Before the current health crisis, adults around the world ranked air pollution as the most important public health issue for governments to dedicate time and resources, according to a 2018 global survey commissioned by Philip Morris International (PMI). Respondents listed mental health and obesity as concerns as well.
In any event, it’s clear there is a societal desire to improve public health. This is driving efforts to achieve ‘better’ through innovation. For example, incentivizing innovation and change in product design or behavior via policy and regulation aimed at individuals or industries.
Automobiles are a prime example of real-time change underway. With concerns over the health of the planet continuing, tackling car pollution is seen as a key issue. In recent years, carmakers have become the target of activists and governments for producing vehicles with low gas mileage per gallon, which release greater levels of harmful toxins into the atmosphere. To address this, governments around the world have implemented supply and/or demand side measures. On the supply side, policies include increasing the minimum miles per gallon on vehicles over a set number of years and advocating for electric car production to reduce dependence on oil. On the demand side, some nations turned to incentives to further entice buyers. In the U.K., car buyers have been granted up to £3,000 to put towards a new electronic auto.
Automobiles are far from the only ongoing example. Another primary environmental concern is the predominance of plastics, namely single-use bags. Despite efforts to dispose of them properly, many find their way into the ocean or other environments where their presence negatively affects wildlife and ecosystems.
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The threat of plastics has led to global advocacy efforts and legislation in numerous countries. As of 2018, 127 countries imposed some form of legal restriction on single-use plastic bags, with some nations introducing bans, while others implementing a surcharge or bagging fee in an attempt to disincentivize consumers. While not as substantial as a price break on an electric vehicle, shoppers who bring reusable bags find themselves saving a marginal sum at stores, which can add up over time.
Other concerns center around sugar consumption. In recent years, efforts undertaken by local and federal governments have produced varying results. New York City attempted to pass a 16-ounce cap on drinks high in sugar content. The proposal did not become law after it faced steep opposition. However, the U.K. did pass a sugar levy on soft drinks in 2018. Given two years notice many manufacturers reformulated their drinks to reduce their sugar content to below the threshold at which the levy was imposed, reducing sugar consumption overall.
All of these are examples of innovation and regulatory measures aimed at companies and consumers to try and address the negative impacts caused by exhaust fumes, plastic bags or consumption of sugar.
Where it comes to the public health issue of smoking, measures to address the issue have been around for decades. These measures aim to discourage people from starting to smoke and aim to encourage those who do to stop. Measures on the supply side, measures on the demand side. But globally, it is evident more needs to be done.
Innovation is happening in the space, with alternatives to continued smoking – such as e-cigarettes, snus and heated tobacco – becoming available with advances in technology. These alternatives do not offer a perfect solution (they are not risk-free) but they present the potential of a better option for adult smokers that would otherwise continue to smoke. They present an important building block that complements prevention and cessation – the best options – and can move more adult smokers away from combustible cigarettes to benefit public health.
Approaches towards innovation in the space of tobacco- and nicotine- containing products differ around the world. Many scientists and public health experts, and some regulators and governments – such as the U.S. and the U.K – recognize the concept of the “continuum of risk” for products delivering nicotine and/or tobacco harm reduction. They also acknowledge that not all tobacco and nicotine products are the same, and understand that innovation is happening and must continue to happen in this space. However, there are others who are more hesitant.
Such skepticism is understandable but should not turn into dogmatic opposition to tobacco harm reduction. Companies are taking up the effort to innovate in this space and scientifically substantiated better alternatives to smoking exist. So the appropriate question to governments around the world should not be whether such alternatives should be made available to the population of adults who would otherwise continue smoking but how.Discussions should focus on which measures are needed to strike the right balance between incentivizing switching and minimizing usage of such alternatives by unintended audiences such as non-smokers, especially youth.
We’re at a historic moment where an innovating industry, scientists and public health reviewing the science, and regulators embracing a pragmatic, risk proportionate approach that gives adult smokers access to and information about better alternatives, can massively accelerate behavior change and create a massive win for public health worldwide. Let’s embrace the moment.