Tobacco harm reduction – a step in the right direction for public health

Growing support for tobacco harm reduction strategies and the impact on public health is growing among many nations. Products that replace cigarettes for adults who would otherwise continue to smoke need to be considered as a step in the right direction.

This is according to Branislav Bibic, Vice President Philip Morris Sub-Saharan Africa, who says that throughout history, civilisation has marched steadily forward with the momentum of harm reduction innovations. “Thanks to those innovations, improvements that can help reduce harm from everyday behaviours and activities have become commonplace,” he adds.

It makes sense, he explains, as we can’t simply eliminate, for example, our exposure to the sun’s rays, but we can slather on sunscreen with sun protection factor (SPF) to mitigate the potential harm of sunburn. “We can’t avoid, for the most part, the need to travel from place to place via car (or bus, train, or plane), but we can buckle our seatbelts to help keep us safe in case of an accident,” he says.

“In that same vein, at Philip Morris International (PMI), we advocate for tobacco harm reduction (THR) strategies to be applied to the known risks of smoking,” Bibic adds. “Indeed, there is growing support for this path among public health bureaus, governments, medical groups, and others.”

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He notes that the best choice for any smoker is to quit tobacco and nicotine entirely. “However, for those who don’t quit, it is also clear that scientifically substantiated smoke-free alternatives, which provide nicotine and are not risk-free now exist that represent a much better choice than continued smoking,” he says. “These products and their potential to benefit public health are central to our vision of a smoke-free future.”

“In order for tobacco harm reduction to help effectively eliminate smoking, adult smokers must be able to choose these lower risk options,” Bibic adds. “Tobacco harm reduction should be considered a complementary strategy, and not a replacement for existing efforts to encourage those who smoke to quit and those who don’t to never start.”

Those efforts must continue, he explains, but tobacco harm reduction can be an important supplement since there are more than 1 billion smokers in the world today and that number looks unlikely to fall materially any time soon. “Therefore, the goal is to develop smoke-free alternatives that present significantly less risk of harm than continued smoking, that are acceptable to current adult smokers who would otherwise continue to smoke cigarettes, and that are not attractive to youth, non-smokers, or former smokers,” he says.

“Given the well-known risks of smoking, it is correct that tobacco products should be subject to strict rules and enforcement as these are necessary to help protect public health,” Bibic says. “But it is obvious that there is more to be done than relying solely on tactics like plain packaging and other traditional regulatory measures.”

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And, he adds, that is where tobacco harm reduction, powered by innovative products and policies, has a role to play. “For our part, as we work to deliver a smoke-free future, we are transforming our company. The scientifically substantiated products that PMI and other companies have developed are making it possible to picture a future in which cigarettes are replaced by less harmful smoke-free alternatives that adult smokers will accept,” he says.

“We believe that that role should include following the science of tobacco harm reduction and putting in place sensible, risk-based regulations governing access to and accurate information about smoke-free products, combined with further restrictions on cigarettes.”

He explains that public health authorities, expert organisations, and society at large are increasingly leveraging innovation to tackle the serious health consequences of smoking. For example, he adds, the United States Food and Drug Administration (FDA) has created separate pathways for innovative tobacco products that are a better choice than cigarettes and authorised the marketing of alternatives to cigarettes that they deem appropriate in the promotion of public health.

“If these better alternatives to smoking are made available and enough smokers switch to them, we can more rapidly achieve a significant milestone in global health – a world without cigarettes,” he concludes.