Scientific advances to cut smoking should be acknowledged – experts

    Dr. Konstantinos Farsalinos

    THE World Health Organization’s (WHO) tobacco control accord should acknowledge scientific and technological advancements if it wants to reduce the number of smokers which continues to increase in absolute terms worldwide, according to harm reduction proponents.

    Dr. Konstantinos Farsalinos, a cardiologist and a leading researcher on tobacco harm reduction (THR), said a successful THR strategy could save millions of smokers. THR involves the use of less harmful and smoke-free alternatives to cigarettes such as vapes, heated tobacco products and snus.

    The latest review by the UK Department of Health and Social Care, its eighth so far, confirms that in the short and medium term, vaping represents a small fraction of the risks of smoking and that there is significantly less exposure to harmful substances from vaping compared to smoking, in biomarkers of cancer, respiratory and cardiovascular diseases.

    “So, we need to think with common sense, with logic, and we need to apply the same principles in terms of legislation as we apply them in every other daily aspect, which is a risk proportionate regulation. We don’t need any complex rulings or any complex laws. We need something which is simple. We need to understand, first of all, the level of risk difference and to encourage in reality people to use these products instead of smoking,” Dr. Farsalinos said.

    Unfortunately, Dr. Farsalinos said since the WHO’s Framework Convention on Tobacco Control (FCTC) and other national health authorities have ignored the merits of THR, the absolute number of smokers globally has increased to about 1.3 billion today despite 60 years of accumulated knowledge about the harm of smoking.

    “We are literally preventing people from quitting smoking through the use of alternative products by demonizing these alternative products just because they contain nicotine,” Dr. Farsalinos said during the THR Summit Spain held recently at the Universidad Rey Juan Carlos in Madrid.

    Renowned public health authorities also identified the FCTC as an example of a global public health agreement that is no longer fit for its purpose as it continues to ignore views of key stakeholders and refuse to acknowledge latest scientific developments.

    Dr. Michael De Luca, a Disaster and Operational Medicine Fellow at the Department of Emergency Medicine of the George Washington University, and Dr. Mario L. Ramirez, an emergency medicine physician at the Department of Emergency Medicine of the Inova Fairfax Hospital, have warned that WHO’s proposed pandemic treaty is doomed to fail if it will be patterned after the FCTC.

    Dr. Farsalinos said: “You don’t need to be a scientist in order to understand the vast difference in the risk between smoking tobacco cigarettes and using electronic cigarettes. On one side, we have tobacco cigarettes which are burning organic matter at temperatures that go up to 800 degrees Celsius when a smoker takes a puff. On the other side, we have a device which uses electricity to heat a coil and to evaporate a liquid, which is subsequently recondensed in temperatures of less than 300 degrees Celsius. Just hearing this, a non-expert, a non-scientist can understand that these are vastly different products.”

    “The level of risk difference is tremendous, and we have seen that repeatedly in lots of studies over the last 10 years. I’ve offered many of them, but all the studies converge basically. I don’t think there is any disagreement. We now see scientific societies accepting the substantial lower level of potential toxins in electronic cigarette aerosol compared to tobacco cigarette smoke,” he added.

    “Unfortunately, all our medical products to quit smoking are not very effective. That’s why most smokers are going to end up using these alternative products. We need clinicians to provide this option to the smoker, instead of misinforming and scaring them,” he said.

    Meanwhile, Clive Bates, former director of Action on Smoking and Health UK and former advisor to British Prime Minister Tony Blair, said the WHO should be held accountable by its shareholders.

    “It’s an international non-governmental organization, a branch of the United Nations, and it has member state countries which sit on its board. They should be holding its feet to the fire. But what they’re doing with smoking is that it’s almost as if the World Health Organization was advising people not to use vaccines for COVID, because they think there’s some risks. It is in almost in the same mental space as anti-vaccine,” he said.