)



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 Published letter from Spanish THR advocates signing a declaration for a smoke-free Spain backed by 170 national and international experts. “Useful beyond Spain and a great piece of work” - says Clive Bates of Counterfactual Consulting Ltd.

Explore the latest data on smoking in Spain and the ongoing debate over tobacco harm reduction, with insights from Clive Bates.

Spain's Tobacco Control Efforts and the Call for Harm Reduction

![E-Cig banners-01 (1).png](https://media.thr.net/strapi/7de2fdaf4efcceb096fb5ddf942363a0.png)

Dr Konstantinos Farsalinos’ multidimensional report on vaping flavours titled “**The case for flavours in tobacco harm reduction to save lives**” examines the science, consumer insights, risks and regulatory considerations relating to vaping flavours. 
 
The review concludes that **restrictions on vaping flavours would risk seriously reducing the life-saving potential of these innovative products.**
 
Click [HERE ](https://media.thr.net/strapi/0cbd3b34cef86dad0032528c324d2f7b.pdf) to read the full report, or [HERE](https://media.thr.net/strapi/e43d913841406aa46d3684a9ae4eeb48.pdf) to read the Executive Summary.









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In Favour of Flavour - A Key Report On How Flavours in Tobacco Harm Reduction Save Lives

On 14 July 2022, a Malaysia [**press release**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) reported that the draft of the proposed [**Tobacco and Smoking Control Bill**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) had been approved by the Cabinet. [**Health Minister Khairy Jamaluddin**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) said: “The Bill was approved by Cabinet yesterday. So I will be sending it to Parliament for this session". The proposed [**Bill**](https://www.thestar.com.my/news/nation/2022/07/14/cabinet-gives-nod-to-proposed-smoking-ban-bill-says-kj) contains provisions to prohibit the sale of cigarettes, tobacco, and vape products to those born after 2005. 

[**13 public health experts**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) were prompted to [**respond**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) to this proposed legislation, and they started by applauding the government’s efforts to strengthen the prevention and control of combustible tobacco-related disease and premature death. However, they [**warned of the unintended consequences**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) of regulating non-combustible, reduced-risk products in the same way as combustible cigarettes. They emphasised two important points about ENDS: 
1. They do not involve combustion and so do not create products of combustion, and
2. To an increasing extent, they can replace smoking for many smokers. 

In this [**letter sent to the Malaysian PM**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf) and Cabinet, the experts urged them to support smokers by encouraging a mass switch from high-risk cigarettes to low-risk ENDS by using risk-proportionate regulation, thus accelerating the end of the epidemic of smoking-related disease. Read the [**full letter here**](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf).

[![Malysia Letter to PM ENDS July 2022.png](https://media.thr.net/strapi/817108fed617cb95c560befe8c5f8ede.png)](https://media.thr.net/strapi/9d545794b8609366290a55953fa5345c.pdf)

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Letter to Malaysian PM: A Call for Risk-Proportionate Regulation of ENDS

Australian government could prevent up to 104,200 deaths by 2080 by relaxing restrictions on vaping products, says Georgetown University (USA) study.

A [**study**](https://doi.org/10.1093/ntr/ntac210) carried out by a leading institution investigates the potential impact of reducing the restrictions on vaping products on public health in Australia. The accepted manuscript, which is published in the journal **Nicotine & Tobacco Research**, was authored by leading researchers **Professors David Levy, Coral Gartner, Ron Borland and Michael Cummings.**

**[Click here](https://tobaccoharmreduction.net/en/articles/Georgetown-University-(USA)-st)** to read the full article. 

To access our **e - book** click [**here**](https://media.thr.net/strapi/d5b691d7b57a532da30f41f52dd63dcc.pdf).

[**Click here**](https://www.tobaccoharmreduction.net/thr-products) to review some information about **smoking cessation products** and to find out more about saving lives through THR advocacy click [**here**](https://media.thr.net/documents/THR_-_Lives_Saved.pdf). 

