The present ‘puritan’ approach to defeating the health risks posed by tobacco smoking should be abandoned by anti-smoking lobbyists and regulators in favour of a pragmatic approach which recognises that alternatives like vaping are up to 95% less harmful, and have the potential to meaningfully reduce the toll on the health of tobacco smokers around the globe.
So says Prof Daniel Malan – an ex-smoker and director of the Stellenbosch University-based Centre for Corporate Governance in Africa, in a report entitled ‘Where there’s no smoke, is there still fire? ethical aspects of tobacco harm reduction, published by the Africa Harm Reduction Alliance (AHRA).
The report suggests that reducing the harm inherent in smoking should be recognised as a strategy in the fight against the well-documented health risks faced by smokers. Tobacco smoking, says the report, still takes up to five million lives globally every year, and sees government earnings by taxes dwarfed by the US $ 1.0 trillion loss to global economies through premature death of workers, lost production and costs of healthcare.
Against these facts must be measured the debatable success of international bids like the Framework Convention on Tobacco Control (FCTC), that was launched by the World Health Organisation in 2005. Legally binding on 180 countries and focusing on the production, sale, distribution, advertising and taxation of tobacco the FCTC, in addition to other measures, should see the incidence of smoking reduce globally from 22.1% in 2010 to 18.95 in 2025 – a reduction of only 3.5% (according to the WHO).
“The simple concept of reducing harm can make a contribution to a much more comprehensive approach to tobacco control. Including both scientific and legal components, the objective is simply to reduce the potential harm by decreasing the risks attached to using tobacco or nicotine. Cigarette substitutes such as vaping and smokeless tobacco are examples,” says Prof Malan.
Confusing the issue that it is better to reduce harm and thereby increase the quality of life of millions of tobacco smokers, is the fact that many opponents of tobacco and regulators do not believe that they can support e-cigarettes and vaping without being seen as simultaneously supporting tobacco companies.
“Clearly the debate is more nuanced, but it is also perfectly understandable that – given the tainted history of the tobacco industry – any product that includes the word “cigarette” will be treated with disdain at worst and suspicion at best. “
“For the sake of more than one billion smokers in the world, most of whom are addicted to nicotine and unable or unwilling to quit, a more pragmatic approach to e-cigarettes is required. Technically, it is correct to argue that it is better to quit altogether than to reduce harm by 95%, but such a puritan approach will do more harm than good.”
“Although vaping is still in its infancy when compared to tobacco smoking, and the body of evidence available is therefore more limited, present evidence from very credible sources seems to be rather convincing. One should, therefore, be questioning why this information is not more widely known.”
Prof Malan points out that amongst the leading institutions commenting on vaping and e-cigarettes are Public Health England and The Royal College of Physicians (UK):
- Public Health England reported in 2016 that; “While vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals which are present pose limited danger. It has been previously estimated that electronic cigarettes are around 95% safer than smoking. This appears to remain a reasonable estimate.”
- The potential benefits of a switch from tobacco cigarettes to e-cigarettes have been confirmed by a report of the Royal College of Physicians in 2016, which stated: “Large-scale substitution of e-cigarettes, or other non-tobacco nicotine products, for tobacco smoking has the potential to prevent almost all the harm from smoking in society. Promoting e-cigarettes and other non-tobacco nicotine products as widely as possible, as a substitute for smoking, is therefore likely to generate significant health gains in the UK.”
“It is important that consumers understand that harm reduction is not harm prevention. It is important for consumers to get accurate information that is presented honestly and transparently,” says Prof Malan, who says that often material is presented in a highly scientific manner that makes it difficult for consumers to understand.
“Vigilant watchdogs are required for both cigarettes and e-cigarettes, but the two products should not be conflated by regulators, life insurance companies or other stakeholders. The overriding criterion should always be to make decisions that will save lives. Adopting a more pragmatic approach to smoking can make a difference. Both smokers and non-smokers deserve that and should demand it,” says Prof Malan.
Prof Daniel Malan is the director of the Centre for Corporate Governance in Africa at the University Of Stellenbosch Business School in South Africa. His focus areas are corporate governance, business ethics and corporate responsibility. He is a member of the following initiatives: the World Economic Forum’s Expert Network and the International Corporate Governance Network’s Integrated Business Reporting Committee.
His educational qualifications include a PhD in Business Administration, a Master’s degree in Philosophy as well as a Master’s degree in Business Administration (MBA), all from the University of Stellenbosch.
More Info on Pragmatism is the key to reducing tobacco-related diseases and deaths here: Africa Harm Reduction Alliance.