Pork chop at a bar mitzvah – reflections on GTNF 2015
Monday, September 21, 2015 at 14:25
Simon Clark

I was in Bologna last week for the Global Tobacco and Nicotine Forum at the Palazzo Re Enzo (above).

As older readers know I've been going to GTNF for several years and there's always something to enjoy, not least the often stunning locations. See Bangalore (2010), Antwerp (2012), Cape Town (2013) and West Virginia (2014).

Since it was launched in Rio in 2008 as the Global Tobacco Network Forum there's been a gradual evolution to the point where the predominant theme is now harm reduction.

Like any sane person I welcome harm reduction and I recognise it's a sensible strategy for the tobacco companies to adopt.

Nevertheless, as a representative of a group that has spent 36 years valiantly defending the freedom to smoke, it feels strange being a slightly peripheral figure at a tobacco industry supported event.

Don't get me wrong. I didn't feel unwelcome – there were far too many friendly or familiar faces – but one moment sums it up.

On a coach to the closing reception at the Enzo Ferrari Museum in Modena I sat beside a very nice American who has spent 20 years testing smoking cessation products including patches and, most recently, electronic cigarettes.

Hank (not his real name) gave up smoking around the same time he began testing alternative nicotine products and I gathered that he sees it as his duty to improve public health and help others quit too.

We chatted amiably throughout the 30-minute journey. I was interested to know more about his work but when it came to explaining what I did he was polite but clearly found it bizarre that anyone would defend smoking.

We didn't fall out but at that moment I felt like a pork chop at a bar mitzvah.

In contrast Hank would have felt totally at home at GTNF and for that I must congratulate the organisers who once again attracted a remarkably eclectic group of speakers, many of them from the public health or harm reduction communities.

In fact I can't think of another event where public health and tobacco industry stakeholders can meet and talk without rancour or suspicion and in a spirit of mutual cooperation.

Credit where credit's due, I respect public health campaigners who are prepared to engage with the tobacco community despite fierce opposition from some of their colleagues. We may have strong differences of opinion but at GTNF I've discovered it's possible to share a platform – even a drink – with anti-smoking campaigners without feeling uncomfortable. That alone is a significant step forward.

If governments, the World Health Organisation and other anti-tobacco bodies are genuinely interested in public health they must follow suit. Nothing good will come of ignoring the tobacco industry. Burying your head in the sand and sticking your fingers in your ears are the actions of a five-year-old child. Declaring industry representatives to be persona non grata is not a credible policy.

If I have a problem with GTNF it's the fact that those who don't want to quit smoking are ever so slowly being excluded from the discussion. Others may disagree but that's my interpretation.

The other issue is logistical. There are so many break-out sessions (19 over two afternoons) the ones you would most like to attend often clash.

Hence I missed what by many accounts was the stand-out session, a vigorous debate about heat not burn (HNB) vapour products.

The panel included rival tobacco company scientists and if the tweets I read are accurate there was a polite but fundamental disagreement about the efficacy of HNB in comparison to e-cigarettes.

Personally I'd like the consumer to be offered as wide a range of tobacco and vapour products as possible. As long as government doesn't interfere too much the consumer will ultimately decide by voting with their wallets.

The concept of HNB intrigues me because I like the fact that some tobacco companies are still trying to find a 'safer' way to consume tobacco. E-cigarettes may mimic the act of smoking but they don't contain tobacco so where does that leave consumers who want the real stuff, albeit in a less potentially harmful device?

Common sense suggests that in terms of risk HNB vapour products come somewhere between cigarettes (high risk) and e-cigarettes (low risk).

Unfortunately some advocates of e-cigarettes seem to view HNB as a threat because the direct association HNB has with tobacco could split the vaping 'movement' and alienate potential allies in public health and government.

I see it differently. Depending on who you believe, there are currently 8-10 million smokers in the UK and an estimated 2.5 million vapers (many of whom are dual users).

What those figures tell us is that the vast majority of smokers don't want to switch to e-cigarettes – not yet, anyway.

There are several reasons for that but the elephant in the room is blindingly obvious – millions of people enjoy smoking tobacco and have no plans to quit because, for them, a more satisfying alternative doesn't yet exist.

If therefore you believe in harm reduction, HNB devices must be given a chance. They may not be as harmless as e-cigarettes but there's a very high chance they are significantly less harmful than smoking.

So the message to government has to be, regulate according to the known risk and let the consumer decide between a wide range of nicotine delivery products.

PS. On the return journey from Modena I found myself sitting next to an investor in tobacco.

He was one of several investors I spoke to during the conference and as a group they were the most pragmatic and least judgemental on the subject of smoking.

To paraphrase one, "The consumer is king. Harm reduction may be the future but smoking is the present."

It echoed my final words to a session on 'Consumer wants and needs' when I made this oft-repeated appeal to the tobacco industry:

"Embrace harm reduction, embrace e-cigarettes, embrace other new technologies including heat and burn and others that have yet to be invented, but don't forget who your core customer is."

Below: part of the Enzo Ferrari Museum at Modena, Italy, that we visited on Thursday night

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