After reading the misguided recommendations of The Union’s new position paper shared in May, ‘where bans are best: Why LMICs must prohibit e-cigarettes and heated tobacco product sales to truly tackle tobacco’. This grossly misleading document points to only one direction the establishment of a systemic fight against electronic cigarettes and heated tobacco products. This is a well-orchestrated campaign to create and capitalize on moral panic and undermine the gains of the vaping community as well as the greater Tobacco Harm Reduction front and their phenomenal exploits. This document presents 10 justifications for their position ranging from industry involvement, targeting of teens/minors and several others including the creation of an addiction avenue among other evils.
Vaping has progressively been deemed an effective quit aid for those on the journey to quitting smoking and also to those who may choose to use a safer nicotine product to avert harm associated with traditional cigarettes. In this regard inhibiting access to them through prohibition will simply push smokers back to cigarette smoking and ultimately the resultant mortalities and associated diseases.
The paper points out that prohibition of the sale of e-cigarettes and heated tobacco products (HTPs) in low- and middle-income countries (LMICs) which form 80 % of the world’s smoking demography be strictly enforced. It goes ahead to note that though these products have proven effective in countries the UK through endorsement of the Royal College of Physicians, Public Health England and the National Health Services as well as very many other credible institutions globally, the same cannot be replicated in LMICs. They argue that this is because England has massive resources geared at ensuring that these products are closely monitored and evaluated with set systems to ensure particular standards are met before using. This they say is not sustainable in LMICs as these processes require huge resource allocations and yet they are already burdened with other more pressing needs.
Uganda is an LMIC by its global standing as far as the human development index is concerned, however, the matter of interest is that are 10,600 persons dying annually and the tobacco atlas notes that more than 29000 children (10–14 years old) and 1117000 adults (15+ years old) continue to use tobacco each day. It is paramount that it is clearly understood that the smoker is a human being and his interests must be well considered holistically as only then will any actions in their interest be rendered valid — “Nothing for us without us!” and yet the union seeks that the smokers’ simply be put in a chokehold of Quit or Die with no viable solutions. By all the more tightening the Tobacco Control’s grip. This is in the 21st century is tantamount killing.
The WHO estimates that by the year 2030 if there are no significant changes to avert the death rates as well as diseases related to cigarette smoking, then 8 million-plus people will succumb to its effects and 80% of these from countries within this category. The public health crisis is therefore clear, the mandate should be that leaders from LMICs through mutual engagements invite stakeholders to join efforts that will progressively be geared towards assimilating safer nicotine products into the general public health policy and come up with mechanisms through dialogue that will see to it that electronic cigarettes, heated tobacco products and the other safe nicotine alternatives are made readily available in a bid to counter the negative effects of combustible tobacco.
In Uganda even though fewer people use smokeless tobacco on average than on average in low-HDI countries, an estimated 743400 people still currently use smokeless tobacco this information should help govern the need for proper checks and balances that can be achieved progressively to ensure that there is access to safe nicotine alternatives such as snus which has credible epidemiological evidence and data proving its efficacy in reducing deaths as well as diseases associated to combustible tobacco.
The whole concept of Tobacco Harm reduction and all the associated tools and innovations it advocates for presents LMICs with a unique opportunity to then allow for guided creativity along these lines. An example is the Green Gold Snus project in Malawi that is keen on locally producing snus, it is run by Patrick Kuyokwa a scholar under the THRSP KAC program.
Clearly, the Union did not have the regard for the locals when drafting these outlandish recommendations. Electronic cigarettes which are 95% safer than traditional cigarettes are quickly being adopted as the preferred quit aid by many people seeking to quit cigarettes and also a preferred safer alternative for those with no intention to quit clear testimonials shared by organizations such as The International Network of Nicotine Consumer Organisations (INNCO), the American Vaping Association (AVA), New Nicotine Alliance (NNA) among others the world over. The pharmaceutically approved NRTs have 55% efficacy as quit aids but this mark is only achieved if one uses more than two at a time, and thus not been found to be appealing by many.
For the phrase ‘Where bans are best: Why LMICs must prohibit e-cigarettes and heated tobacco product sales to truly tackle tobacco’ the reverse is true.
