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It’s time to talk realistically about tobacco harm reduction, says German association

The opinions within this article reflect those of Frank Henkler-Stephani and the German Association of the Tobacco Industry and New Products.

We need more constructive non-political discourse about tobacco harm reduction to bridge the “substantial information gap” and counter the impact of bad science on the current prohibitionist mindset. That’s the view of the German Association of the Tobacco Industry and New Products (Bundesverband der Tabakwirtschaft und neuartiger Erzeugnisse, BVTE), according to a recent interview with TobaccoIntelligence about the dangers of misinformation and “sloppy legislation”.

Frank Henkler-Stephani (pictured), senior director of tobacco harm reduction at BVTE told TobaccoIntelligence that misinformation in the media was not always intentional but often a result of negatively biased scientific reports about vaping.

“Scientific literature is dominated by reports about the adverse effects of vaping, which are often based on controversial evidence,” he said. “If unchallenged, uncertain or misleading data can easily be misunderstood as real health risks.”

Henkler-Stephani, who will be among the featured speakers at the EVO NXT event to be held on 5th and 6th April in Málaga, Spain, added: “It’s easier for scientists to measure adverse or damaging effects than design experiments or models around reduced risk.”


Science needs to inform policy


Citing the results of a recent survey by the German Federal Institute for Risk Assessment (BfR), in which most respondents said they regarded vaping as equally or more harmful than smoking, Henkler-Stephani said the industry should be engaged in bridging the “substantial information gap”.

He called for major initiatives to be driven by critical scientists to educate policy-makers and give them a more realistic and complex picture of the true nature of harm reduction to inform legislation, which has become “somewhat sloppy” in distinguishing the health risks of smoking, vaping and using nicotine pouches.

One flaw Henkler-Stephani highlighted in recent legislation has to do with a European Commission delegated directive to ban characteristic flavours in heated tobacco products, which he claims takes away an important incentive for switching to a less hazardous product. He added that the German parliament was obliged to adopt this, without assessing the impact on both individual smokers and public health in Germany.

Further demands to extend flavour bans to e-cigarettes have been motivated by the desire to discourage young people from vaping. However, Henkler-Stephani believes prohibiting flavours across the board is tantamount to prohibiting e-cigarettes, and that would discourage adult use as well by reducing vaping to a medical process. It stems from a misperception of whether it is cigarettes or nicotine itself that is the most harmful.

“Comprehensive flavour restrictions would question the value of e-cigarettes as appealing alternative products. In consequence, supply chains will probably shift to grey and black markets,” he said. “Permanent campaigning against nicotine puts pressure on politicians to tighten up regulation, but consumers and industry need to assure that a proper balance is maintained.”

He believes measures such as implementing age restrictions on sales, as well as age-appropriate branding and product design, would be more effective than an overall flavour ban and less challenging to enforce. They would also prevent circumvention using grey market products or food flavours.

It should be noted the vast majority of jurisdictions claiming youth vaping issues already have age-based prohibition policies in place and this has seemingly not impacted youth availability of vaping products. Though of course this does not mean that additional restrictions will meet with any more compliance.


Expected issues at COP10 resulted in no decisions


Henkler-Stephani believes Germany’s political commitment to fight nicotine is in conflict with more liberal approaches for other compounds. “It’s strange that they are legislating in favour of cannabis, leaving nicotine pouches prohibited. In general, cannabis products will be smoked, as the law opens little room for alternative applications and harm reduction.”

He rejects the “widely held belief” that tobacco is a driver of cannabis consumption. “Numbers show that tobacco use has declined while cannabis use is increasing. Many consumers use both together, but their primary intention is to consume cannabis.”

German policy-makers aren’t the only authorities who are critical of vaping. The World Health Organization (WHO) has consistently taken an overly cautious, bordering on prohibitionist, stance on vaping and other tobacco alternatives.

