Reducing harm from tobacco

Vietnam remains among the top 15 countries with the highest rates of male smoking in the world, with over 15 million users. Therefore, adding "Risk Reduction" to the Law on Prevention and Control of Tobacco Harm is becoming an urgent need.

Acting Director of the FDA's Center for Tobacco Products (USA), Bret Koplow, emphasized the need for nicotine risk classification. (Photo: Tobacco Reporter)

Experts emphasize that, in addition to addiction treatment support, less toxic alternatives are needed to protect public health, especially since the success rate is only around 9.5%.

Vietnam is facing a significant burden from tobacco, as cigarette smoke contains over 7,000 toxic chemicals that cause cancer, cardiovascular and respiratory diseases. According to a 2019-2020 survey in 34 provinces and cities, only 9.5% of smokers successfully quit, while new data from the World Health Organization (WHO) shows a slight decrease in the percentage of adult male smokers from 45.3% in 2015 to 38.9% in 2023, but approximately 15 million people of legal smoking age still remain.

A 2021 survey by VnExpress newspaper with over 4,000 participants revealed that 93% had considered quitting smoking, but 43% failed and 26% relapsed. 94% agreed that reducing the harm caused by smoking is important.

Many experts note that a control model based on the level of harm should be considered, rather than an absolute ban, as many countries apply, to increase feasibility. Currently, the Law on Prevention and Control of Tobacco Harm lacks solutions for those who are not ready to quit, leading to an annual healthcare burden of up to 108 trillion VND, according to a 2022 study by the Vietnam Health Economics Association.

The draft amendment to the Law on Prevention and Control of Tobacco Harm in 2026, currently being developed by the Ministry of Health , focuses on banning e-cigarettes and heated tobacco products from 2025, expanding the ban on display at points of sale, and strengthening post-inspection to reduce passive exposure.

The World Health Organization (WHO) also initiated tobacco harm reduction through the Framework Convention on Tobacco Control (FCTC) in 2003, with three pillars: reducing supply, reducing demand, and reducing harm. The WHO's TobReg group asserts that effectiveness is only achieved when switching to less toxic products than traditional cigarettes, under strict supervision.

However, Professor Tikki Pang, former WHO Director, points out that challenges in Asia are slowing progress, while the United States is leading the way with its Food and Drug Administration strategy. The United States (FDA) when integrating harm reduction into its regulatory framework.

Recently, at the Tobacco and Nicotine Policy Conference organized by the U.S. Food and Drug Administration, Bret Koplow, Acting Director of the Center for Tobacco Products (CTP) at the FDA, emphasized that tobacco harm reduction is a principle integrated into the entire FDA regulatory framework.

This statement marks a significant shift in the U.S. approach to tobacco control after years of maintaining traditional measures.

According to public health experts worldwide, the FDA's approach is expected to help gradually reduce dependence on cigarettes among those using nicotine-containing products. This means that the need for nicotine does not necessarily have to be tied to smoking cigarettes, the most harmful product.

Simultaneously, the United States has implemented comprehensive controls on both cigarettes and other tobacco products. On one hand, the country supports smoking cessation, warns of harm, bans advertising, and increases taxes on cigarettes. On the other hand, the FDA conducts rigorous scientific evaluation and conditionally permits the sale of certain non-combustible tobacco products as a lower-risk alternative for smokers.

The United States also employs a strict post-marketing review mechanism, requiring businesses to be transparent with information and control their communication and marketing messages to ensure consumers have access to accurate information about the health effects of products.

The latest data from the U.S. Centers for Disease Control and Prevention (CDC) for the period 2017-2023 shows that, while the total number of adults using nicotine has not changed significantly, consumer behavior has shifted as the rate of cigarette smoking has decreased.

Given the modest rate of smoking cessation and the large number of smokers, the amendment of the Law on Prevention and Control of Tobacco Harm needs a more comprehensive approach. Besides the goals of reducing supply, reducing demand, and supporting smoking cessation, consideration should be given to adding scientifically-based harm reduction solutions for those who are unable or unwilling to quit, in order to reduce exposure to secondhand smoke and the burden on the healthcare system.

This approach aligns with WHO recommendations and international experience, contributing to improved effectiveness and sustainability of tobacco control policies in Vietnam.

MY TRINH

Source: https://nhandan.vn/giam-tac-hai-tu-thuoc-la-post938424.html