The debate over prohibition often focuses on intentions, but the real question is whether restrictive policies achieve their public health goals. As governments around the world consider tighter controls on nicotine and tobacco products, evidence continues to raise important questions about the unintended consequences of prohibition, including the growth of illicit markets, the role of organized crime, lost tax revenue, and reduced access to lower-risk alternatives for adults who smoke.
Transcription:
00:04 - 00:11
[Brent Stafford]
So the strapline for this year's conference is prohibition in public health. Do they go together?
00:12 - 00:32
[Ondrej Koumal]
Well, I would say they go against each other, right? Prohibition on one side is not necessarily promoting public health. So I think that if you look at, for example, drug harm reduction, they have this U-curve, right? On one side, you have no regulation, and on the other side, they have prohibition. And both of them have the highest level of harm. You have to find the sweet spot that is somewhere in the middle.
00:33 - 00:35
[Brent Stafford]
And so that sweet spot then is not being found?
00:36 - 01:09
[Ondrej Koumal]
I think that sweet spot depends on a country, on a product, what product we're talking about, in which context. If we bring it to tobacco products or nicotine products, which is what this conference is about, then I would say that there is a certain... absence of logic or rationality in the debate where cigarettes are legal and available in every single country in the world, but actually the products that are far better are not or are being disputed, so that I think is absurd.
01:10 - 01:19
[Brent Stafford]
WHO, and this isn't really to get on their case, it's just to discuss what they say, and they say that nicotine should be eradicated.
01:20 - 02:06
[Ondrej Koumal]
Well, maybe it should, but it won't, because I think that, look, people have been using nicotine or tobacco products before Philip Morris, and even if they destroy the tobacco industry, as they say, I think that people will still be using nicotine and tobacco products. And these products are already here, right? They are here. And the only question I think for the governments or for the WHO is how they will be available. Who will make them available? Will they be distributed, made, sold by criminal gangs? Or will they be sold by companies that are regulated, employ people, pay taxes, etc. So I think that is a more appropriate question rather than whether nicotine will or can be eradicated.
02:06 - 02:24
[Brent Stafford]
Euromonitor International put out some stats that shows that the illicit evapor market globally is $47 billion US a year, and that represents 76% of all evapor sales. That's a massive amount.
02:24 - 03:03
[Ondrej Koumal]
That is, I have not seen that report, so I'm sorry, I cannot comment on it rather than be, just like you are, astonished. Sure, yeah, so if true, what do you think? The number is crazy. Well, clearly, it just again shows, I mean, part of the reason is that, of course, these products are available in countries where they are not legal, so that will definitely... constitute a big chunk of that amount so you have a million of vapors even in countries that have eradicated vaping de facto or technically you know on paper but not in reality and it just shows that I think that many countries are still looking for that sweet spot that we talked about right.
03:03 - 03:10
[Brent Stafford]
This year's conference's strap line is prohibition and public health. Do they go together?
03:11 - 04:40
[Andrew Manson]
No, they don't. I mean, regulation is largely a political process and regulators often look to quick solutions, not necessarily successful solutions. And I also find regulators don't look back at how successful their regulatory outcome is, and there's a reluctance to change and alter that. If a regulatory outcome is unsuccessful in terms of the overall effect, then regulators are very reluctant to say they were wrong, to admit they were wrong and to try an alternative approach. So is it hubris? I wouldn't say, I don't know if it's hubris, I think it is the reluctance of politicians to admit they're wrong. Because they are, in many countries, they are criticized for that and it comes back as a sound bite. So I think they like to try things. And I think to some extent we should be more forward in offering solutions, understanding problems early and offering solutions.
04:41 - 04:54
[Brent Stafford]
What about public health? Because their tool is an intervention. And so are they looking back at their interventions enough to see what's working and what doesn't?
04:54 - 05:27
[Andrew Manson]
I don't... I don't know about public health so much in that regard, but I think they should, certainly they should look back at their intervention. And I think some do, to be fair. But again, going back to regulators, I think in most countries the Ministry of Finance tends to be stronger than the Ministry of Health. And decisions are more made on fiscal reasons and political reasons.
05:27 - 05:48
[Brent Stafford]
Well, so what about the data that we've been hearing here this week that the illicit global evapour market is $47 billion U.S. And that represents 76% of the entire worldwide evapour market. Where's the ministries of finances looking at that?
05:49 - 06:40
[Andrew Manson]
That is a very good point because the fiscal loss is immense. And not only that, as was clearly experienced in the US 100 years ago, prohibition feeds organized crime. And organized crime nowadays is even worse than the mafia in the US because it funds people trafficking and terrorism and other things. So I think the Canadian government in legalizing cannabis bought fiscal revenue into Canada and also helped to suppress the illicit trade. And we should take sort of positive models of that and try to educate regulators and financiers around the world.