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Message from the Executive Director

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Tobacco industry must cease targeting young people in LMICs

Message from the Executive Director, 29 May 2020

On this World No Tobacco Day, we find ourselves in an unprecedented time, in the midst of the COVID-19 pandemic. Though much remains to be determined about this disease, we know that it attacks the respiratory system and that people with non-communicable diseases (NCDs) are more likely to experience serious illness or death. Smokers may have worse outcomes—hospital admission, need for mechanical ventilation, and death—than non-smokers.   

And because smoking is one of the leading causes of NCDs and seriously inhibits overall immune health, there has never been a more urgent time to stop smoking.

There has also never been a better time for vigilance. Even in the midst of a respiratory pandemic, the tobacco industry continues to produce and market traditional cigarettes, while promoting novel products like e-cigarettes and heated tobacco products (HTPs) that it labels as “safer” than previous offerings.

These novel products are promoted through aggressive social media campaigns to attract young users, and come in dessert and candy flavours with a decidedly youthful twist. The tobacco industry would have us believe that novel products are part of a grand plan to eradicate smoking and help current users transition to less harmful products. But this evidence, and their advertising budget of US$ 8 billion per year – that’s nearly US$ 22 million per day – suggests otherwise.

If history has taught us anything about the tobacco industry, it is that the industry is always looking for two things: new markets and a next generation of consumers. This pattern is being repeated with e-cigarettes and HTPs: the industry has turned its attention to low- and middle- income countries (LMICs), which are home to 80 percent of the world’s smokers. And within those countries, the industry is directing its focus to young people.

Despite this disturbing trend, and the fact that context is critical, nearly all of the discourse surrounding e-cigarettes and HTPs—in the media, academic papers, and amongst the scientific community—has focused on the public health impact of novel products in high-income countries. And while a contentious debate has ensued, it has assumed that the playing field is level—that lessons about potential cessation utility from the United Kingdom might apply to the Ukraine. This is certainly not the case, and it is for precisely this reason that The Union is releasing “Where Bans Are Best: Why LMICs must prohibit e-cigarette and HTPs sales to truly tackle tobacco” this World No Tobacco Day.

As this position paper explains, LMICs lack both the resources and the enforcement mechanisms required to fully support comprehensive e-cigarette and HTP regulations. The Union’s tobacco control work is focused in these countries because they are the epicentre of the tobacco epidemic. In such environments, young people can easily obtain cigarettes; nearly 38 million young people aged 13-15 already use tobacco. Indeed, tobacco is cheap, widely used, and with few notable exceptions, often culturally ingrained.

The introduction of novel products in such environments will have deleterious effects, hooking a new generation of nicotine addicts and potentially producing twin epidemics. In addition, e-cigarettes and HTPs will also drain critical resources away from what is most urgently needed—complete and full implementation of the World Health Organization’s Framework Convention on Tobacco Control (FCTC) and the evidence-based MPOWER measures.

The theme of this year’s World No Tobacco Day is ‘Preventing youth from industry manipulation and preventing them from tobacco use and nicotine use’. ‘Where Bans are Best’ provides guidance and recommendations for the countries hardest hit by the tobacco epidemic to protect themselves and their youth against the tobacco industry’s insidious tactics to hook the next generation of users.  I trust that it will empower tobacco control advocates, providing them with ten key arguments to explain why this is the right moment to argue against the sale, manufacture, import and export of novel products.