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Wednesday 28 April 2010 – DAY THREE –
Daily Update
– 7
Tobacco regulation
hindering harm
reduction
THE REGULATORY ASPECTS
of tobacco and
nicotine were fragmented and did nothing to help
harm reduction, Adrian Payne of Tobacco
Horizons UK told delegates.
There were four building blocks of regulation, he
said – preventing onset, promoting cessation,
protecting third parties and harm reduction. ‘Failure
to make use of the fourth is something we need to
address,’ he said. The WHO Framework Convention
on Tobacco Control was the global policy
framework, which sought increased access to
pharmaceutical nicotine. ‘But harm reduction
doesn’t figure, which is why it doesn’t filter down to
national policy. It’s a missed opportunity.
‘The real step change in risk is when you take
away the smoke,’ he said – smoke-free products
were less harmful because the components of the
smoke did the damage, not the nicotine itself.
‘There’s every reason to believe that smokeless
tobacco products are vastly less harmful.’
However, regulatory barriers either existed or
were being created to block the sale of smoke-free
products. E-cigarettes replicated the hand-to-
mouth motion of cigarettes and provided a vapour,
he said – ‘they’re quite hi-tech and don’t generate
smoke.’ However, there was pressure to move
them under EU regulation to either the ‘medical
device’ or ‘medicinal product’ category, both of
which would take time and money, and some
pressure groups even wanted them classified as
tobacco products, ‘which is weird because they
don’t actually contain any tobacco.’ This move
would put them under the auspices of the WHO
framework and ‘deprive people of products that
are safer, and recreational rather than medicinal.
‘It could cost lives,’ he continued. ‘What do
you say to people who smoke E-cigarettes – that
“they’re no longer available and you should go
back to smoking cigarettes”? It could even count
as a violation of human rights, as they’re a
technological advancement.’ Furthermore, many
anti-tobacco adverts were examples of
stigmatisation, he told delegates. ‘And they don’t
work anyway. Despite virulent anti-smoking
campaigns you’re seeing quit rates stalling.’
At the very least there should be a basis for
engagement on a more holistic regulatory
framework, he said, and there was a need for
holistic global consistency. ‘We’re not thinking in the
proper way about how to regulate tobacco and
nicotine products – there really needs to be some
global thinking about this. Current approaches are
disjointed and counter-intuitive to harm reduction.
Smokable products need to be evaluated on what
benefits they can bring in relation to cigarettes. You
have to give people options other than “quit or die”.
But the question is who will take the lead on this.
Maybe it could be someone in this room.’
Pushing abstinence the
‘least ethical’ of
possible alternatives
‘PEOPLE USE NICOTINE
products because
they get benefits from them,’ Carl Phillips of
TobaccoHarmReduction.org told delegates. ‘It’s
not just compulsion or dependence or addiction.
Smoking is deadly but it does not destroy lives in
the way other drugs do.
‘Public policies are almost always evaluated
based on the net benefits,’ he continued. ‘Tobacco
harm reduction is not only superior to forgoing harm
reduction but it’s also superior to promoting
abstinence. Cigarettes have a purchase price but
they also have a health cost that people pay on top
of that price. Tobacco harm reduction reduces that
health cost by around 99 per cent. You still have to
buy it, but it doesn’t kill you – that’s the value.’
The ‘anti-smoking extremist position’ was to
simply reduce consumption, he said. ‘It’s the drug
war mentality, which we know does not work.
Looking at the total welfare, there’s a much bigger
surplus from using a low-risk alternative.’
From any public policy standpoint, pushing
abstinence was the least ethical of all possible
alternatives, he told delegates. ‘It would be
outlandish to tell consenting adults that the only
way to avoid STIs is to eliminate sex from their
lives. It’s equally outrageous to tell them that they
can’t use an almost totally safe version of nicotine.’
At today’s FilmFestival…
This is my destiny:
Khoshan’s life has been destroyed by her
addiction to opium. Her harsh daily ex-
istence in Badakhshan, a remote and un-
forgiving province of north-east Afghani-
stan is further complicated by her and her
husband’s addiction. Her family’s land has
been sold to pay for it and they have been
ostracised from their local community.
Her baby has been addicted since birth
and her teenage son can no longer afford
to go to school and has little prospect of
entering into a goodmarriage. The title of
the film represents Khoshan’s fatalistic
reply to all this, and a response of many
ordinary Afghans to the trauma of 30
years of brutal civil conflict.
BALKA:
Zina andMarina, two active drug users in
Odessa, Ukraine, discover their HIV status
in the first part of this three-part docu-
mentary chronicling the lives of women
struggling with drug use and HIV. The
second part tells the story of Tanya, a
mother of two who has made the trans-
ition into replacement therapy while her
husband continues to use drugs.
Addicted in Afghanistan:
One million Afghans are estimated to be
addicted to drugs, especially heroin – and
40 per cent of these are women and
children. Looking through the eyes of
Jabar and Zahir, two 15-year-old drug
addicts living in Kabul, this intimate
observational documentary explores the
heartbreaking realitybehind the statistics.
The Film Festival runs from 12.30–18.00
in the cinema, auditorium level.