Tobacco Harm Reduction and the right to health

Tobacco harm reduction and the right to health 13 Loose snus is pinched into shape before being inserted into the mouth, often under the upper lip. ‘Portion snus’ is sold in small teabag-like sachets. The nicotine content of snus varies between brands, with the most common strength being 8 mg of nicotine per gram of tobacco. Stronger varieties can contain up to 22 mg of nicotine per gram of tobacco. “I have not smoked in five years using snus. Once I got over the ritual habits of smoking, I have found snus superior in every way to cigarettes.” Snus user 39 Tobacco-free snus is a recent addition to the range. These products use other plant fibres impregnated with nicotine instead of tobacco. 36 Mark A Levin (2013) Tobacco control lessons from the Higgs Boson: Observing a hidden field behind changing tobacco control norms in Japan. American Journal of Law Medicine . 39 p.471–489 37 Paralympic Games website (2019): Tokyo 2020 venues will be smoke-free https://www.paralympic.org/news/tokyo-2020-venues-will-be-smoke-free 38 The decline in sales has been calculated from Japan Tobacco Inc monthly sales and share of market. 39 Reddit user Gunter73 (December 2019), answering a thread comparing snus use to cigarette use https://www.reddit . com/r/Snus/comments/ef3ssr/does_snus_help_relieve_stress_like_cigarettes_do/ Case study: Japan – rapid rise in sales of heated tobacco products, rapid fall in cigarette sales According to the WHO, 19% of Japan’s adult population were daily smokers in 2015, with smoking higher among men (30%) than women (9%). These levels are much lower than the extraordinarily high percentage of male smokers in Japan back in 1968, at 78%. But the decline had, until recently, abated. Japan does not have an overtly hostile approach to tobacco. Until 1985, the tobacco industry was a state monopoly and it still owns one-third of Japan Tobacco, Inc. (JTI), remaining the largest shareholder. Recently voluntary bans have been introduced by some companies and a street smoking ban introduced by some cities. 36 For the 2020 Tokyo Olympics there will be smoking bans in all indoor and outdoor venues and in the perimeter areas of venues. 37 Since the tobacco industry introduced heated tobacco products to the Japanese market, in pilot areas from 2014, before a nationwide rollout in 2016, cigarette sales have dropped by an astonishing 33%. 38 Such spectacular results have never been seen as a result of the implementation of any tobacco control measure, anywhere in the world. This dramatic transformation in cigarette sales has been brought about simply by selling a safer alternative to smoking, the use of smart marketing, and consumers deciding to switch from smoking to heated tobacco. No action was required on the part of public health and tobacco control, except perhaps to help create a climate where smokers wish to quit; it has been at no direct cost to the Japanese taxpayer. Snus In contrast to the new safer nicotine products, snus has been used for over 200 years, but only recently has its relative safety compared to cigarettes been confirmed by independent clinical and epidemiological investigation. Snus is a moist to semi-moist smokeless tobacco product, made from ground tobacco leaves and food-approved additives. The final product is placed in the mouth (not chewed). Image: Swedish Match file photo