Tobacco industry participation key to end world’s smoking epidemic

Though the COVID-19 pandemic continues to dominate global healthcare narratives, smoking remains the leading cause of preventable death in the world, claiming a toll of lives twice as many each year as COVID has taken since its discovery nearly 2 years ago.

With over 1 billion users world-wide, tobacco claims nearly 8 million lives and is responsible for nearly 200 million disability-adjusted life years annually. The estimated cost of tobacco use on the world’s economy is equally staggering, with an estimated 2% of total annual GDP, or nearly $2 trillion channelled towards the burden of smoking-related diseases every year.

A new report prepared by expert representatives from a ​ range of countries for The International Commission to Reignite the Fight Against Smoking, calls for the tobacco Industry, with their unique insights, resources and capacity for innovation, to join the fray by acknowledging their social responsibilities and standing up against the greatest global health challenge of our time.

The study, which has been lauded as “a hugely authoritative call to reshape global efforts to help smokers switch from smoking” also emphasises the role of decisive regulation and policy, based on science.

Though numbers of tobacco users have fallen since they peaked in the 50’s, they are not falling fast enough. The scourge of smoking threatens to take anywhere between six and ten million lives per year, potentially accumulating a devastating total of one billion deaths over the course of the 21^st century.

Furthermore, over 80% of tobacco users now reside in LMICs, in some of which, levels of smoking are not actually dropping at all. Within certain population groups identified in the study as particularly vulnerable to tobacco, usage may even be on the rise⁶.

“In South Africa, which is considered the 2^nd most stressful country to live in, with commensurate rates of depression and anxiety, there are almost 12 million smokers - over 31% of the population, with prevalence among South African men at a striking 47%”, notes ophthalmologist and health care leader Dr Kgosi Letlape. He served as one of the panel of experts that contributed to the report.

The study also considers the complicating factor of the (sometimes decades-long) time-lag between commencement of tobacco use, and the eventual onset of disease and ill-health.

Dr Letlape observes that, when COVID-19 came onto the scene, the world was united in a sense of urgency, which catalysed swift decisive action. He asserts that a similar sense of urgency must be cultivated among tobacco industry stakeholders - including users, manufacturers, HCWs, and government - given the severe public health consequences of tobacco use, and the devastating figures of tobacco-related deaths.

“There is a dire need for intervention from civil society and government, as well as the industry itself In LMICs like SA”, Letlape suggests. “The findings of our extensive study indicate that a technology-driven approach, backed by logical governance, based on scientific data, rather than emotional or cultural sentiment, holds the key to drastically reducing the harmful effects of smoking and reducing preventable deaths”.

“The tobacco industry has earned a poor reputation through decades of deceit and malfeasance. Furthermore, many nations who are current signatories of the UN’s Framework Convention on Tobacco Control (FCTC) own or partly control state-run tobacco companies, which gives rise to a conflict of interest in which tobacco parastatals must agree to curtail an activity from which they themselves profit,” says Letlape.

Nevertheless, Letlape and his colleagues at the commission believe that the tobacco industry is now needed as a key stakeholder in the struggle to end tobacco smoking.

“The pharmaceutical industry offers precedent for how an embattled industry with a dubious public perception can reform, commit unequivocally to public good, and regain public trust. When the COVID pandemic struck, the world acknowledged the need for the pharmaceutical industry’s capacity for sophisticated innovative solutions. Likewise, we must recognise that the tobacco industry has the expertise necessary to drive innovation in the field of tobacco cessation and disruptive THR (Tobacco Harm Reduction) technologies, of which they sit at the forefront.”

Among the 19 key recommendations at the heart of the commission’s research is that all companies should publish a fully transparent plan with measurable outcomes and targets, for phasing out combustible products entirely.

Another is the sharing of intellectual property around less harmful technology, to increase affordability and access to THR technologies in LMICs, where R&D capacity is diminished, but where there is nevertheless potential for local manufacture. Some progressive pharmaceutical firms have already started to share THR patents, Letlape says.

Letlape also stresses the role of partnerships, especially PPPs, in improving access, affordability and acceptability of new cessation and THR technology.

“One possible focus-area where PPPs could prove crucial, is education and awareness campaigns that combat the misinformation that persists around the relative risks of tobacco products vs their alternatives. Tobacco companies, and public health actors could collaborate with communications consultants and social media specialists to assuage such concerns through dissemination of information and education”.

On the role of policy and regulation, Letlape says that around the world tobacco policy is confused, hindered by misinformation, and not based on the best available scientific data.

He notes that, as with regulation, the taxation of products should be proportionate to their relative risks and potential harms. By this logic, alternatives to combustibles, like ‘vapes’, would become cheaper, thus affording more LMIC smokers the opportunity to switch to safer alternatives.

In essence, the paper calls on stakeholders to engage in a rational conversation. that must include grounded science-based regulatory oversight; risk-appropriate regulation and taxation of the various products and alternatives; transparent collaborative research; and clear communication with the public.

Dr Letlape says that the support of international public health agencies, like the WHO is critical to the fight against smoking by introducing regulation, acknowledgement of THR technology’s potential and obliging cigarette manufacturers to publish ingredients on the product packaging. ​

“These interventions together with a concerted push towards non-combustion THR devices could save millions of lives each year, especially in LMICs and amongst high-risk and marginalised communities”, he concludes.

/Ends.

• The International Commission to Reignite the Fight Against Smoking was established with the belief that efforts to prevent premature death and disease from tobacco use require much greater imagination and ambition.
• The commission was established to recommend a set of actions to accelerate an end to adult smoking and other toxic tobacco use.
• Read more at https://www.fightagainstsmoking.org/
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Issued by HWB Communications Pty Ltd