UNIVERSITY OF UNIVERSITY OF MARYLAND SCHOOL OF MARYLAND SCHOOL OF

LAWLAWThe Basis of a The Basis of a

Comprehensive Comprehensive Regulatory Policy for Regulatory Policy for

Reduced Harm Tobacco Reduced Harm Tobacco ProductsProductsDavid Sweanor, Adjunct David Sweanor, Adjunct

Professor of Law and Professor of Law and Medicine, Medicine,

University of Ottawa, CanadaUniversity of Ottawa, Canada

dsweanor@uottawa.cadsweanor@uottawa.ca

The WHO estimates that The WHO estimates that cigarette smoking will cigarette smoking will result in a billion deaths result in a billion deaths this century. this century.

Smokers smoke for the Smokers smoke for the nicotine but they die from nicotine but they die from the smoke.the smoke.

It is possible to provide It is possible to provide massively less toxic alternative massively less toxic alternative products, yet existing products, yet existing approaches to tobacco control approaches to tobacco control focus almost exclusively on focus almost exclusively on complete nicotine cessation. complete nicotine cessation.

This is inconsistent with what This is inconsistent with what science tells us about addiction science tells us about addiction and self-medicationand self-medication

Reducing risks for continuing Reducing risks for continuing users of tobacco/nicotine needs users of tobacco/nicotine needs to be integrated into public to be integrated into public health campaigns.health campaigns.

There are four strategies for There are four strategies for reducing death, injury & diseasereducing death, injury & disease

Reducing risks without requiring Reducing risks without requiring abstinence is one of themabstinence is one of them

THE WAY THE WAY FORWARFORWAR

DD

A regulated marketplace A regulated marketplace for nicotine delivering for nicotine delivering products that is based on products that is based on a pragmatic risk reduction a pragmatic risk reduction strategy.strategy.

Combine prevention, Combine prevention, cessation and protection cessation and protection with risk reductionwith risk reduction

The successes and failures of The successes and failures of tobacco control efforts to date.tobacco control efforts to date.

Some resounding Some resounding successes & Canada is one of successes & Canada is one of the best examplesthe best examples

But some glaring failures:But some glaring failures: Psychiatric co-morbiditiesPsychiatric co-morbidities Undermining the potential Undermining the potential

of medicinal nicotineof medicinal nicotine

Look at the history of Look at the history of efforts to deal with efforts to deal with

other causes of death, other causes of death, injury and disease.injury and disease.

Nothing comes Nothing comes ‘regulated’‘regulated’

Industries morphIndustries morph

The range and relative risk The range and relative risk of alternatives to of alternatives to

contemporary cigarettes. contemporary cigarettes. The key difference: The key difference:

Combustible vs. Non-Combustible vs. Non-combustiblecombustible

But also a big range of risks But also a big range of risks between different smokefree between different smokefree productsproducts

The evolving global The evolving global regulatory environment for regulatory environment for tobacco and nicotine tobacco and nicotine products.products.

The market is going The market is going through changes we’ve through changes we’ve seen with other goods and seen with other goods and servicesservices

The basis of product The basis of product regulation:regulation:

BansBans StandardizationStandardization Political favourPolitical favour Reducing harmReducing harm

Replacing the abstinence-only Replacing the abstinence-only paradigm with a pragmatic paradigm with a pragmatic science-based public health science-based public health approach that includes risk approach that includes risk reduction strategies for reduction strategies for continuing users can achieve a continuing users can achieve a great advance for global great advance for global health.health.