“They used to say that the more money you make, the longer you live.” This is the first sentence of the webinar “A world without cigarettes: Do we use all possible means to achieve the goal or not?”, organized by the International Union for Tobacco Control and Harm Reduction (SCOHRE) in cooperation with the Polish Society. public health. And the reason why it was said is to… challenge and formulate a new, more relevant truth: health is indeed closely related to the economy and vice versa, but for different reasons.

Especially with regard to smoking and the measures taken by governments around the world to limit it, decisions are taken jointly by the ministries of health and the economy. One cannot function or speak an opinion without the other, which raises suspicion or rather confidence in the conflicting interests, intentions and, ultimately, in the decisive role that smoking plays in the economy of each country, supporting it, and in the corresponding public health. inflicting damage on him. .

To begin with, the main tools we have for mass elimination of smoking are: 1. information (what are the risks for the smoker? what is the risk to his health? what are the steps to quit smoking?) 2. social support. (in a number of countries there are anti-smoking clinics or smoking cessation clinics) 3. public prohibition (see the need to remove the smoker from the dining area for smoking, marginalizing him because of his habit), 4. medical prevention. The above measures have worked quite effectively to date to reduce the percentage of smokers, but in no case have led to their minimization. In particular, the Polish Society for Public Health notes that 30% of the country’s population smokes daily. With this in mind, the goal is shifting from eliminating smokers to reducing the risk caused by smoking, both active and passive.

This is how substitutes for conventional cigarettes appeared: products that heat rather than burn smoke, electronic cigarettes using liquid, nicotine packets, other nicotine products (gum, patches, etc.). But, as we have learned, there is no official conclusion that the substitutes really helped. In fact, it’s highly likely that they made the anti-smoking campaign difficult. To begin with, there is not enough research to prove with certainty that heating instead of burning tobacco and e-cigarettes are not as harmful as conventional cigarettes. The question has even been openly raised as to what is the point of reducing the incidence of lung cancer but increasing the incidence of cancer of the vocal cords. It also appears that the consumption of cigarette substitutes is much higher, mainly because their consumer can use them more widely. What do we mean? A traditional smoker will avoid smoking in the living room of their home to avoid the smell, especially if there is a child in the room. On the contrary, the user of an electronic cigarette or a heated cigarette will smoke more easily because he disturbs the neighbor less and pollutes the space less. Another thing is that there is also no convincing evidence that substitute aerosols are not as harmful as regular cigarette smoke. Then there is no data fixing the percentage of users who quit smoking after switching from conventional cigarettes to substitutes. In other words, the habit is not broken, but modified. Finally, the question arises, to whom are the new smoking products addressed? For current smokers only? No. Also, many, mostly young, start their smoking life with “substitutes”, simply giving up regular cigarettes. So what is the purpose of these new products? Solve a problem or create a new one? The main conclusion about new “alternative” ways of smoking and their contribution to reducing health risks and harms seems to be that there is no conclusion.

With this controversial introduction, we come to the main topic, namely the economic factor. The main “weapon” in the hands of state health to reduce the number of smokers and, consequently, morbidity and mortality is taxation. As taxes on harmful products such as cigarettes increase, their use is discouraged. At the same time, as long as some people continue to pay a high “price” for their habit, government revenues are increasing. Indeed, one of the reasons why alternative types of smoking, which theoretically do less harm, do not have lower taxes, is precisely so that the state does not decrease revenue. It is not an exaggeration to say that in most countries ministries of health warn that smoking causes serious harm to health, and ministries of economy respond that quitting smoking causes serious damage to the economy. The two ministries seek balance and manage interests to… cut costs and increase revenue. Admittedly and admittedly, high taxes on smoking products are for profit, not for the health of citizens. On the other hand, smokers place a significant burden on the health care system, as they get sick more often and more severely. The debate has generally been that the smoker should generally be taxed more because he makes more use of public health and therefore increases costs. It was answered that this would be unfair discrimination, especially since the smoker “pays the price” through taxes on cigarettes.

The conclusion from all of the above was that the consumer must be aware of the risks of each product, as well as the role it plays in the economy and in health. More research should also be done so that there is real knowledge, and not guesswork, about how harmful new types of smoking are and what is the main purpose of their existence. The bottom line is that the phrase “a world without cigarettes” should be the goal, not the motto of an ambiguous advertising campaign.