Consumers of Safer Nicotine Products


Funding of the CTFK vs all consumer advocacy groups worldwide

The challenge grassroots consumer advocate groups face is illustrated by the amount of support and resources they receive when compared to the funding available to those organisations that campaign against tobacco harm reduction. This disparity can be demonstrated by the Campaign for Tobacco Free Kids, which received US$160 million from Bloomberg Philanthropies in 2019 to campaign against flavours in nicotine vapes around the world over three years.[ix] Groups like this cast doubt on the safety and effectiveness of safer nicotine products in smoking cessation, despite significant evidence to the contrary. Their significant funding and high profile ensures their views are widely represented in national and international media.

See the "Tobacco harm reduction consumer advocacy organisations" Briefing Paper for more details.

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Japan: Cigarettes and Heated Tobacco Products Value and Cigarettes Volume 2011-2021

- No Fire, No Smoke: The Global State of Tobacco Harm Reduction

As of 2018, Euromonitor International expected that heat-not-burn (HNB) devices would account for at least 22 percent of the Japanese market for tobacco by 2021 if it continues to drive out cigarettes. What is interesting about the Euromonitor tracking is that the total volume of tobacco purchased is not expected to change, but the type of tobacco purchased is. This is somewhat different to the experience in Sweden and Norway where the switch to safer nicotine products (SNP) has been accompanied by longer term declines in tobacco consumption – the difference, of course, being that tobacco users in Sweden and Norway have a much longer experience with SNP.

For up-to-date estimates of the current number of users of heat-not-burn products in Japan, check out the GSTHR Japan country profile here: https://gsthr.org/countries/profile/jpn/4/

See also p. 57 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Cigarette Volume Decline in Japan 2016-2018

Clive Bates

The uptake of heat-not-burn (HNB) products is disrupting the traditional Japanese cigarette market. Japan Tobacco International is the major tobacco company with around 60 percent of the Japanese cigarette market, and unlike some tobacco companies, releases monthly information on sales. From 2016 to 2017 its volume of cigarettes sales fell 14 percent, with a further fall of 13 percent in 2018 (based on 2016 levels). This is an extraordinary collapse in cigarette sales, of 27 percent over two years. A 27 percent drop in cigarette sales in two years is unprecedented in Japan: over the 16 years from 1996 to 2012 domestic cigarette consumption fell by 46 percent – or just over 2.9 percent a year on average. It is likely the highest drop in cigarette consumption over that time seen in any country.

Euromonitor International expects that HNB will be at least 22 percent of the Japanese market for tobacco by 2021 if it continues to drive out cigarettes. What is interesting about the Euromonitor tracking is that the total volume of tobacco purchased is not expected to change, but the type of tobacco purchased is. This is somewhat different to the experience in Sweden and Norway where the switch to safer nicotine products (SNP) has been accompanied by longer term declines in tobacco consumption – the difference, of course, being that tobacco users in Sweden and Norway have a much longer experience with SNP.

See also p. 56 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Trends in Current Use of HNB Tobacco / E-Cigarette, Both Sexes, Japan

Takahiro Tabuchi , Silvano Gallus , Tomohiro Shinozaki , Tomoki Nakaya , Naoki Kunugita , Brian Colwell

Surveys of the adult population show the initial uptake of heat-not-burn (HNB) devices in Japan. In 2015, 1.3 percent of adults were using e-cigarettes (despite their illegality) but only 0.3 percent were currently using IQOS and 0.3 percent Ploom TECH HNB devices. One year later, in 2016, these levels had not changed greatly. By 2017, e-cigarette use had increased to 1.9 percent, while use of IQOS had increased to 3.6 percent, use of Ploom TECH increased to 1.2 percent, and use of the glo HNB product was 0.8 percent. The other sources of information about HNB come from market data. Philip Morris International’s (PMI) IQOS uses ‘HeatSticks’ which accounted for 0.4 percent of the tobacco product market in December 2015, rising to a 14.1 percent share of the tobacco market by December 2017.56 In two years, IQOS has overtaken specific cigarette brands – for example PMI’s own Marlboro which has about eight percent of the tobacco market.

The other sources of information about HNB come from market data. PMI’s IQOS uses ‘HeatSticks’ which accounted for 0.4 percent of the tobacco product market in December 2015, rising to a 14.1 percent share of the tobacco market by December 2017. In two years, IQOS has overtaken specific cigarette brands – for example PMI’s own Marlboro which has about eight percent of the tobacco market.

See also p. 55 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Weekly Google Search Volume for HNB Tobacco / E-Cigarette 2013-2017 (Past 4 Years) in Japan

Takahiro Tabuchi

In 2014, Philip Morris International introduced the IQOS heat-not-burn (HNB) device to the Japanese market, initially as a test in the city of Nagoya. It was then rolled out across Japan in 2016. Japan Tobacco International had started Ploom sales online in December 2013 and launched Ploom TECH in March 2016. British American Tobacco started selling its HNB glo device in December 2016. There was extraordinary interest in IQOS, as reflected in internet searches in 2016. This Figure shows weekly Google searches from 2013 to 2017, normalised to 100 to show relative search volume.

