Cigarettes may become a thing of the past as smokers switch to nicotine products that do not burn, and this may be as soon as 10 to 15 years from today.
This was the bold forecast of a top executive of Philip Morris International, the world’s most successful cigarette company at the opening of the 2020 Global Forum on Nicotine.
“With the right regulatory encouragement and support from civil society, including the public health community, we believe that cigarette sales can end in many countries in 10 to 15 years. That’s right, in 10 to 15 years,” Dr. Moira Gilchrist, PMI vice president of strategic and scientific communications, said during the virtual version of the GFN on June 11, 2020.
Gilchrist, who holds a degree in Pharmacy and a Ph.D. in Pharmaceutical Sciences, was one of the panelists who discussed the topic “Nicotine: science, ethics, and human rights” during the annual conference organized by London-based Knowledge Action Change Limited. The forum sheds light on tobacco harm reduction products such as e-cigarettes, heat-not-burn tobacco products, and snus as safer alternatives to combustible cigarettes.
Gilchrist said PMI is undergoing a transformation despite the skepticism it faces from health authorities and other groups.
“We have committed to replacing cigarettes with better alternatives as rapidly as possible,” said Gilchrist who has been with PMI since 2006 and has worked exclusively on reduced-risk product programs in roles related to research and development as well as commercialization. Prior to joining PMI, she worked in the pharmaceutical sector for more than 10 years.
“Our goal is a smoke-free future—a future in which all those adults who would otherwise continue to smoke instead switch to scientifically-backed products that are less harmful than smoking,” she said.
“We are changing. I can really understand why these changes have been met with skepticism,” said Gilchrist, adding that with the rejection of any product or any scientific evidence which PMI develops in absence of any debate, “it is men and women who smoke that stand to lose the most”.
“As of today, we have made significant investments and dedicated more than a decade of high-quality R&D work to deliver on our commitment. And we are progressing at an astonishing pace. Smoke-free products now represent an important and growing portion of our total net revenue [18.7 percent in 2019], up from essentially nothing in 2015,” she said.
“Our reallocation of resources follows the same trajectory. Today, more than two-thirds of our commercial expenditures [71 percent] and almost all our R&D expenses [98 percent] are dedicated to our smoke-free portfolio,” the PMI executive said.
Gilchrist said that as a result, some 10.6 million men and women have stopped smoking and switched to IQOS, PMI’s lead smoke-free product, as of end-March 2020.
“Our ambition is that by 2025, at least 40 million people will have done the same. That would mean 40 million fewer smokers around the world,” she said.
“This ambition in our progress to date shows that we can play our part to accelerate the decline in cigarette smoking well beyond what can be achieved through traditional tobacco control measures alone,” Gilchrist said.
Gilchrist said the impact of these smoke-free products is already being seen, with a study by researchers working for the American Cancer Society concluding that the rapid decline in cigarette sales in Japan was most likely due to the introduction of IQOS.
She admitted that despite these results, health authorities refuse to acknowledge and validate the success of smoke-free products in reducing the smoking rate. “In an ideal world, we will be having an open evidence-based conversation to figure out how to replicate these results as quickly as possible and in as many countries as possible. Astonishingly back in the real world, we are far from this,” she said.
“Many public health advocates and organizations are completely unwilling to objectively assess the opportunity that smoke-free products like IQOS present. Why? Because these solutions are coming from the industry. They justify their stance by repeating the almost 20-year-old text from Article 5.3 of the FCTC,” she said, referring to the document of the World Health Organization-Framework Convention on Tobacco Control.
“They claim that there is a fundamental and irreconcilable conflict between the tobacco industry’s interest and public health. As a scientist, I find this alarming. In the 20 years the world has progressed, so has science and technology. The organizations and individuals who have decided not to see the glaringly obvious are participating in scientific censorships, pure and simple,” she said.
Gilchrist said that as a result, adult smokers and users of smoke-free products remain confused about whether smoke-free products are a better choice than continuing to smoke.
She also said that the reluctance on the part of governments to put in place risk-proportionate regulation to accelerate switching and the decision by some countries to impose outright product bans are denying adult smokers access to these better alternatives, meaning that most will simply continue to smoke.
“All of this is at odds with the scientific evidence, including numerous independent studies which show that smoke-free products have the potential to positively impact the health trajectory of existing adult smokers,” she said.
Gilchrist believes that science and evidence will eventually prevail, starting with the study results in Japan, the country where IQOS was introduced.
“While there is new long-term disease evidence today, we are studying the first positive indicators that are starting to show in Japan. We are seeing promising data that shows a sequential relationship between the introduction of heated tobacco products in the country and the decline in the most common smoking-related diseases. More research is needed but it is not something we can ignore,” she said.
“Eventually, it too may be something very difficult others not to see as well. The facts are clear. Better alternatives to cigarettes exist today and we have to act,” she said.
“The question is not whether smoke-free products should be made available to them. Rather the discussion is how fast can we make it happen?” she said.
Nearly 600 individuals participated in the 2020 GFN which delivered presentations from 30 expert speakers on the theme “Nicotine: science, ethics, and human rights”.
Participants included consumers, scientists, regulators, manufacturers and distributors of smoke-free nicotine products, public health professionals, policy analysts and parliamentarians who discussed a diverse range of topics such as the latest evidence on the interplay between nicotine, smoking, and COVID-19; the impact of the deliberate and continued misattribution of the so-called ‘EVALI’ lung-injury crisis to nicotine vaping instead of illicit THC; moral panics over low youth vaping rates taking precedence over the health of millions of adult smokers and vapers and Big Philanthropy’s effect on global public health.
The annual forum, the seventh so far, was held online on June 11 and 12 amid the threat of the COVID-19 pandemic this year.
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