Category: Medical

Together – The Swedish experience in using alternative nicotine products to combat the dangers of traditional smoking revealed a strange paradox. Although the Swedes consume nicotine at the same rates as the rest of the European countries, the Swedes have become significantly less susceptible to health problems associated with tobacco.

It’s not a coincidence

I have partnered with international public health experts to produce a study or report titled ‘No Smoking… Less Harmful,’ which explains that the way tobacco or nicotine is consumed is the basis for exposure to the risks of smoking or not, not the consumption of nicotine itself.

In short, smoking traditional cigarettes leads to many health problems, but using chewing tobacco or nicotine pouches does not have the same effect.

After many scientific studies and research that confirmed the benefits of alternative tobacco and nicotine products, Sweden began to rely on these products as less dangerous alternatives to nicotine consumption, which led to much
better health outcomes. The death rate from tobacco among Swedish men became 38% lower than the European average, and the incidence of lung cancer decreased by about 41%. This is despite the fact that the rate of nicotine consumption may be equal among EU countries, including Sweden. One in four people consume nicotine in Sweden, which is almost the same rate as in neighboring countries.

‘We haven’t avoided nicotine,’ the Swedes say, ‘we’ve simply become dependent on safer forms.’ The historical narrative that ‘nicotine is the enemy’ was proven wrong. We discovered that this was a big mistake, and we were able to change the public’s perception and the rules for nicotine use in Sweden, which improved public health and reduced the health risks to society and smokers, without the need to impose a total ban on nicotine, which had long been a socially acceptable habit.

Nicotine, like caffeine, has long been a familiar companion to many, a stimulant for some and an outlet for others. But our approach shows that w
e need to focus on how we use nicotine. By offering and regulating safer alternatives, we can address health issues without stopping nicotine use.

Smokers who want to quit should be helped.

The revision of the findings on nicotine has changed the world’s perceptions and beliefs. The popular belief that nicotine is a major cause of cancer has been scientifically proven wrong, and everyone knows that nicotine gum and patches do not cause cancer. Why should tobacco-free nicotine pouches or chewing tobacco be any different? But if we fail to differentiate between the products and provide accurate information, we risk the lives of those who need help dealing with the dangers of traditional cigarettes.

As the world continues to struggle against smoking, Sweden is offering a model that cleans the air in a scientific and practical way at the same time.

The report, ‘No Smoke, Less Harmful,’ is a call for the world to rethink its war on nicotine. A shift in favor of tobacco harm reduction that could save millions o
f lives. It is a call for policymakers, practitioners and society as a whole to stop demonizing nicotine and recognize that the real enemy is smoke, not nicotine.

Written by: Dr. Carl Fagerstrom, Associate Professor and Tobacco and Nicotine Researcher.

Source: Maan News Agency

Together – Many countries around the world have recorded significant reductions in the number of smokers. In Finland, the percentage of smokers has been on a downward trend, with only 11% of adults between the ages of 20 and 64 still smoking daily, with ongoing attempts and initiatives to reduce this percentage. As for Sweden, it is almost smoke-free within a year. However, in other parts of the world, the project to reduce the number of smokers remains a distant dream.

Anyone who looks closely at the contradictory results of attempts to reduce the number of smokers from one country to another will find that the secret lies in the contradictory view of the medical and health community regarding nicotine alternatives.

In search of answers to many questions, a number of doctors and public health experts, headed by Kari Vinho, a pulmonologist in the Central Finland Welfare Region, Kirsi Timonen, an assistant professor and clinical physiologist in the Central Finland Welfare Region, and Maria Huttunen, a dermat
ologist in the Central Finland Health Services Region, confirm that adopting nicotine substitutes and smoke-free alternative products is not a primary goal of their creation; they are an entry point to achieving the ultimate goal of quitting, which remains the best option ever, and remains an effective factor in saving more lives from the risk of premature death due to traditional tobacco smoking. In other words, switching to these alternatives, which may not be completely risk-free, remains less burdensome than continuing to smoke traditionally, which ultimately leads to death due to its negative health consequences.

The three doctors pointed out that smoking traditional tobacco causes many diseases, the most prominent of which is lung cancer, which many years of clinical experience have not succeeded in eliminating. Worse still, the consequences of traditional smoking extend to include patients feeling guilty about themselves due to their tobacco consumption, which the doctors explained that they see durin
g their daily follow-up of many medical cases.

