Ignoring the evidence: Is ‘conventional wisdom’ hindering the fight against smoking?

It’s a question that the European Commission seems unable to answer. Is the campaign to stop people smoking cigarettes being held back by an impulse to ban all tobacco products? The evidence suggests that nicotine-based alternatives to smoking, such as e-cigarettes have an important part to play, writes Political Editor Nick Powell.

The big argument about cigarette smoking is in effect over. No-one still suggests that smoking is not an extremely harmful actIvity and everyone agrees that anyone who still smokes should stop. People who have never smoked should certainly not start and this especially applies to youngsters, who shouldn’t acquire a taste for nicotine from e-cigarettes and other substitutes.

Unfortunately, there’s a temptation in some quarters to make a leap from that consensus and make an argument that amounts to saying ‘it’s all bad, so let’s ban it’ or at least make it massively expensive through taxation. That creates a business opportunity for tobacco smugglers, especially if smokers aren’t even offered the chance to switch to much safer substitutes.

But the ‘ban everything’ brigade have become very influential. The European Health and Digital Executive Agency recently agreed a €3 million contract to support of getting at least 95% of the population off tobacco by 2040. The only bid was from a consortium that includes, in an advisory role, the European Network for Smoking Prevention (ENSP), which is against alternative products.

ENSP denies any conflict of interest in providing technical and scientific expertise to the consortium. However Swedish MEP Sara Skyttedal tabled a question to the European Commission asking if it saw any risk of conflict of interest by involving ENSP. She stated that it “lobbies the Commission on tobacco policy and advocates a total ban on safer nicotine products”.

It was a priority question, which the Commission is expected to answer within three weeks. It was submitted on 17 April but with no reply published by the end of May. The Commission can of course point to its requirement that all conflicts of interest are declared and to its rules on transparency and openness.

Sweden is the only member state where cigarette smoking has fallen below 5%, an achievement that’s been attributed to the availability of the traditional Swedish alternative of snus. It’s a tobacco product that is not smoked but placed under the upper lip and carries a much lower risk of cancer, including mouth cancer.

Another Swedish MEP, Jessica Polfjard, has called for snus and other oral products to be available throughout the EU, as they are in Sweden. She said that they would “play an important part in providing substitutes for regular cigarettes and other more harmful products”.

In a recent speech, the CEO of Philip Morris International (PMI), Jacek Olczak, reaffirmed his commitment to getting his company out of the cigarette business but remarked that “the faster I go, the more people shout at me”. He said PMI’s mission was clear, “to reduce smoking by replacing cigarettes with less harmful alternatives”, adding that “cigarettes belong in museums”.

Mr Olczak said there should be no mistake about the fact that people who have never used tobacco or nicotine, especially minors, should not use alternatives to cigarettes. “And there’s no doubt that quitting altogether; or better still, never starting, is the best choice.”

But he argued that it was time to look at real world examples, such as Sweden. It was estimated that 350,000 smoking-attributable deaths among men every year could have been avoided in the rest of the EU if had matched Sweden’s tobacco-related mortality rate.

After similar heated tobacco products to Sweden’s snus were introduced in Japan in 2014, there was an unprecedented decline in adults smoking cigarettes over the next five years. In Singapore, where smoke-free alternatives are banned, sales of cigarettes have gone up. “Not taking an evidence-based decision on smoke-free products today is a decision with consequences”, Mr Olczak concluded.

Jancek Olczak delivered his speech in London, where the UK government has set out a ‘Swap to Stop’ policy that aims to achieve a smoke-free England by 2030. The Minister for Primary Care and Public Health, Neil O’Brien, has set out a strategy that targets smokers by promoting vaping but also aims to stop e-cigarettes being used by children.

A trading standards task force will crack down on illicit vape sales, especially to those under 18, with £3 million to fund a ‘flying squad’ that will enforce the law. There will be a call for evidence on tackling youth vaping. There will also be a consultation on compelling cigarette manufacturers to put advice on quitting inside packs.

Meanwhile, a million vaping starter kits will be offered to adult smokers who access the National Health Service’s smoking cessation scheme. The focus will be on the most deprived communities. Pregnant women will be given a financial incentive to stop smoking, in the form of shopping vouchers worth up to £400.

The minister said the British government would “look at where we can go beyond what the EU Tobacco Products Directive allowed”. He also ruled out a complete ban on smoking for everyone born after a certain date, preferring an approach based on “personal choice and offer of help”.

Share this article: