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Published by the Foundation
for a Smoke-Free World
This latest report in The Global State of Tobacco Harm Reduction series from UK-based public health agency Knowledge·Action·Change (KAC) examines the role of tobacco harm reduction. The authors show there is an urgent need to scale up tobacco harm reduction if its full public health potential is to be realized.
Their first report, No Fire, No Smoke that was published in 2018, documents the history and development of harm reduction, as well as use, availability and regulatory responses to safer nicotine products around the world.CLICK TO ACCESS THE REPORT
The 2020 Tobacco Transformation Index ™ represents the first comprehensive effort to evaluate tobacco companies’ commitments and actions as they relate to tobacco harm reduction.
The 2020 index assesses the activities and performance of the world’s 15 most globally and regionally influential tobacco companies as they pertain to tobacco harm reduction. This includes analyzing and comparing companies’ respective product offerings, sales performance, and capital investments for both high-risk tobacco products and reduced-risk alternatives. The 2020 index also compares companies’ activities and performance across 36 countries, which are divided into groups of low-medium income (LMIC) and high-medium income (HMIC).
By monitoring and critically evaluating tobacco companies’ behavior, including actions that either support or impede tobacco harm reduction, the Index provides objective, transparent information to all stakeholders and incentivizes companies to act more quickly and responsibly than they otherwise would.CLICK TO ACCESS THE REPORT
Few have attempted to study the introduction and spread of tobacco cultivation in Asia using an analytical frame, which integrates the imperial economy, local social structures, and the commodity history of tobacco. This is a report on preliminary archival and ethnographic work on the economic and social relationship between tobacco cultivation and imperial expansion in Asia, focusing primarily on British India (today’s nation-states of India, Pakistan, and Bangladesh), China, and Japan.CLICK TO ACCESS THE REPORT
This paper outlines rational, researched-based strategies for phasing out combustible cigarettes, including a “nudge” approach and logical regulatory actions. Central to this plan are scientifically informed policies regarding THRPs. Unfortunately, the media and public oﬀicials have distributed so much misinformation about these products that an increasing numbers of smokers think their health risks are equal to that of combustible cigarettes. This view is not only inaccurate but dangerous, and public oﬀicials have an ethical and professional obligation to correct these misperceptions.CLICK TO ACCESS THE REPORT
Research by leading international business and corporate governance scholar Daniel Malan identifies inherent conflicts of interest with many of the countries leading the development of global tobacco control policy. The “Contradictions and Conflicts” report specifically identifies contradictions between governments’ fiduciary responsibility to maximize state monopoly profitability and their health responsibility to minimize public health risks, as well as generate potential solutions.
Tobacco products kill 8 million people every year. Between 2000 and 2019, overall global tobacco use declined by less than a quarter of a percentage point per year, despite global attempts to address the pandemic, spearheaded by the World Health Organization’s Framework Convention on Tobacco Control (FCTC), in force since 2005. There are currently 182 parties to the FCTC, which has as its main objective “to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure”CLICK TO ACCESS THE REPORT
This is a summary of expert contributions to the 2020 Dubrovnik Consultation, a summit meeting on regulatory issues, taxation and other perspectives in tobacco harm reduction. This summit was originally planned as a live meeting in Dubrovnik, Croatia in mid-2020, but was postponed due to the global COVID-19 pandemic. The expert contributions to the virtual meetings are summarized in this document. The Dubrovnik Consultation is a unique opportunity to identify areas of intervention in tobacco harm reduction regulation and to enable the Foundation of the Smoke-Free World to prioritize future areas of research.CLICK TO ACCESS THE SUMMARY
The Foundation for a Smoke-Free World is committed to filling key knowledge gaps in our collective understanding of tobacco production and use, especially in the low- and middle-income countries where it is increasingly grown and consumed. In that vein, this report provides a glimpse of the tobacco landscape in India. As one of the world’s largest producers and consumers of tobacco, understanding this landscape and the opportunities to transform – both literally and figuratively – have never been more important. This report only scratches the surface of the forces shaping that landscape, but we hope that, in doing so, it encourages others to make even greater explorations of it.Click here to access the report
The Watching Brief series chronicles the most up-to-date data on smoking across the world. In the first of this series, Foundation economist Ayda Yurekli examines the current state of the Hungarian tobacco industry. From analyses of excise taxes to an investigation of illicit trade, this two-part Brief offers an illuminating look into the past, present, and future of smoking in Hungary.
Issue 1: In January of 2020, the Hungarian government significantly reduced its excise tax on e-cigarettes (ENDS), while it left heated tobacco product (HTP) excise taxes unchanged. We examine the potential impact of ENDS tax reduction on public health and government interests.
Issue 2: Hungary recently achieved a 9-percentage-point reduction in smoking prevalence – from 36% in 2005 to 27% and may set a target rate for being smoke-free in the near future.Click here to access the two-part piece
The Foundation for a Smoke-Free World commissioned a poll in five countries that explores the relationship between COVID-19 social distancing and health among 6,801 tobacco and nicotine users. More than two thirds of the respondents rely on tobacco and nicotine as their main tool to manage stress and anxiety. Nearly 40% of smokers increased use of these products in recent weeks, which could equate to elevated use by more than 50 million smokers in the five countries polled.
The havoc wreaked by the COVID-19 pandemic is twofold: in addition to suffering direct effects of the virus, the world is grappling with the challenge of social distancing. The mental and physical toll of this practice may be particularly profound for millions of smokers who, as a way to cope with stress, have increased their tobacco intake.
The “COVID-19 State of Smoking Poll” was conducted online by the Nielsen Company for the Foundation for a Smoke-Free World during the period starting April 4 and ending April 14, 2020. Survey respondents from the United Kingdom, Italy, South Africa, India, and the United States (New York and California) were between the ages of 18 and 69, and were regular smokers of combustible tobacco or users of nicotine vape products.