The three doctors, who are public health experts, say that the number of smokers around the world is still alarming, which is not satisfactory to the conscious medical and health community. When discussing the reasons for the decline in the number of smokers in Finland and Sweden, the doctors believe that adopting a risk reduction strategy was the main factor in the results achieved in the two countries with regard to tobacco control.

In Finland, where smokers who were trying to quit smoking were still craving nicotine, doctors were open to a risk reduction strategy: giving patients nicotine, which has been shown not to be the main cause of smoking-related diseases, although it can be addictive and is not without risks, while avoiding – as much as possible – exposure to the chemicals contained in traditional cigarettes, and those resulting from their combustion, which lead to psychological and physiological addictive effects that create a barrier and deterrent
to quitting smoking, and which are primarily responsible for most of the harms and diseases associated with smoking.

As for Sweden, it dealt with smoking and the addiction that nicotine can cause with a methodology that put the responsibility of its government on supporting smokers to save their lives and giving them the opportunity to embark on their journey against smoking in a different way than what is prevalent. It provided them with alternatives that may be better than tobacco, such as chewing tobacco products, modern nicotine pouches, electronic cigarettes, and heated tobacco products that have been scientifically proven to be less dangerous than traditional combustion cigarettes because they produce 95% fewer harmful chemicals, and allowed them to be traded at reasonable prices.

In a related context, according to the three doctors, Public Health England has allowed the sale and use of heated tobacco products in almost all EU countries, including Sweden and Estonia, which is important for Finnish tra
velers who can carry these products with them without facing legal issues related to them. The British Public Health Authority is making heated tobacco products and e-cigarettes available to about a million smokers, as part of its plan to prioritize trying alternatives that may be better, over limiting smokers to the two options of quitting immediately or risking death.

Finland is expected to reach its goal of becoming a smoke-free country, with around 300,000 people quitting smoking cigarettes but continuing to consume nicotine in other forms, such as from pharmacies, shops or elsewhere. Finnish customs data suggests that legalizing nicotine pouches has reduced smuggling and illegal trade of these products, but high taxes on nicotine pouches may encourage smuggling, which explains why smoking rates in Sweden are lower than in Finland.

The three doctors conclude that the doctor’s duty requires him in many cases to choose between the dangerous and the less dangerous for the patient’s best interest, which mea
ns in the struggle against smoking, the necessity of transferring patients who want to quit to non-combustible nicotine as an option that may be better than consuming tobacco from traditional cigarettes.

Source: Maan News Agency

Bangladesh, India and Thailand are examples of increasing smoking rates. Sweden, Norway, the United Kingdom, New Zealand and Japan are achieving positive results using alternative tobacco products.

Together – In the context of combating diseases resulting from smoking, governments of countries take many measures that aim to reduce these health damages and protect societies and citizens. Despite this, smoking rates are increasing in many countries of the world, as a result of adopting unscientific policies.

Bangladesh, India and Thailand are examples of increasing smoking rates. Sweden, Norway, the United Kingdom, New Zealand and Japan are achieving positive results using alternative tobacco products.

Bangladesh, one of the most densely populated countries, is a model for what many countries in the world are witnessing, as it witnesses a continuous increase in the number of smokers, which results in an increase in the rates of diseases associated with smoking, most notably cancer, in addition to the high ra
tes of death resulting from smoking.

Statistics and reports indicate that about 126,000 people die annually due to diseases related to traditional smoking in Bangladesh, which represents about 13.5% of the total deaths in the country. In addition to the huge economic burden resulting from health care costs related to tobacco-related diseases, which represent about 1.4% of the country’s gross domestic product. More than 7 million adults in Bangladesh suffer from smoking-related diseases, in addition to 61,000 children being exposed to diseases resulting from passive smoking, according to the results of research conducted by the Bangladesh Cancer Society in 2019.

Dr Fazliye Kibera Chowdhury, Consultant Pulmonologist and Respiratory Medicine at Evercare Hospital, Chittagong, said that combating smoking requires a comprehensive, science-based approach to control the health damage and deaths caused by it. He stressed the need for a precise strategy that goes beyond the traditional strategy to address the complex
ities of addiction that tobacco consumption can cause.

