E-Cigs Pushing Tobacco Into New Era of Harm Reduction

WILLIAMSBURG, Va. — The quit or die dilemma is not necessarily the only option when it comes to tobacco use, according to presenters at this week's Tobacco Merchants Association (TMA) annual conference.

Citing World Health Organization numbers, Scott Ballin, director of the Alliance for Health, Economic and Agriculture Development, noted there are more than 1 billion smokers globally. While this number is staggering, the world is entering "a new era" for tobacco products with an opportunity to rewrite the rule book, he said.

Science, technology, innovation and new players entering the tobacco industry are all taking key roles in the new era of harm reduction, he added.

"Today, it is less important who made the product [and more important] what the product is," Ballen pointed out.

As an advocate of harm reduction, he explained that the idea of engagement and dialogue around the continuum of risk is "slowing catching fire" at many venues and various levels — including the Food and Drug Administration and organizations like TMA, which has made harm reduction a major component of its annual conference for the past few years.

The electronic cigarette segment, while not the only path, has emerged as the poster child for harm reduction.

Smokers have traditionally been faced with two options: keep smoking or quit smoking — the quit or die dilemma, said Clive Bates, founder of Counterfactual Consulting. Now, there is a third option: switch to a product that presents a lower risk like e-cigarettes. 

There is some skepticism surrounding the public health impact of e-cigarettes, Bates acknowledged. E-cigarettes are battling an image problem as 65 percent of U.S. smokers believe electronic cigarettes are less dangerous than traditional cigarettes, a drop from 85 percent between 2010 and 2013. There is a similar risk perception problem in England, he said.

Still, "subject to continued innovation. I think these products will take off and take over," Bates said.

The real question is what these products will be like in the next 25 years. There is a global call to action to be a tobacco-free world by 2040. Bates believes this goal may not be totally unrealistic and the tobacco industry and public health stakeholders should try to "eat into that with low-risk nicotine products."

This can be done, he said, with regulations, risk communication, public health policies, and products and innovation.

According to Bates, there is "huge public health potential by 2040" around harm reduction if there is:

• 25 years of innovation;
• Regulation and policy that enhances the value proposition;
• True and fair presentation of risk and science;
• Increased pressure on smoking; and
• New accountability in the public health community. 

While the idea of harm reduction is gaining steam in the tobacco realm, it is not an entirely new concept. Harm reduction has been a viable tool in many other areas, like automobile safety improvements and public health products like sunscreen, according to David Sweanor with the University of Ottawa. 

"We have done this with so many other things and so many of them are simple," Sweanor said.

TMA's 100th Annual Meeting & Conference ran May 18-20 at Kingsmill Resort & Spa in Williamsburg.