It is discouraging to see various countries, like the U.S. and others restrict access to tobacco harm reduction (THR) products like vaping, heat-not-burn technologies (HNB), chewing tobacco, and snus.  THR products are a viable solution to help smokers transition away from products that all health officials can agree are deadly – combustible cigarettes.  Burning and inhaling smoke from tobacco is what causes cancer, heart disease, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. 

The latest country to enter the fray is Taiwan, whose government is attempting to pass severe restrictions on harm reduction products.  While amendments have been written by the Taiwan Ministry of Health to their Tobacco Hazards Prevention and Control Act (THPCA), they are stalled.  The legislation is the strictest seen in more than 13 years and work on it was originally delayed due to COVID.  There is supposedly strong support for the amendments in the legislature and by the public, but nothing has been sent to the legislative branch for review and no one seems to know what is causing the continued delay. 

The legislation would do several things, including raising the legal age to purchase tobacco products from 18 to 20 years of age, banning flavored tobacco products, increasing the size of graphic health warnings, and expanding the indoor smoking ban.  Although the legislation would prohibit the sale of e-cigarettes, it would allow the commercialization of heated tobacco products (HTP) if authorized by a health risk assessment.  The long delay continues to leave many harm reduction products in limbo, including HTPs that have done so much to reduce the use of combustible cigarettes within neighboring countries, like Japan and South Korea.  Hopefully, there are some individuals within Taiwan’s government ranks taking a hard second look and recommending that e-cigarettes not be banned since it would no doubt encourage the use of illicit products and a thriving black market, which the communist Chinese government would be happy to support, as it already does in the U.S.  What is needed is a robust discussion around all THR products, including vaping and heat-not-burn, and how these products have reduced smoking combustible cigarettes.

According to the U.S. Centers for Disease Control and Prevention (CDC) smokers die on average 10 years earlier than non-smokers and smoking is responsible for more than 480,000 deaths per year in the United States.  If smoking in the U.S. continues at its current rate among U.S. youth, 5.6 million of Americans younger than 18 are expected to die prematurely from a smoking-related illness.

England is leading the world in appreciating the value of utilizing THR products.  In July 2017, England’s Department of Health and Social Care released a document, “Towards a Smokefree Generation – A Tobacco Control Plan for England.”  In addition to their continued campaigns to educate citizens about the danger of smoking and promoting cessation; encouraging smoke-free places to protect people from second-hand smoke; gathering information on the effectiveness of various stop-smoking strategies, like ad campaigns, regulations, taxation, reduced access to illicit tobacco products; they also encourage the use of e-cigarettes.  Public Health England (PHE) has recommended that anti-smoking laws not include e-cigarettes and that they not be part of a smoke-free policy.  PHE has regularly updated studies on e-cigarettes and alternative nicotine delivery devices, as they have found they “could play a crucial role in reducing the enormous health burden caused by cigarette smoking.”

CAGW continues to argue for more rational approaches to the use of THR products, not only in the U.S., but across the globe.  If health officials truly want to help people to stop using combustible cigarettes, which are known to cause harm and death, THR products like e-cigarettes, HNB products, and snus should play an important part in that goal.