By Jamshed Baruah
GENEVA (IDN) — The COVID-19 pandemic has led to millions of tobacco users saying they want to quit. On May 31, WHO/Europe celebrated ‘World No Tobacco Day’. Under the tagline “Commit to Quit”, the aim of this year’s campaign was to support 100 million people worldwide in their attempt to give up tobacco through a range of initiatives and digital solutions.
Although many smokers are keen to kick tobacco and nicotine addiction, they don’t have adequate means or support to do so. Without assistance, only 4–7% of those who attempt to quit succeed in doing so. Structured, well-funded and accessible cessation programmes are therefore an important component of actions such as “Commit to Quit”.
According to WHO—the World Health Organization—the scale of the tobacco epidemic is colossal, posing one of the biggest threats to global health ever faced and killing over 8 million people every year. The dangers extend beyond the physical health of individuals—also impacting social and economic well-being. The annual cost of smoking is estimated to be $1.4 trillion worldwide.
Besides the long-established harmful effects of tobacco use, quitting is particularly important this year due to the coronavirus pandemic. The global crisis has supercharged health complications for smokers. Coronavirus should give a strong motivation to quit tobacco use as smokers are at much greater risk. The underlying diseases caused by smoking are key risk factors for death from COVID-19 and smoking is associated with increased severity of disease and death in hospitalized patients.
Furthermore, support for quitting—like many other services—was seriously impacted by lockdown. The pandemic dramatically reduced access to and the availability of face-to-face advice services that individuals may usually receive through health services. Reinvigorating support for those eager to give up tobacco is thus a WHO priority for 2021.
Cessation services can help double the chances of putting out tobacco products for good. Thanks to monumental public health efforts, one-third of the world’s population—2.4 billion people, including 140 million in the WHO European Region—now have access to cessation services at the best practice level. These are essential services for all countries in the grip of the tobacco epidemic.
On the occasion of the 2021 World No Tobacco Day on May 31, WHO called on “all governments to ensure their citizens have access to brief advice, toll-free quit lines, mobile and digital cessation services, nicotine replacement therapies and other tools that are proven to help people quit.”
An Issue Brief jointly by ATCA (African Tobacco Control Alliance*), ENSP (the European Network For Smoking And Tobacco Prevention) and GGTC (Global Center for Good Governance in Tobacco Control), points out that the largest tobacco transnationals—Philip Morris International (PMI), British American Tobacco and Japan Tobacco International—are key players in and are poised to dominate the NENTPs market.
“To promote its new products, the tobacco industry repeats decades-old strategies to undermine evidence-based tobacco control measures,” notes the Issue Brief. In fact, the tobacco companies’ conduct in marketing novel and emerging nicotine and tobacco products (NENTPs), undermines efforts towards implementation of Article 14 of the WHO FCTC Framework Convention on Tobacco Control (cessation).
The three organizations state that the tobacco industry misleads the public about what constitutes cessation strategies by promoting “reduced-risk nicotine products”, including NENTPs, as cessation tools. Tobacco companies promote NENTPs as “safer alternatives” and “smoking cessation aids,” contributing to a “smoke free future” or “a better tomorrow,” despite the WHO stating that these “cannot be safely recommended for consumption” and have the potential to undermine tobacco tax policies and smoke free environments.
With the marketing of “smoke free world” and “a better tomorrow” alongside NENTPs, positioned as “harm reduction” devices, warns the Issue Brief, tobacco companies give a false impression that the best means to help the population quit smoking are NENTPs, despite the lack of evidence. Globally-recognized evidence-based cessation approaches require synergy with other tobacco control measures such as tobacco tax increases and smoke free environments, and do not include NENTPs.
“In the guise of ‘cessation’ or helping smokers quit, the tobacco industry justifies the risks of youth uptake,” reprimand the three organizations. “While it outwardly asserts the importance of regulation to protect the youth, it aggressively markets to the youth, especially through social media.”
Furthermore, as a response to alarming rates of NENTP use among the youth, the tobacco companies engage in public relations strategies but resist flavour bans, which is a key strategy used by the tobacco industry to hook young consumers. Conveying misleading information about product safety also contributes to youth uptake. Despite mounting litigation on youth addiction to the NENTPs, the tobacco companies have resisted accountability: to date, there has been no known payment of compensation for damages.
The Issue Brief states, tobacco industry disparages the effectiveness of evidence-based cessation approaches and mischaracterizes these as ‘Quit or Die’; then claims that failure to recognize NENTPs as cessation tools hampers cessation efforts. By promoting unproven potentials of NENTPs and simultaneously amplifying traditional cessation approaches as ineffective, the tobacco industry promotes NENTPs in a manner that effectively discourages governments from implementing Article 14 of the WHO FCTC and adopting evidence-based cessation strategies.
“Notably, assuming for the sake of argument that NENTPs can become cessation tools, a majority of smokers in the world are impoverished and cannot afford them. Further, assuming them to be affordable, dependence in the highly addictive new NENTPs can drive them deeper into poverty,” argue the three organizations.
They further stress that by resisting tax increases, the tobacco industry interferes with the governments’ ability to provide accessible and affordable cessation support.
“The tobacco industry is known for its efforts to resist taxes, even during the COVID-19 pandemic, when it is needed the most, not only for better recovery but also for cessation services.”
Consistent with the polluter pays principle and the right of victims to restitution, a universally accepted principle in human rights, the Article 14 Guidelines specify that Parties can “consider placing the cost of cessation support on the tobacco industry and retailers, through such measures as designated tobacco taxes; … and annual tobacco surveillance/ control fees for the tobacco industry and retailers.”
By resisting taxes, the tobacco industry undermines the possibility of sustainably financing cessation efforts as recommended by the Guidelines. [IDN-InDepthNews – 01 June 2021]
*We very much regret the error in the original version, which mistakenly referred to ATCA as Air Traffic Control Association. It’s Africa Tobacco Control Alliance, a network of civil society organizations.
Photo: Compared with continuing smokers, the hazard ratios for death were lower among quitters than those who continued smoking. Source: pulmonologyadvisor.com
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