In the ongoing battle against preventable deaths, smoking remains a formidable opponent, claiming millions of lives worldwide each year. Although efforts to discourage smoking have reduced its prevalence, the total number of people who smoke has continued to grow due to population growth, with a Scientific American report highlighting that about 1.14 billion people still smoke globally.
In the US, where the impact of tobacco-related illnesses reverberates through communities, concerted efforts continue to address this public health crisis. From stringent regulations on tobacco advertising to the introduction of reduced-harm products, stakeholders are intensifying their endeavors to curb smoking rates and safeguard the public’s well-being
The toll of smoking on public health
The World Health Organization (WHO) estimates that more than 8 million people die prematurely every year from tobacco use. The majority of these deaths stem from non-communicable diseases such as ischemic heart disease, chronic obstructive pulmonary disease, stroke, and cancer of the trachea, bronchi, and lungs. In the US, cigarette smoking is linked to about 80% to 90% of lung cancer deaths, according to the Centers for Disease Control and Prevention. Other countries with high smoking rates report similar statistics, with respiratory diseases accounting for 7.5% of all deaths in France.
Furthermore, the impact of smoking extends beyond just the smoker. Exposure to secondhand smoke also poses significant health risks, increasing the risk of morbidity and mortality of lung cancer and cardiovascular disease. In a study published in the journal Nature, researchers established that these deleterious health effects are largely due to the combustion of toxic compounds found in cigarettes, which include heavy metals like cadmium. Researchers concluded that the accumulation of cadmium in the blood due to smoking and passive smoking mediatesthe increased risk of all-cause mortality.
In response, policymakers and tobacco manufacturers alike have taken steps to address this pervasive public health issue head-on.
What’s being done to reduce smoking
Amidst mounting pressure to address the public health crisis stemming from traditional cigarette smoking, industry giants like Philip Morris International (PMI) and British American Tobacco (BAT) are undergoing a shift towards reduced risk products. Recognizing the evolving consumer preferences and health-conscious attitudes, these companies are investing heavily in innovative alternatives such as modern oral nicotine products and heat-not-burn devices.
For instance, in 2023, PMI unveiled a zero-tobacco stick for use with its I Quit Ordinary Smoking (IQOS) heat-not-burn device called the LEVIA heat stick. In contrast to its predecessors, the LEVIA does not contain tobacco, instead using a nontobacco substrate infused with nicotine in flavors like tobacco, menthol with blueberry, and peppermint. This is in line with plans to have smoke-free products account for more than two-thirds of PMI’s total net revenues by 2030.
Meanwhile, BAT has expanded its portfolio with modern oral nicotine products called VELO nicotine pouches. Unlike heat-not-burn devices, pouches do not require combustion or heat to deliver nicotine. Rather, they’re placed between the lip and gum for the nicotine to be absorbed. Marketed as an alternative to traditional combustible tobacco products, VELO pouches come in a variety of flavors, such as mint, coffee, and citrus, to cater to a wide taste preference. These pouches are also available in 2mg, 4mg, and 7mg strengths, allowing users to reduce their nicotine intake gradually.
At the policy level, the US Food and Drug Administration (FDA) has been working to prohibit the sale of menthol cigarettes and flavored cigars. Compared to regular cigarettes, menthols are more addictive and particularly difficult to quit. Menthol bans have been enacted in states like Massachusetts and California. However, a ruling from the FDA would halt sales nationwide and could potentially save millions of lives.
With continued research, education, and advocacy, there is hope for a future where smoking-related preventable deaths become a relic of the past, paving the way for healthier generations to come.