June 2022. ETHRA submitted to the European Commission's call for evidence which aims to evaluate the legislative framework for tobacco control, which will include the Tobacco Products Directive and the Tobacco Advertising Directive.

Dear European Commission

Evaluation of the legislative framework for tobacco control – call for evidence

European Tobacco Harm Reduction Advocates (ETHRA) is the voice of 27 million EU consumers of safer nicotine products. ETHRA is a consortium of 25 grassroots consumer associations in 17 European countries, supported by experts in tobacco control and nicotine research. We are a voluntary operation with no industry funding or conflicts of interest. Our transparency registration number is 354946837243-73.

Please find attached our response to the call for evidence regarding the evaluation of the legislative framework for tobacco control. We have focussed on how the European Commission and other bodies evaluate the evidence, drawing on what we see as failures in the SCHEER report. Our main point is that the value of evidence usually depends on:

  • How it is evaluated. For example, is vaping risk compared to smoking or abstinence?
  • What questions are asked and not asked? For example, how many Europeans no longer smoke because of vaping, snus, heated tobacco or other safer nicotine products?
  • What counterfactuals are considered: will people be deterred from vaping smoke instead?

Questions like “how do we prevent youth vaping?” do not provide an adequate framework for evaluating the evidence because they do not capture the effects of anti-vaping policies on youth and adult smoking or likely countermeasures by consumers and suppliers.

We highlight the importance of rigorous application of the EU’s core principles relating to the internal market, proportionality, and non-discrimination in policymaking. We believe rigorous application of these foundational ideas would change the current approach to safer nicotine products. These principles justify a risk-proportionate regulatory philosophy with a critical distinction drawn between combustible and non-combustible nicotine products, not between tobacco and non-tobacco or between novel and established products.

We provide a summary of evidence to support some basic insights that should inform tobacco control policy as it applies to safer nicotine products and tobacco harm reduction.

  • Smoke inhalation, not nicotine, is the primary cause of ill-health, and there are, beyond any reasonable doubt, significantly lower risks in using non-combustible forms of nicotine products. European Union policy should focus on reducing smoking, not tobacco.
  • Cigarettes and safer alternatives function as economic substitutes; therefore, tax, regulation or other interventions designed to address vaping will affect smoking. These substitution effects are the source of perverse consequences arising from poorly designed policies for safer nicotine products and causing increased smoking.
  • Multiple lines of evidence triangulate to show that vaping products support adult smoking cessation at minimal risk – these products should be primarily treated as an opportunity rather than a threat.
  • A more sophisticated approach to youth uptake of safer nicotine products is necessary. There is no evidence for gateway effects, but there is accumulating evidence that safer nicotine products divert some young people from smoking and may be beneficial to young people who would be more likely to take up smoking.

We hope the views in the attached submission are helpful. We look forward to further engagement with the Commission during the targeted stakeholder on these important issues.

Yours sincerely

Damian Sweeney
On behalf of ETHRA & Partners

Read our full submission [link]

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