![SAVM study - Aus.jpeg](https://media.thr.net/strapi/f235d472c8d6f96ab6938deb2ead7e96.jpeg)





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Relaxed controls on vaping products could prevent Aussie deaths

On September 28th, a new **Asia Harm Reduction Alliance** platform was launched, to bring together consumers, policymakers, and harm reduction experts in the health care community in the Asia Pacific and the Middle East region. 

The new website, along with a [**Twitter page**](https://twitter.com/HRA_asia) and [**YouTube Channel**](https://www.youtube.com/channel/UC_IPnHiXfRrRBBlhBPmZgAA), will provide advocates with up-to-date information on tobacco, alcohol, and drug health policy, scientific research, and news.

Dr. Marewa Glover, Director, Centre of Research Excellence: Indigenous Sovereignty & Smoking, New Zealand, is featured on the site as one of the champions of the platform, along with six other health experts. Dr. Marewa Glover quotes: 

*“**There are compassionate and more cost-effective ways to reduce smoking prevalence. One of these is to encourage switching to a low-risk alternative. The use of e-cigarettes (vaping) has been found to be more effective than nicotine replacement therapy in enabling people to quit smoking**”*

To read more and visit the website, [**click here**](https://asiaharmreductionalliance.net/).

![AsHRA_color_light_bg.png](https://media.thr.net/strapi/ce9b18da365e34a6fd289ae08f21432a.png)








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New Platform Revealed: The Asia Harm Reduction Alliance 

Misconceptions about vaping safety persist due to the misnomer 'EVALI.' Evidence shows it's linked to illicit THC products, not nicotine #ecigs. Public awareness is crucial for informed choices.

Misperceptions about the safety of vaping are rife; the misnomer of 'EVALI' is a major contributor. There is no evidence that anyone developed EVALI from nicotine #ecigs. Rather, it was illicit THC products containing Vit E Acetate.

The cost of this misinformation is that only 11.2% of respondents to the National Cancer Institute (NCI)'s [**2020 HINTS survey**](https://hints.cancer.gov/view-questions-topics/question-details.aspx?PK_Cycle=5&qid=1282#) said that e-cigarettes are safer than combustible cigarettes - a fact acknowledged by the Centers for Disease Control and Prevention. 

75 public health experts, and Iowa's Attorney General Tom Miller, [**wrote**](https://drive.google.com/file/d/1o0mlqZaMMUeD7Eapc1H0CdSsTz4HsuxE/view) to the Centers for Disease Control and Prevention in August 2021 petitioning for the lung injury to be renamed Adulterated THC Vaping Associated Lung Injury (ATHCVALI). This name communicates far more accurately to the public what health risks exist. However, the CDC has thus far declined to correct the misnomer of 'EVALI'.

One of the 75 public health experts, Michael Pesko (health economist at Georgia State University), [**said to reporter Marc Gunther**](https://medium.com/the-great-vape-debate/the-cdcs-evali-screwup-ff09f4c3e187): "The CDC made a gross error. The CDC's miscommunication is actually killing people, in my opinion."

Recommended reading:
-  [**Letter from Iowa's Attorney General Tom Miller and 75 public health experts to the CDC**](https://drive.google.com/file/d/1o0mlqZaMMUeD7Eapc1H0CdSsTz4HsuxE/view)
-  [**Marc Gunther's article 'The CDC’s EVALI screwup'**](https://medium.com/the-great-vape-debate/the-cdcs-evali-screwup-ff09f4c3e187)

![HINTS survey 2020 misinformation.png](https://media.thr.net/strapi/58605f6c56e2a8322ded4a7fd2501154.png)


hand holding a truth card above a table full of lie cards

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The misnomer of 'EVALI' is "actually killing people"

Misconceptions about vaping safety due to 'EVALI' misnomer. Evidence links it to illicit THC, not nicotine #ecigs. Public awareness crucial for informed choices.

The Misnomer of 'EVALI': Misinformation and Public Health Concerns

A study by the National Library of Medicine examines the influence of e-cigarette flavors on smoking cessation outcomes. Learn more and access related resources.