However, Henkler-Stephani said some delegates at the recent tenth Conference of the Parties (COP10) to the WHO Framework Convention on Tobacco Control (FCTC) were trying to put tobacco harm reduction on the agenda by flagging issues around biased assessments and blocking certain decisions.

This seemingly resulted in something of a stalemate. For example, no decisions were taken on ingredients and additives in heated tobacco and vaping products. Such issues were instead postponed until COP11. The WHO did, however, repeat its call for further restrictions.

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    The BVTE disagrees with the WHO’s stance in other areas


    Henkler-Stephani said concerns about biased discussions of tobacco harm reduction were raised by some developing countries, in particular where smoking rates were still high.

    “In the future the impact of smoking will be a major health problem in African countries, for example. If it was feasible to increase the ratio of vaping in such countries, it would benefit their health services. My impression is that people are starting to question whether vaping and smoking should be treated equally by health policy.”

    He also warned that environmental concerns raised at COP10 could fuel “backdoor vaping bans”. This included requests to address plastic waste of electronic devices and other tobacco alternatives.

    “COP10 has opened a new field for misinformation, and we need to respond more profoundly in future,” he said.

    He described the WHO’s call for governments worldwide to ban cigarette filters as single-use plastics with no proven health benefits as an “incredible” and “ridiculous” suggestion that would result in smokers inhaling between 20% and 30% more toxins.

    It should be noted this is not the scientific consensus with many public health advocates – including some in favour of harm-reduction policies – who support bans on filters as crutches that make continuing smoking more pleasant whilst accomplishing little in terms of reducing the potential harm of conventional cigarettes.

    Henkler-Stephani said the BVTE is summarising evidence to disprove the WHO’s claims that filters can even increase the toxicity and health risks of cigarettes, based on assumptions that filters necessitate a deeper and more intense inhalation.

    He doubts that the WHO is likely to alter its prohibitionist stance towards vaping because it would damage the organisation’s reputation and alienate the parties that have applied its proposals.

    The only instance in which he could envisage change happening would be if more countries carried out their own scientific risk assessments to prove the benefits of vaping and other new technologies for harm reduction.


    Lack of response makes it hard for BVTE to clarify important issues


    Henkler-Stephani says many of his attempts to join discussions with health and policy-making bodies to clarify “contradictions and legislative biases” and reduce the “hostility towards the tobacco industry” have been refused.

    “This makes it hard for the BVTE to fulfil its role of clarifying important points in complex issues for policy-makers and illustrating the possible consequences of ignoring the science of nicotine, tobacco or tobacco harm reduction before making legislative decisions,” he said.

    He cites the example of the proposed ban on “harmful” menthol in e-cigarettes, which was put forward two years ago.

    “Although the scientific assessment was clearly faulty, both the federal ministry in charge and the federal government’s drug and addiction commissioner rejected any meetings or discussions with the BVTE,” he said. “The BfR also failed to respond to our critique.”

    Again it should be noted that opposition to a menthol flavouring ban for combustible products is not consensus or universally considered to be based on faulty scientific assessment and many in harm reduction actively support such a measure – particularly if menthol is left as a permitted flavour for alternative tobacco products.

    On a somewhat optimistic note, Henkler-Stephani feels change might come from people who are growing tired of intrusive and over-reaching regulation that fails to tackle pressing problems.

    “Parties of the centre are increasingly challenged by dissatisfied voters and new political movements. They need to respond. Tobacco and nicotine might benefit from a growing reluctance to impose further bans, burdens or restrictions,” he said. Though he sounded a word of caution about such a scenario: “Perhaps, this is rather an optimistic prediction.”

    • Henkler-Stephani will be exploring ways for the industry to correct misinformation about vaping at the EVO NXT event on 5th and 6th April in Málaga, Spain.

    – TobaccoIntelligence staff

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    This article was written by one of TobaccoIntelligence’s international correspondents. We currently employ more than 40 reporters around the world to cover individual nicotine markets.

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