Europe’s respiratory specialists don’t support harm reduction: is this news?

No smoking and no nicotine consumption at all is better for your health than quitting cigarettes without quitting nicotine.

At the same time, anyone under-age should, of course, stay away from e-cigarettes, heated tobacco products, nicotine pouches and all sorts of nicotine-containing novel tobacco products, which are meant for adult users only.

None of this is breaking news for nicotine consumers or for anyone in the tobacco and nicotine industries. On the contrary, these are some fairly obvious statements that do not need any additional scientific research to back them up.

Nevertheless, the European Respiratory Society (ERS), one of Europe’s main respiratory medicine organisations, felt the need to update its latest position statement on smoking alternatives in order to stress these concepts.


Stating the obvious


The updated position statement from the ERS revolves around the fact that, according to its experts, there is not enough evidence available for them to recommend the use of these products as smoking-cessation tools.

“The ERS maintains a firm position that all nicotine and tobacco products are highly addictive and harmful,” the updated statement reads. “For current smokers, complete cessation of all nicotine products is the recommended goal to achieve freedom from addiction and reduce tobacco-related diseases.”

In addition, the ERS points out, many novel products such as vapes, nicotine pouches and heated tobacco products are particularly popular among adolescents and young adults who, by using them, are initiated to nicotine consumption and develop a dependence at an early age.


Still promoting abstinence


The ERS’s experts then go on to say that “promoting complete cessation is the optimal public health strategy for increasing quit rates and reducing smoking consumption” and that they therefore do not support the use of “these devices” as a cessation tool.

“When cessation aids are required, it is preferable to use evidence-based interventions, such as Nicotine Replacement Therapy (NRT) or tobacco cessation medications,” they wrote.

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    These positions differ only slightly from those expressed by the organisation in 2019, when the ERS said it believed that anti-smoking strategies promoting the use of nicotine-containing novel products were not effective and based on incorrect assumptions and undocumented claims.

    However, the group said, evidence it collected over the past three years seems to highlight the possibility of adverse respiratory and cardiovascular effects of novel tobacco products, which makes them all potentially dangerous.


    Just a marketing strategy?


    You may very well agree with the ERS’s claim expressed in its latest position statement that Big Tobacco is exploiting the concept of harm reduction to market its novel products. But how realistic is it for a health organisation to keep promoting complete cessation while the only options it recommends as aids to quit smoking are unappealing and relatively inconvenient licensed replacement products?

    While the ERS, which covers Europe through its offices in Switzerland, the UK and Belgium, says it is basing its recent position statement update on research produced after 2019, it also seems to ignore some important recent acknowledgements of the role novel tobacco products play as harm reduction tools.

    One example is the “swap-to-stop” scheme launched by the UK government to help smokers quit by providing them with vaping kits.


    A conservative wave


    At the same time, though, the ERS’s tougher stance against novel tobacco products was interpreted by many as something that may have been encouraged by UK prime minister Rishi Sunak’s recent crackdown on disposable vaping products in the country.

    The same measure could soon apply in France as well, while there are restrictions on many other novel nicotine products – such as the EU-mandated ban on flavours in heated tobacco which is slowly being transposed by member states.

    While these measures may indicate a growth in popularity of conservative positions in the region when it comes to harm-reduction policies, the question remains as to whether clamping down on novel tobacco products will actually help reduce nicotine addiction or will it prove counterproductive for the fight against tobacco smoking and related diseases.

    – Tiziana Cauli TobaccoIntelligence staff

    Photo: Andy T

    Tiziana Cauli

    Senior reporter/health & science editor
    Tiziana is an Italian journalist from Sardinia. She has worked for both international and local media in Italy, South Africa, France, Spain, the UK, Lebanon and Belgium. She also worked as a communications manager for several international NGOs in the humanitarian sector. Tiziana holds a degree in Political Science and a PhD in African Studies from the University of Cagliari and she’s a graduate of the Carlo De Martino school of journalism in Milan.