This [**study**](https://pubmed.ncbi.nlm.nih.gov/36250607/) (published by the [**National Library of Medicine**](https://www.nlm.nih.gov/)) is amongst a few that have considered the impact of e-cigarette flavors on smoking cessation outcomes. This study examines the effects of e-cigarette use and e-cigarette flavors on quit attempts and the quit success rate of smokers. 

[**Click here to read the full study**](https://pubmed.ncbi.nlm.nih.gov/36250607/).

[**Click here to access more resources on tobaccoharmreduction.net**](https://www.tobaccoharmreduction.net/resources).

[**Click here to access our e-book on tobacco harm reduction**](https://www.tobaccoharmreduction.net/thr). 

![Research Quotes.png](https://media.thr.net/strapi/dc75bcb3ee407d28c6467fa931cb07e9.png)




Article Illustration of logos for National Library of Medicine and Tobacco Harm Reduction

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Key United States Survey: Large study shows that smokers who try e-cigarettes are more likely to try to quit smoking, or to quit smoking entirely. Those using flavoured e-cigarettes are more likely to quit smoking successfully. 

This study explores how e-cigarette flavors affect smokers' quit attempts and success rates.

E-cigarette Flavors' Impact on Smoking Cessation

Malaysian webinar reveals misconceptions about THR products and the need for proper regulation to promote harm reduction.

On the 22nd June, a [**webinar** ](https://www.youtube.com/watch?v=RnSgB5AxPfU&t=307s)hosted by thr.net took place. Moderated by [**Dr. Delon Human**](https://www.tobaccoharmreduction.net/dr-delon-human) and [**Jessica Perkins**](https://www.linkedin.com/in/jessica-perkins-963a4b32/) from ****tobaccoharmreduction.net****, the panel featured leading medical expert [**Dr. Konstantinos Farsalinos**](https://twitter.com/FarsalinosK), [**Professor Sharifa Ezat Wan Puteth**](https://www.linkedin.com/in/sharifa-ezat-wan-puteh-b2b05b196/), President of the Malaysian Society for Harm Reduction and [**Professor Neil McKeganey**](https://twitter.com/McKeganey1), director of the Centre for Substance Use Research at the University of Glasgow.


“Many Malaysian smokers are seeing ecigs, and other non-combustible nicotine alternatives as their fire escape. We need to promote evidence-based regulation that gives comfort to consumers to switch from the most harmful to the least harmful alternatives." - said [**Dr Delon Human**](https://twitter.com/HumanDelon). 


The 3 eminent academics discussed the need for regulation of tobacco harm reduction (THR) products in Malaysia, and misconceptions about alternative nicotine products and flavours.


**Key misconceptions and the role of health practitioners**


The **[Kantar survey](https://media.thr.net/strapi/57d0472d80a9339de39153e6793d973b.pdf)** showed that many adults in Malaysia are misinformed about the relative risk of THR products such as vaping. More than a third of Malaysians perceive them as more harmful or as harmful as cigarettes. “These figures underline the importance of health practitioners to encourage the efforts of smoking cessation”, argued [Professor Neil McKeganey](https://twitter.com/McKeganey1).


However, the survey shows that just **4%** of people who **vape** said that they were encouraged to do so by a health practitioner. This also stems from the fact that many of them do not understand the relative risks of vaping or the fact that nicotine itself does not cause cancer. 


All the speakers agreed that there is a huge role to be played by health practitioners in advising smokers to switch to less risky products, such as vaping. But in order to do that, misconceptions about reduced-risk products need to be dispelled. 


[**Professor Sharifa Ezat**](https://www.linkedin.com/in/sharifa-ezat-wan-puteh-b2b05b196/) spoke about THR encountering resistance from regulators and policymakers, since it’s a relatively new concept and the risk perception is skewed by exaggerated and fear-mongering media reports. 


The survey also found that **52% of Malaysian smokers** perceive vaping to be less harmful than smoking cigarettes. On this basis, **86%** said that vaping should be made available to smokers as a *less harmful* product and **90%** believe that **vaping should be actively promoted as a less harmful** alternative to smoking cigarettes.


