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Harm-Reduction

Speakers stress need for tobacco harm reduction strategy 

They call for sensible regulations for vaping products to achieve government’s health agenda and revenue ambitions

Speakers at an event urged policymakers to incorporate Tobacco Harm Reduction (THR) strategy in their tobacco control plans and establish safer alternatives such as vaping products as smoking cessation medium like progressive nations around the world. 

To commemorate World Vape Day 2022, Voice of Vapers Bangladesh organised a panel discussion titled “The Need for a Tobacco Harm Reduction Strategy: Achieving the Government’s Health Agenda & Revenue Ambitions” held at a Dhaka hotel on 28 May, reads a press release.

Dr Delon Human, president of Health Diplomats and an expert on harm reduction said, “Bangladesh is widely recognised as a resilient nation, known for her prowess to prove her critics wrong. Historically, the indomitable spirit of Bangladeshis has made them question the status quo and establish the rights of its people. The stupendous development across all sectors is a true testament of that.” 

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自由開講》理性態度看待緩減菸害

《菸害防制法》修法一直受大眾的矚目。目前台灣有近三百多萬吸菸者,但非吸菸者卻有近二千萬。對於非吸菸者而言,縱然他們可能真心希望台灣是民主和開放社會的範例;假如決議就只有簡單的少數服從多數,吸菸者幾乎可以說是沒有勝算,結果不是真正的民主,而是多數人暴政。

民主是和衷共濟,透過協商找出最接近兩全其美的方案。本次修法,屢受關注及討論原因之一,是衛生福利部提出的版本中,包括全面禁止電子煙在內之各式類菸品。

「為甚麼不乾脆戒菸?」對那些非吸菸者,可能會覺得戒菸事在人為,只要有決心的話,誰都可以立地成佛。然而事實證明,過去幾年容許吸菸者有替代品可供選擇的國家,吸菸率的降幅尤其明顯。以英國為例,自從 2013 年英國公共衛生署積極建議吸菸者改用電子煙,英國整體吸菸率下降了 25%。相比之下,世界上電子煙法規最嚴格的澳大利亞,同期的吸菸率僅下降了 8%。

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The Devastating Impact of the FDA’s Proposed Menthol & Flavored Cigarette Ban

The FDA’s announcement to ban the sale of menthol cigarettes and flavored cigars has been roundly condemned from all sides of the political spectrum, and is opposed by groups as diverse as American Council on Civil Liberties (ACLU), Rev. Al Sharpton’s National Action Network, the National Black Justice Coalition, Americans for Tax Reform, Americans for Prosperity, and Heritage Action for America.

Americans for Tax Reform convened a virtual seminar on the impact of this proposed ban with policy & law enforcement experts, covering the science and evidence (or lack thereof) underpinning the ban, the disastrous implications for law enforcement and vulnerable minority populations, the consequences of a thriving black market, and alternative, proven methods of tobacco harm reduction the FDA should be enacting instead of prohibition.

Chaiwut Thanakamanusorn is right: Thailand can save lives and promote innovation by legalizing nicotine alternatives

Bangkok, TH – As Thailand considers revising its ban on harm reducing nicotine delivery products, a global consumer advocacy group is praising the actions of Digital Economy and Society Minister Chaiwut Thanakamanusorn, who has recognized the importance of harm reduction in saving the lives of smokers who want to quit.

“The growing body of evidence from countries around the world points to a steep decrease in smoking rates once we allow harm reducing nicotine alternatives such as vaping products, snus, nicotine pouches, and heated tobacco products,” said Yaël Ossowski, deputy director of the Consumer Choice Center. “The smoking rate in the United States, Canada, and the United Kingdom are already at historical lows.

“Considering that over 50,000 Thai die each year due to smoking, amending the current bans and restrictions on these alternative nicotine products would mean lives would be saved almost immediately.

“In that, we praise the comments and recent actions of Digital Economy and Society Minister, Chaiwut Thanakamanusorn, who has been willing to hear the evidence on the scientific and health evidence in favor of vaping and nicotine alternatives and has made the case for how innovation in harm reduction can help save lives,” said Ossowski.

“In addition, the National Tobacco Products Control Committee’s ban on vaping imports has paved the way for a dangerous illicit market, meaning that ordinary Thai citizens who gain access to these life-saving products are not only at risk of significant fines by authorities, but also face more health risks related to illicit products that are not inspected and regulated by state agencies. Added to that, the government is losing out on potentially millions in tax revenue that could be used to fund healthcare, education, and vital social projects.

