Washington, Special Envoy
On a disheveled day at a Washington hotel, doctors, scientists, university professors and lawyers gather summit. They face an epidemic and seek answers. Before them becomes an inevitable fact: a billion people smoke around the worldand a billion people will continue to smoke until 2025, according to WHO. And here the riddle: what to do?
The scenario unfolding is as complex as a kaleidoscope. He no longer speaks only of the common smoker and the cigarette he burns. Have more. The alternatives to appease nicotine addiction today are so great that they make you dizzy. They are called "alternative products with reduced risk ", something like devices that "They do bad, but not so much" or "much less." There are vaporizers, inhalers, tobacco pouches that release nicotine, tobacco heaters and other inventions.
And although in principle the development of these alternatives is intended to help the smoker quit smoking or switch to something "less harmful" than a conventional cigarette, at this point in the game certain options generated more chaos than control.
But let's start at the beginning.
"Smoking is harmful to health". Clearly this is for now the only certainty which unites all parties involved: scientists, companies, smokers …
For years, tobacco companies adopt the phrase as a mantra. Other companies went further. Giant Philip Morris International faced a complete reconversion of his image with own hymn: "If you do not smoke, do not start, if you smoke, stop smoking, if you do not stop smoking, change".
The already famous electronic cigarette O It's cigarette is one of those alternatives created to remove the smoker from the traditional cigar
The main cause of the damage caused by cigarettes comes from the combustion of tobacco. The danger is not just the nicotine itself, which causes dependence and increases blood pressure and heart rate. The great predator is combustion and smoke filled with toxic particles.
A man smokes an electronic cigarette in San Francisco, California / AFP
Getting a "cigarette" without incinerating tobacco leaves has led to a number of different products adopted by technology, among which It's cigarette
The electronic cigarette is what is called a product without tobacco. It is a unit that vaporizes a solution of liquid nicotine. The toxic substances emitted by the e-cigarettes "they would be smaller" than in the case of ordinary cigarettes. At the congress on It's cigarette there seemed to be agreement in Washington. But there was also a consensus that you do not know exactly What are your risks?
"We do not know what the long-term effects of & # 39; vaping & # 39; (or steam). There is a consensus that & # 39; vaping & # 39; is probably less harmful than smoking, but we do not know how much less harmful"they explained.
But it has another problem: this alternative ended up in the hands of the boys. 16 year old "vapean". And there is more and more, to the point that in the United States it was declared an "epidemic".
Jerome Adams, US Surgeon General or US Health Minister, warned in December about the huge increase in electronic cigarettes among young people. "So much so that today I officially declare the use of electronic cigarettes among young people as an epidemic in the United States," he announced months ago.
The number of children in the United States who use electronic cigarettes has increased by 1.5 million last year. It is worth saying that in 2018, 3.6 million students high schools and universities vapored.
"There is even greater concern about the rapid increase in vaping use in adolescents, in part fueled by evidence that a young man is testing It's cigarette you are more likely to smoke later"they warned in Washington
This is then the new nightmare. For many reasons. One, because you do not know in the long run what happens to that vapor that is drawn.
Two, according to figures presented at the Washington summit, 30% of young people in the United States also use marijuana in e-cigarettes. Or any other type of liquid that nobody knows what it is. Liquids brought in from the outside or made at home without any kind of control or label indicating what is done. 40% of youth admit that they use it because their friends use it. And just over 30% use for the flavors. Yes: sweet tastes. Steam with fruit, dessert, caramel … very few choose the flavor of tobacco.
Liquids for electronic cigarettes, for sale in California. / AFP
Three The door for these guys to jump from the electronic cigarette to the conventional cigarette was now completely open.
In industry they admit that the situation is out of control. There is no regulation for these products. In any case, there are prohibitions, as is the case of Australia, where by law Nicotine is "poison." Possess liquid nicotine This is a crime. Consuming is paid with two years in prison, explains Colin Mendelshon, a professor at the University of New South Wales in Sydney.
This severe restriction opened up an opportunity for the clandestine market without any regulation
The case of Juul
Juul, under surveillance. / AP
One of the products of electronic cigarettes that erupted among children in the United States is "Juul". a It's cigarette which landed on the market in 2015, betting heavily on social networks, with an advertising campaign that showed Young models with sweet and colorful graphics.
