The World Health Organisation (WHO) estimates that there are about 1.3 billion smokers worldwide.
Although smoking prevalence has declined in many countries over the last forty years, within the last decade those declines have plateaued in many countries. In fact, according to the WHO’s own predictions, there will still be more than one billion smokers by the year 2025.
For many decades, the primary strategies for reducing the harm associated with cigarette smoking was focused on preventing smoking initiation and promoting smoking cessation.
However, for those adult smokers who do not quit a different approach is required. Science is at the forefront of addressing this through innovative products that have the potential to reduce the harm compared to continued smoking and in so doing help to reduce smoking rates.
Philip Morris’ harm reduction strategies are transforming its business to focus on smoke-free alternatives like its flagship heat-not-burn technology branded IQOS, in an ambitious attempt to make cigarettes obsolete.
“While everyone knows that cigarettes are harmful, and it is well known that the best way to avoid the harms of smoking is never to start, or to quit altogether, the reality is that many don’t,” says Buhle Binta, Head of Scientific Engagement at Philip Morris South Africa. “Alternative products that have the potential to significantly reduce the risk of smoking related diseases for adults compared with continued cigarette smoking are a fundamental complement to the regulatory efforts aimed at reducing smoking prevalence.”
According to the Royal College of Physicians, harm reduction is a strategy used in medicine and social policy to minimise harm to individuals and/or wider society from hazardous behaviours or practices that cannot be completely avoided or prevented.”
Binta adds that tobacco harm reduction is starting to gain support from a range of stakeholders – including public health organisations, healthcare professionals and regulators – to complement the existing strategies to reduce smoking prevalence.
“There are now rapid developments in nicotine-containing products that are better alternatives to cigarettes with the potential to reduce the harm for adults compared to continued smoking,” she explains. “These include, for example, e-cigarettes and other vapour products, smokeless tobacco such as snus, and other non-combustible nicotine or tobacco products like heated tobacco products. These products are not risk free and contain nicotine, which is addictive.”
“Heated tobacco technology is relatively new but is gaining momentum as a better alternative for adult smokers compared to continued smoking,” Binta adds. “We believe in the science, and we believe it can benefit millions of adults, who would otherwise continue to smoke.”
To this effect, she explains that PMI recruited scientists to work on an important idea: developing less harmful products for adult smokers who don’t quit. Hundreds of scientists and engineers at PMI’s global research and development centres in Switzerland and Singapore have developed and evaluated the heated tobacco technology of PMI (branded IQOS) that heats and does not burn tobacco, producing a tobacco aerosol that provides nicotine.
“Our products are tested to the highest standards, and go through several robust scientific assessments, including, to date, 18 non-clinical and 10 clinical studies involving thousands of participants,” she says. “The totality of evidence available shows that, while IQOS use is not risk-free and it provides nicotine which is addictive, switching completely to IQOS presents less risk to your health than continuing to smoke cigarettes.”
“A cigarette burns at extremely high temperatures which creates thousands of chemicals, over 100 of which have been classified by public health experts as harmful or potentially harmful,” she says. “By eliminating the burning - as is the case with products such as heated tobacco, snus and e-cigarettes - the levels of harmful chemicals generated can be significantly reduced compared to cigarettes.
IQOS heats tobacco to a lower temperature (less than 350°C), ensuring that combustion does not occur. Because there is no combustion, IQOS does not produce smoke and produces significantly less harmful and potentially harmful chemicals compared to the smoke of a lit cigarette.
“The ongoing assessment of these smoke-free alternatives is hinged on our comprehensive step-by-step assessment programme,” Binta explains. “This programme is inspired by the practices of the pharmaceutical industry and is in line with the USA’s Food and Drug Administration’s 2012 guidance on the assessment of Modified Risk Tobacco Products.”
In addition to this, she says assessments are also conducted according to international standards.
Binta notes that for PMI as a company the plight is quite simple. “PMI wants to stop selling cigarettes as quickly as possible. We believe that with the right regulatory encouragement and support from civil society, cigarette sales can end within 10 to 15 years in many countries,” she concludes.