“If Thailand were to embrace innovation and endorse a strategy of harm reduction, they would not only be saving potentially millions of lives, but the country would also create a new wave of entrepreneurial investment and drive that would surely lead to an economic boom,” concluded Ossowski.

Vaping not a gateway to smoking, states CCC policy paper

The Consumer Choice Center (CCC), a consumer advocacy group based in the United States, recently published a policy paper that examined key facts demonstrating that vape is not the gateway to smoking. 

“Vaping is often blamed for encouraging smoking among adults and teens,” said Maria Chaplia, a research manager at CCC and author of the CCC paper titled “Vaping And The Gateway Myth”. 

“Such unjustified criticism of vaping prevents millions of smokers around the world from switching to a safer alternative. The gateway rhetoric does not do anyone any good, has no merit and should be abandoned,” she continued.

NOT THE SAME

According to the research report by the CCC, the objective of vaping is to provide a less dangerous alternative to cigarettes that minimises the risk of health complications.

Public Health England has validated this statement, stating that vaping is 95 per cent less harmful compared to smoking.

Furthermore, vaping has a cancer risk of less than 0.5 per cent when compared to smoking, according to a study published in the British Medical Journal.

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Pentingnya Kampanye Harm Reduction pada Perhelatan Besar di Indonesia

Beberapa waktu lalu, Indonesia menggelar salah satu perhelatan olahraga terbesar di dunia, MotoGP. Perhelatan ini diseleggarakan di Sirkuit Mandalika yang terletak di pulau Lombok, di provinsi Nusa Tenggara Barat (NTB).

Tidak bisa dibantah, kesempatan untuk menyelenggarakan perhelatan yang sangat bergengsi ini tentu merupakan sesuatu yang cukup langka, dan hal yang dapat terjadi begitu saja. Untuk dapat menjadi tuan rumah dalam perhelatan yang sangat bergengsi ini, dibutuhkan berbagai persiapan yang sangat matang dan biaya yang tidak sedikit.

Indonesia misalnya, harus mengeluarkan biaya setidaknya sejumlah 9 juta euro untuk menjadi tuan rumah perhelatan olahraga internasional tersebut. Dana tersebut dibayarkan kepada perusahaan Dorna Sport, yang merupakan perusahaan induk dari perhelatan MotoGP (suara.com 3/12/2021).

Biaya ini tentunya belum juga termasuk dana yang harus dikeluarkan untuk membangun Sirkuit Mandalika tersebut, yang menjadi tempat perhelatan MotoGP. Diestimasi, pembangunan sirkuit internasional tersebut memakan biaya sebesar 1,2 triliun rupiah (sports.okezone.com, 1/2/2022).

Namun, biaya yang sangat besar ini tentu bisa sangat dimengerti, mengingat MotoGP merupakan salah satu perhelatan olahraga terbesar di dunia. Tidak bisa dipungkiri bahwa melalui perhelatan internasional ini, kita memiliki kesempatan yang sangatbesar untuk mempromosikan Indonesia di mata dunia internasional. 

Dengan suksesnya penyelenggaraan ajang olahraga internasional sebesar MotoGP, diharapkan akan semakin banyak turis yang datang ke Indonesia, dan akan semakin banyak investor yang menanamkan dananya di negara kita.

Tidak hanya itu, perhelatan olahraga internasional sebesar MotoGP juga pasti akan mendatangkan banyak pemasukan melalui iklan dan juga penjualan tiket. Tidak sedikit perusahaan multinasional dari brand ternama yang pastinya akan membayar mahal untuk menaruh nama dan juga mempromosikan produk-produk yang mereka jual kepada publik.

Tidak hanya produk-produk yang dibuat dan dijual oleh perusahaan-perusahaan multinasional dari luar negeri, perhelatan ajang kompetisi olahraga internasional sebesar MotoGP juga memberikan kesempatan yang besar untuk mempromosikan berbagai produk-produk lokal yang dibuat oleh para produsen dari Indonesia. 

Upaya untuk memperkenalkan berbagai produk dalam negeri, apalagi kepada masyarakat internasional, tentu saja merupakan hal yang sangat penting untuk meningkatkan industri dalam negeri di negara kita.

Selain itu, bukan hanya kampanye dan iklan dari produk-produk dalam negeri, perhelatan olahraga internasional seperti MotoGP juga memberi ruang kesempatan yang besar untuk melakukan kampanye sosial, seperti mengenai kesehatan, dan lain sebagainya. 