The Foundation for a Smoke-Free World commissioned a survey in seven countries including Greece, India, Japan, Norway, South Africa, the UK, and the US. The survey captured participants’ demographic data, their habits and perceptions regarding tobacco and tobacco harm reduction (THR) products, as well as their experiences around quitting tobacco products. A total sample of 54,279 adults between 18-69 years of age who were current users of any tobacco or THR product (46,220) as well as quitters who quit within the past five years (8,047) participated in the survey. This is a follow-up poll to the Foundation’s 2017 survey to stay informed of global tobacco/nicotine use habits and perceptions, which was conducted in 13 countries.
Results of the poll have been analyzed and presented at scientific meetings, submitted as manuscripts for publication in peer-reviewed journals, and have been picked up by several international media outlets.
Posters presented at the annual Society for Research on Nicotine and Tobacco meeting in New Orleans, Louisiana (2020) are available here. The first explores (current and former) product users’ perceptions regarding nicotine, and the second looks at the data from the six countries that were surveyed in both 2017 and 2019 (Greece, India, Japan, South Africa, UK, and US) on the perceptions of relative harm of e-cigarettes compared to traditional combusted cigarettes over time.Perceptions of nicotine in current and former tobacco & tobacco harm reduction product users from seven countries.
It’s time for insurers to rethink how they quantify and reduce smoking risks. Smoking risks affect life and health insurers worldwide. Tobacco risks and regulations have an impact on underwriting, pricing, claims and reserves in all countries. Smokers account for a significant proportion (10–15 percent) of life and health insurers’ books of business, and insurers worldwide are exposed to the mortality and morbidity effects of tobacco. Smokers also number disproportionately among the uninsured, and insurers may be missing out on smoker segments that are insurable – relatively “good risks” within a spectrum – but currently priced out of the market.
The report reviews current insurer practices and challenges relating to how they detect policyholders’ smoking status, quantify smoking risks, and reduce risks through smoking cessation. It then recommends potential solutions leveraging emerging technologies, products, and processes to address these barriers. Solutions are illustrated with real-world case studies from organizations innovating at the frontier.CLICK TO ACCESS THE REPORT
Over the past two decades, global patterns in tobacco production and trade have shifted dramatically. While research by tobacco control groups and public health organizations has focused on tobacco production and elucidated several key trends driving these shifts, considerably less is known about patterns of tobacco trade. Understanding the global tobacco economy—and the major players in it—depends on developing a more complete knowledge of all stages of the tobacco supply chain, including production of tobacco, trade of unmanufactured tobacco leaf, processing of tobacco leaf into various tobacco products, and trade and consumption of manufactured tobacco products. As with many other commodities, tobacco has its own unique and evolving supply chain. This report focuses on understanding patterns in production and trade of unmanufactured tobacco leaf.CLICK TO ACCESS THE REPORT
The Foundation for a Smoke-Free World aims to foster discussion on the transformational possibilities of achieving a smoke-free world in this generation. Tobacco companies have an opportunity to adopt business models that will lead to a world without combustible cigarettes. There are more than a billion smokers in the world today. Smoking prevalence is declining, but at a rate far too slow to achieve the Foundation’s objectives for smoking cessation and tobacco harm reduction. Furthermore, in accomplishing this transition successfully, we must ensure that vulnerable populations, including smallholder tobacco farmers, are supported to find sustainable alternative activities and livelihoods.
This report contributes to the discussion by presenting six case studies of companies that undertook significant business transformations. The six cases demonstrate varying motivations, and, as business transformation is not without risk, some of the companies performed better than others.CLICK TO ACCESS THE REPORT
The Global Trends in Nicotine reports contribute to laying the groundwork for the Foundation’s work in the area of industry transformation, and represents an important step in the Foundation’s research program. Specifically, the reports identify the major players in nicotine delivery, outline their product organization and geographic focus, and quantify their output. Building upon this work, the Tobacco Transformation Index will over time evaluate 15 of the largest nicotine delivery companies in the world.
Highlights from the 2019 update include:
The GSTHR report maps for the first time the global, regional and national availability and use of safer nicotine products, the regulatory responses to these products, and the public health potential of tobacco harm reduction.
Every six seconds someone dies from a smoking-related disease and the problem is likely to worsen; the steep smoking declines in richer countries are slowing while in poorer countries smoking is set to rise. Existing forms of tobacco control are proving insufficient. While many people give up smoking, on their own or with medicinal products, many fail. ‘Quit or die’ is no longer the only option for those who cannot give up. Safer nicotine products offer another way. There is substantial international, independent evidence that these products are demonstrably safer than cigarettes. These potential lifesaving products could lead to a global revolution in public health.CLICK TO ACCESS THE REPORT
EY-Parthenon (EY-P) conducted a landscape analysis in July 2018 to identify and characterize smoking cessation products and services
In late 2017, the Foundation commissioned a poll that served as a baseline assessment of a continuous effort to evaluate and monitor the global state of smoking and tobacco harm-reduction efforts. The Foundation engaged Kantar Public, an integrated consulting and research agency, to conduct this poll. The purpose of the survey was to gain a clear understanding of smokers’ experiences and challenges, their habits and perceptions of risk regarding tobacco products and alternative nicotine delivery systems (ANDS), and the influence of these risk perceptions on their choices of products used, among adults across the world. The survey included a quantitative questionnaire, completed by more than 17,000 adult participants in 13 countries. A qualitative part of the survey, made up of focus group discussions in major cities in seven countries, provided additional context and insights.CLICK TO ACCESS THE REPORT