Hello and welcome to GFN News on GFN TV. I'm your host, Joanna Junak. This news, we find out what's happening in Denmark and Sweden to European countries with plans to ban nicotine and vaping products. In the United States, drug policy reform organizations are arguing the government not to move forward with a proposed ban of mendel cigarettes. And after the news, Brent Stafford of RegWatch interviewed Chimwemwe Ngoma, a leading tobacco harm reduction advocate from Malawi. Last month, the Danish authorities proposed a ban on cells of cigarettes to people born after 2010. This move could prevent the next generation of Danes from ever using any form of tobacco, said Health Minister Magnus Honika, adding that smoking is the country's leading cause of cancer. But now, due to European Union rules, it seems unlikely that the Danish plants will proceed in their current form. The Ministry of Health said that the ban on sales of nicotine or tobacco products to people born after 2010, which required changes to the European Union tobacco products directive. GFN News will keep you updated as this story develops. Meanwhile, the Swedish government is introducing a bill to prohibit flavored illiquids. The proposed law includes nicotine and nonnicotine eliquid and regulates all synthetic nicotine products. If the law is passed, the set of flavorbased products will be illegal from January 1, 2023. The bill, titled Stricter Rules for New Nicotine Products, is currently being reviewed by the Council of Legislation. We asked Stephan Matissan, journalist, editorinchief of Vape Colon and a proponent of tobacco harm reduction in Sweden. A few questions, Stefan. Why does the government want to ban fake flavors?
Stefan: Well, the main reason with all the flavor balance that we're seeing around the world right now is to protect kids from becoming addicted to nicotine. Basically. That is the rationale of this flavor ban. First and foremost, it's not about health, really. They particularly stated that vaping is really not that risky. When you look at the data, the only thing that's risky with vaping is the nicotine addiction. And that is why they want to ban almost all flavors. They have an exception, which is the cryptic flavor flavoring that we call tobacco flavorings. That supposed to be allowed. So that's where we're at, basically.
Joanna: Is vaping such a problem in Sweden?
Stefan: I think if you're going to answer that question, and if you look at it from two sides, prevalence of youth vaping here in Sweden is very low. If you look at regular use once a day, once a week kind of use, it's below 1% of the youth population. But when you look at young people who have ever tried a vape, obviously a lot higher, it's around 40%, something like that, and it's slowly going down, going down. So according to the government, this is a problem. They want to stop this development of youth trying ecigarettes. But if you look at it from a more objective perspective, the problem is not really that big smoking prevalence is around 6%, about when it comes to daily use among youth. And I think the prevalence of smoking one month and stuff like that is around. So no, it's not a big problem, but the government sees that way, of course.
Joanna: And what would be the consequences for vapors if the bill comes into forest?
Stefan: The consequences for vapors, it's hard to tell, of course, but according to the government's own investigation, more vapors will go back to smoking cigarettes, of course, and some vapors will quit completely. But there are no numbers of this, no one knows. So the consequence for users is that they will not have access to the flavors in the e-cigarettes that actually keeps them off smoking. And what that means in practice is impossible to say. We can look at studies from other countries and we know that basically smoking will go up again. And that's the deal. We are about somewhere between 100,200 thousand papers in Sweden and a third of us are daily vapors, which is kind of a measurement of how many are actually vaping, only not smoking as well. So the consequence, well, who knows? People will go back to cigarettes. I think that that is the bottom line of this. And I think the most the thing about a slave, about like this and all flavor bands is that they completely ignore that this is a problem. They think it's worth it. They say so in this proposition in Sweden as well. They know that people will go back to smoking, vapors will go back to smoking. They know that less smokers will try vaping or transition to vaping, but they simply don't care because of the risk as they see it. Young people trying Ecigarettes and being risking addiction, which they don't even mention addiction sometimes young people shouldn't use Ecigarettes, it's a bad habit. So that is the bottom line for us. Many more vapors will not be vapors anymore. We turn back to smoking, but it doesn't matter to the government. It's not important.
