When it is impossible to go against the law of supply and demand, deciding to "ban" is not feasible. The more important and urgent issue is how to control TLTHM to both achieve the goal of promoting the positive side of the product's role in reducing the harmful effects and minimizing related problems. Accordingly, the key point is the need to improve management qualifications and capacity.
Management experience from advanced countries
According to the World Health Organization (WHO), cigarettes kill more than 8 million people each year. Of which, more than 7 million people died from direct tobacco use and about 1.2 million people died from exposure to secondhand smoke. It is worth mentioning that only 8-10% of smokers have successfully quit.
Faced with this problem, the governments and health agencies of many countries have re-evaluated the current tobacco control strategy, according to which harm reduction products to replace cigarettes are affirmed to be one of the factors to end the smoking era.
The US Food and Drug Administration (FDA) is one of the most prestigious organizations in the world to pioneer the licensing of a number of TLTHM products, also known as non-smoked cigarettes, including electronic cigarettes (TLDT) packaged with cigarette essential oils, heated tobacco products (TLLN), and a few oral products.
In the UK, in 2022, more than 4.3 million people switched to smoke-free products, of which more than half (2.4 million people) had completely quit smoking. The British anti-smoking organization ASH also strongly supports the conversion of smokers to smoking tobacco, and believes that the number of users who have never smoked before who do not smoke tobacco is not a concern, as this is only a minority and is mainly a test drive for curiosity.
Many prestigious journals have published scientific studies proving the ability to reduce damage thanks to technology to eliminate the combustion process. Notably, research published in the journal Circulation conducted on over 5 million smokers in Korea shows that: smokers who switch to TLLN have a lower risk of cardiovascular disease than those who continue to smoke.
Studies also show that TLLN does not lead to the " cau-making phenomenon" (from TLLN use to smoking). For example, in Japan, the rate of dual users is less than 30% of TLLN users. TLLN products are also not attractive to people who have successfully quit smoking and have never smoked.
In the list of countries supporting tobacco harm reduction solutions globally (over 80 countries), there are Germany, France, Italy, Switzerland, Norway, the Netherlands, Canada, New Zealand, Japan, Korea, China, Malaysia, the Philippines, ... The common model of these countries is to soon put TLTHM under the law; strictly punish violations; combine propaganda so that products can only reach the right target adults who need to convert; coordinate with tobacco manufacturing companies to have appropriate control measures.
Many problems in countries where TLLHM is still outside the legal framework
In these countries, although the product is not yet allowed to be traded, buying and selling is still taking place vigorously in the black market, because the need to minimize the harm is real. For example, in Vietnam, a survey by an online newspaper with over 2,000 adults showed that up to 70% of people think that solutions to reduce the harmful effects of cigarette smoke are important.
Having been outside the legal loop for too long, smuggled e-commerce has increasingly become a threat to society, especially to users' health. Recently, there have been many cases of drug poisoning and other banned substances disguised as illegal drug trafficking. From a harm-reducing product, due to not being strictly managed, e-commerce has become a danger to the community and a burden to authorities.
At the seminar on the trend of approaching solutions to reduce the harmful effects of tobacco in Vietnam organized by the VietnamPlus e-newspaper in coordination with the Vietnam Medical Association in early August, leading health experts all said that since TLTHM has not been legalized, the solution to reduce the harmful effects of tobacco is still overlooked, smokers, especially patients, will miss a good opportunity to improve their health.
Dr. Dao Van Tu - Head of the Required Treatment Department, Director of the Clinical Research Center, K Central Hospital, said that many scientific studies have proven that the transition from TLD to TLLN helps reduce toxins and reduce exposure. This can be seen as a promise that many future health problems will be controlled with tobacco harm reduction tools, he said.
Sharing the same view, Associate Professor, Dr. Tran Van Ngoc, Vice President of the Vietnam Lung Association, President of the Ho Chi Minh City Respiratory Association, said: We need to manage TLTHM and refer to good management policies in the world. The problem of strict management is our level.
MSc. Dr. Le Dinh Phuong - Head of the Department of Internal Medicine and Family Medicine, Phap Viet Hospital - FV, Ho Chi Minh City also said that it is necessary to improve management capacity: "If we accept TLLN as we accept methadone (a heroin replacement solution) and manage it well, it will be very beneficial for the community, for patients and solve the problem of misuse".