The good news from the survey, however, is that those who have actually managed to switch to vaping, did so in order to cut down on smoking or quit completely (**49%**). 


**The use of flavours in vaping**


The [**Kantar survey**](https://media.thr.net/strapi/57d0472d80a9339de39153e6793d973b.pdf) showed that nearly a third of respondents (**61%**) who **vape** used **fruit flavours**, hence the use of flavours is a powerful way for people to cut down on or quit smoking entirely. [**Dr Farsalinos**](https://twitter.com/FarsalinosK) commented on the issues of flavours, and highlighted that if products do not taste good, smokers will unlikely want to use them to quit smoking. What can prevent e-cigarette users from relapsing back into cigarettes, is to provide a variety of flavours for them to choose between - keeping the e-cigarette experience more interesting. 


**We need to provide practical solutions through risk - based regulation**


In **[Malaysia](https://twitter.com/Tobaccoharmred1/status/1539529585695539202)** today, e-cigarette products are unregulated, which on the one hand means that users can easily access products that can help them to switch or quit smoking; but on the other hand it provides poor quality manufacturers the opportunity to use potentially dangerous ingredients - causing harm to consumers. 


The [**Kantar study**](https://media.thr.net/strapi/57d0472d80a9339de39153e6793d973b.pdf) saw that consumers are willing to embrace regulation of THR products, and the members of the panel agree that regulation is necessary to avoid having any substandard items on the market that could be dangerous to people’s health. However, as proven by other countries, bad regulation can cause people to switch back to smoking or never switch to vaping in the first place.


Success can only be achieved through proper information, knowledge and favourable legislation. [**Professor McKeganey**](https://twitter.com/McKeganey1) said that what will be important for any future legislation of THR products in Malaysia is that it increases the accessibility, availability and safety of these products compared to cigarettes. 


This webinar was the start of a much-needed debate in **Malaysia on tobacco harm reduction**. It highlighted how consumers feel about it and where it can go next. 


Malaysia skyline at dusk with a THR webinar tag

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NEW WEBINAR - MALAYSIA: ON THE PATH TO LIFE - SAVING ALTERNATIVES. A CALL FOR REGULATION TO PROTECT CONSUMERS

Explore findings from Malaysia's THR webinar addressing tobacco harm reduction, misconceptions, and the role of health practitioners.

Malaysia's THR Webinar: Insights & Misconceptions

Learn how switching to less harmful nicotine vaping products could save 4.7 million life years and prevent 300,000 deaths in Germany by 2060.

In Germany’s population of 84 million, 1 in 4 people still smoke cigarettes. According to their ministry of health, smoking is the biggest preventable cause of death and disease in Germany. Meanwhile, there is mounting evidence that nicotine vaping products are significantly less harmful than combusted tobacco, and provide a viable escape route for smokers who want to quit, but can’t. 

What would happen if Germany’s smokers switched to less harmful nicotine vaping products? At the No Smoke Summit in September 2021, Prof David Levy from Georgetown University explained with reference to his newly developed SAVM simulation model - **4.7 million life years saved, and 300,000 deaths avoided by 2060**. 

Click [**HERE**](https://www.youtube.com/watch?v=7MaaYZZdrCc) to watch his presentation


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Public health implications of vaping in Germany: Prof Levy’s SAVM model predicts 4.7 million life years saved, and 300,000 deaths avoided by 2060

Discover how smokers in Germany could save 4.7 million life years and prevent 300,000 deaths by 2060 when switching to nicotine vaping.

Saving Lives in Germany: The Impact of Switching to Nicotine Vaping

LIVES SAVED | What if German smokers switched to vaping? 🇩🇪

A group of world-renowned tobacco harm reduction experts spoke at the Africa Tobacco Harm Reduction Forum ([**ATHRF**](https://www.athrf.org/)) a week ago, to discuss a potentially transformational product for the Africa market: **#OralNicotine** (Is it a gateway to a smoke-free Africa?).

Watch the full event recording [**HERE**](https://www.youtube.com/watch?v=KJBIix8q4IM) on the AHRA YouTube channel!