In the same context, a recent report published by the world-leading medical journal The Lancet, prepared by Robert Beaglehole and Ruth Bonita, both former officials at the World Health Organization, on the effectiveness of alternative products in achieving positive results in combating smoking, called for the need to adopt a ‘harm reduction’ strategy as a central focus within the WHO Framework Convention on Tobacco Control, alongside measures to reduce supply and demand, stressing that these modern ‘low-risk’ products have brought about a major shift in the current battle to reduce smoking-related death rates, and have helped to quit consuming traditional tobacco products.

The strategy of ‘reducing risks’ using alternative tobacco products has achieved positive results in many countries around the world, including Sweden, Norway, the United Kingdom, New Zealand, and Japan, where each of them witnessed a record decline in the number of smokers, thanks to
the ability of adult smokers to access alternatives that may be lower in risk to traditional cigarettes.

In a related context, tobacco products are not similar in their characteristics, features or consequences of consumption, which emphasizes the need to distinguish between the various types of alternative smoking products at the level of legislators and consumers alike, in order to be able to enact appropriate legislative, regulatory and supervisory policies, in line with the risk rates associated with each of them, noting that the confusion between these products is one of the reasons for the slowness in introducing appropriate and effective monitoring mechanisms, as traditional cigarettes are classified as the ‘most toxic’ due to their reliance on combustion, which produces many harmful chemical compounds that cause many diseases, while products that heat tobacco instead of burning it, and electronic cigarettes, belong to the group of smoke-free alternative products with lower levels of harmful substance
s compared to traditional products.

The biggest difference between these two categories lies in the components of each; e-cigarettes rely on a liquid containing nicotine, while heated tobacco products rely on heating the tobacco instead of burning it, which makes them less harmful because the burning process is eliminated.

According to the World Health Organization, e-cigarettes and heated tobacco products contain nicotine, which has not been proven to cause smoking-related diseases, although it can lead to addiction. However, they differ from each other in composition; heated tobacco products consist of short-length tobacco sticks and produce an aerosol containing less nicotine than traditional cigarettes, while e-cigarettes consist of solutions of aromatic oils with about 15,500 flavors used, many of which are toxic and cause health effects, and can cause fires and explosions, in addition to the possibility of mixing with other substances within the solutions. Although they are not completely risk-free, e
xtensive scientific research indicates that they are 90% less risky than traditional tobacco products.

Experts stressed that quitting is always the best option, and despite the differences between alternative products and traditional cigarettes, it is still necessary to combat tobacco among young people. They called for adherence to regulations regarding alternative products, which is of utmost importance, which also requires ensuring that no products are marketed to non-smokers, especially young people, and that strict safety measures and tobacco control policies remain comprehensive. They stressed that by relying on the scientific approach, adopting innovative harm reduction policies, along with adhering to traditional tobacco control measures, Bangladesh can join the global fight against smoking-related non-communicable diseases and cancer.

In their report, the experts noted that statistics for the year 2019 revealed that 4.7 million deaths in the Asia-Pacific region were due to smoking, calling for the
need to take immediate measures to reduce these risks, in addition to the need to continuously update strategies to fill current knowledge gaps.

It is also worth noting that while some countries have made significant progress in combating smoking, many others are still suffering from a worsening crisis despite joining the World Health Organization, such as Thailand and India, where the core of the problem lies in recognizing and understanding the real challenge of traditional cigarette consumption, which requires focusing on changing this behavior, rather than adopting a comprehensive approach to all forms of tobacco consumption. It also requires policymakers to be careful in this regard, so as not to inadvertently contribute to the increase and escalation of the smoking scourge.

‘We must advocate for a science-based approach, not conventional policies,’ concludes Dr Fazliye Kibera Chowdhury. ‘Eliminating combustible cigarette consumption by 2035 is an achievable goal, provided policymakers show the courage
to adopt innovative solutions, while immediate cessation for smokers and never engaging in smoking for non-smokers remains the best option.’

If they do not want to quit smoking, low-risk alternative products can give them the opportunity to live a healthier life.

Source: Maan News Agency

Geneva – Ma’an – The World Health Organization announced that thousands of cholera cases were recorded during the month of June, and that at least 160 people died due to the disease.

According to the organization’s statement, infections and deaths were recorded in 18 countries, and it turned out that the number of infections in June was 14 percent lower than in May. 32,467 new infections were recorded in the Eastern Mediterranean region, about 18,700 in Afghanistan, more than 6,600 in Yemen, and more than 5,200 in Pakistan. Overall, the number of infections recorded during the period from January 1 to June 30, 2024 in 25 countries amounted to 249,793 infections.

