Listen to science: Tobacco harm reduction is real

BAT Senior Manager - Scientific Research Analucia Saraiva 

There has been a great deal of evolution around the science of tobacco harm reduction over the past two decades, but there remain gaps in their administration due to the lack of awareness. Part of the challenge, says British American Tobacco (BAT) Senior Manager - Scientific Research Analucia Saraiva, is that most of the data in this space is still produced by the tobacco industry itself, which leads some policymakers and members of the public to view it with skepticism. Saraiva is clear that the research is peer reviewed, and believes that tobacco companies need to be more vocal about tobacco harm reduction so that regulators, healthcare professionals, and policymakers would take note. 

Over the past 35 years, Saraiva has observed the transition from traditional combustible tobacco products to smokeless nicotine alternatives, a shift supported by scientific efforts to identify harmful constituents in cigarette smoke and, enabling nicotine to be delivered in a potentially less harmful way.

BAT and the wider industry have significantly built out their research and development capabilities, recruiting scientific experts across disciplines, and investing in global innovation centres dedicated to designing and developing smokeless products with reduced risk profiles for adult consumers who would otherwise continue to smoke. 

“I believe nicotine pouches represent a significant part of the solution when it comes to tobacco harm reduction. The reason why is because, of course, they involve no combustion – meaning the consumer will consume the nicotine with no smoke, no ash and no tar. We don’t promote them as a nicotine replacement therapy; however, on the risk continuum, the products sit in a very similar position. While nicotine is addictive and not risk free, the scientific consensus is clear that it is the smoke from burning tobacco that is the primary cause of smoking-related diseases. Pouches contain no tobacco, no burning, no smoke and no inhalation when used as intended – and that absence is what positions them favourably on the risk continuum.”

She went on to explain that the concept of risk continuum is a matrix that lists tobacco and nicotine products based on their relative levels of risk. This continuum places products along a spectrum from highest risk (cigarettes) to lowest risk (nicotine replacement therapy). Whilst the best thing a smoker can do is quit, the continuum illustrates that smokeless alternatives such as vapour products, oral nicotine products, and nicotine replacement therapies generally produce fewer harmful chemicals and expose users to lower levels of harm compared to smoking. To advance tobacco harm reduction and encourage smoking transition to potentially less harmful ways of nicotine consumption for those adult smokers who would otherwise continue smoking, Saraiva believes healthcare professionals have a greater role to play, especially in low- and middle-income countries, as they are often the first line of contact for smokers. However, there is a degree of skepticism as there is very little being spoken about nicotine. “I never had a professor who walked me through the profile of nicotine, the harms of tar, and the architect of cigarettes versus smokeless products. This is not something you learn at university.” 

Offering her perspective on claims that industry reports on harm reduction are biased, Saravia acknowledged that these products are relatively new and therefore require time to become the subject of independent scientific scrutiny. While most of the existing evidence has been generated through industry-led studies, Saraiva also highlighted that independent public health bodies are increasingly validating the reduced risk potential of nicotine pouches. 

“I think harm reduction is a concept that is still not accurately understood. I’m aware of some prohibitions, which are currently in place in Sri Lanka for heated tobacco products and smokeless tobacco pouches.”  BAT wants to completely transition and see revenues coming much more from smokeless nicotine products than cigarettes. Product needs to be affordable, acceptable, and accessible. Our ingredients undergo rigorous assessment from toxicologists. We don’t add anything above recommended levels, and our product regulatory compliance team reviews every product and recipe across every market we operate in,” Saraiva added. 

She also pointed out that robust measures are in place to prevent underage access to these products. BAT is clear that its products are intended for adults only, and preventing underage access is central to its commitment to responsible stewardship.