November marks the launch of the first “Effective Anti-smoking Policies Global Index.” Published by the We Are Innovation network, an alliance comprised of 30+ think tanks and NGOs based in Europe, the United States, and Latin America, the index analyses the public policies to eradicate smoking in 59 countries divided into 4 regions, evaluating them in 10 objective categories such as the regulatory framework of Non-Combusted Nicotine Products (NCNPs), their prohibition, display, packaging, and taxation, among others.
The evidence from studies, articles, reports, and meta-analyses all agree that NCNPs are 95 to 98 percent safer than tobacco consumed traditionally by combustion. The most up-to-date scientific evidence also shows that NCNPs are the most effective method to abandon combusted tobacco and avoid almost all smoking-related health harms. Therefore, the index claims that public health policies should seriously consider vaping, nicotine pouches, snus, and heated tobacco.
The Top 3 countries of the index are Switzerland, the United Kingdom, and New Zealand. The former has a legal framework for all NCNPs, while the national health authorities of the United Kingdom and New Zealand promote vaping for smoking cessation.
Beyond any doubt, the UK presents the best legal framework for vaping, gathering 90 points out of 90 according to the index’s methodology. However, it needs to catch up in the overall ranking due to its ban on snus. Except for Sweden, snus tends to fall under a general ban by the European Union. Needless to say, the UK is not part of the EU anymore and should do away with that prohibition.
Latin American countries like Chile, Mexico, Brazil, Argentina, and Uruguay find themselves in the bottom ten due to a combination of prohibitions and the position of their national health authorities, who are still hostile towards NCNPs as tools against smoking.
However, the outlier is Australia, where all products are banned — placing it at the bottom of the index. This makes Australia the most pro-combustion cigarette country in the world. Down Under is vape hell, it seems, which risks the lives of millions of current Aussie smokers who cannot switch to innovative, safer alternatives.
The EU at a crossroads
This year, the European Commission launched a call for evidence asking for feedback about its Tobacco Products Directive (TPD), which regulates traditional tobacco products and NCNPs. The initiative gathered a staggering 24,359 responses in less than a month. The current EU directive already imposes limits and restrictions that hamper the effectiveness of NCNPs as smoking cessation tools.
According to the index, the European Union needs to advance in the definition of a specific regulatory framework for nicotine pouches, the legalization of snus, and the improvement of taxation and health recommendations on all NCNPs. Moreover, the 240-page document offers guidance to the authorities for public policies that effectively reduce and minimize tobacco harm and provide information to citizens. To this end, the index suggests allowing both physical and online retail, promoting the use of NCNPs as an active policy to limit smoking, and communicating the absolute and relative harms of nicotine vaping or consumption in any of its NCNPs forms so that consumers can make informed decisions.
All in all, smart regulation open to innovation is needed to incorporate the costs and benefits of evidence-based policies from a practical perspective, balancing the risks that the measures may pose, understanding that interventions may have unintended consequences, that high bureaucratic and tax barriers nullify positive future transformations, and that the most extreme bans usually create black markets with severe consequences.
Federico N. Fernández is CEO at We Are Innovation. We Are Innovation is the voice of a vibrant global civil society that wants to progress through innovation, the adoption of new technologies, and human creativity.
