The FCTC dilemma on heated tobacco products

Abstract

Background In October 2018, the Conference of the Parties of the Framework Convention on Tobacco Control (FCTC or Convention) adopted its first decision on novel and emerging tobacco products, including heated tobacco products (HTPs). The decision remains ambiguous, e.g. by making a distinction between tobacco sticks and HTP devices. Against this background, the article seeks to answer two interrelated questions: whether and to what extent HTPs are covered by the FCTC, and whether regime provided by the Convention is suitable for their regulation. Results HTPs need to be classified under the FCTC as tobacco products. The distinction made by the Conference of the Parties between sticks and devices leads however to unsatisfactory results as it creates loopholes in tobacco control standards existing at the international level. A better approach, as argued in this article, is to conceptualize the notion of ‘tobacco products’ in functional terms as a combination of both a device and stick. While subjecting HTPs to all FCTC disciplines is, in light of our current scientific knowledge, a rational approach, such classification can be modified in the future once a sufficient amount of new evidence on their risk profile is collected. Any decision on the optimal regulatory model for HTPs will need to take into account not only health risks and potential benefits for individual users, but also the specific systemic concerns (e.g. HTPs as a gateway product). The state of scientific research is however not the only factor that will determine the fate of HTPs under the Convention. What is equally important is a conceptualization of the FCTC’s objectives. If a complete eradication of the tobacco epidemic is the ultimate goal, reduced levels of risk may not be enough to justify the different (i.e. more lenient) regulatory regime for HTPs. Conclusions The Conference of the Parties should clarify the definition of tobacco products in light of recent changes in the market. When designing the regulatory regime for HTPs under the FCTC in the future, one has to consider not only scientific evidence but also pay attention to the objective of the Convention (or more generally to the values that underlie the current tobacco control paradigm).

The commercial promotion of electronic cigarettes on social media and its influence on positive perceptions of vaping and vaping behaviours in Anglophone countries: A scoping review

“…Consequently, it is crucial to mention the demand for additional regulation of user-generated content on social media, driven by tobacco control considerations. Considering that unambiguous definitions of tobacco-related products are urgently needed [ 75 ], classifying e-cigarettes as a unique product as undertaken by Canada, may contribute to improved jurisdictions, and harm reduction [ 76 ]. Overall, it is imperative to conclude that comprehensive statutory frameworks concerning e-cigarette advertisements are urgently needed across the globe, considering the alarming danger of vaping.…”

Tobacco market trends in 97 countries between 2007 and 2021

“…However, the tobacco and nicotine market has been disrupted by the introduction of emerging tobacco or nicotine products, such as e-cigarettes and heated tobacco products (HTPs) 2 . These are often promoted by the tobacco industry (TI) as 'reduced-risk products', which can be particularly appealing to the growing number of smokers who are now aware of the health risks associated with tobacco use, even though the risk of these products is not zero, and they are addictive 3,4 . Moreover, the flavors and stylish designs of many emerging tobacco or nicotine products make them very attractive to young people 5,6 .…”

Awareness, Attitudes, and Concerns Regarding Heated Tobacco Products Among Physicians in Japan

“… 12 HTP use can encourage conventional cigarette use. 13 , 14 Public health experts found that HTPs continue to pose a health risk for smokers and nonsmokers because they contain nicotine, carcinogens, and heavy metals that are released with the exhaled steam. 6 , 15 Several case reports have revealed an association between HTPs and the onset of acute eosinophilic pneumonia.…”