Enlightened UK report on tobacco harm reduction has important lessons for Australia

Posted by DrMendelsohn on 18 July, 2017

UK Dept Health.JPGThe Department of Health (UK/England) has once again committed itself to tobacco harm reduction. In its latest Tobacco Control Plan, Towards a Smokefree Generation, it endorses the important role of electronic cigarettes for smokers who are otherwise unable to quit.

‘The best thing a smoker can do for their health is to quit smoking. However, the evidence is increasingly clear that e-cigarettes are significantly less harmful to health than smoking tobacco’.

The Department of Health recognises that reducing harm in smokers who cannot quit, for example with e-cigarettes is an important complementary strategy to existing tobacco control policy, such as mass media campaigns, smoking clinics and high tobacco taxation.

This is especially important for disadvantaged smokers, such as people with mental illness, for whom quitting is more difficult and who suffer poor health as a result.

The report notes that

‘many smokers are turning to e-cigarettes to help them in their attempts. In 2016 it was estimated that 2 million consumers in England had used these products and completely stopped smoking and a further 470,000 were using them as an aid to stop smoking’.

The adult smoking rate in England now is 15.5%, lower than the Australian smoking rate for the first time ever. It is very likely that the widespread use of e-cigarettes has contributed to the recent rapid decline. In Australia, where e-cigarettes are illegal and discouraged, smoking rates have remained unchanged over the last 3 years. Now 15.7% of Australian adults smoke.

The UK/England Health Department has committed to ensuring:

  • Safer alternatives to smoking such as e-cigarettes are widely available
  • E-cigarettes are not banned in smokefree areas. Individual organisations are encouraged to make their own policies
  • Smokers are informed about the risks and benefits so they can make informed choices
  • Health professionals are provided with support and guidance  for assisting smokers to quit with e-cigarettes
  • A range of safe and effective e-cigarettes are available on prescription
  • Continuing monitoring of the impact of these products, including evidence on safety, uptake, health impact and effectiveness
  • Safer alternatives to smoking such as e-cigarettes are widely available

Meanwhile in Australia…

Australia appears to be in a parallel universe to the UK. E-cigarettes with nicotine are still illegal here and their use to reduce harm from tobacco is actively discouraged by all 9 federal and state health departments and peak medical bodies such as the National Health and Medical Research Council and Therapeutic Goods Administration.

This is in spite of tobacco harm reduction being endorsed in Australia’s National Tobacco Strategy. As a signatory to the World Health Organisation FCTC treaty, Australia also has obligations to introduce tobacco harm reduction strategies. E-cigarettes is the best tobacco harm reduction tool available. Snus (moist, low risk tobacco kept in the mouth) is also of proven value but is strongly discouraged and highly taxed in Australia.

However, hope remains. The federal parliamentary inquiry is now closed and is reviewing the many submissions made - it will make recommendations to the Minister for Health on appropriate changes to the current regulations. A Senate Inquiry is also under way. Submissions can be lodged to this inquiry by 4 August 2017.

Australian regulators need to recognise the huge opportunity that e-cigarettes offer to public health. By focussing on the small and theoretical risks, we are condemning many smokers to an early death.

Towards a Smokefree Generation, A Tobacco Control Plan for England. UK Department of Health, July 2017
Clive Bates. English tobacco control plan embraces tobacco harm reduction - world first
Let workers vape in office, Government plan suggests. Telegraph, UK

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