Tobacco harm reduction matters – The Lancet

A recent Lancet Editorial
1
The Lancet
Tobacco control: far from the finish line.

on the world’s slow pace of tobacco control singled out the UK as a leader in reducing the number of smokers. It accomplished this feat, the editorial said, through measures such as increased tobacco taxes, comprehensive smoke-free laws in public spaces and health warnings on product packaging.

Yet there was no mention of other nicotine delivery devices, such as e-cigarettes and heated tobacco products, although strong evidence shows that smokers who used e-cigarettes in combination with tips in person were twice as likely to quit as those who used other nicotine replacement products.
2
  • Hajek P
  • Phillips-Waller A
  • Przulj D
  • et al.
A randomized trial of electronic cigarettes versus nicotine replacement therapy.

This is despite a series of seven vaping reports published by Public Health England which note that such devices could play a “crucial role in reducing the huge health burden caused by smoking”.

3
Public Health England
Vaping in England. Summary of the 2021 evidence update.

Indeed, these findings were welcomed by Action on Smoking and Health,
4
Action on smoking and health
The MHRA’s improved guidelines on medical licensing for e-cigs are being welcomed by health officials, clinicians and tobacco experts.

the Royal College of Physicians,

5
Royal College of Physicians
Tobacco and health 2021: maturity for tobacco control?

and the national health service,

6
National Health Service
Using e-cigarettes to quit smoking.

the latter, as part of an effort to make the UK smoke-free by 2030, is currently considering adding e-cigarettes to its prescriptions to combat smoking.

7
Regulator clears way for NHS e-cigarette prescriptions in England.

The Lancet should commend the UK for showing how smoking can be made obsolete through approaches that include tobacco harm reduction.

I am a former executive director of the non-communicable diseases department of the World Health Organization and played a major role in the development of its international framework convention on tobacco control. From September 2017 to October 2021, I served as President and CEO of the Foundation for a Smoke-Free World, a not-for-profit entity funded by Philip Morris International, whose mandate is to support scientific research and the development in tobacco control.

References

  1. 1.

    Tobacco control: far from the finish line.

    Lancet. 2021; 3981939

  2. 2.
    • Hajek P
    • Phillips-Waller A
    • Przulj D
    • et al.

    A randomized trial of electronic cigarettes versus nicotine replacement therapy.

    N Engl J Med. 2019; 380: 629-637

  3. 3.

    Vaping in England. Summary of the 2021 evidence update.

  4. 4.
    • Action on smoking and health

    The MHRA’s improved guidelines on medical licensing for e-cigs are being welcomed by health officials, clinicians and tobacco experts.

  5. 5.
    • Royal College of Physicians

    Tobacco and health 2021: maturity for tobacco control?

  6. 6.

    Using e-cigarettes to quit smoking.

  7. 7.

    Regulator clears way for NHS e-cigarette prescriptions in England.

Related articles

  • Tobacco control: far from the finish line
    • Tobacco control works – slowly. The number of smokers worldwide has declined and deaths attributable to tobacco are on the decline. This progress is evident in the WHO’s fourth report on international tobacco trends, released on November 16, which estimates that there will be 1.30 billion tobacco users worldwide in 2020, up from 1.32 billion in 2015. 60 countries are now on track, up from 32 countries 2 a few years ago — to meet the voluntary global target of a 30% reduction in tobacco consumption between 2010 and 2025. Such progress is welcome.

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