The 4th Asia Harm Reduction Forum: Tobacco Harm Reduction Developments in 2021 and What to Expect in 2022

The 4^th Asia Harm Reduction Forum (AHRF) was held virtually on June 28 with the theme “Tobacco Harm Reduction Developments in 2021 and What to Expect in 2022”. The Forum was organized and hosted by Philippine-based consumer advocacy group, The Vapers PH with Clive Bates, David Sweanor and Joe Kosterich leading the roster of speakers.

Prof. Dr. Achmad Syawqie Yazid of YPKP Indonesian Public Health Observer, who gave the Forum’s opening remarks, was joined by other representatives from regional vape consumer groups, such as, Dr. Lorenzo Mata of Quit for Good (Philippines), Asa Saligupta of ENDs Cigarette Smoke Thailand and Johan Sumantri of Asosiasi Vape Indonesia also shared their insights and local experiences.

The AHRF is an annual gathering of scientists, academics, consumers, journalists, regulators and policymakers to discuss the issues facing the inclusion of harm reduction in the public health policies of governments, with the objective of reinforcing the need to integrate tobacco harm reduction as a vital policy for tobacco control by governments in the region, which is home to more than 60% of the world’s smokers.

At the conclusion this year’s AHRF, the speakers signed a Declaration calling on governments to adopt tobacco harm reduction as an integral part of their tobacco control strategy with the hope that ultimately they will take on a tobacco harm reduction model that incorporates combustion-free products, akin to countries like the United Kingdom.

DECLARATION

We urge governments to adopt tobacco harm reduction as part of their national tobacco control policy and strategy, and promote harm reduction measures, such as access to and the use of combustion-free alternatives for smokers. We call on governments to:

Recognise that cigarette smoking is one of the leading preventable causes of tobacco-related illness and death. Burning tobacco is the main cause of smoking-related disease, not nicotine or inhaling vapour, and the Asia Pacific region has over 60% of the world’s smokers.

Reassess their current approach to tobacco control policy and regulation, and abandon the traditional ‘quit or die’ mindset. Incorporating tobacco harm reduction strategies in national tobacco control policies protects public health, by providing smokers with an alternative that reduces their risk of contracting tobacco-related illnesses and death, dramatically causing a decline in smokers and hastening the demise of the cigarette.

Adopt risk-proportionate regulations rather than ban combustion-free alternatives to cigarettes, so that the benefits of these alternatives can be maximized while minimizing the likelihood that they will be used by the youth and non-smokers. Concerns that vaping may appeal to the youth or may serve as a ‘gateway’ to smoking are inconsistent with the evidence: e-cigarettes have been gateways out of smoking for millions and have been accompanied by declining youth smoking rates. Providing appropriate access to and correct information about combustion-free alternatives for smokers is more beneficial than an outright ban on these alternatives.

Remember that public health is about people. With appropriate regulation, governments will be able to help millions of men and women who smoke and will continue to smoke by telling them the truth that although the best option is to quit smoking and the use of any nicotine-containing product, switching to a regulated combustion-free alternative is a better choice than continuing to smoke.

SGD & DATED

 

Highlights of the Forum:

Prof. Dr. Achmad Syawqie opened the forum and spoke about the concept and importance of harm reduction particularly in regard to tobacco. He emphasized that harm reduction principles uphold commitment to social justice and avoid stigma.

• “Quit or switch – It’s all about the choice. The most important is your commitment to change to a healthy and better life. Smokers who want to quit or switch must be able to assess the tools that can assist them…”

Clive Bates provided a discussion on the WHO and FCTC and their current stance and response to harm reduction, and how it could be better with some suggested solutions. He encourages governments and stakeholders to embrace harm reduction, a concept that is deeply embodied in the Framework Convention for Tobacco Control (FCTC). Risk-proportionate regulations include tools such as taxation, advocating for stronger regulation for tobacco products that burn, and a much more permissive approach for the smoke-free products. He also talked about better policy appraisal, an area where the World Health Organization (WHO) can improve. The WHO must stop pushing prohibitions as it is a recipe for illicit products made to lowest standards and supports the burgeoning black market. By making these novel tobacco products difficult to acquire, people will ultimately resort to high risk products.

• “Embrace harm reduction – it’s there in the FCTC. There is a framework for doing it, which is called risk-proportionate regulation. Tax, regulate and communicate much stronger regulation for the smoke products, and a much more permissive approach for the smoke-free products. Use the regulatory framework to encourage people to migrate from high risk to low risk products.” https://www.youtube.com/watch?v=mDKWMwLsf5M

 

David Sweanor talked about how Japan became a global leader in reducing smoking. The inhalation of smoke as a way of getting nicotine – the leading cause of preventable disease worldwide – is unnecessary as there are a range of products that allows smokers to get the nicotine without inhaling smoke. We can increase that range of products and move markets, through regulation. The opportunity exists and it is therefore our chance to make public health history. We have to look at what has been achieved through the substitution of products, low risk products for high risk products.

• “People can only make as good a decision as the information around them allows, and we should not deprive people of the information they need to make an informed decision, and deprive them of the access they need to the products that allow them to act on the informed decision.” https://www.youtube.com/watch?v=9ZDAusunCQ8

Joe Kosterich discussed different approaches to tobacco control, particularly comparing Australia and New Zealand, providing insights on what can be applied in other countries. He advocates making less harmful alternatives to cigarettes as easy to obtain as cigarettes.

• “Going down a path of making access to less harmful alternatives to cigarettes as easy to obtain as cigarettes is a very good principle to apply. Tell people to do neither but encourage people who are smoking to switch to these.”
• https://www.youtube.com/watch?v=6qjrsWb2sgY

 

Dr. Lorenzo Mata spoke about vaping as a viable alternative to cigarette smoking and the activities that his organization, Quit for Good, is undertaking in support of tobacco harm reduction in the Philippines.

• “In as much as we want all smokers to quit, in reality, not everyone would want to quit. We in Quit for Good put forward that the traditional “Quit or Die” approach to public health must be abandoned immediately. A third option must be provided to our adult smokers who do not wish to quit. Tobacco Harm Reduction, through the use and promotion of safer alternatives to combustible tobacco, should be employed to substantially reduce the risk of death and disease of smoking.”
• https://www.youtube.com/watch?v=0twvf-bRFis

 

Asa Saligupta of End Cigarette Smoking in Thailand (ECST) discussed the state of tobacco harm reduction in Thailand from the perspective of consumers. He advances that restriction on vaping and tobacco harm regulation has had little effect on its demand; thus, for more than a decade, the smoking rate in Thailand remains the same. It is, therefore, critical that we reevaluate the approach of banning novel tobacco products or e-cigarettes.

• https://www.youtube.com/watch?v=pLnxmbYEIkI

Johan Sumantri of Asosiasi Vaper Indonesia (AVI) spoke about the advocacy strategies of his organization in support of tobacco harm reduction in the country. He debunks the popular, yet erroneous, view of the public in Indonesia that – vaping is the same or even worse than cigarettes.

• https://www.youtube.com/watch?v=m7Bk41JrWbw