Joanna: Thank you Stefan. And now to discuss opposition to the proposed mental cigarette ban in the United States, let's cross over to Will Godfrey from Filter magazine. Hi Will.
Will: Hi Joanna.
Joanna: When was this bank proposed and why is it controversial?
Will: The FDA first announced this plan about a year ago and just recently its new commissioner confirmed that it will move forward with specific proposed rules to be published later this month. The plan has divided groups that are normally allies. We've seen some support for it from within the THR community, for example, as well as opposition. Proponents say it would improve public health and that only sellers, not smokers, would be targeted by enforcement. But many of us in the drug policy space point out that prohibition never ends use and always creates additional harms. As we've seen time and time again in the war on drugs. Very significantly, mentals are preferred by a large majority of black smokers in the US. When something is banned, illicit markets inevitably develop in the communities that use it, with lines blurring the desert and supplier. So why target this population that has already borne the brand of criminalization over drugs? We'd all like to see smoking replaced by safer alternatives, but why resort to criminalization for this one category of cigarette when harm reduction alternatives, including mentholflavored vapes, could and should be promoted?
Joanna: What form has the latest opposition taken?
Will: A coalition of organizations sent a recent letter to the FDA and top officials making some of these very points. Policies that amount to prohibition have serious racial justice implications, they wrote. It will lead to illegal unlicensed distribution in communities of color, trigger criminal laws in all 50 states, increase negative interactions with police, and ultimately increase incarceration rates. The breadth and diversity of this coalition is notable. It includes leftleaning organizations like the Drug Policy Alliance and Students for Sensible Drug Policy, rightleaning groups like the REEDOn Foundation and R Street Urban Survivors Union, the National Drug User Union, and police reform groups like the Law Enforcement Action Partnership and National Association of Black Law Enforcement Officers, among many. More. Systemic racism has indeed left communities of color behind in health care, in the economy, and in the criminal justice system, they write. But prohibition is not the answer. Harm reduction is what happens now. The process is moving forward, but enactment, if it happens, could still be years away. And with significant opposition mobilizing, the debate will only get more intense. The situation around the regulation of harm reduction products could have a significant bearing too.
Joanna: Thank you. We'll see you next time.
Will: Thanks Joanna.
Joanna: And now we go over to Brent Stafford and his guest Chimwemwe Ngoma, leading tobacco harm reduction advocate from Malawi. Chim has led the Tobacco Harm Reduction Malawi project since 2018. He also works on KAC tobacco harm reduction scholarship program. In today's news, Tim will share his thoughts on the smoking problem in Africa and why adoption rate of tobacco harm reduction is so slow in many African countries. Over to your Brent.
BRENT: Hi, I'm Brent Stafford, and welcome to another segment of RegWatch on GFN.TV. Often regions in the world that could benefit greatly from tobacco harm reduction are the very places where THR policies struggle to take hold. And one of those places is more than a region, it’s the continent of Africa. Joining us today to talk through the challenges is one of the leading THR advocates in Africa, Chim Ngoma, assistant program manager at Knowledge-Action-Change. Chim, thanks for coming on the show.
BRENT - PT1: Now the African continent is obviously diverse as it is large. What can you tell us about smoking in Africa?
CHIM - PT1: All right. So maybe let me just try to give a brief introduction about the tobacco leaf, the history of tobacco leaf in Africa. There is a long history of tobacco leaf in Africa, and it is in some societies deeply entrenched. And to the extent that they are sometimes used for traditional purposes, such as gifts during traditional ceremonies and installation ceremonies. In addition to that, the tobacco leaf is sometimes used for medicinal purposes in some societies where it is used for dressing of wounds and as anaesthetic for toothache. And moving on to smoking. The problem is really big in Africa and the W.H.O. attest to this. It's this that smoking rates are on the decline in many parts of the world. Smoking rates in Africa are on the rise, and it is projected that by 2025, smoking rates in Africa will have increased to 51 million.
BRENT - PT1: Wow. So why is it on the rise in Africa?
