The health authorities need a smoking cessation policy that promotes the use of electronic cigarettes and vaping devices to reduce harm from tobacco, experts said.

Asian, Canadian and European experts at the Asia Harm Reduction Forum Seoul 2019 Thursday picked e-cigarettes and heat-not-burn tobacco as one of the tools to induce harm reduction.

About 100 experts representing 18 countries in the areas of public health, medicine, science and regulation attend the Asia Harm Reduction Forum Seoul 2019 in Yeoui-do, Seoul, on Thursday.

Korea Harm Reduction Association and Yayasan Pemerhati Kesehatan Publik (YPKP) Indonesia jointly held the forum in Yeoui-do, Seoul.

In Korea, most experts say there is no difference in harm between traditional tobacco and heated tobacco. The Ministry of Health and Welfare runs a smoking cessation advertisement that contains a claim that not only traditional cigarettes but heat-not-burn products are harmful.

However, the speakers at the forum emphasized that vaping could reduce harm from tobacco. They also said that the “gateway effect” of e-cigarette users switching to cigarettes was weak.

Konstantinos Farsalinos, a cardiologist at Onassis Cardiac Surgery Center in Greece, said in a keynote speech that harm reduction from tobacco was absolutely necessary.

“Although efforts have been made to encourage people to quit smoking with nicotine substitutes and drugs, the success rate is still low. The question is whether nicotine substitutes have a real impact on smoking cessation,” Farsalinos said.

He said heated cigarettes were less dangerous than regular tobacco, citing many pieces of evidence of their effectiveness and their role in helping smoking cessation. “In countries like Japan, heated cigarettes are popularly used for smoking cessation. It is difficult to make people stop harmful smoking without allowing e-cigarettes or vaping device,” he said.

Tikki Pangestu, a professor at the Lee Kuan Yew School of Public Policy of the National University of Singapore, said although some Asian countries control the sale of e-cigarettes and some say e-cigarette users do not help others quit smoking, their stance was not based on scientific evidence, and their attitude was not constructive for smoking cessation.

“Critics say e-cigarettes have a gateway effect, making young people move on to cigarettes. However, other data does not say so,” he said.

David Sweanor, a professor of law at the University of Ottawa Centre for Health Law, Policy and Ethics, also said e-cigarettes and heat-not-burn products would cut the use of regular cigarettes and reduce tobacco’s harm.

Hiroya Kumamaru, vice director of AOI Universal Hospital Japan, said e-cigarettes were replacing traditional tobacco, and that some studies have confirmed that there were no gateway effects.

“After heated tobacco arrived in Japan in 2014, the nation’s tobacco consumption fell dramatically. This year, it went down 21 percent from a year earlier,” Kumamaru said.

Due to the concern that young generations could switch from e-cigarettes to regular ones later, researchers conducted a study, but there was no such thing as gateway effect, he added. “According to the study, heat-not-burn products have lower carcinogen risk, but they are not without any carcinogen risk. We should not be satisfied with lower harm with heat-not-burn products. We should give more thoughts to the next level for smoking cessation,” he said.

More than 100 professionals in the public health, medicine, science, and regulation from 18 countries, including the U.S., Canada, the U.K., Australia, New Zealand, Greece and Singapore, attended the forum.

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