Philip Morris South Africa's Managing Director Hugo Marcelo Nico, speaks about harm reduction in Africa Reporters Workshop held in South Africa

Photo: PMI
Interview with Hugo Marcelo Nico, General Manager PMI Southern Africa, 14 august 2018, Johannesburg, Sandton by Tinomuda Chakanyuka (Zimbabwe) and Placide Muhigana (Senegal). Africa Reporters Workshop on Harm Reduction
28 August 2018
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interview

To what extent is the proposed South African Draft Control of Tobacco Products and Electronic Delivery Systems Bill, 2018 accommodating or acknowledging harm reduction as a policy? If not, what about the Bill could be changed specifically in this area?

The current proposed Bill does not acknowledge harm reduction. I think there's space to really differentiate combustible products versus smokeless alternatives. In the current form, the draft considers all nicotine products the same way and that's what we are encouraging government to do is to review this classification and mainly differentiate cigarettes or burning tobacco that is the most dangerous way of consuming nicotine versus smokeless products like e-cigarette, snus or IQOS - heat not burn products - that have scientifically proven to have the potential to reduce  the harm, in that sense the current bill doesn't contemplate it and we are encouraging the SA government to look into it.

Are you saying that alternative products have to be taken out completely of that bill?

There are different ways, one is to make a clear distinction in the law, to differentiate the products or allow the minister to do so, in the current regulation, there's an exemption clause where the minister of health has the potential to exempt certain products from certain regulations.

The most important for me in the regulation to split combustible products, cigarettes versus smokeless products and alternatives so that they can be regulated in different ways.

Of course the regulation needs to stop people from start using and encourage smokers to completely stop. But as well is to contemplate that there are today alternatives in the market that are better choices if you are going to continue to consume nicotine and encourage the smokers who want to continue to smoke to switch to this better alternatives.

Let's talk about those safer alternatives that are being marketed, there seems to be discord amongst scientists and researchers on evidence that actually backs these safer alternatives, has there any research been done, extensive research to back these - should I call them claims - that there are safer alternative may be you could share with us some of the insights.

Absolutely! The first think to say is that this smokeless products are not risk free, but it is a significant reduction of the exposure to harmful constituents compared to smoking.

The best option for a smoker is to completely stop smoking. Having said that there's solid base of science behind those products. If I refer specifically to IQOS which is the heat not burn product of Philip Morris, there's 10 year of research, the research is publicly available. There's more than 200 public publications of the scientific community reviewing our findings. And we have the dossier submitted already to the Food and Drugs Administration in the US.

That dossier alone is more 2 million pages long of science and substantiation, there's a big body of evidence and probably the products that have been analyzed on different markets across Europe as well.

The majority of the scientific evidence all point out to the reduction of risk, so there is a solid body of evidence behind the heated tobacco products as IQOS but also from Public Health England for example on e-cigarettes.

Speaking of your product IQOS, you introduced it here in South Africa, is it a pilot market, are you likely going to roll it out into other markets in Africa?

Well, South Africa is the first market where we introduced IQOS, it has been introduced last year.

It is having a good success with the smokers. And the objective is to continue to roll out reduced risk products to the rest of the continent as well. Not only IQOS, we have different products on our portfolio - reduced risk products - and gradually we will be introducing them into other markets of Africa.

Because ultimately our goal is that all the smokers have the opportunity to access the smokeless products and that one day cigarette will become irrelevant and that there will not be smokers and that they will all switch.

That is our ambition as an organization, we want to play our role in transforming the industry.

The message that those alternative products are a lesser risk for consumers doesn't sink in people's mind, people don't agree with that, what could be done by manufacturers, the distributors or even the press in order for people to admit with this evidence?

Let's talk about South Africa, there are 7 million smokers for example and only 30% of those smokers believe that there alternatives that are potentially less harmful but the vast majority of them think that those products are as harmful and there is 20 % that believe they are more harmful. There's long way in terms of education that we need to do with the smokers.

It's a role of the industry but not only, I think that the media community can play a fundamental role and government can play a fundamental role, the scientific community, the physicians can play a role. If we talk about harm reduction in tobacco everyone needs to be contributing in playing the role of giving accurate scientifically based information to the smokers so that they can actually evaluate what alternatives they have and choose what is better for them.

This whole campaign around harm reduction points to the extinction of the combustible cigarette if I got you right, now against this back ground what is the future of cigarette manufacturing companies and also countries whose economies are anchored on tobacco farming in the wake of this campaign, if it is to be embraced in its totality.

