Can science, tech eliminate harm of tobacco smoke?

KUCHING (Oct 10): Cigarette smoking is undeniably one of the leading causes of preventable diseases and deaths worldwide, linked to various cancers, respiratory diseases, and cardiovascular conditions.

Many believe nicotine is the culprit, but the reality is not.

Nicotine occurs naturally in tobacco, and in some plants from the Solanaceae family, at much lower levels.

It is present in many products including combustible tobacco products (eg., cigarettes and cigars) and smoke-free products that provide nicotine without combustion (eg., snus, nicotine pouches, e-cigarettes, and heated tobacco products).

This compound stimulates the brain to release dopamine, creating feelings of pleasure and reward, which makes quitting smoking very challenging for many individuals. Although nicotine is addictive, it is not the main cause of smoking-related diseases.

As awareness on the dangers of smoking grows, many adult smokers are exploring alternative options to satisfy their nicotine cravings while potentially reducing the health risks brought by tobacco smoke.

This shift is mainly driven by public health campaigns, stricter regulations and a growing body of scientific evidence highlighting the harms of smoking.

One of the innovations that hit the market recently are heated tobacco products (HTPs), which heat tobacco at a lower temperature without burning tobacco.

This approach is said to reduce the levels of harmful chemicals produced by tobacco smoke, thereby limiting exposure to harmful substances like tar, carbon monoxide and various cancer-causing chemicals.

“It is a well-established fact that cigarettes cause numerous diseases, knowledge that has been around for decades. However, the technology and science to offer smokers better alternatives for their health were not available until recently,” said PMI International Communications and Engagement vice-president Tommaso Di Giovanni.

He was interviewed by The Borneo Post on the sidelines of the 11th Global Forum on Nicotine that was held in Warsaw, Poland this year.

Di Giovanni also said that when PMI realised that scientific advancements had reached a point where they could genuinely provide better alternatives, the company knew that it was time to act.

“We know that by eliminating combustion, which is responsible for the majority of harmful compounds in cigarette smoke, this could lead to significantly safer products for consumers,” said.

The best option is for the smokers to quit smoking. However, not all smokers want to quit smoking.

Di Giovanni said that by 2016, the company decided to encourage tobacco smokers who do not want to quit to switch to smoke-free alternatives.

Smoke-free alternatives, including HTPs that heat rather than burn tobacco, offer a potentially less harmful option to traditional smoking. For instance, devices like PMI’s IQOS are designed with this purpose in mind, providing adult smokers with a different approach to consuming tobacco.

“This approach makes sense for public health because we are offering better alternatives. The likelihood of improving public health outcomes is high, and it also aligns with our business goals to create a smoke-free future,” Di Giovanni concluded.

Separately, Roberta Costanzo, a Scientific Information Associate at PMI, said there are over 500 scientific publications, articles and book chapters on HTPs and smoke-free products over the years.

“It is very important for us to be transparent, sharing all the methods we use, the studies we have conducted, the results we have obtained, and even the raw data from these studies,” said Costanzo when met at PMI’s research facility called the Cube in Neuchatel, Switzerland.

She added that by being transparent, it would allow the scientific community to analyse the data and engage in discussions with PMI.

Costanzo also claimed that over the years, more and more experimental studies as well as governments are starting to recognise smoke-free products.

“Some of them have conducted their own assessments of the products and their results are basically aligned with the findings we have obtained in-house,” she said.

PMI Head of Regulatory Market Activations, Rishaad Hajee said the IQOS is a simple yet revolutionary approach which significantly reduces the production of potentially harmful chemicals.

“Unlike traditional cigarettes, which burn tobacco and release numerous toxic substances, research has shown that heated tobacco products reduce the levels of harmful and potentially harmful chemicals (HPHCs) by an average of 90 to 95 per cent,” said Hajee.

He also claimed that the US Food and Drug Administration (FDA) in 2020 has authorised the marketing of IQOS as a Modified Risk Tobacco Product (MRTP), which demonstrates that heated tobacco product is fundamentally different from combustible cigarettes.

He also stressed that PMI adopted stringent commercialisation practices to ensure that the company’s heated tobacco products are only sold to adult smokers and their marketing materials have made it clear that they do not target non-smokers or minors.

This cautious approach, he said, is crucial to uphold the product’s integrity and ensure it reaches its intended audience, primarily adult smokers who are seeking a better alternative like heated tobacco products or other smoke-free products.

Besides heated tobacco products, smokers have also turned to vaping, which involves using e-cigarettes or vape devices to heat a liquid (often containing nicotine) to create vapor that users inhale.

This method eliminates the combustion process responsible for many harmful chemicals found in traditional cigarette smoke.

Many smokers switch to vaping as it offers a similar experience without the harmful byproducts of burning tobacco, such as tar.

Additionally, the ability to control nicotine levels and the variety of available flavors make vaping an appealing choice for adults looking for alternatives.

However, it is important to note that vaping should only be considered by adult smokers seeking to reduce harm, and not by those who do not already smoke, especially youth, as much of its health dangers are still being studied.

Other forms of tobacco alternatives include products like snus which is a moist powder tobacco product that is placed under the upper lip, providing nicotine without the need for inhalation.

Asked if Malaysia can be a smoke-free country, Di Giovanni said: “Clearly, we believe that a smoke-free Malaysia, a country without cigarettes is possible.”

He pointed out that New Zealand and the United Kingdom are leveraging on smoke-free products to aim for smoke-free status by 2030 and 2035 respectively, and both countries are making significant progress, with smoking rates already very low.

“This success is largely because they encourage smokers who do not quit to replace cigarettes with better alternatives. Consequently, the decline in cigarette use is much faster there than elsewhere,” he added.

He also said Sweden serves as a notable example in Europe, having reached a smoking rate of just five per cent among its population.

This achievement, he said, is primarily due to the widespread adoption of snus.

He added that unlike other European countries, Sweden did not create obstacles to the adoption of snus, resulting in significantly fewer smokers on its streets today.

“The overall smoking incidence in the country remains remarkably low, about four to five times lower than the rest of Europe. Importantly, Sweden’s rate of smoking-related diseases is less than half of what is found in the rest of Europe,” said Di Giovanni.

He said Sweden’s experience is a fantastic case study, with extensive epidemiological data proving the benefits of adopting less harmful tobacco products.

“This data has been thoroughly studied by experts, many of whom present their findings at conferences,” he said.