See also p. 55 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Smoking Cessation Services in England Lose Business - Customers Declined by 45% Since 2011-2012

- No Fire, No Smoke: The Global State of Tobacco Harm Reduction

E-cigarettes are now the most common method used to quit smoking, having overtaken NRT, medication and behavioural support by 2013 in England. This graphic reflects the change in the use of stop smoking services since e-cigarettes in light of this shift in how people use nicotine. The UK has a network of specialist stop smoking services and help with quitting is also provided through a wide range of NHS services. They have seen a rapid drop in customers since 2011-12. In part this might be due to reduced resources, but is also likely to be linked to the fact that people now have additional ways to quit.

Given the interest in e-cigarettes, staff in stop smoking services have had to respond to patient requests as to whether using e-cigarettes is a good way to quit smoking. After some reluctance to embrace e-cigarettes, some stop smoking services now incorporate them into what they offer clients. The first to do this was the smoking cessation programme run by Louise Ross, then service manager for Leicester City (UK) stop smoking service, which started using e-cigarettes in their programme from 2014. The service achieved success with other health professionals, including persuading midwives to convince pregnant women that vaping is safer than smoking, and convincing GPs to record vapers as ex-smokers. The Time to Switch poster went viral round the world within a couple of hours of appearing on billboards in Leicester. The call to action on the poster was that all smokers should consider switching to vaping, and that vapers should consider quitting smoking altogether.

See also p. 53 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Aids Used in Quit Attempt in Past 12 Months, England, Smoking Toolkit Study 2011-2015

- No Fire, No Smoke: The Global State of Tobacco Harm Reduction

These data suggest there are large numbers of smokers both trying e-cigarettes and using them, and who have quit smoking altogether. Coupled with the rapid decline in smoking, to 15.1 percent, this indicates a strong association between the rise of e-cigarettes and the ongoing decline in smoking. There appears to be a new landscape of smoking cessation. E-cigarettes are now the most common method used to quit smoking, having overtaken NRT, medication and behavioural support by 2013 in England.

These changes are also reflected in the use of stop smoking services. The UK has a network of specialist stop smoking services and help with quitting is also provided through a wide range of NHS services. They have seen a rapid drop in customers since 2011-12. In part this might be due to reduced resources, but is also likely to be linked to the fact that people now have additional ways to quit.

See also p. 53 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Proportion of E-Cigarette Users in Great Britain, 2012-2017

- No Fire, No Smoke: The Global State of Tobacco Harm Reduction

The anti-smoking charity ASH has conducted repeat surveys on the use of e-cigarettes in the adult population in Great Britain (England, Wales, and Scotland) since 2012. Sample sizes are substantial at around 12,000 adults (18 and over) each year. This graph illustrates these data, and shows a steady increase in the proportion of the adult population who use e-cigarettes, up from just under two percent in 2012 to nearly six percent in 2017. There appears to be some slowing of the increase in 2016 and 2017. ASH, working with King’s College London, has estimated the prevalence of e-cigarette usage in Great Britain by using the findings of the surveys and applying these to the most recent population data available in each year.

These data show that in 2017:

» An estimated 2.9 million adults in Great Britain currently used e-cigarettes;

» Of the 2.9 million current e-cigarette users, approximately 1.5 million (52%) were ex-smokers.

See also p. 52 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Proportion of Current Smokers, All Persons Aged 18 and Over, UK, 2011-2017

- No Fire, No Smoke: The Global State of Tobacco Harm Reduction

Using Annual Population Survey (APS) data provided by the Office for National Statistics (ONS), this graphic shows the continued declining trend between 2010 and 2017 in each of the four UK countries (England, Wales, Scotland and Northern Ireland). Overall smoking prevalence in the UK in 2017 was 15.1 percent, which equates to around 7.4 million people in the population, a statistically significant decline of more than five percentage points since 2011. England had the lowest level of smoking at 14.9 percent (approximately 6.1 million people), Wales at 16.1 percent (approximately 386,000 people), Scotland 16.3 percent (approximately 677,000 people) and Northern Ireland the highest at 16.5 percent (approximately 226,000 people). Northern Ireland’s overall trend is down, but not as consistently as the other three countries.

See also p. 51 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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Death Rate per 100,000 Attributable to Tobacco, All Causes of Death, Men 30 Years and Older

Lars Ramström - Institute for Tobacco Studies

This figure illustrates what percentage of all deaths are tobacco-related across Europe – which gives an indication of the chances of dying of a tobacco related disease. Using more recent data from the Global Burden of Disease study, it is calculated that in Sweden 11 percent of male and 12 percent of female deaths are tobacco-related. In all EU countries the percentage is higher: for example, in Greece 26 percent of male deaths are tobacco related; 23 percent in Spain, Belgium and the Netherlands; 21 percent in Italy and Denmark; and 20 percent in the UK and Luxembourg.

Dr Lars Ramström calculated the potential future premature deaths that could be avoided in the EU if the ban on the marketing of snus is revoked: “If snus is made available by lifting of the current ban in the EU, and truthful public education encourages substitution of snus for cigarettes as in Sweden, then around 320,000 premature deaths per year can conceivably be prevented among men 30 years and older in the current EU countries”.

See also p. 50 of the report: No Fire, No Smoke: The Global State of Tobacco Harm Reduction 2018 — Global State of Tobacco Harm Reduction (gsthr.org)

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