CHIM - PT1: All right. So the W.H.O. attributes this increase to the increase in population. But it should also be noted that whereas the rest of the world is adopting tobacco Harm Reduction products, for example, in the U.K., they have embraced electronic cigarettes. In Sweden, they have embraced snus. In Japan, they have embraced hidden open products. In Africa. The adoption rate of tobacco Harm Reduction is slow.
BRENT - PT1: So give us an understanding about smoking in terms of the differences between men and women.
CHIM - PT1: All right. So in Africa. Smoking is predominantly a male habit. And there are white differences between I mean, white differences in smoking rates between men and women. For example, in Lesotho, the smoking rates in men is about 52%, as compared to less than 1% of women. And this is true and applies in many other African countries.
BRENT: Chim, Let's take a moment to talk a bit about your background. Fill us in on how you came to tobacco harm reduction.
CHIM - PT1: All right. Thank you, Brent. Thank you. Bring back in 2018. I used to work for a local NGO in Malawi on drugs and substance abuse, and I also worked as a citizen journalist where I used to write stories on various social issues happening around me and in my community for publication in the national platforms. But by this time, I had limited understanding of tobacco harm reduction and on effective research and how to help smokers quit smoking. But after carefully analysing the concept of tobacco, harm reduction and content around it, and further relating to tobacco Harm Reduction to other fields where harm reduction is practiced, I came to a personal conclusion that total harm reduction is the most practical and effective solution for ending smoking in Africa. So from that time, I made a decision to advocate actively for tobacco harm reduction so that my friends, relatives and everyone who is a smoker can get to know about tobacco Harm Reduction and make informed decisions regarding their health and escape and grieve as a result of smoking.
BRENT - PT1: Were you a smoker yourself?
CHIM - PT1: No. Of course I have experimented with cigarettes and vaping products.
BRENT - PT1: So yes, you don't always need to have been a smoker or to have seen the value of tobacco harm reduction as a policy and to get out there and advocate for it. So let me let's move to vaping as a topic because of course we talk about that endlessly here on RegWatch. Is vaping popular in Africa?
CHIM - PT1: All right. So Vaping is not that popular in many African countries, and tobacco Harm Reduction in general is a newly formed concept and a lot of people do not really know about the concept of tobacco Harm Reduction and vaping products. Of course, I know of other countries like South Africa where a lot of people, a lot of smokers are taking up vaping instead of smoking.
BRENT - PT1: So has Vaping made an impact when it comes to Africans quitting smoking?
CHIM - PT1: At the moment, I would say that countries like South Africa, where vaping products are available at a better price and they are accessible by smokers, smokers, some smokers are able to switch to these safer means of consuming nicotine. So I would say that for countries like South Africa, vaping is making a difference. But in other countries like Malawi, where nicotine products, like vaping products are limited in supply or they are ridiculously priced, I think it is yet to make a meaningful impact.
BRENT - PT1: Now is tobacco harm reduction a well-known concept?
CHIM - PT1: Right. So Harm Reduction, like I mentioned earlier, it is not a very well-known concept in many African countries and I know of so many countries in Africa that do not have specific laws regarding the sale and use of CFA nicotine products. And that means that tobacco Harm Reduction is not a widely known concept. But with the growing data advocacy voice in Africa, I believe that smokers and authorities will get to know about Harm Reduction so that they can make them accessible and available for consumers to adopt them and switch to the lifesaving technologies.
BRENT - PT1: Well, you know, I mean, it's actually as a concept that's been around, you know, originating in the West and there's many places that still can't get their head around. Overall harm reduction and then when it comes to FR, it's even harder for them. They just think that people who smoke should just quit.
CHIM - PT1: Yeah, that's true. And what Africa has as a problem at the moment is that it is sitting at the receiving end of almost everything, including information on vaping products and tobacco harm reduction in general. So yes, we are lagging behind on that and our friends in the western part of the world are the ones on the forefront in the adoption of technologies like electronic cigarettes.
BRENT - PT1: Now we've been told that our policies has had some real success in some regions of Africa. Do you think that's the case and how so?
