New research published in the Harm Reduction Journal has demonstrated the robust link between declining smoking rates and adopting alternative nicotine products. The paper titled Can alternative nicotine products put the final nail in the smoking coffin? looked at what happens when governments encourage vaping and other harm-reduction alternatives.
Smoking kills about 8 million people each year. Global smoking rates sit at over 22%. Governmental tobacco control policies haven’t had a major impact on the total number of smokers across the world, and research suggests that worldwide smoking levels have reduced from 1.32 billion to 1.3 billion between 2015 and 2020.
A reduction in smoking by 20 million isn’t much, but it is perhaps clouded slightly by a population increase of 329 million people. Some people like to suggest warning labels on packaging should take credit. However, the fact that there are now over 80 million vapers worldwide, might have more to do with it than telling people what they already know, that smoking kills.
Whatever our differences, almost everyone agrees that smoking is a public health crisis. Getting that 1.3 billion down is a huge priority to reduce pain and suffering across the globe. So, what can be done to speed up the process?
Everyone has theories about what will work. But sometimes, the best approach is to look at what has and is driving down smoking rates.
I’ve never met someone who told me they gave up smoking because they realised it was bad after reading a SMOKING KILLS message on a cigarette box. While evidence suggests that smokers’ ability to understand the real risk of smoking can be low, the number of people who believe it is safe is relatively insignificant.
As pointed out in the excellent paper Tobacco control: getting to the finish line, the people at the vanguard of tobacco control policy are working with old-fashioned ideas.
“The missing strategy in WHO and FCTC policies is harm reduction. Most people smoke because they are dependent on nicotine. Tobacco harm reduction reduces the harm caused by burnt tobacco by replacing cigarettes with much less harmful ways of delivering nicotine; these alternatives have great potential to disrupt the cigarette industry.”
The author of the paper, Karl Fagerström, looks at five different countries where alternative nicotine products are popular. They are:
He points out that the UK and New Zealand governments support harm reduction. At the same time, the other three administrations don’t explicitly support vaping and similar products, but they are relatively permissive.
Then, the paper compares these countries with their neighbours with lower uptake of tobacco harm-reduction products.
When compared with other EU27 countries, the UK is quitting smoking more quickly. Since 2014, smoking has dropped from 18% to 14% in the UK. In the same period, it’s gone from 27% to 25% in the EU27.
There are a couple of things to note here. Once smoking levels get closer to 0%, each drop becomes more difficult. However, the UK has outperformed Europe by 2% over time, despite having less low-hanging fruit.
Sweden is something of an outlier when it comes to low smoking rates. Many people attribute the wide availability of Snus as the reason why it has had lower smoking rates than its Nordic neighbours.
Since 2011, Norway and Sweden have seen smoking rates drop into single digits, 8% and 6%, respectively. In comparison, Denmark and Finland have been less vaping-friendly, and while their smoking rates have declined, they still sit at around 13%.
Australia’s notoriously hardline approach to tobacco control is not working. In 2011, Australia’s smoking rate was 15.7 while neighbours New Zealand had rates of 16.4%. In the last decade, New Zealand has broken into single figures (9.4%), while Australia has lagged behind at 10.3%.
Similarly, smoking rates in Japan have declined faster than in Australia, with heated-tobacco products a popular alternative in the Asian country.
Countries that take a mature, scientific approach to harm reduction are reaping the benefits of faster-declining smoking rates. Harsh tobacco control policies don’t work. The UK, Sweden, New Zealand, Japan, and Norway are showing other countries the way forward. It’s up to us to make these governments listen. So, get involved.