O It's cigarette of Juul has the form of pen drive, something like a USB memory. It is loaded with small capsules with nicotine extract and comes in different colors: something so seductive in its minimalist look that boys "They just have to have it."
A Juul device. / AP
One of the things that was revealed in Washington was that young people who choose Juul they do not do it for the pleasure of smoking, more than half admit that they have to the brand, as someone who wants to have an iPhone But if it is just a fad, it is also highly dangerous. What starts at age 16 as a teenage game can end in addiction.
Sentence and pressure on Juul fell like a guillotine. And now the company, valued at $ 38 billion, should have changed its advertising image to that of an adult woman who smoked 30 years ago, who "chooses the device as the best option for ordinary cigarettes."
The company had to deliver its marketing strategy with a multimillion-dollar television campaign, now categorized as a company that helps adults quit smoking.
The new advertising face of Juul, Carolyn, a former smoker of 54. / AP
In the United States, electronic cigarettes are technically illegal. But the FDA (the Food and Drug Administration) has opened a window until 2022 for companies to present an attractive product that can be legally marketed and regulated in the country. Until then, e-cigarettes they abound.
Information can help complete the image: the industry "vaporeo" generates US $ 24,457,512,300 for the United States economy, they revealed in Washington. And the number would more than double by 2025.
The smoker who does not want to quit smoking
So far the problems summit of Washington are two: one, the need to regulate these products, especially establish the majority (21 years) to those who use them. It's two, lack of data on damage that these products produce in the body in the long run.
The third problem is the adult who does not want to stop smoking the conventional cigar. Or that after quitting smoking, it quickly returns to addiction.
In Washington, almost in chorus, it was agreed that the goal is and will be to make people stop smoking, what they call "cessation". But if despite warnings that the industry is forced to spread and that doctors express, these people continue to smoke, then the goal becomes "to change " (to change) for a less harmful device.
IQOS by Philip Morris./Bloomberg
The FDA has just approved a product that moves away from the electronic cigarette controversy and is closer to the "look" of an ordinary cigarette, but "95% less harmful".
It is an "electronically heated tobacco system" under the trade name of IQOS, ownership and development of Philip Morris.
For the FDA, IQOS is "suitable for health protection" and authorized it for sale in the United States.
The FDA's decision was expected in the industry with several anxieties. This agency is usually a beacon to the rest of the world's regulators, who use it as a reference when making their own decisions.
For PMI, the FDA's decision It was "a historical landmark". And they quickly clarify that the product is focused "to the right audience", I mean the adults
"Overall, IQOS's average user between 30 and 49 years ", they explain.
Unlike ordinary cigarettes, the IQOS system heats (but does not burn) tobacco at a stable temperature below 350 degrees. An ordinary cigarette burns 600-degree tobacco.
A man tests Philip Morris' IQOS after its launch in Tokyo in 2018. / Reuters
It is a system that consists of a charger the size of a small cell, where a "pipette" is inserted that heats the tobacco. (holder). A specially processed tobacco is used which is "packaged" in a cigarette a little larger than a cigarette (tobacco het).
The device does not use liquid nicotine, is not an electronic cigarette, It does not release smoke or leave ashes. Releases a vapor that contains nicotine. According to company data, IQOS is available in 44 countries and the company has invested more than 4,500 million dollars there.
It is not a risk free product and it is only for smokers who continue to smoke. What effects does it have in the long run? Epidemiological data are not yet available. It takes longer.
In Argentine, the industry is not marketing IQOS for the time being.
In the case of electronic cigarettes, these are prohibited.
Professor and physician Nancy Rigotti of Harvard Medical School and director of the Massachusetts General Hospital's Tobacco Treatment and Research Center, spoke at the Washington forum. one last dilemma. Patients come to the office with questions about all of these options and doctors do not know what to answer.
For Rigotti, doctors are "not informed".
The sources of information for health professionals are usually the media. In addition, there is little evidence of the long-term safety of these devices. Therefore, it is difficult to find guidelines or advice without evidence. Some will advise to keep trying with the old nicotine patches. Others will suggest switching to low-risk devices. Yes, everyone agrees: if you can, do not smoke anymore.