Data from the just ended 5th Summit on Tobacco Harm Reduction in Greece indicates that disparities exist to smoking trends in countries where smoking prevalence is low, with those from low income backgrounds constituting the biggest number of smokers.
Smoking rates in high human development index (HDI) countries are currently on a downward trend. In New Zealand for example, smoking rates have gone down to about 5% in high income people while in Maori Women, smoking rates are around 40%. This was said by Mrs Marewa Glover the Director of the Centre of Research Excellence: Indigenous Sovereignty & Smoking, New Zealand, while giving her Keynote address at the Summit.
“Smoking prevalence has diminished in New Zealand from 27% in 1992 to 18.4% in 2011-12 and then to 10.9% in 2020-21, one of the lowest in the world. Yet, smoking prevalence varies greatly according to income level, and it remains higher among the poorest and the most disadvantaged.
“This shows that interventions to reduce smoking must seek to reduce such inequities; it is particularly important that these inequities are eliminated before thinking about imposing criminalizing policies that could worsen socio-economic disparities,” said Mrs Glover.
In New Zealand people started switching to electronic cigarettes or vapes around the year 2011 and this trend soon spread. The New Zealand Vaping Regulation, which was passed in May 2020 and came into force in August 2021, signaled a shift from harm reduction focus to prohibition, from a focus on improving health to a morally based form of social engineering.
Speaking during a panel discussion on Smoking disparities within low smoking prevalence countries, Dr Peter Harper, a Harm Reduction Consultant to Philip Morris International (PMI) said in the UK, the proportion of current smokers continued to decrease for several decades from almost 50% in 1974 to 14.1% in 2020.
According to 2020 data, smoking prevalence is marginally higher among men (15.5%) vs. women (12.1%); it is highest among those between 25 to 34 years (18.3%); and it is highest in Scotland (16.0%) and lowest in Northern Ireland (13.2%). Current e-cigarette use in Great Britain was 3.8% daily and 2.6% occasionally in 2020; it has increased from the 3.7% in 2014, when reporting began.
“What we have got is a massive disparity of who is smoking across the world and how different techniques are trying to lower smoking rates have worked. In the United Kingdom, we are at about 14.1% which is really a very significant reduction from the mid-70s. The 14.1% smoking rate in the UK equates to 6.7 million and smoking is marginally higher among men at 15.5% (3.7 million) and 12.1% in women that is about (3.0 million.),” said Dr Harper.
Smoking in the United Kingdom in also highest among the 25- 34-year age group (18.3% 1.5million). Smoking Prevalence was also highest in Scotland in 2020 at 16.0% (658,000) whereas smoking prevalence was lowest in Northern Ireland in 2020 at 13.2% (181,000).
The least likely to smoke population groups in the United Kingdom are married adults and those in civil partnerships (9%) while the single and cohabiting are more likely to smoke (20%). Smoking prevalence by socio-economic status in the UK shows that those in managerial level are least likely to smoke (10%) while those in routine and manual labour are susceptible to smoking (25%).
Dr Rafael Castillo said in the Philippines, there was high smoking disparities and the poor groups of society and less educated constituted the largest number of smokers. According to the 2015 Global Adult Tobacco Survey (GATS), Dr. Castillo said, 7 in 10 Filipino smokers would like to quit tobacco, but only 4% of those who smoked in the past 12 months reported success in fully quitting the deadly habit. Although sin taxes seemed at first to be the answer to the problem, Dr. Castillo added that it soon appeared that despite the large amount of taxes collected by the government, this measure failed in achieving tobacco control.
Professor Hellen Redmond from the United States of America said, while the goal of the federal government is to stop people from smoking completely, it was almost impossible to do so without offering low-income people alternative options to get their nicotine.
“Most Harm reduction organisations in the United Sates are not pushing for safer nicotine products and embracing a philosophy of tobacco harm reduction. Those are all obstacles to working with vulnerable population. It seems that the USA government doesn’t care if people from vulnerable populations die from smoking-related diseases and added that they have a long history of not caring about diseases that afflict the most disadvantaged (e.g., AIDS), the most recent example being the COVID-19 pandemic. We have to confront the reality that the most vulnerable people do not count for the government, the speaker said and raised the question as to how to make the government care,” said Professor Redmond.
Meanwhile, Dr Solomon Rataemane from South Africa said the situation in South Africa was almost the same to those in other Sub-Saharan African countries.
“The country has the so called “Drug Master Plan”, which for the past 15 years focused on alcohol and hard drugs; only the past 5-8 years did it bring in tobacco. The concept of harm reduction has been an issue, as many people consider that it means that smokers should be assisted to continue their habit.”
Prof. Rataemane also presented the Global Adult Tobacco Survey (GATS) study, conducted in 2021, which looked at adult tobacco use and examined the existence and effectiveness of numerous measures such as monitoring of tobacco use and prevention policies, protecting people from tobacco smoke, offering help to quit tobacco use, warning about dangers of tobacco, enforcing bans on tobacco advertising, promotion and sponsorship, and raising taxes on tobacco. The study had a robust methodology and it included information on respondents’ background characteristics, with a total of 7245 households surveyed, and a total of 6311 interviews completed (overall response rate of 91.5%).
