The recently released position paper by a Paris-based non-profit, The Union, which proposes a ban on e-cigarettes and heated tobacco products in developing nations have met with strong resistance from healthcare advocates and harm reduction activists in these countries.
The Union made its recommendation on grounds that lower- and middle-income countries (LMICs) have weak regulations and hence it is better to ban smoking alternatives which can lead to uptake among youth. Activists have opposed this view stating it will increase health inequalities between western and developing nations and it encroaches people’s right of liberty to choose safer alternatives to combustible cigarettes.
Samrat Chowdhery, Director of Council for Harm Reduced Alternatives, said, “There is now little doubt in the scientific community that smoking alternatives such as e-cigarettes are significantly less harmful. It is highly discriminatory to propose that while smokers in the west can have access to risk reduction, those in developing countries cannot. This appears to be a colonial, patronizing mindset veiled as philanthropy.”
He added, “LMICs are sitting on a tobacco epidemic timebomb, where 80% of the world’s tobacco users live. What we need are humane, pragmatic solutions that can reduce tobacco-related deaths and disease. Western nations that have embraced lower-risk alternatives are witnessing sharp declines in smoking rates, so their efficacy in combating the epidemic is established. And yet, organizations like the Union want to deny access to harm prevention to people who can least afford to deal with the consequences of tobacco use.”
Public health researcher Dr. Sree T. Sucharitha said the Union position is a case of intellectual bankruptcy. Referring to a de facto ban on e-cigarette research in India, she said, “Such bans affect the advancement of science and research into tobacco harm reduction (THR) and perpetuate unilateral, top-down, unscientific policies which adversely impact not only tobacco users and their families but also the communities intricately linked to the ecosystem.
“THR has a lot more relevance and applicability in LMICs and ideally its focus should be on gendered, mental health affected, disadvantaged groups including migrant populations and others who don’t find a mention in the Union’s vision for LMICs. Developing nations have an equal right to THR and should be at the heart of the global agenda”, she added.
Legal counsel Pingal Khan said, “Discrimination based on economic prowess if a country is against any modern legal framework. Most multilateral arrangements provide more flexibility to the lesser developed countries and not the other way around. If we are to accept this rationalization by the Union, we are effectively implying that citizens of economically weaker nations should have lesser freedom of choice (of safer options in this case) and consequently lesser dignity of life. “