Big Question 2 - What are the Desired Outcomes of THR?
Our vision for success in Tobacco Harm Reduction
(THR) is to create A Better Tomorrow™ by Building a Smokeless World. This world is one in which people who would otherwise continue to smoke can use forms of tobacco and nicotine that are less risky*† than cigarettes, and at the same time, see a substantial and significant reduction in projected population level smoking-related morbidity and mortality.
KEY SUMMARY POINTS
1
THR is aligned to the WHO and EU Beating Cancer plan and governmental public health strategies on tobacco to enable national smoking rates <5%.
2
THR is integral to these public health strategies as some adult consumers wish to continue using nicotine products.
3
Sweden is the vanguard THR country with the fewest adult smokers and lowest lung cancer deaths in Europe, driven by increased prevalence in lower risk tobacco and nicotine products use.
"Vaping can benefit public health, given substantial evidence supporting the potential of vaping to reduce smoking’s [health] toll. [...] Although not the final word, the totality of the evidence indicates that [...] while the long-term health consequences are unknown, completely substituting vaping for smoking likely reduces health risks, possibly substantially."
Joint published statement
from 15 Past Presidents of the Society of Research on Nicotine and Tobacco[1]
We are aligned with the goals of governmental public health strategies on tobacco to achieve low national smoking rates. The World Health Organization (WHO) considers countries to be smokefree when smoking prevalence is less than 5% of the population.[2]
What are our desired outcomes for THR?
We seek three main outcomes:
- Reduce the public health impact of our business through adult smokers who would otherwise continue to smoke increasingly choosing lower risk profile Smokeless Products instead of cigarettes.
- 50 million adult consumers# of Smokeless Products by 2030.
- At least 50% of our revenues in Smokeless Products by 2035, in markets where Smokeless Products are permitted.
Two sides of the discussion
THR has been the subject of a significant public discussion for the last two decades, with proponents stating its potential for a positive public health impact. Meanwhile, opponents seek the complete elimination of tobacco and nicotine from society.
In a 2020 editorial, U.S. tobacco research academics surmised that consensus could perhaps be achieved through a "strategic dialogue on harm reduction that is led by one of the governmental agencies, a scientific organisation and/or by respected scientists who are not strongly associated with one particular ideology. At this meeting, the current and evolving science, modeling that projects population health effects under different scenarios, identification of research gaps and consensus on a potential path towards a sensible and agreeable harm minimization approach can be developed. Keeping focus on how best to regulate combusted tobacco products and ANDS [Alternative Nicotine Delivery Systems] and allowing Tobacco Harm Reduction as a component of a comprehensive tobacco control program would be one such approach.”[3]
While we do not agree with all of the views expressed by the authors, the editorial[3] summarised the discussion and a way forward as follows:
- The concern over THR is in part based on the experience with low-yield cigarettes.
- Balancing providing adult smokers with Reduced-Risk*† Products vs potentially addicting the underaged to these products.
- A future approach includes strong regulation of combusted and reduced-risk*† tobacco and nicotine products.
<5%
WHO considers countries to be smoke-free when smoking prevalence is less than 5%[3]
The future
THR is a journey toward profound potential public health benefits. As described in the opening letter from our Research & Science Director, the Swedish experience is the vanguard example of THR. If every EU country had the tobacco-related mortality rates of Sweden, 2.9 million premature deaths could have been averted between 2000-2019, according to a report by a global network of public health experts.[4] Going forward, similar improvements in tobacco-related mortality are within reach if THR policies are enacted.
We believe that our THR ambitions are bold but achievable. We currently have 23.9 million adult consumers of our Smokeless Products, and by 2030 we aspire to have 50 million#. This aspiration will require not just changes in consumer behaviour but also changes in society itself, particularly in terms of the policies of national and international regulatory and public health bodies, opening up markets that currently do not allow Smokeless Products, and general acceptance of a balanced view on THR.
If we can change the conversation around THR and Smokeless Products, we can change the future.
Disclaimers
* Based on the weight of evidence and assuming a complete switch from cigarette smoking. These products are not risk free and are additive.
† Our products as sold in the U.S., including Vuse, Velo, Grizzly, Kodiak, and Camel Snus, are subject to FDA regulation and no reduced-risk claims will be made as to these products without agency clearance.
# The number of consumers of Smokeless Products is defined as the estimated number of Legal Age (minimum 18 years 18 years) consumers of the Group’s Smokeless Products - which does not necessarily mean these consumers are solus consumers of these products. In markets where regular consumer tracking is in place, this estimate is obtained from adult consumer tracking studies conducted by third parties (including Kantar). In markets where regular consumer tracking is not in place, the number of consumers of Smokeless Products is derived from volume sales of consumables and devices in such markets, using consumption patterns obtained from other similar markets with adult consumer tracking (utilising studies conducted by third parties, including Kantar).
References
[1] Balfour, D.J., et al., Balancing consideration of the risks and benefits of e-cigarettes. Am J Public Health, 2021. 111(9): p. 1661-1672. DOI: 10.2105/AJPH.2021.306416
[2] World Health Organization, Tobacco-free generations: Protecting children from tobacco in the WHO European Region. 2017. Available at: https://cdn.who.int/media/docs/librariesprovider2/euro-health-topics/tobacco/20170428_who-tobaccofreegeneration-draft09.pdf?sfvrsn=76e790c9_2&download=true
[3] Hatsukami, D.K. and Carroll, D.M., Tobacco harm reduction: past history, current controversies and a proposed approach for the future. Prev Med, 2020. 140: p. 106099. DOI: 10.1016/j.ypmed.2020.106099
[4] International and Local Tobacco Harm Reduction Experts, Report: Integrating harm reduction into tobacco control. Lives Saved. Available at: https://smokefreesweden.org/lives-saved.pdf
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Smokeless Products: An Introduction -
01. Our Vision: A Need for Reappraisal -
02. The Big Questions -
03. Impact of Smoking -
04. Our Smokeless Science -
05. Our Smokeless Products -
06. THR: A Global Transformation -
07. THR: Global Regulation -
08. THR: Scientific Engagement -
09. Our Future Outlook -
10. References -
11. Our Published THR Science
