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On Wednesday 2nd December, the Special Committee on Beating Cancer of the European Parliament (BECA) convened a hearing with leading specialists in cancer prevention entitled “Facilitating a healthy lifestyle: how to reduce cancer related lifestyle risk factors.” This was the first committee hearing to focus on prevention.

Before introducing the experts, Chair of the BECA, Bartosz Arłukowicz, opened the hearing by stressing the importance of preventative measures in combating cancer, stating that 40% of cancer cases in Europe are preventable.

Expert speakers

Professor Ute Mons got to the crux of the problem right away by pointing out that cigarettes are the most dangerous consumer product on the market due to combustion, and that smoking causes one in five cancers in the EU. Mons’ presentation was very focused on tobacco control measures and she extolled the virtues of the FCTC guidelines and MPOWER in reducing smoking. Plain packaging in particular, she suggested, had been very effective in reducing smoking rates and she proposed that this should be made mandatory for tobacco products. She finished by saying there is scope to strengthen EU legislation, especially the Tax Directive and Tobacco Products Directive. Professor Mons couldn’t stay for questions but invited the members of the Committee to submit questions in writing, which would be answered and published on the Committee’s website.

Professor Nataliya Chilingirova also spoke about lung cancer and prevention, reiterating Prof Mons’ earlier point that lung cancer is the leading cause of cancer death in men and women, with smoking responsible for 90% of lung cancers. For this reason, she said, prevention strategies play a key role in fighting cancer, smoking cessation being the most important. Regarding novel tobacco products she said that although the WHO takes a restrictive approach to novel products and does not endorse them, exposure to toxicants is reliably lower and this difference in risk should be reflected in legislation.

With the expert presentations completed the hearing moved on to questions and comments from MEP’s. Most of the MEPs referred to tobacco as a cause (the culprit is combustion, not tobacco per se) but there were a few notable contributions which addressed risk reduction and vaping.

MEP contributions

Kateřina Konečná talked about the complex problem of reaching left behind groups and those on the fringes of society. Konečná said that although complete abstinence may be the goal of public health it is unrealistic, and so harm reduction should be considered.

Directing questions to Professor Mons, rapporteur of the Beating Cancer committee Véronique Trillet-Lenoir asked about neutral packaging, mandatory health warnings and banning flavours for tobacco products.

Sarah Cerdas wanted to know what the experts’ opinions were on new tobacco products and what evidence was available to MEP’s to enable them to reach informed decisions when legislating for these new products.

Next to speak was Peter Liese, whose contribution was the most positive towards harm reduction thus far. Liese opened by saying that lifestyle changes, such as stopping smoking, can provide the greatest benefit in reducing the risks of cancer. Pointing out the difficulty some people have in giving up smoking, he suggested that the committee need to be more open towards e-cigarettes. To further make the point he recalled comments from WHO expert Dr Shultz to the health working group in February where he said, “there is no scenario in which e-cigarettes are more dangerous than tobacco (smoking).” He ended by saying that there is a need to make sure that e-cigarettes are not more difficult to access than tobacco, and asked the speakers their opinions on this.

Echoing earlier contributions, Dolors Montserrat said that there is a need to examine ways of reducing risk for tobacco users.

Pietro Fiocchi wasted no time in getting to the point with his first question. “Vaping – we know it has some negative effects, but scientific studies show a much lower incidence of lung cancer. What is your position (Prof Mons) on this, considering the negative position taken by Commissioner Kyriakides on this topic?” He went on to ask about studies on the effects of high taxation on tobacco and alcohol products, saying that some studies show they are counterproductive, especially for young people.

Tomislav Sokol focused on the broader topic of tobacco harm reduction, including snus. He enquired if, given the EU’s scepticism towards THR products and the alleged lack of evidence, there should be more EU funded research on the topic in order to facilitate a common EU policy.

The final MEP to speak was Andrey Slabakov, who emphasised the importance of cancer prevention, and asked what strategies could be employed to help those groups of long term smokers who are unable or unwilling to quit smoking.

The floor was then handed back to Professor Chilingirova to address some of the questions raised by the MEP’s. Her thoughts on harm reduction and novel tobacco products were especially insightful: she said that alternatives are important as restrictions do not work for those who have made a personal choice to smoke, that stigmatisation is not a helpful tactic and that restrictions which apply to cigarettes should not be placed on novel products. She added that the data to date shows that novel products are reduced risk products and they are a good option for smokers that don’t want to quit.

Overall, the hearing was more positive than expected. The fact that several members of this very important and influential committee recognised the need for harm reduction strategies is a positive development and one to be cautiously optimistic about. The opportunity is now there for consumers and advocates to build on this by contacting their MEP’s and getting the message across that harm reduction matters.

 

Beating Cancer Plan timeline

Mr Bartosz Arłukowicz, BECA Chair, confirmed the Cancer Plan has been delayed from December 2020 to the beginning of 2021

 

Resources

Professor Mons' replies to written questions from MEP's [link]

Presentations from the BECA hearing [link]

Facilitating a healthy lifestyle: how to reduce cancer related lifestyle risk factors, public hearing [link]