CHIM - PT1: All right. So. Um, I don't really think that's the case because [00:09:30] we have some problems here in Africa when it comes to the adoption of these safe nicotine products. And when polices are formulated on certain nicotine products, I think they are formulated in a way that they are prohibitory to those who are who are low earning smokers. For example, in Kenya, they have a law on electronic cigarettes. And in short, I would say that electronic cigarettes in Kenya are taxed and the taxpayer electronic cigarette devices are about $30 and pay cartridges are about $25, which is against the average monthly income of a smoker living in Kenya, which is about $125. And similarly in South Africa, we are seeing, again, heavy tax measures on
the same. But. I would say that these such kind of measures are prohibitory for smokers who are on low incomes. So I think that. Um, Harm Reduction and Vaping is facing a lot of resistance in Africa. The adoption of these products are facing some resistance, but when it comes to some success, I would say that some countries like South Africa, like you have said, they have not rushed into banning several nicotine products like vaping, like other countries in Africa have done, like Uganda, Mauritius, Gambia. So I think this is some kind of a success story when it comes to not rushing into banning of certain nicotine products like vaping, because at least in South Africa, the product is being regulated rather than being banned. So yes, it could be considered as a success story.
BRENT - PT1: But as you say, though, it's clear that there is a war on Vaping in many countries in Africa.
CHIM - PT1: Yes, that's true. And this is mainly because there is some misinformation and disinformation going around by Bloomberg funded organizations like the Campaign For Tobacco-Free Kids. And there are other beneficiaries who are propelling misinformation and disinformation that siphon nicotine products like vaping products as harmful as combustible cigarettes, thereby pushing for their banning. And like I said, there are other countries in Africa that have banned these CFR nicotine products without following proper procedure. So I think countries like South Africa, which undertook a socio economic impact assessment before coming up with the decision, is something that is commendable and the rest of the continent that the rest of the countries on the continent should emulate.
BRENT - PT1: Now, Bloomberg is obviously somebody that we'll talk about in just a little bit more depth in just a moment. But before we do that, besides obviously the incessant war on Vaping, you had mentioned that affordability was an issue. What are the biggest obstacles to adopting Vaping and I know say for nicotine products in general, it's important to bring that up because there are other products besides vaping products.
CHIM - PT1: So the adoption and implementation of tobacco, Harm Reduction and Vaping in this case is facing a lot of obstacles here in Africa. And one of the obstacles revolves around the availability, accessibility and affordability of these vaping products where these vaping products are available. They are priced so highly that an average income earning smoker cannot really afford. Secondly, there is misinformation going around on vaping. You remember about the Evali outbreak in the USA? Africa received a lot of misinformation and disinformation about Evali and vaping and we saw some codas starting to call for an outright ban of vaping products because of the misinformation they got about the Evali from the media, because the media mainly framed news on the Evali with alarming and fear trends. So these are some of the obstacles facing the adoption of safer nicotine products in Africa. On top of that, there are other smokers who live in rural areas and off the electrical grid. This means that these smokers cannot necessarily maintain and sustain their use of electronic cigarettes because they require constant recharging and stuff like that.
BRENT - PT1: Yeah. One should never forget. Certainly. I'm well aware that I need to be, like, within five feet of a plug in anywhere I go or a very strong battery. And that's to keep my use of vaping products going without power, you know, forget it.
CHIM - PT1: Yeah. True. And what these smokers who live in rural areas [00:15:00] and off the electrical grid are safe and nicotine products that may be of low tech. I know smokers, every smoker is different, is unique. What works for one might not work for the other, but it would make sense for smokers living off the electrical grid in Malawi and the rest of the African continent to have access to these low, safe and I mean low tech nicotine products so that at least they can have a choice.
BRENT - PT1: Yeah. Choice is what's key. I mean, we fight. We're fighting for that here in North America all the time. It's the same thing. Access and choice of products. What about flavour bans? I mean, is that kicked around much?
CHIM - PT1: Not at the moment because what we are struggling with at the moment is the cause on banning of electronic cigarettes in general, not a flavour ban. So we haven't made such kind of a resistance as of yet.