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Oral Nicotine in Africa: A Call for Product Safety Standards, says Tobacco Harm Reduction Experts

Africa Tobacco Harm Reduction Forum: A Gateway to a Smoke-free Africa | 14 February 2022, Nairobi

Contribute to the UK government's vital survey on smoke-free alternatives. Your insights shape policies, ensuring accurate risk communication. Be a part of informed decision-making for a smoke-free generation. Your voice matters!

The UK government has recently released an important survey and they want to hear from you!

Your ability to save lives doesn’t solely rely on actions but on accurate risk communication and informed choices. Developing policies that guide a nation's future should be grounded in providing precise and comprehensive information to consumers regarding smoke-free alternatives and their comparative risks. 

The UK government's online survey offers each individual or organisation the opportunity to step forward, share their insights, and be a part of the [decision-making process](https://www.gov.uk/government/consultations/creating-a-smokefree-generation-and-tackling-youth-vaping/creating-a-smokefree-generation-and-tackling-youth-vaping-your-views). Your voice holds weight in advocating for policies that prioritise accurate risk communication.

Global advocate, Clive Bates, has started providing his perspectives and responses to the survey. Bates’ article is also a great resource to understand more about the survey and what it entails. 

Read [Clive Bate’s overview commentary](https://clivebates.com/uk-smoking-and-vaping-policy-consultation-my-draft-response/).

The survey is available [HERE](https://consultations.dhsc.gov.uk/en/65201ed1f3410a69990d3081) until 6 December 2023.

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Engage and Influence: Make Your Voice Heard in UK Government Surveys

Shape UK policy on smoke-free alternatives! Contribute insights to the government's survey by Dec 6. Your voice guides informed decision-making.

Shape UK's Future: Join Smoke-Free Survey for Informed Policies

Dr. Mendelsohn's book navigates smokers through vaping's safety while addressing societal opposition, exposing hidden motives. Dive into Part 3 for an analysis of ideological battles shaping the vaping debate.

**Dr Mendelsohn’s** book provides a comprehensive and practical **how-to guide for smokers** considering vaping as a safer alternative to smoking, but it also delves into a deeper analysis into societal beliefs around vaping. In **Part 3 (‘Controversies and Solutions’)**, **Dr Mendelsohn** dissects how we have reached a point in the debate where an appreciation of the scientific evidence supporting vaping is not enough to overcome the vehement backlash: “Much of the opposition is not about the evidence. It is driven more by hidden ideological, moral, political, and other agendas. [Part 3] explores how anti-vaping groups defend the indefensible and justify their position without the support of science”. 

[**Click here**](https://www.tobaccoharmreduction.net/articles/BOOK-REVIEW:-DR-COLIN-MENDELSO) to read the full review.

![Twitter Infographics THR.NET (15).png](https://media.thr.net/strapi/05972b6c8a750bd860e0c0018544b696.png)



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Book Review: Dr Colin Mendelsohn's 'The Healthy Truth About Vaping'

Explore Dr. Mendelsohn's guide for smokers embracing vaping and his critique on societal resistance in this insightful book review.

Decoding Vaping: Dr. Mendelsohn's Guide and Societal Critique

The 8th WHO report on tobacco and new products faces scrutiny from a sector expert for alleged flaws and links to Bloomberg Philanthropies' policy influence.

The World Health Organization’s recently released 8th report on the global tobacco epidemic relating to new and emerging products,  is deeply flawed and unscientific according to a tobacco sector expert. This thought-provoking assessment also explains why the report is raising concern about the influence that Bloomberg Philanthropies exerts on WHO policy.

Concern over unscientific stance in WHO's 8th report on global tobacco epidemic

An industry expert critiques the WHO's 8th report on tobacco and new products, raising concerns about its methodology and influence from Bloomberg Philanthropies.

Controversial WHO Report on Emerging Tobacco Products: Critique by Industry Expert

Discover why Health Canada's proposed vaping flavor regulations are crucial for balancing youth protection and adult harm reduction in Canada. Have your say!

