Is low-nicotine tobacco just another WHO smokescreen?
Could nicotine-free tobacco eliminate the scourge of smoking once and for all? The World Health Organization (WHO) seems to think it could. Now, they’re pointing to research from the Technical University of Dortmund, which is currently developing tobacco with the world’s lowest nicotine levels in hopes of helping smokers quit or reduce their habit. They’re asking for trouble.
Of course, any innovation that gives consumers more options in how to beat their addiction is welcome. But there are many reasons to be skeptical of WHO’s claims that this could eliminate smoking worldwide. After all, they’re wrong about this kind of thing a lot. Millions in worldwide taxpayer funds have been spent to promote tobacco control policies proven to be ineffective in lowering world tobacco consumption, such as plain packaging and a hostile approach to e-cigarettes. And these policies are already making things pretty tough for smokers.
So far, the researchers have modified a tobacco strain that normally contains 16 milligrams of nicotine per gram to merely hold 0.04 milligrams. That’s a whopping 99.7 percent reduction — significantly less than the 0.4 mg/g concentration, which was the lowest of any tobacco crop prior to the study. Study authors Dr Felix Stehle and Julia Schachtsiek argue that “nicotine‐free (or nicotine reduced) cigarettes may contribute to reduce the number of smokers and nicotine consumption, thus reducing the risk of death from tobacco use.”
This could be true, but it misses a crucial point. Nicotine itself, while addictive, is a relatively benign stimulant — no more harmful than caffeine. As Michael Russell, a pioneer of tobacco harm reduction and developer of nicotine gum, said in 1976: “People smoke for nicotine but they die from the tar.”
But for people already addicted to nicotine, that’s less than helpful. A lower nicotine or nicotine-free cigarette may be less likely to get a smoker hooked if they try one. It could also be useful in helping smokers gradually reduce nicotine intake if they practice some self-discipline. But if they simply can’t do that, then smokers are just going to smoke more cigarettes to maintain their level of dependency. In the meantime, they’ll be exposing themselves to even more carcinogens.
While WHO reports claim that smokers of low-nicotine tobacco won’t smoke more cigarettes to compensate, the evidence from clinical studies has been mixed.
In cooperation with the UN, governments might decide to force manufacturers to only produce low- or no-nicotine tobacco, as has been proposed by lobby groups like the Australian Medical Association. But a similar prohibition on alcohol failed, and no western government has attempted a total tobacco ban for the same reason: smokers will simply go to the black market for their fix if they can’t get it legally.
If smokers are forced to use low- or no-nicotine cigarettes instead of their preferred variety, then this amounts to an effective tobacco tax hike (consumers have to buy more cigarettes to get the same nicotine fix). These taxes are already regressive, since the poor are disproportionately more likely to smoke, struggle to quit and turn to cigarettes as relief from depression or stress. They also lose a greater chunk of their family budgets to their addictions than affluent individuals.
WHO’s endorsement of low- or no-nicotine cigarettes as a ‘harm reduction’ strategy is also at odds with its hostility to vaping. Unlike low nicotine cigarettes, vapes deliver nicotine without tobacco. Public Health England concludes that vapes are at least 95 percent less harmful than smoking, and actively recommends nicotine vaping to smokers trying to quit or improve their health.
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Fears of a “teenage vaping epidemic” have been debunked, as most teenage use is experimental and usually nicotine-free. Research instead shows that a vast majority of vapers are former smokers, and that an estimated 6 million Europeans alone had quit by transitioning to vaping by 2014. The city of San Francisco’s recent decision to ban vaping, then, is just a win for tobacco.
Smokers deserve the freedom to choose the quitting method best for them. Many quit cold-turkey, others quit with nicotine patches and gums, millions have used e-cigarettes and some will likely find low- or no-nicotine cigarettes useful, despite the potential for compensatory smoking. It’s why innovations in this space should be celebrated.
WHO’s current policy of embracing and potentially mandating low- or no-nicotine tobacco, while simultaneously opposing greater access to nicotine vapes for adult smokers, will only cause medical and economic damage. But while WHO plays around with regulation, over 7 million lives are claimed by tobacco-related causes each year. And if WHO keeps going down this path, it could very well just make things worse.
This article appeared in the Los Angeles Daily News on 8 July 2019.