BRENT - PT1: Well, yeah. I mean, they're just going straight for the banning now. You were talking about Bloomberg. One of the biggest organizations that he funds and works with is called the Union. They don't get a lot of press campaign for tobacco free kids. You know, a lot of people know what that group is. But the union, they're the former worldwide tuberculosis society and they're based out of France. And their strong push is that they're kind of the regulatory shop that's a part of Bloomberg's entire process. And so we're showing some pictures from the union right now. We've covered the union to some extent. Now they've got pre-packaged off the shelf regulations that they force on LMICs low and middle income countries, many of those obviously in Africa. Are you familiar with the union and have they've been pushing this kind of ban band ban regulation onto countries in Africa?
CHIM - PT1: Yes, I'm familiar with the union and what they are doing. And at the moment, I believe that there is something that is being done by the Union on Africa. What the Bloomberg is basically doing is imposing Western tobacco control measures on Africa, which are not only expensive but complex to implement for any resources, trade, economy or government in Africa. Additionally, I think what the Bloomberg is doing is basically propelling its ideologies and beliefs instead of pushing for science and evidence.
BRENT: So then Chim is Bloomberg and what they're doing, do you see them presenting as the biggest obstacle for safer nicotine products in Africa?
CHIM - PT2: Yes. I think that's one of the obstacles, because what basically the Bloomberg is doing is initiating or pushing Africa into a war against nicotine instead of waging the war against smoking. So here I think we are hitting the wrong target.
BRENT - PT2: Now, is it fair to say that those people pushing these policies, the Bloomberg's the union cetera? Are they taking advantage of governments in Africa for some way, in some reason?
CHIM - PT2: I think that would be true because a lot of governments in Africa don't have enough resources. So basically they we our governments look up to what they say is what the Bloomberg says, because they get some funding from there. So basically, instead of the governments making their own decisions, making their own socioeconomic impact assessments and making science based policies, they try to please the Bloomberg and the W.H.O. and everyone who gives them a little of funding.
BRENT - PT2: And I guess that's what kind of kind of does make it a bit colonial in a certain way. So, I mean, what about the authorities then in Africa themselves? As you're saying, they're kind of just signing, I guess, with Bloomberg's people and they're not embracing. So you have public health and you've got government. Is there anybody on your side?
CHIM - PT2: All right. So the public health or the governments do, to be specific, here in Malawi It is very difficult for them to meet the basic requirements for a good health care system, such that when you go to our public health care institutions, for example, here in Malawi, you go to a public hospital, you barely find cell phone nicotine products, including the nicotine replacement therapies. So basically, there is some sort of neglect due to underfunding in many of these governments in Africa. But I've seen that, for example, in Malawi there is some sort of willingness to embrace tobacco Harm Reduction the authorities that we have involved or engaged here in Malawi have been receptive of the concept of tobacco harm reduction. But of course we haven't really seen most of them or most of the governments in Africa are openly talking about or sharing the health benefits of tobacco harm reduction. They are silent on that.
BRENT - PT2: Chim, I know you'll be hosting one of the keynote presentations at the Global Forum on Nicotine. The conference is in Warsaw, Poland, this June 16th to 18th. Why is a conference like GFN22 important for advocacy?
CHIM - PT2: In the world of advocacy, there is a common phrase that goes. Nothing about us without us. And the Global Forum on Nicotine attracts a wide range of participants ranging from academicians, lawmakers, scientists, innovators and many others coming together to discuss nicotine. And I think it is I mean, the GFN is one of those platforms where consumer voices and views are supposed to be heard and taken into consideration before anyone implements or comes up with any initiative that would, in turn affect the consumer.
Joanna: Thank you, Brent and Chim, for an interesting discussion. We look forward to seeing you both in Walter this summer. That's all for today. Thanks for watching and see you next time. For more tobacco harm reduction updates and brands for coming interview with Sutpatwadan, a UK licensed medical doctor of Indian origin who is passionate about helping people quit risky forms of tobacco. Goodbye for now.