Tobacco Harm Reduction: Survey Shows Global Citizenry Reject Divisive Approaches to Policy Making

A global survey was conducted by the international research firm Povaddo for Philip Morris International (PMI) that covered 22 countries around the world (the Americas, Africa, Europe, and Asia) with the participation of over 44,000 respondents. The June 2022 survey showed that the majority of people are frustrated by social polarization on topics that are important to societies.

According to William Stewart, President and Founder of Povaddo, this was one of the most comprehensive surveys ever conducted related to tobacco harm reduction. The research, conducted in February, used statistically valid samples of public opinion gathered in each of the countries. Stuart stated that “it was a very massive undertaking. I think it is one of the largest studies, in terms of geographic scope, that explored  the role of science in policy making and focused on tobacco harm reduction.”

It showed that 88% of respondents agree that governments need to listen to the people they represent when making decisions that affect the lives of a large portion of the population. According to the survey, respondents are looking for more dialogue and compromise:

“On a broad level, what the survey tells us is that polarization exists in a lot of societal issues. But at the same time the masses really reject polarization. People acknowledge that things like compromise, common sense and middle ground are really the better approach for a more inclusive way of governing.” He highlighted two data points that underpinned the results; 71% say that the debate around big issues in their country has become far too partisan and only focused on advancing the most extreme proposals. The results showed clear consensus around the belief that significant progress can only be made by meeting in the middle.

In the context of public opinion the “quit or die” doctrine, when it comes to smoking, is not enough of a solution” according to Lindsay Stroud, Director of Taxpayers Protection Alliance's Consumer Center in the United States. She went on to say that “nicotine is highly addictive. But I think smoking is a really personal experience for people and when you approach them with something drastic like “quit or die”, or use patches or gum (commonly known as nicotine replacement therapy) that doesn’t mimic the sensation of cigarette, it is unlikely that you will get a positive response. However, when you are able to personalize your quit approach with further options, it does happen to be more successful in getting people to use less cigarettes.”

The topic of tobacco harm reduction is one of the most divisive topics nowadays with one of the strongest and most powerful opponents to this approach being the World Health Organization (WHO). For Grégoire Verdeaux, Senior Vice President, External Affairs, PMI, the stance against tobacco harm reduction should no longer have to be that categorical:

“I think we are not fighting different agendas with the World Health Organization. They say you should not start smoking cigarettes. We say the same thing. They say if you have started you should try quitting and we say the same thing. But that is not good enough as an answer.” Verdeaux continued to lament the situation saying, “I wish the WHO would agree to work with us. We don’t believe that we are pursuing a fundamentally different agenda. We relay messages and principles to cigarette smokers on prevention and  cessation which I believe are very close to the ones of the WHO".

At the moment the difference is about the availability of alternatives, and this is where the organization should open up the dialogue quite frankly like every international organization today that has a global problem to solve. There is a notion that the tobacco industry cannot work for less harmful alternatives and I also think that there is the idea that abstinence is possible for all people, and this is where we disagree. However, we do not disagree on ideological grounds. We disagree on the facts. We have spent U.S.$9 billion on research and development on what is recognized by the Food and Drug Administration (FDA) as less harmful alternatives to cigarettes”.

What about Africa?

In Africa, there is only one country where smoke free alternatives are available, and this country is South Africa. PMI’s vision is to “deliver a smoke free future” around the world by 2025. Nevertheless, in the African continent the alternatives to combustible cigarettes are nearly nowhere to be found. “It is true that the smoke free alternatives are currently less available in Africa. You have a diversity of factors that play a role here".

In Senegal the prevalence of cigarette smoking is at 6.1% of the adult population. “ I assume that it is not the number one health issue that the government wants to address. Of course, you have wide disparities, population groups and regions where smoking prevalence is higher. South Africa for instance is one of the countries in Africa where the prevalence is comparatively much higher. Also smoke free alternatives are costly to develop ... I personally have no doubt that if the WHO and other parties give a chance to better, less harmful alternatives to smoking these alternatives will come to Africa in due time.”

PMI has the ambitious goal of replacing combustible cigarettes with smoke free alternatives by 2025 supported by a large body of independent research. However, skepticism around new products is a constant in the world we are living in, and PMI’s alternatives to combustible cigarettes are no exception.