Innovation can save lives

Innovation drives societal advancement.

From the beginning of humanity, innovation has been a driving force behind societal advancement. In short, we are because we innovated. In our fast-paced world, embracing innovation not only transforms how we live and interact with others, but also drives economic growth and enables us to address the most pressing challenges we face, paving the way for a more sustainable future for all. As one of the most impactful issues of our times, finding ways to reduce and eventually stop the devastating effects of smoking must remain top of mind in terms of implementing innovative policies around the world.

There are approximately one billion smokers globally.1 In Canada, over 3.8 million people smoke, daily or occasionally.2 While tobacco use has decreased over the past years, it is estimated that smoking kills approximately 46,000 Canadians each year.3 Innovation is at the heart of tobacco harm reduction. It involves reducing population harm associated with smoking cigarettes by developing novel products and broadly adopting regulations to allow access to scientifically substantiated alternatives for adult smokers who do not quit smoking.

Trends in tobacco control policy.

Regulations on smoke-free products such as heated tobacco products, e-vapor products or e-cigarettes, snus, and oral nicotine pouches vary significantly worldwide, reflecting the diverse approaches governments take to address the complex health and societal challenges associated with their use. Looking back at how governments have tackled the issue of smoking, the focus has primarily been on traditional prevention and cessation strategies. Although, the idea of regulating tobacco products originated in the 1960s, regulatory policies have since then followed identifiable trends, including advertising restrictions, limiting the areas where one may use such products, health warnings, taxation, and more. During the late 1990s, a group of global tobacco control experts was convened by the WHO and asked to explore how to strengthen efforts to reduce the harm caused by smoking. This group recommended that complementing prevention measures and cessation support programs with a harm reduction approach would significantly reduce smoking-related harm in future generations.

More and more governments around the world have adopted the principles of harm reduction in their tobacco policies and have recognized that smoke-free products can have a role to play in reducing the harm caused by smoking. These governments are complementing traditional tobacco control measures such as those intended to discourage initiation and encourage cessation of smoking, with harm reduction approaches such as providing adult smokers that do not quit with information about, and access to, scientifically substantiated smoke-free products to accelerate the move away from cigarettes. Countries such as New Zealand and Czechia officially embraced a harm reduction approach as a complementary policy to address the issue of smoking and accelerate its decline. In the U.S., Italy, Bulgaria, Cyprus, Portugal, and Greece, regulators have adopted regulatory frameworks defining the scientific requirements for the communication towards the consumers about reduced-risk or reduced-harm effects of innovative tobacco products compared with smoking.

On the other hand, there are also countries which have taken the approach of regulating smoke-free products the same as cigarettes. Often this approach includes limiting or outright banning communication with adult smokers, which makes it hard for them to make informed decisions. These approaches disregard the potential role that scientifically substantiated smoke-free products can have in moving adult smokers away from cigarettes, which are the most harmful means of nicotine consumption.

An evolving regulatory landscape.

New technologies will continue to emerge, and regulations must continue to adapt at a rapid pace. Many countries have updated their existing regulatory frameworks to regulate novel smoke-free products under unique or dedicated product categories. These categories include a level of differentiation compared with combustible tobacco products, including differentiated health warnings, flavor and packaging requirements, and others. This approach recognizes that not all tobacco products are equally harmful. Indeed, nicotine-containing products fall on a continuum of risk, with cigarettes at the highest risk on the continuum. Heated tobacco products (HTPs) have a significant potential to serve as an acceptable alternative for adults who would otherwise continue to smoke. This innovative and evolving category includes products that vary with respect to temperature, heating source, or the way the tobacco may be processed. Following a similar trend, e-vapor products are also classified as unique products in many countries and regions. New Zealand or the EU—which has implemented the Tobacco Products Directive —are examples of countries or regions which acknowledge that HTPs and e-vapor products are different from cigarettes.

Science-informed policy.

In the midst of our fast-evolving tobacco control regulatory landscape in Canada, the primary role of regulations remains the same: protecting the health of the public while leaving no-one behind. The reliance on data and scientific evidence to make informed policy decisions, and a harm reduction approach that sees the most harmful products being subject to the most restrictive regulations, have the potential to see the greatest impact for all Canadians. Building on our past successes, is it the right time now to embrace innovation as part of an effective tobacco control agenda for a sustainable future?

References

1. Reitsma MB, Flor LS, Mullany EC, Gupta V, Hay SI, Gakidou E. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and initiation among young people in 204 countries and territories, 1990–2019. Lancet Public Health 2021; published online May 27

2. Report of the second Legislative Review of the Tobacco and vaping Products Act – Government of Canada

3. Report of the second Legislative Review of the Tobacco and vaping Products Act – Government of Canada