By Elizabeth Merab

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Safe cigarette? Well, to most people, that is an oxymoron, but to giant tobacco companies that make them, heat-not-burn devices are a “healthier” alternative to regular cigarettes.

To show how serious this safety message is, in January, Philip Morris International, one of the world’s largest cigarette manufacturers, relaunched its website. Front and centre on its home page, a freshly fashioned statement of purpose now meets a visitor’s eye: “Designing a smoke-free future.”

Far from the images of its familiar top sellers, like Marlboros or Virginia Slims on its homepage, Phillips Morris now has a display of an open-ended rider: “How long will PMI be in the cigarette business?”

While this may seem a curious ambition for a company that sold more than $26 billion in tobacco products last year, its pledges are even more baffling: Phillip Morris has pledged up to $1 billion to fund the Foundation for a Smoke-Free World as a US charitable organisation, meant to fund research to eliminate the use of smoked tobacco globally.

It gets even more interesting: In a bid to introduce and promote alternative cigarettes, Phillip Morris announced a 12-year, $80-million-a-year funding for the new organisation, with the aim of making grants on “how to best achieve a smoke-free world and advance the field of tobacco harm reduction.”

The move has already sparked scepticism at a time when these companies have been accused of trying to silence industry opponents and fight restrictions imposed by governments.

Soon after Phillip Morris made the announcement, the World Health Organisation put out a statement saying it will not engage with this new Foundation.

Unanswered questions

“There are many unanswered questions about tobacco harm reduction, but the research needed to answer these questions should not be funded by tobacco companies,” read the WHO statement.

The international health agency went on to say that the tobacco industry and its front groups have misled the public about the risks associated with other tobacco products.

“This includes promoting so-called light and mild tobacco products as an alternative to quitting, while being fully aware that those products were not less harmful to health.”

According to WHO, this “decades-long history means that research and advocacy funded by tobacco companies and their front groups cannot be accepted at face value.”
A number of organisations have banned funding from tobacco companies or researchers funded by the industry.

Now manufacturers are changing tack in a bid to introduce products that are fronted as less risky than conventional cigarettes — such as e-cigarettes.

According to industry stakeholders, a new generation of alternative tobacco products that appeal to smokers could offer a breakthrough in harm reduction.

Alternative products

During a stakeholders’ meeting held in Nairobi two weeks ago, Leadership Impact Dynamics founder Ade Adeyam said the industry must offer alternative products as a tool to help stop smoking.

“We believe we can have a big impact on public health by promoting alternatives to smoking cigarettes,” said Ms Adeyami.

“Given the undisputed harm caused by cigarettes on human health, the potential negative impacts of e-cigarettes certainly pale in comparison as there is no tar in e-cigarettes.”

Tobacco kills more than 7.2 million people every year with more than six million of these deaths resulting from direct tobacco use while more than 890,000 are as a result of non-smokers being exposed to second-hand smoking.

In Africa, 146,000 adults aged 30 years and above die every year from tobacco-related illnesses. This makes tobacco use one of the biggest public health threats the world has ever faced, according to the WHO.

The conference, titled “Tobacco Harm Reduction: Towards a Smoke Free World,” brought together participants from 14 African countries, and sought to identify ways to adopt and promote reduced-risk alternatives aimed at accelerating the transition out of harmful tar-based cigarettes while tackling the Sustainable Development Goal on good health and wellbeing.

war against cigarette smoking

As tobacco companies strive to replace traditional combustible cigarettes with e-cigarettes, which are battery-operated devices that emit doses of vaporised nicotine or non-nicotine solutions for the user to inhale, the war against cigarette smoking has reached a fever pitch.

Many alternative cigarettes have been brought to the market, with claims that by eliminating tobacco from the smoking process, the resultant cigarette is safer. There are many varieties, many of them less expensive than tobacco cigarettes, which also make them widely popular.

Disclosures that smoking cigarettes is directly linked to lung cancer, weakened immune systems, and other severe health problems have resulted in massive campaigns against smoking.

A graphical presentation of WHO Tobacco and its environmental impact: an overview 2017. Smokers who do not quit and who are concerned about their health are looking for less harmful alternatives to smoking. GRAPHICS | ANTHONY SITTI | NATION

The only problem is, smoking cigarettes is addictive, so while people want to eliminate the dangerous side of smoking tobacco, the craving for nicotine is hard to kick out, leading to a wide range of “alternatives” to smoking, many of which have become popular over the past decade.

For instance, electronic cigarettes aim to provide a similar sensation to inhaling tobacco smoke, without the smoke.

Some cigarettes are now being sold as “all natural” and marketed as having no chemicals or additives. A cigarette burns shredded tobacco leaves to generate smoke containing nicotine, which occurs naturally in tobacco, as well as many harmful chemicals.

It is these harmful chemicals – not the nicotine – in cigarette smoke that are the primary cause of smoking-related diseases.

Heat-not-burn products aim to avoid the smoke exposure, according to an American Heart Association release, by raising the temperature of tobacco to a level where nicotine-containing vapour is released, without cranking up the heat to burn the tobacco.

Concern

But is there any type of safe smoking? Harouna Ly, Philip Morris International director of corporate affairs, actually agrees that the best way to reduce the risks associated with smoking is not to smoke or use any nicotine product at all.

If WHO numbers are anything to go by, the majority of smokers simply do not quit. In fact, the health agency predicts that there will be more than one billion smokers by 2025. 

“Providing less harmful alternatives for those who would otherwise continue smoking is a common-sense approach to public health, embraced by a growing number of experts and health authorities worldwide,” he argues.

Philip Morris, the world’s second largest international tobacco company, fronts itself as developing alternatives to smoking that do not contain smoke, but have the nicotine and taste that can satisfy existing smokers.

One such product is IQOS, PMI’s first heated tobacco product. To use it, one has to push a flavoured packet of tobacco called a heat stick into the mouth of a tubular, pipe-like holder.

Once the button on the holder is pressed, it heats up a metal blade inside, which cooks the tobacco to roughly a third of the temperature of a traditional cigarette.

Health effects

“Smokers have different preferences. They look for a combination of nicotine, taste, ritual, and experience. Moreover, smokers who do not quit and who are concerned about their health are looking for less harmful alternatives to smoking,” explains Harouna Ly.

But some tobacco control stakeholders have a different opinion, arguing that any method of nicotine delivery – no matter how advanced the technology – is still harmful.

According to Kenya Tobacco Control Alliance co-ordinator Thomas Lindi, there is no proof they are healthier or safer than other cigarettes, nor is there good reason to think they would be.

Smoke from all cigarettes, natural or otherwise, has many chemicals that can cause cancer (carcinogens) and toxins that come from burning the tobacco itself.

“There is nothing like safe cigarettes because all cigarettes are harmful,” notes Mr Lindi.

The International Institute for Legislative Affairs believes that more research is needed from independent, public health- driven sources on the effectiveness of harm reduction strategies in tobacco control.

Smokers once believed that “light” and “low-tar” cigarettes had lower health risks. But studies have shown that the risk of serious health effects is not lower in smokers of light or low-tar cigarettes. Because of this, the US Food and Drug Administration has banned the use of the terms “light,” “mild,” and “low” in any cigarette sales unless the FDA specifically allows it. So far, the FDA has not.