“No one dies from nicotinosis, but from tobacco smoke they do”

At this point no one doubts that smoke Bush. He smoking causes every year 8 million deaths throughout the world (50,000 in Spain) and is directly related to various types of cancer, among them lung cancer, which is the one that causes the highest number of fatalities in the world. Furthermore, it causes cardiovascular accidents, pulmonary emphysema and chronic bronchitis, among other diseases. However, there is a significant percentage of people who are unable to give up this habit, despite the risk it poses to their health.

Dr. Fernando Fernández Bueno, oncological surgeon at the Gomez Ulla Hospital in Madrid and spokesperson for the Platform for the Reduction of Harm from Smoking, at the 11th Global Forum on Nicotine, held in Warsaw (Poland). (Photo: ElPlural)

“What do we do with these people? Not everyone tolerates nicotine patches, or cytisine, which is a drug that works very well to combat addiction. It cannot be used, for example, with pregnant women and there are psychiatric patients or patients with comorbidities to whom you cannot prescribe pharmacology,” explains the Dr. Fernando Fernández Bueno, oncological surgeon at the Gómez Ulla Hospital in Madrid. He is one of the experts who has participated in the 11th Global Forum on Nicotinewhich has brought together specialists from all over the world in Warsaw (Poland) to discuss alternatives to tobacco and harm reduction.

Nicotine is not the cause of death of patients, it is tobacco smoke, which has an infinite number of toxic substances

For Fernández Bueno, the first thing is to stop smoking, but if this is not achieved, specialists must offer their patients other options to minimize the damage. “Nicotine is not the cause of death of patients, it is tobacco smoke, which has an infinite number of toxic substances. Nobody dies for nicotinosis”, argues. “The safest thing is always not to smoke, secondly, there are nicotine replacement therapies, thirdly, snus and nicotine patches, and then the electronic cigarette and heated tobacco,” he summarizes.

He confesses his confusion at other specialists and the administration itself who refuse to accept these alternatives, without paying attention to the scientific reports that support them. “I’m not a smoker and I have no interest,” he insists, pointing to e-cigarettes, heated tobacco and nicotine pouches as therapy. “The goal is to use it as a tool to combat smokers’ addictionnot as something playful”

Concern about the comparison of alternatives to tobacco with conventional cigarettes

Participants in the Forum expressed their concern about the Cancer Fight Plan who is studying the European Union and that puts conventional cigarettes, vapers and heated tobacco in the same bag. With these measures, the European Commission aims to reduce tobacco consumption to below 5% in 2040. “Tough restrictions on new nicotine products could force millions of people to return to the habit of smoking,” they warned.

“Vapers and nicotine pods should be affordable and accessible. The experience of other countries is that these products can dramatically reduce smoking rates and the risk of cancer,” said the Dr. Colin Mendelsohnfounding president of the Australian Tobacco Harm Reduction Association.

Faced with the restrictions, the participants at the regulation table gave countries such as New Zealand, Japan and above all, Sweden. All of them have advocated alternatives to conventional tobacco and have managed to significantly reduce the smoking rate.

The Swedish case is especially significant because it is about to become the first smoke free country according to WHO criteria, which puts the smoking rate below 5%. Right now, it is at 5.6%.

“There the snus and, after 50 years of use in, let’s say, more modern conditions, together with the new nicotine pouches, there is already data on its incidence. Sweden is the country with the least cancer in Europe, of all types of cancer. So, if it has been proven that nicotine is not carcinogenic, and this is not what I say, the WHO, the FDA say it. [Administración de Alimentos y Medicamentos de los Estados Unidos] and the EMA [Agencia Europea de Medicamentos]”Why is it prohibited in Europe?” Dr. Fernández Bueno asks in amazement.

The FDA, after an exhaustive study of alternatives to conventional tobacco, concluded that these products may have a positive effect on public health. Although he insists that no tobacco product is safe, he does believe that alternatives such as heated tobacco reduce the risk. On July 7, 2020, they authorized the marketing of the Philip Morris heated tobacco device, expressly arguing that “scientific studies have shown that completely switching from conventional cigarettes to this product significantly reduces physical exposure to harmful or potentially harmful chemicals.” ”.

Fernández Bueno also criticized the Comprehensive Tobacco Prevention and Control Plan (PIT) of the Pedro Sánchez Government for not taking into account the Swedish experience and the British government’s anti-smoking policies, which include electronic cigarettes as a harm reduction tool for people who have not been able to stop smoking.