Salah satu kampanye yang bisa dilakukan diantaranya adalah mengenai pentingnya langkah dan kebijakan yang mendukung harm reduction untuk para perokok, khususnya di negara kita.

Sudah menjadi rahasia umum bahwa Indonesia merupakan negara dengan jumlah populasi perokok terbesar di dunia. Pada tahun 2020 saja misalnya, hampir 40% penduduk dewasa di Indonesia merupakan perokok aktif, yang merupakan salah satu negara dengan tingkat prevelensi populasi perokok yang terbesar di dunia. Hal ini tentu menimbulkan permasalahan kesehatan publik yang besar, yang harus segera diselesaikan (economy.okezone.com, 13/12/2020).

Untuk itu, berbagai kebijakan yang ditujukan untuk mengurangi jumlah perokok di Indonesia merupakan hal yang sangat penting. Salah satunya adalah, melalui kebijakan yang bertujuan untuk harm reduction. 

Kebijakan ini berfokus bukan pada pelarangan tetapi bagaimana kita bisa membantu para perokok untuk mendapatkan produk yang lebih aman. Dengan demikian, mereka dapat perlahan-lahan meninggalkan kebiasaan merokoknya yang sangat berbahaya.

Penyelenggaraan MotoGP di Mandalika sendiri juga dimeriahkan oleh kampanye program untuk mengurangi rokok (smoking reduction program) yang diselenggarakan oleh perusahaan produsen vape asal Indonesia, Movi. 

Dalam program tersebut, dikampanyekan mengenai metode harm reduction melalui inhalasi uap herbal dengan menggunakan berbagai bahan tradisional yang berasal dari Indonesia (tribunnews.com, 24/3/2022).

Hal ini tentu merupakan sesuatu yang positif dan bisa dicontoh di berbagai acara atau perhelatan lainnya, terlebih di perhelatan internasional, yang tentunya menarik banyak perhatian para penonton dan pengunjung. 

Perhelatan internasional yang menarik banyak perhatian publik tentu merupakan salah satu tempat yang paling cocok dan tepat untuk mengkampanyekan pentingnya kebijakan dan program yang berfokus pada harm reduction untuk mengurangi jumlah perokok aktif di Indonesia.

Terlebih lagi, kebijakan atau program yang berfokus pada harm reduction merupakan sesuatu yang belum populer dan belum banyak diketahui secara luas oleh masyarakat Indonesia, termasuk juga para pengambil kebijakan. 

Tidak sedikit masyarakat Indonesia dan para pengambil kebijakan yang masih berpandangan bahwa satu-satunya cara untuk mengurangi prevelansi perokok di Indonesia adalah melalui kebijakan pembatasan dan pelarangan ketat. 

Padahal, kebijakan pembatasan dan pelarangan ketat, tanpa dukungan dari adanya produk alternatif yang lebih aman, merupakan kebijakan yang sangat berbahaya, dan justru dapat semakin menyuburkan berbagai praktik pasar gelap yang menjual produk-produk ilegal.

Sebagai penutup, kebijakan dan program yang berfokus pada harm reduction merupakan hal yang sangat penting untuk mengurangi tingkat perokok di Indonesia, dan sudha terbukti berhasil di negara lain, seperti Britania Raya. Dan perhelatan-perhelatan besar merupakan salah satu tempat yang tepat untuk mengkampanyekan pentingnya program tersebut.

Originally published here

Hawaii: Eliminating vape flavors would cause more problems than it would solve

By Yaël Ossowski

When the state acts to protect our children, we trust it will do so with knowledge and responsibility. Considering the rise in availability of vaping products this last decade, it is understandable that the State Legislature has been called on to act.

But if Hawaii curbs the sale of flavored vaping products — intended for adult former smokers — this will not eradicate the problem of youth access. Rather, it may make it even worse.

Health committee chair Rep. Ryan Yamane admitted as much last week, stating “I don’t want our youth who are electronic savvy to get access to unknown supplies or, who knows, black-market cartridges laced with dangerous substances through the internet where we don’t know where it’s coming from.”

What Yamane alludes to is the 2019 EVALI epidemic, when illicit cannabis vaping devices made their way into the hands of thousands of people across the country, causing death and serious lung injuries that spread panic around vaping products. There were 4 cases in Hawaii.

