The end of smoking?

We know how to end smoking. But governments, the World Health Organization and so-called public interest groups stand in the way.

As consumer products, combustible cigarettes are looking like more and more like videocassettes, encyclopedias and Kodak film.

In the US, they are being displaced by superior technologies, including e-cigarettes, oral pouches and devices that heat tobacco without burning it.

Tobacco markets in other countries, notably Sweden and Japan, are moving away from cigarettes even faster. They are on the road to ending smoking.

This is welcome news.

Cigarettes are lethal. The alternative nicotine products are not harmless, but they won’t kill you, at least as far as we can tell.

But instead of seeking to accelerate this market transformation, some governments and public interest groups, along with the World Health Organization, stand stubbornly in the way.

Backed by the billionaire philanthropist Michael Bloomberg, the WHO continues to crusade against e-cigarettes, as do groups like the Campaign for Tobacco Free Kids and the American Cancer Society. As I’ve reported, they have undue influence in low- and middle-income nations, some of which have banned the safer products. More about that, in a moment.

First, though, here’s the latest evidence that smoking is on the way out in the US:

Item: In a detailed 44-page report on the tobacco and nicotine market, Goldman Sachs in March predicted that the consumption of combustible cigarettes in the US will be surpassed this year by safer nicotine products, notable e-cigarettes and oral pouches such as ZYN.

“Smokers continue to convert to reduced risk alternatives,” writes Bonnie Herzog, a respected industry analyst at Goldman.

Millions of people who smoke are brushing aside misinformation from the government and public interest groups and choosing safer ways to obtain nicotine.

“That is truly extraodinary progress,” says David Sweanor, a lawyer and longtime advocate for safer nicotine products who tracks industry trends.

It’s the tar and chemicals in smoke that make cigarettes lethal. Nicotine has benefits as well as risks.

Item: No company has done more that Philip Morris International to drive the transition to what it calls “smoke-free” nicotine products. PMI, as it’s known, sells a device called IQOS that heats tobacco without burning it and owns ZYN, the fast-growing oral nicotine brand.

PMI said in its latest earnings report that smoke-free products now account for 42 percent of its net revenues and 44 percent of its gross profits. Setting the pace is ZYN, an oral pouch, whose sales grew by a remarkable 53 percent over last year. Sales of all smoke-free products grew by nearly 15 percent, while cigarette sales fell.

In Japan, PMI’s Iqos and other heated tobacco products are on the verge of outselling cigarettes. Sales of cigarettes have fallen by more than 50 percent in Japan since the newer products were introduced a decade ago.

Item: This week’s [April 29] earnings report fromAltria, which sells Marlboro, the most popular cigarette in the US, provided more insight into the transition. The Wall Street Journal headlined its story: Altria Profit, Revenue Down on Falling Cigarette Sales.

Cigarette sales fell by nearly 14 percent. Altris said that the decline of smoking was caused in part by “the growth of illicit e-vapor products.” (Most e-cigarettes sold in the US have not been authorized by the FDA, which has failed to effectively regulate the nicotine market.) Altria estimated that the number of US vapers grew from 18.5 to 20 million in the last year.

All of this comes as smoking has rapidly fallen out of favor among kids. Fewer than two percent of high school and middle school students smoke, the latest government data shows.

“The rapid and nearly complete disappearance of adolescent smoking is arguably the single most dramatic, and ultimately important, tobacco control achievement to date,” Kenneth Warner, the former dean of the school of public health at the University of Michigan, wrote earlier this year in an essay headlined Kids No Longer Smoke Cigarettes. Why Aren’t We Celebrating? Vaping by kids is also down by about 70 percent from iuts peak sharply from its peak in 2019.

How, then, have groups like the Campaign for Tobacco Free Kids and the American Cancer Society responded to the decline in smoking? Mostly, it seems, by worrying about the dwindling number of kids who vape, by exaggerating the risks of e-cigarettes and by glossing over their potential benefits to adults who smoke.

Typical is Tobacco-Free Kids. The nonprofit selectively cites US government sources and says “there is inadequate evidence to conclude that e-cigarettes are effective at helping smokers quit.”

The American Cancer Society says that “studies have not proven that e-cigarettes are more effective than other available methods for helping people quit tobacco products” and that it “does not recommend the use of e-cigarettes as a method to quit other tobacco products.”

Contrast these one-sided and fundamentally misleading messages to the excellent advice about vaping from the UK’s National Health Service. Vaping, it says, is “one of the most effective tools for quitting smoking.” But the NHS also cautions that “vaping is not completely harmless and we don’t know yet what the long-term effects may be” and it says that “children and non-smokers should never vape.” That’s a balanced approach to an unavoidably complex issue.

Worst of all among the anti-vaping crowd is, perhaps, the World Health Organization which has managed to influence developing nations — most recently Mexico and Vietnam — to enact bans on e-cigarettes. The WHO is implacably opposed to tobacco harm reduction.

Last month, writing in Filter, I looked at a ban on e-cigarettes enacted last year by Vietnam. My story, headlined Michael Bloomberg Won His Vietnam War on Vaping, reports that Bloomberg-funded groups supported the ban and celebrated its passage. It’s hard to understand why the WHO and other so-called public health groups would push for bans on safer nicotine products while cigarettes remain legal.

Next week [May 7], I’ll visit Cape Town, South Africa to speak at an event called Can South Africa Quit Like Sweden? The advocacy group Quit Like Sweden, which is paying my travel expenses, aims to show governments how Sweden has dramatically reduced smoking by making safer nicotine products available and affordable. Oral nicotine pouches known as snus have been popular and legal for decades in Sweden.

Partly as a result, Sweden will soon become the first country in the world to bring the percentage of adults who smoke below 5 percent. Contrast that with its neighbors in the EU, where snus are banned and smoking rates are on average about five times greater.

Nevertheless, the WHO, the FDA and the Bloomberg-funded NGOs appear to remain deeply uninterested in any evidence that challenges their priors.

By email, David Sweanor puts it this way:

“The failure of major health bodies to facilitate this transition is public health malpractice. The opposition to it is worse. But the lack of curiosity about what is happening in these markets is worse still.”

Globally, an estimated 1.2 billion people continue to smoke. Shouldn’t they have the freedom to choose the safer alternatives?