It is worth noting that in January 2023, the World Health Organization considered the cholera outbreak a ‘level 3 emergency,’ which corresponds to the highest level of complexity. The organization’s statement read: ‘Given the number and geographical distribution of outbreaks worldwide, and the shortage of vaccines and other resources, WHO continues
to assess (according to June’s findings) the global risk as very high.’

What is striking is that the world is facing a ‘critical shortage’ of oral cholera vaccine, as 17 countries have requested 102 million doses since January 2023, while only 51 million doses have been produced during this period. As of July 8, 2024, the global stockpile of cholera vaccines stood at just 7.5 million doses.

Cholera is a serious disease caused by the infectious bacterium Vibrio cholerae, which is transmitted through food or water.

Source: Maan News Agency

Washington – Ma’an – The US Centers for Disease Control announced the spread of listeriosis, or what is known as Listeria, in 12 states at the same time.

The center stated in its statement that two people died due to the disease, and 28 others were transferred to the hospital.

The statement indicated that the actual number of infections with the disease may be higher. According to it, most of those infected had eaten meat products, including mortadella and sausages, but so far there is no confirmation that this is actually the cause.

Earlier in Canada, two people died and nine others were hospitalized. It was noted that all of the infected people had consumed plant-based soft drinks.

The infection that causes this disease is usually transmitted to the human body by eating foods contaminated with the Listeria monocytogenes bacteria (vegetables and animal products), which causes severe intestinal disorders. It affects the nervous system and can cause meningitis, encephalitis and death.

At risk are people o
ver 60 years of age, pregnant women, newborns, and people with weak immunity.

Source: Maan News Agency

Bethlehem-Ma’an- Smoke-free nicotine products, such as e-cigarettes, heated tobacco, chewing tobacco, and e-cigarettes, are significantly safer than smoking traditional cigarettes and have proven highly effective in helping smokers quit a potentially deadly habit. Nicotine is certainly addictive, but it is smoke that kills. It is therefore extremely important to adopt the most effective methods to encourage smokers to quit, even gradually, with the help of innovative alternatives developed by companies such as Philip Morris International.

This is where expert opinion comes in to prove the importance of providing helpful alternatives. In this regard, Professor Peter Hajek, Professor of Clinical Psychology and Director of the Tobacco Dependence Research Unit at the Wolfson Institute of Preventive Medicine, Queen Mary University of London, who was speaking as a smoking cessation expert at the 8th World Congress of the World Association of Dual Disorders (WADD) and the 26th Congress of the Spanish Society of Dua
l Pathology (SEPD), which brought together more than 2,000 international mental health experts in Mallorca, said that after more than a hundred studies, many of which focused on the ingestion of toxins during e-cigarette smoking, it now represents only a fraction of the risks involved in burning tobacco, which occurs with conventional cigarettes.

Professor Hajek is in favour of young people not consuming nicotine in any form, but the main concern is that smoking kills and causes cancer and cardiovascular disease, while the risks of e-cigarette smoking are much lower. He believes that the idea of ??banning cigarettes in which tobacco is burned is a good idea, but if we want to avoid the black market and criminal networks, access to less risky alternatives must be made available to adult smokers.

The smoking cessation expert also mentioned the importance of eliminating passive smoking, stressing that the emissions from e-cigarettes are so low that they do not harm others, because the toxins responsible for sm
oking-related harm are produced by burning tobacco in traditional cigarettes, and most of them are not present in e-cigarette aerosols, and the few chemical compounds present in them are at much lower levels, hundreds of times lower. However, he did not rule out the possibility of some impurities, which can be corrected, and which constitute only a small part of the health risks posed by burning tobacco.

He also mentioned that we should encourage smokers to switch to e-cigarettes by reducing taxes, making them cheaper, and promoting them as a much less dangerous alternative.

For her part, Georgian addiction expert Tata Asatiani stressed in a television program dedicated to reducing tobacco harms, while speaking about nicotine, that it is very important to distinguish between nicotine and products that rely on burning tobacco. Nicotine does not cause life-threatening complications, but the carcinogens in cigarette smoke do. She stressed the need to try to replace cigarettes with something less harmful, and t
hat bans and restrictive measures are useless.

Source: Maan News Agency