The CDC has concluded that virtually every case was linked to a supply of bootleg THC vape cartridges laced with Vitamin E Acetate. While these products are far removed from the vaping devices found in convenience stores and vape shops, even though activists have attempted to connect them, the EVALI crisis demonstrates the ills associated with unregulated black market products.

Massachusetts enacted a ban on flavored vaping products in 2019 and the results should raise caution. Since the ban, a massive influx of smuggled tobacco and vape products has resulted in a thriving black market, siphoning tax revenue for the state, criminalizing adult consumers trying to make the healthier choice, and exposing kids to black market dealers who don’t ask for ID.

Making a product illegal will not necessarily make the demand for it go away, as the era of Prohibition taught us.

If Hawaii moves forward with a vaping flavor ban, they’ll not only endanger our kids, but they will also push adult consumers to switch back to smoking combustible tobacco, a disaster for public health. Over 1,400 Hawaiians lose their lives to smoking-related illnesses each year. As found in multiple studies and even Public Health England, vapers benefit from 95% less harm than cigarettes.

Fortunately, more than 7% of Hawaii’s adult population uses vaping products, accounting for over 100,000 Hawaiians who have switched to a better alternative, including our elderly. According to data from the Hawaii Journal of Medicine and Public Health, the largest demographic of Hawaiian vapers are actually over 65.

If those retirees have their smoking cession options taken away, it will not only nudge them back to smoking and put their health at risk, but it would cost Hawaii dearly. Smoking-related healthcare costs already cost Hawaiian taxpayers $141.7 million annually, not to mention the pain of long-term illnesses and deaths experienced by many families.

Our goal should be to expand people’s choices to quitting tobacco, not to limit them severely.

What’s more, similar bans to what is proposed here in Hawaii have actually been demonstrated to increase smoking rates among youth in jurisdictions like San Francisco. Data from the Journal of the American Medicine Association shows that the flavored vaping product ban caused increased smoking rates for youth aged 18 and younger.

If we are concerned about youth gaining access to vaping products, we need to ask why it is happening. Are retailers breaking the law and selling it to them? Are they asking older friends or family to acquire for them? Will adult users of these products still have less harmful alternatives to cigarettes if we outlaw them? These are important considerations.

Teenagers seek out risky behavior, whether it is drugs, alcohol, or vaping devices. Education and parental responsibility, however, would be much more effective than a sweeping ban that would boost a new black market and deprive responsible adults of products they have sought to improve their lives. This is the choice Hawaii will have to make.

Yaël Ossowski is deputy director at the Consumer Choice Center.

Smoking is up for the first time in a generation. The public health lobby is to blame

By Yaël Ossowski

It often takes a long time for health policy influencers, advocates, and proponents to admit fault. 

When it is about topics such as diet fads, saturated fats, food pyramids, and sugar consumption, long-held consensus beliefs and government actions later proved erroneous have had a lasting negative impact.

But nothing has been more egregious and harmful in our current age than the public health lobby’s persistent denialism of the harm reduction value of nicotine vaping products and other alternatives to cigarettes.

That denialism has come in many forms: public information campaigns demonizing vaping devices, misinformation on lung illnesses caused by tainted cannabis cartridges, bans, restrictions, and taxes on flavored nicotine products (especially those without tobacco), Kafkaesque market authorization applications handled by the drug regulators, and a never-ending crusade to deny adult consumers from having access to life-saving products because of illicit and risky behavior by teens.

These public health bodies, anti-smoking groups, and allied journalists, whatever their intent, have sought to convince the public that not only is smoking bad and dangerous — an easy admission — but also that alternative nicotine devices like vaping products, nicotine pouches, and heated tobacco are just as or even riskier than a pack of smokes.

Those conclusions are easily debunked by the millions of passionate vapers who have long since put down cigarettes and taken up customized tanks, vaporizers, and flavored liquids that give them a familiar nicotine sensation without the tar and combustible byproducts of tobacco.

David Butow for Rolling Stone

The public health mission to muddy the popular perception of nicotine alternatives such as vaping — even though it is scientifically proven to be 95% less harmful than cigarettes — is causing actual damage to American public health. And now we have the proof.

That proof is found both in the increased sales of cigarettes nationwide and also in a highly concentrated study on teen smoking in a jurisdiction where flavored nicotine vaping was outlawed.

According to the sales figures collected by the Federal Trade Commission for its 2020 Cigarette Report, Americans bought more cigarettes in 2020 than they have in more than a generation.

