LETTERS: Smoking is the leading cause of preventable death the world over. However, even with the prevalence of alternatives to smoking, many are sceptical of their benefits and are wary of their long-term detriment.
That said, having attended the Global Tobacco and Nicotine Forum 2020, it is imperative that information shared during these conferences is made public.
One of the concerns with using alternatives is the gateway effect that it may have on non-smokers.
Similar to how marijuana is considered a gateway drug, it is feared that alternatives to smoking, such as vapes and e-cigarettes, due to their pleasant flavour compared with cigarettes, will have the same effect on non-smokers.
Hiroya Kumamaru, a cardiovascular surgeon and vice-director of AOI International Hospital in Japan, in his keynote speech, presented a survey involving 64,000 Japanese schoolchildren between 2017 and 2018, which showed that the initiation use of alternatives is lower compared with cigarettes.
Another concern is the claim that the availability of alternatives will attract ex-smokers to resume tobacco and nicotine use.
Kumamaru disproves this by providing evidence that less than 0.1 per cent of ex-smokers restarted use of tobacco via IQOS in the first year. In the second year, it was even lower at 0.0 per cent.
The study shows that less than 30 per cent of Japanese IQOS users become dual-users (people who smoke conventional cigarettes, as well as use heat-not-burn devices), emphasising the harm-reduction potential of these alternative products.
With this information, to capitalise on the harm-reduction potential of these alternative products, regulations must be outlined.
However, to have an effective framework for all markets, there needs to be a pioneering country or region that sets an example of the best way to regulate these products.
Derek Yach, president of the Foundation for a Smoke-Free World, says that people should not just focus on how to regulate these alternative products, but also highlight how long it takes for regulatory decisions to be made.
Regulations need to be decided upon pragmatically and swiftly to maximise the benefits these products could provide in terms of public health.
Yach talked about the need for countries, such as the United States and the United Kingdom, to generate the simplest and fastest way to create a regulatory framework for developing countries to base their policies around it.
Next year, Malaysia will table a tobacco control bill that will enhance or hinder the benefits posed by alternative products, as matters such as taxation, advertising and sales practices will be included in the bill.
To provide context about the smoking problem in Malaysia, the National Health and Morbidity Survey conducted last year stated that 31 per cent of those exposed to second-hand smoke had experienced it at home.
However, products that do not emit smoke, such as the IQOS, which have been proven to reduce the amount of harmful toxicants being released, will have an enormous effect on the health of these people who would otherwise be exposed to second-hand smoke from conventional cigarettes.
Thus, it is imperative for public health institutions and governments to recognise the benefits of ease of access to information and risk-proportionate taxation when deciding on a regulatory framework for these devices and to maximise its harm-reduction potential and to serve as policy examples for other countries.
John Soosai
Kuala Lumpur
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times