**Why the consultation is important to THR:**


Health Canada has identified the availability of a variety of desirable flavours in vaping products, despite the current vaping restrictions, as one of the factors contributing to the rapid rise in youth vaping in Canada. However, banning almost all flavours, will make it less likely for adult smokers to switch to less harmful vaping products, or use them to quit tobacco altogether. Ultimately, the unintended consequence of such a ban can be very detrimental to both tobacco control and harm reduction. 

**How you can help**
 

Health Canada is seeking comments from health partners, general public, interested members of the industry, and people who vape, use tobacco products, or use both vaping and tobacco products. Please send in your comments before the deadline. 


**How to participate**


[mail](https://www.canada.ca/en/health-canada/programs/consultation-proposed-vaping-product-flavour-regulations-order.html#a4)
[email](mailto:hc.pregs.sc@canada.ca)



**Comments submitted**

Health Canada is seeking comments on their proposed ban on flavours in vaping products (e-cigarettes).  Deadline: 2 September 2021(at noon EDT)

Why Consultation Matters for THR: Health Canada's Vaping Flavor Regulations

In a change that will favour vaping consumers today, Italy has **adjusted its tax on e-liquids** for the fourth time in four years. 

The tax rate on e-liquids containing nicotine will decrease from €0.175 (U.S. equivalent: $0.19) per millilitre to €0.13, and the zero-nicotine e-liquid tax will fall from €0.13/mL to €0.08. The new, lower tax rates are in line with the levels set in 2021 (these levels had seen an increase in January 2022). 

Italy has experienced a turbulent history when it comes to vaping products. In 2014, the Government made vapes as expensive as cigarettes, which meant that 75% of the ‘thriving’ vape industry had been wiped out. The tax was the highest in the EU, which almost doubled the price of e-liquid. This meant that vapers were now seeking the black market and some returned to smoking. 

However, in 2019 the vaping community applied pressure to the Parliamentary legislators and they finally reduced the tax rate by 80%, to a far more reasonable €0.08 per mL for e-liquids containing nicotine, and €0.04 for nicotine-free e-juices. However, last year the legislators increased the tax yet again, only to (finally) reduce them today. 

**References**

1. Vaping 360: [https://vaping360.com/vape-news/113815/italy-will-reduce-e-liquid-tax-april-1st/](https://vaping360.com/vape-news/113815/italy-will-reduce-e-liquid-tax-april-1st/)

![2 hands for Italy post.jpg](https://media.thr.net/strapi/87c2bcc76eacff986d85a3a64b8fedc0.jpg)


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Today (April 1st 2022) - Italy reduces tax on e-liquids 

Experts challenge outdated FCTC stance on tobacco harm reduction, urging WHO to reconsider before COP9 summit for evidence-based change.

The FCTC is a treaty that was adopted by the World Health Organisation in 2003, and remains in force today. 

It seeks to protect present and future generations from the harms associated with tobacco consumption. However, its prohibitionist approach toward less harmful novel nicotine products - such as e-cigarettes, vapes, and pouches – is outdated, ideologically driven, and squandering the opportunity to save lives. 

One hundred experts have come together to call on the WHO leadership to launch a comprehensive rethink in their stance to tobacco harm reduction, before the COP9 summit in November. The letter makes seven key points, and then delivers six recommendations – all based on contemporary scientific evidence and expertise.

Click **[HERE](https://media.thr.net/strapi/89229bee7fc5b89d6d6ec9fad08412b1.pdf)** to read the letter.



Illustration of a letter to WHO calling for rethink

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100 experts sign a public letter on the failure of the WHO’s current Framework Convention on Tobacco Control (FCTC), urging a comprehensive rethink before COP9

Experts challenge FCTC's stance on harm reduction in tobacco control. Read their letter, calling for a rethink before COP9 summit, backed by scientific evidence.

Rethinking FCTC: Experts Urge WHO for Tobacco Harm Reduction

Discover how flavors aid tobacco harm reduction. The latest 2023 research by Dr. K. Farsalinos highlights flavors' role in smoking cessation.

A [new and updated revision of the "Case for Flavours in Tobacco Harm Reduction"](https://media.thr.net/strapi/34d52398d9056adece15e8bda5172870.pdf?updated_at=2023-08-29T12:28:33.423Z) by Dr. [Konstantinos Farsalinos](mailto:kfarsalinos@gmail.com), originally published in 2022, has been newly released for 2023.

The latest report contains updated studies on flavours, showcasing the most recent and up to date research, including the findings of a longitudinal study on non - tobacco vs tobacco flavours, and the effects on smoking abstinence. The study also describes how vaping non-tobacco flavours was not associated with youth smoking initiation but was associated with increased adult smoking cessation.

Read the [full report](https://media.thr.net/strapi/34d52398d9056adece15e8bda5172870.pdf?updated_at=2023-08-29T12:28:33.423Z) to learn more about how flavours save lives in tobacco harm reduction.

[Click here](https://www.tobaccoharmreduction.net/updates/flavours) to access more content on flavours on [THR.net](https://www.tobaccoharmreduction.net/thr).

![flavour-review.png](https://media.thr.net/strapi/cc8124fe583a68bf399f3dd01ed025b4.png)

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UPDATED - THE CASE FOR FLAVOURS IN TOBACCO HARM REDUCTION, TO SAVE LIVES BY DR KONSTANTINOS FARSALINOS

Discover the updated report by Dr. K. Farsalinos on the role of flavors in reducing tobacco harm. New studies show flavors' impact on smoking cessation. Learn more.

Flavours in Tobacco Harm Reduction: Latest Research 2023

CAPHRA endorses NZ's harm reduction stance, praising Smokefree Act repeal. Emphasis on adult choices, vaping regulation. Coordinator Nancy Loucas aligns with economist Eric Crampton.

The Coalition of Asia Pacific Harm Reduction Advocates ([CAPHRA](https://twitter.com/caphraorg)) today expressed its support for the New Zealand Government's decision to repeal elements of the Smokefree Environments Act.

“The decision, part of the NZ First 2023 Coalition Agreement, is seen by CAPHRA as a balanced approach to tobacco control that focuses on harm reduction rather than outright prohibition,” said Nancy Loucas, a public health policy expert and passionate advocate for tobacco harm reduction and executive coordinator of CAPHRA.

"CAPHRA applauds the government's decision to prioritise [harm reduction strategies](https://www.tobaccoharmreduction.net/thr)," said Ms Loucas. "We believe that vaping and other harm reduction tools can play a significant role in helping smokers quit, and we are pleased to see the government recognising this."

The organisation also shares the government's concerns about the potential for a black market to develop if the sale of tobacco is overly restricted.

"A regulated market is always preferable to an unregulated one, where product safety cannot be guaranteed," Loucas added.

CAPHRA supports the government's plan to reform the regulation of vaping, smokeless tobacco, and oral nicotine products.

"These products can be part of a comprehensive harm reduction strategy," Loucas said. "We also support the government's decision to ban single use disposable vaping products, which are often of lower quality and can be more harmful than reusable devices."

The organisation agrees with the government's plan to increase penalties for illegal sales of tobacco and vaping products to those under 18. "These products should only be available to adults who can make informed decisions about their use," Loucas stated.

CAPHRA also supports the government's decision to tax only smoked products. "This approach recognises the harm reduction potential of smokeless products and vaping devices," Loucas said.

CAPHRA's views align with those of Eric Crampton, a well-known economist and commentator on public policy in New Zealand. "We are in agreement with Mr. Crampton's views on this issue," Loucas noted.

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CAPHRA supports NZ Government's decision to repeal elements of the Smokefree Environments Act

CAPHRA supports NZ's harm reduction. Applauds Smokefree Act repeal, prioritizing adult choices, regulating vaping. Coordinator Nancy Loucas aligns with economist Eric Crampton.

Public health implications of vaping in Germany: Prof Levy’s SAVM model predicts 4.7 million life years saved, and 300,000 deaths avoided by 2060

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