“The total number of cigarettes reported sold by the major manufacturers, 203.7 billion units in 2020, increased by 0.8 billion units (0.4 percent) from 2019, the first increase in cigarettes sold in twenty years,” cites the report.

Americans could be buying more cigarettes for a multitude of reasons: lockdowns, stress from both the pandemic and the government responses to the pandemic, job losses, closed schools, and more. Or perhaps because they’ve been told repeatedly by trusted public health sources and news outlets that vaping, an alternative that millions of adult consumers are now using to quit smoking, is just as dangerous.

Whatever your conclusion, the trend that lowered the percentage of US smokers down to 14 percent in 2019 (when the last complete nationwide survey was completed) is halting. And that should concern us all.

We see anecdotal echoes of this in a recent style piece in the New York Times, highlighting the “comeback” of cigarettes among the bourgeois hipster crowd in Brooklyn, New York. 

“I switched back to cigarettes because I thought it would be healthier than Juuling,” claimed one woman. It seems the public health lobbies have done their job.

On the more evidentiary side, an extensive May 2021 article published in JAMA Pediatrics found that after San Francisco’s ban on flavored vaping and tobacco products, more teens took up smoking.

“San Francisco’s ban on flavored tobacco product sales was associated with increased smoking among minor high school students relative to other school districts,” concludes the paper.

As tobacco harm reduction advocates have claimed for several years, the persistent public health campaigns, echoed by headline-grabbing media outlets, to demonize and restrict access to vaping has led to a predictable rise in smoking rates, both among adults and teens.

Whatever your view on whether vaping devices, heated tobacco, snus, or nicotine pouches are the most attractive and effective gateway away from smoking, this recent uptick in smoking demonstrates actual harms result when politically-charged health lobbies seek to extinguish market alternatives. And we must ask why they persist.

The opposition of these groups, along with affiliated journalists and researchers, to the rise of nicotine alternatives may have less to do with quantitative questions of science and health and more to do with how these products were created and are delivered: by entrepreneurs providing solutions in the market.

These entrepreneurs are vape shop owners, makers of vape liquids, gas station owners, vaping technology firms, tobacco firms pivoting to alternative products, and an entire creative class of vaping influencers both on and offline who are trying to give smokers a second chance at a long life. These are the true heroes of harm reduction in the 21st century.

The fact that spontaneous markets can deliver helpful and healthier solutions because of consumer demand, rather than by edicts, funding, and programs directly controlled by public health bureaucracies and agencies, runs counter to much of the ideology in the tobacco control space. 

It is the former, therefore, that is the true American innovative spirit that has helped make this country so prosperous and competitive, while the latter has failed us again and again.

If we want to reclaim a true public health victory and help smokers quit to give them long and fruitful lives, it is time to cast aside this aversion to the innovations of the market. The future health of our nation depends on it.

Yaël Ossowski is deputy director at the Consumer Choice Center

6 Reasons Nicotine Is Not Your Enemy

This month’s Christmas festival has great news on public health. In countries that encouraged and accepted tobacco harm reduction policies, the number of smokers has dropped significantly.

In the UK, for example, smoking levels have dropped by 25% since 2013 (when e-cigarettes became popular). Over the past four years in Japan, cigarette sales have fallen by 34%, while sales of reduced-harm alternatives such as heat-not-burn tobacco surged to 30% in 2019.

This was achieved because people who usually look for nicotine do so in a harmless way.

But while these numbers are important wins for consumers, the entire army of nicotine’s unscientific scapegoats undermines their success. This approach has dire consequences: fewer people switch to less harmful alternatives such as vaping, nicotine pouches, or heat-not-burn tobacco devices.

In the Philippines, additional categories of harm reduction are being legalized, but still failing to achieve the widespread adoption required.

Read the full article here

Researchers Call for End to ‘War on Nicotine’

A new research paper attempts to clarify the confusion surrounding nicotine consumption and the role it plays in the diseases caused by smoking. The paper, released by the Consumer Choice Center, outlines six main reasons why the “war on nicotine is pointless” and should end.

“Instead of celebrating declining numbers of smokers and far fewer deaths, many governments, public health agencies and anti-smoking activists have been on the hunt for new enemies,” the researchers wrote. “They decided to scapegoat nicotine, and as a result, the fight against smoking gradually transformed into a fight against nicotine. Such an approach has dire consequences: fewer people switching to less harmful alternatives.”

Read the full article here

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