This is the last worrying of this sad, and sadly influential, document.
This document which lists off various risks of the use of smokeless tobacco (ST) without differentiation among types, does so, only to make an argument for elimination of use and not for elimination of those risks. It is not that subtle a distinction but the former does not take users into account and the latter does.
When benign authorities address risky behaviors that many people like to engage in, and knowing that many of them will continue those behaviors even in full awareness of the health risks, they usually evolve strategies that will encourage users to reduce those risks (often through education or through developing safer satisfying variants) rather than attempting the impossible goal of eliminating the behavior itself.
The use of illicit drugs serves as a good example of persistent adherence despite great costs. Using heroin not only has a risk of overdose but of incarceration, periods of great vulnerability, financial burden, stigma and in general social dislocation. If heroin use is so difficult to eradicate, what hope is there for a drug (nicotine) that while having an effect does not incapacitate, can improve performance, and has health risks that tend to only arise after years of use (if they do at all). (And the public health response to an illegal activity thankfully and rationally has been to embrace safe practice education, needle exchanges, and providing a safer alternative (methadone), and ironically this has been accepted by many more than support a similar approach to legal tobacco).
As much as we might debate the precise magnitude of the effects of smoking, there is no doubt that there is an associated substantial risk; this is not certain about ST, and whatever risks there are are certainly less than smoking. In the context of harm reduction, it is not so much how risky ST is but that it can serve as a satisfying substitute for smokers. However, if human behavior is any guide, awareness of health risk differences is not always enough. If a smoker is financially strapped that may be enough to move them to another form of nicotine. Which brings us to the following excerpt from page 4:
“One of the major challenges in regulating smokeless tobacco products is their low cost. This is one reason such products are accessible to youth. Uniform taxation policy on all tobacco products, so as to discourage shifts to cheaper tobacco products”
My comments are in respect to Western more than non-Western product where we are quite certain of the comparative risk differences and while the FCTC document does not make that differentiation, it is that very willful dismissal that helps introduce a coercive global policy that threatens demonstrably safer products and the hope of establishing popular and safer alternatives to smoking.
Recently, in America there have been calls to increase the taxes on ST in some jurisdictions (calling it a loophole) and while many are argued as a source for needed revenue for strapped state budgets, the original reason given for tax hikes on tobacco was to pay for the increased burden of smoking on the health system. (This burden is disputed but that is not the issue here).
If the reason for taxation is to pay for health costs then safer products should be taxed less. Not only does it makes sense that product variations with fewer externalities should be cheaper but it may nudge nicotine users toward safer choices even if they are unaware of the risk differences.
What the Convention Secretariat is doing is eliminating any consumer choice among products based on price. Since, all other factors being equal, people will prefer what they already do, this would maroon many smokers who otherwise might switch. (It would also contradict their concern about tobacco use taking up too much of a family budget).
Eliminating price differences among tobacco products is a strong first step toward prohibition. Keeping smokers smoking by discouraging any reasons to try alternatives means the disease burden remains high, and will build popular approval for an outright ban on all products (no doubt including e-cigarettes).
The bottom line is that this organization has no regard for the health or welfare of nicotine users of any kind. They will willingly sacrifice millions of lives to service their desire for tobacco prohibition.
-Paul L. Bergen