More than a campaign this is our vision for our organization, this is something we are driving as an organization it doesn't have an end, this is the direction we set for our company that we are going to pursue. About the tobacco growing countries, two of our reduced risk products IQOS and TEEPS are using real tobacco, what IQOS does is it heats tobacco instead of burning it, it heats the tobacco to 300 degrees and creates an aerosol containing the nicotine, the flavor and the enjoyment the smokers is looking for but it's leaving behind the 90 to 95% of the dangerous constituents that otherwise come out of the smoke of the combustion of the cigarette.

We are using real tobacco so there is still a need for tobacco in the heat stick we use in IQOS there's tobacco coming from Africa, there is still a future. Clearly we are working as well on our supply chain with tobacco growers across Africa to help them to diversify crops as an option as well to find alternatives, we have food crops programs and we have educational programs for the tobacco growing communities. There's a big range of initiatives that we are doing together with the tobacco growing industry to look if there would be a reduction of total need of actual tobacco, what other farming would be an alternative for this farmers. There will still be a need for tobacco because in our products there's actual tobacco.

In the case of a reduction that could happen in the future what are the alternatives and that is discussion that we are currently having with our suppliers and with the farmers, initiatives we have started a few years back.

In terms of the future of the tobacco industry, we as PMI - we are the most successful company in the world, we have the most successful brand that is Marlboro - we foresee the end of combustible cigarettes one day but not the end of our company, our company is transforming with science and technology into a company that can offer a better alternative, a better life for the former smokers, we see the future of our organization through this smoke free vision.

You have your footprint here in Africa, have you perhaps considered some of the smoke free traditional tobacco products in Africa that really speak to the tradition of locals such as snuff, have you considered that ?

Absolutely, I think that if we want to bring a smoke free environment to every single smoker, we need to consider as well smokeless products that don't require electronics, we have a version that is called TEEPS that heats tobacco using charcoal for example, it is similar to a cigarette stick but you have a charcoal that heats tobacco instead of burning it. Snus is an alternative tobacco for the oral use, snuff as well there's a big market not only in South Africa but in Congo and in many other African countries as an alternative to the combustion.

The biggest problem is on the combustion, when you burn tobacco you have the majority of the 4000 chemicals of which about 60 to 100 are recognized as dangerous, if you eliminate combustion you are able already to bring harm reduction. Alternatives like you are referring as snuff and snus already exist in Africa.

There's the issue of affordability of those new products for Africans, what are you doing in that field to solve this issue of the price of those devices?

We need to look at the portfolio, that's what we were referring to before, electronics clearly go down in price over time that makes them more affordable, but to have alternative that don't use electronics, the TEEPS using charcoal at the end or snus, snuff, there are more affordable alternatives to cater for every smokers because even in South Africa where we are placed, an IQOS can be a product for 2 million smokers but there is another 5 million what is the product for them?

That's why we are developing a range all portfolio of alternatives of cater different tastes, different affordability and different rituals as well.

What would be the role of harm reduction in tobacco control policies according to you?

I think it's a complement to all the efforts aiming to stop the use of cigarettes, regulation is to continue to dissuade people to start smoking and encourage smokers to stop smoking, and we need to complement that with these smokeless alternatives. And harm reduction comes there, when you are able to tell to a smoker the best thing you can do is to stop. But if this person tried 5 times to stop or is not willing to stop the use of nicotine then there's a range of products that are not risk free but are significantly better than to continue to smoke.

I think today those products are available, today the products are in the market, the main obstacle we have today is that the smokers just don't know that's why it is fundamental that we provide accurate factual, science based to the smokers so that they make informed decisions.

Lastly about tobacco producing countries what is being done to sell the smoke free message and make it palatable to these countries because obviously there's resistance in these countries out of fear that their earnings may be depleted, what is being done to educate governments on this ?

I think as I mentioned one fundamental activity is to work together with these countries to find alternatives to tobacco growing, how we can complement tobacco growing with other crops and as I mentioned there are already programs in place, that we sponsor as PMI in the countries where we acquire tobacco to encourage the farmers to educate the next generation, to keep kids out of the fields put them into the schools, so we have a school program,  to create alternative crops to have a portion of land dedicated to be able to supply us with tobacco.

This kind of initiatives that the industry can do together with a government can show alternatives building in the medium and long terms, we are talking about several years  from now but we need to be preparing to that and the same discussion is to be done with governments. As I mentioned as well our products contain tobacco, there will still be demand. And in case of a reduction of the demand, we need to be prepared for alternatives.

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