The fight against smokingone of the historical pillars of the World Health Organization (WHO), is going through a moment of review after decades of policies based on restriction and prevention. Although these strategies have managed to reduce consumption in many countries, progress has slowed in recent years and there is still a large smoking population.
In this sense, three eminences linked to the WHO, Robert Beaglehole, Ruth Bonita and Tikki Pang, have made self-criticism and have proposed a change of approach in the anti-smoking strategy in order to accelerate the decline in smoking on a global scale, through an article recently published in ‘Nature Health’.
Tobacco control stagnation
The diagnosis is based on a context of slowdown in the application of the Framework Convention on Tobacco Control (FCTC) and a loss of political momentum in various regions. Something that compromises the effectiveness of traditional strategies based on the prevention, regulation and taxation of conventional cigarettes.
Faced with this stagnation, the study introduces the explicit incorporation of harm reduction through access to non-burning nicotine productssuch as heated tobacco, electronic cigarettes or nicotine pouches. That is, alternatives classified as a “historic opportunity”, which could play a relevant role in reducing smoking if they are integrated within an appropriate regulatory framework.
Thus, the objective they propose is to reduce the daily prevalence of adult smokers to below 5% in 2040. To achieve this, they advocate combining traditional policies with greater availability of regulated alternative products, always under health supervision.
Regulation and protection of minors
One of the central aspects of the article is the compatibility between this approach and the protection of minors. The authors maintain that the experience of countries such as New Zealand, Sweden, Japan and the United States shows that it is possible make progress in reducing smoking in adults completely removing youth consumption, as long as there are strict controls and effective preventive policies.
In these cases, the regulation of non-combustion products has been accompanied by specific regulatory frameworks and access control mechanisms, especially aimed at preventing their use among adolescents.
The debate in Spain
However, in Spain this debate comes late and without clear regulation, in a context in which the difficulties in controlling the sale and access of minors have been one of the main problems for years and have slowed any progress.
Thus, the recent approval of a Non-Law Proposition (NLP) in Congress can be read as a first political step to address this regulation, opening the door to a more orderly approach that allows protecting minors and offering more effective responses to adult smokers.
The risk of unbalanced regulation
The article also warns of the consequences of unbalanced regulation. According to the authors, imposing greater restrictions on less harmful alternatives to the cigarette itself can be counterproductive, by limiting access to lower risk substitutes.
Therefore, they demand a model based on the principle of regulatory proportionality, in which taxation, regulations and public communication adjust to the level of risk of each product. All of this, without giving up the protection of minors, considered an essential priority of any public health policy.