Is nicotine really the substance that causes smoking-related disease? Or has decades of misinformation blurred the line between nicotine and smoke? Dr Mohamadi Sarkar discusses one of the most misunderstood topics in tobacco control: the difference between the risks of combustible cigarettes and smoke-free nicotine products.
Transcription:
00:00 - 02:44
[SPEAKER_01]
The fundamental problem is that many in tobacco control believe that people who use tobacco products should quit all tobacco products. And there's this disconnect that within the spectrum of tobacco products, there are some products, like cigarettes, that are most risky. And then you have other products. We kind of depict it as a risk cliff. On top of the cliff is the most risky product, and then you have lower risk. I mean, look, that goes back to the fundamental principle of harm reduction, that moving people away from minimizing the risk from some behaviors that they're causing, not abstinence only. And many in tobacco control would like to see complete abstinence from all tobacco products, including safer nicotine products. You may be familiar with the famous quote from Michael Russell in 1976. He said something which was so pointed that, smokers smoke for nicotine but die from the tar. And I think somewhere along the line, public health, the ones in tobacco control have lost sight of that. If we can get people off combustible cigarettes, get them off these thousands of chemicals that they're inhaling. Cigarette smoke has got 7,000 chemicals, 70 of which are carcinogens. Imagine they're inhaling this every day, 10, 20 times a day for decades. If we can get them to drop that and move to safer forms of nicotine, that can make a real meaningful impact in the lives of these individuals. Because there are some people who want to just continue to use nicotine. They're just unable or unwilling to quit. And is it quit or die? Or is it giving them options that are less harmful? And that's why I think it's important that we recognize that in order for them to make the switch, We'll have to give them a range of products, inhalable, heated tobacco products, e-vapor, nicotine-positive, because one size does not fit all. And you have to give them the option to find the product that meets their needs. When we do our studies, for example, with the nicotine pouches, we have a range of nicotine flavors. and when they start to study they usually kind of experiment with different nicotine levels, different nicotine levels and flavors and eventually very quickly they find a product that meets their needs and then they kind of gravitate towards that.
02:45 - 02:51
[SPEAKER_00]
So final question, if you could change anything about the regulatory environment what would that be?
02:52 - 04:02
[SPEAKER_01]
If I had the empowerment to make that decision I would say that you know we need a clear understanding of what are the requirements what are the scientific studies that would be needed to demonstrate the APPH construct and we really need FTA to take a hard look and make quick decisions and to be clear on science and evidence but make quick decisions and a lot more decisions that we have a open range of products for consumers to choose from and do them within the 180 days that's required in the Tobacco Control Act framework. And another thing that I would do is make sure that, you know, adults are well informed about the differential risk of products, about the, you know, that nicotine does not cause the harm that's a misperception they have. So correcting the misperceptions and making available a range of FDA regulated products would really make a meaningful impact on individual consumers, on public health, and it's good for everybody.