It is a coincidence that the 5th Scientific Summit on Tobacco Harm Reduction was hosted in Athens city which is located in Greece. The word “ethics” originates from the Greek word “ethos.” Within recent years, a variety of substitute tobacco products have been invented with the goal of lowering the risk that is connected with tobacco smoking. These products include electronic cigarettes and vaping.
The use of tobacco products is one of the most important risk factors for the four most common types of chronic diseases that are not contagious: cancer, heart disease, respiratory disease, and diabetes. Just in 2019, tobacco consumption was responsible for more than 8.67 million fatalities across the globe (6.53 million in males, and 2.14 million in females). The primary cause of mortality for the majority of these individuals (7.37 million) was smoking, followed by exposure to second-hand smoke (1.30 million).
While it is desirable to create an atmosphere that is smoke-free, it is essential to keep in mind that due to the addictive quality of nicotine, there are bound to be smokers present in any given setting at any given moment. Nicotine has a powerful addictive quality. Because it produces a bodily in addition to a psychological reliance, it is extremely challenging to give up using it. On their very first attempt, few if any people are successful in giving up smoking.
Because of this, the ethical standards of harm reduction acknowledge that substance use will continue to take place despite the best efforts of healthcare professionals. Even if a person’s choices could put them in danger, medical professionals have a moral responsibility to honor the decisions that patients make for their care. In accordance to the American Cancer Society, the majority of people have numerous failed attempts at quitting smoking before they are finally successful. For this reason, forcing people to give up smoking in the absence of an option that is both less dangerous and does not involve smoking could have negative consequences.
At the recently concluded 5th Scientific Summit on Tobacco Harm Reduction, a law professor at the University of Ottawa David Sweanor stated that in order for the world to have an ethical system for the regulation of nicotine products, it is necessary to possess something that recognizes the health goals that are consistent with prevalent health challenges.
“It is imperative that you conduct an analysis of the efficacy of the programs that you are now putting into place. You need to recognize the costs that these programs place on people and what exactly it is that they are imposing. You need to do what you can to lessen the impact of those burdens as much as you possibly can. You want to make sure that the responsibilities end up being properly balanced, and you want to ensure that you have an equitable distribution of the responsibilities so that you do not needlessly bother or disadvantage a certain portion of the population.
We believe that we have a clear failure on matters of ethics, and if we look at this situation from the perspective of what happened in the domain of nicotine and tobacco, what is the goal?
“It’s not apparent because some people are saying the objective ought to be a public health necessity, but it sounds like you want to minimize the amount of damage done to the greatest extent possible while adhering to ethical standards. It should be obvious that attempting to shoot everyone who disobeys your orders is not an effective method for reducing harm. That violates the code of ethics. According to Professor Sweanor, “You have to acknowledge that we have cigarettes, which are causing 8 million lives per year, and our goal is to minimize that as quickly as we can in ways that are compatible with human dignity and rights.”
He went on to say that there is a persistent source of conflict between those who prioritize scientific pragmatism in public health policy and those who prioritize morality in this area.
“This occurs frequently in the field of public health. This is the case with a wide range of problems, including the war against drugs, sex ed, alcohol policy, and nicotine regulation, to name just a few. Is it a search for morality in which we endeavor to eliminate sin, or is it a quest for public health in which we try to make people healthier? We need to get a consensus on that objective. After that, we take a look at how effective it was. It is necessary for us to have the capability of analyzing our methods in order to determine whether or not they are producing the desired results. What we are attempting to accomplish is to be of service in an improved manner.
Tobacco and nicotine countermeasures appear to have left both socio-economic and psychosocial hardships on smokers as a result of enforcing heavy taxes and high costs on cigarettes. This is despite the fact that public health talks about enabling individuals to assist them to make better choices about their health.
According to Professor Panos Vardas, a Cardiologist, quitting smoking without using alternative nicotine alternatives could have devastating results.
“The complete and total abstinence from smoking is the golden standard for those of us who work in cardiology.” Without a shadow of a doubt, smoking is completely and utterly disastrous. The negative effects of smoking on one’s health include an increased risk of developing cancer, having a heart attack, and passing away unexpectedly.
However, the question that remains is, if smoking has been prevented, what are some of the other ways that modern improvements have been accomplished? In my opinion, if we desire to act ethically, we will need to base our decisions on actual scientific data. “If these alternative methods of nicotine use are effective, if people like these alternative methods, and if clinical data is suggestive of the less harmful effects to human beings, then why not?” questioned Professor Vardas. “Why not?”
In the meantime, a cardiologist who works as a research fellow at the Onassis Cardiac Surgery Center in Athens named Konstantinos Farsalinos believes that realists and pragmatics are necessary when discussing tobacco control and the reduction of harm caused by smoking.
“The usage of seatbelts when driving and the use of helmets while riding a motorbike is a classic example of reducing harm in our everyday lives. This is due to the fact that neither the seatbelt nor the helmet completely removes the possibility of being hurt or killed in a car accident. They lower the risk, and no one is going to advise you that you should not drive your automobile until it’s really necessary unless you make use of these safety features.
On the weekends, everyone loads up their automobiles and visits their own family. That danger affects each and every one of us. According to Farsalinos, “We take precautions to lower the danger (also known as harm reduction), but we don’t always reduce the risk.”
A study that was carried out by research teams for the American Cancer Society examined the changes that took place in tobacco sales in Japan during the same time frame as heated-tobacco products (HTP) were introduced onto the market. The findings demonstrated a large drop in tobacco sales that started about the same time that PMI’s IQOS HTP was first made available to the public. In addition, there are presently clinical investigations being conducted in Japan to determine whether or not the adoption of heated tobacco products has resulted in a reduction in the number of patients admitted to hospitals with tobacco-related conditions.
