Despite all the warnings, an estimated 1.1 billion people smoke cigarettes, according to the World Health Organization. While staggering, keep in mind that this figure is likely to stay stagnant despite ongoing efforts to reduce cigarette consumption. Put simply, estimates suggest there will still be around 1 billion smokers in the world by 2025.
In trying to reduce smoking around the globe, it’s clear that a more nuanced approach is needed that complements traditional measures aimed at preventing people from starting to smoke, especially youth, and getting adult smokers to stop altogether.
With 1.1 billion smokers in the world, there’s more that can, and should, be done, and it would be a mistake to assume that there is a one-size-fits-all solution. In any given year, more than nine out of 10 smokers will continue to smoke. Now there’s growing support among scientists, public health experts, and governments that scientifically substantiated smoke-free alternatives can play a role in helping decrease smoking prevalence. For this to happen though, smokers across the world need access to and information about these alternatives.
Key to this? Understanding that not all tobacco and nicotine-containing products are the same—despite what some organizations suggest. While smoke-free products are not risk-free and contain nicotine, which is addictive, it’s the burning that’s the main problem. The high temperatures reached when a cigarette burns creates thousands of chemicals, over 100 of which have been classified by public health experts as harmful or potentially harmful. By eliminating the burning—as is the case with products such as snus, e-cigarettes, and heated tobacco—the levels of harmful chemicals generated can be significantly reduced compared to cigarette smoke.
While this has to be scientifically assessed for each product, it’s the reason why many experts and a growing number of governments believe that tobacco and nicotine-containing products should be regulated according to their risk profile.
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Let’s take Sweden as an example. It’s often seen as one of the most socially progressive, generous, and advanced countries in the world. Those Nordic folks are also a fan of snus, a form of oral tobacco that’s placed behind a person’s lip to release flavors and nicotine. In Sweden, it’s replaced cigarettes as the main tobacco product. In 2017, only 5 percent of Swedish men smoked, according to the European Commission, while 18 percent used snus. Many suggest this is the reason Sweden now has the lowest death rate attributable to smoking-related diseases of any European country.
Moreover, in the U.S., eight varieties of one particular snus product have become the first to be authorized to be sold as modified risk tobacco products by the U.S. FDA—meaning the FDA determined, among other things, that the products, as they are actually used by consumers, will benefit the health of the population as a whole.
In Japan, a different type of smoke-free alternative is also having an impact. The country is seeing significant decreases in cigarette sales, likely as a result of the introduction of heated tobacco. These products heat tobacco without burning it.
Between 2011 and 2015, cigarette sales in Japan generally declined at a slow but steady pace. Since the introduction of heated tobacco in 2015, cigarette sales have been falling five times faster than the 2011-2015 period, according to a key study published by researchers from the American Cancer Society. The authors conclude it was the introduction of heated tobacco that’s “likely reduced cigarette sales in Japan.”
Then there’s also vaping. Among U.S. vape consumers surveyed in a 2018 National Health Interview survey, 25.2 percent of current vapers had quit cigarettes within the last year, according to a U.S. Centers for Disease Control and Prevention (CDC) study. Furthermore, the CDC’s findings revealed that, within the sample population tested, 17.3 percent of adult e-cigarette users had given up cigarettes within the last one to four years. The report also noted that only 1.1 percent of current e-cigarette users in the sampled population had never smoked cigarettes.
Smoke-free alternatives should only be marketed to adult smokers who would otherwise continue to smoke or use nicotine products. It will always be best for one’s overall health to quit tobacco and nicotine products altogether, but for the hundreds of millions of adult smokers who would otherwise continue to smoke, evidence from Sweden, the U.S., and Japan suggests that, where scientifically substantiated alternatives are available, they may help reduce overall smoking rates.
It’s time for major players in the space to take the lead. Philip Morris International (PMI) is doing just that. Most surprising perhaps is their goal: PMI claims they’re committed to stop selling cigarettes as quickly as possible. The company even believes that, with the right regulatory encouragement and support from civil society, cigarette sales can end within 10 to 15 years in many countries. No more cigarettes? It may seem like a fantasy, but that may just be what the future holds.