The non diminishing number of smokers, the high health risks and premature death risks caused by smoking are reasons to believe that changes in the smoking reduction policy are necessary in Latvia. It is recommended that Latvia take into account the successful experience of other countries in the field of reducing the harm caused by smoking, ensuring that smokers of traditional cigarettes have access to less harmful alternatives and more information, concluded the seminar “Towards a smoke free society” organised by the Smoke Free Association.
The situation in Latvia is constantly bad
The number of smokers in Latvia is constantly quite high. The risks caused by smoking, just like twenty years ago, are a significant cause of high morbidity and mortality rates in Latvia. Previous attempts to reduce the number of smokers with various restrictions have proven to be quite ineffective. Other countries have had a similar experience, so today in many places smoking reduction policies are undergoing significant changes as they are looking for new and more effective ways to reduce smoking. The new innovative approach is characterised by an emphasis on harm reduction and has already proven its effectiveness, for example, in Sweden and Great Britain.
The research “Use of tobacco and nicotine-containing products and smoking cessation” carried out by the research centre SKDS in 2022 shows that more than one third of the population (35%) uses tobacco and nicotine-containing products in Latvia. 24% do it regularly, and 11% occasionally. In Latvia, as it is also elsewhere in the world, about two-thirds of smokers want to quit this harmful habit. The main reasons for quitting smoking are health problems and concern for health (73%), as well as the desire to save money (69%). Among them, 84% of traditional cigarette users who want to quit have tried to do so at least once before. 27% succeeded, while 54% of respondents quit smoking, but after some time started smoking again.
Traditional cigarettes are the main cause of addiction
In general, the most commonly used tobacco and nicotine-containing product in Latvia are traditional cigarettes – 72% of smokers use them, while 38% use e-cigarettes. Regular cigarettes are also the first product that smokers have started using regularly (88%). Only 5% of respondents mentioned e-cigarettes. The main reasons why respondents start using smokeless nicotine products at all – there is no smoke, the breath, hands and clothes do not stink (52%), these products are less disturbing to others (48%) and these products can be used indoors (47%), to stop or reduce smoking cigarettes and other classic tobacco products (39%), and also because it is considered a less harmful alternative (34%).
The experience of Sweden – the availability of less harmful alternatives must be ensured
Experts point out that Sweden is a good example of how effectively and in a relatively short period of time reduce the number of smokers in the country significantly. Accordingly, the burden caused by smoking on the national health care system decreases, and the number of both smoking -related diseases and premature deaths decreases. The director of the Swedish Institute for Environment and Public Health, Christofer Fjellner, emphasises that Sweden is an example of how to significantly reduce the number of smokers without any drastic restrictions, tax changes and upheavals in society.
K. Fjellner points out that cigarette smoking is now a dying phenomenon in Sweden. Currently, only about 7% of the population smoke in the country, which is the smallest number of smokers in Europe. Sweden has managed to achieve this by promoting the use of snus as a less harmful alternative to tobacco. In general, Swedes consume about the same amount of tobacco as the public in other countries, but unlike other countries, they do not burn it and therefore do not take in the harmful and carcinogenic substances that are produced during the cigarette combustion process. K. Fjellner emphasises that snus has made a huge difference in the Swedish healthcare sector, because Swedes continue to use tobacco, but no longer die from it.
In Sweden, women smoke cigarettes more than men – only 6% of men and 8% of women. This is also reflected in morbidity and mortality statistics. Swedish men stand out on the European scale – compared to other countries, Sweden has the lowest number of men who have fallen ill or died due to usage of tobacco products.
Analysing the Swedish experience, K. Fjellner points out that if the alternatives are sufficiently attractive, they can leave a significant impression on the young audience as well, forming new habits. Thus, for example, in Sweden, the youth audience has the smallest number of smokers, but the largest number is among the elderly population over 55 years of age. It is most difficult for these people to change their habits.
Harmful products should be taxed higher
K. Fjellner emphasises that fighting smoking addiction is very difficult and often even impossible, unless the smoker has the opportunity to start using an alternative that is attractive and less harmful to health. If the alternative is sufficiently attractive, it will not be necessary to spend funds on any additional campaigns or to introduce new and new restrictions. It is therefore important to legalise less harmful alternatives and make them more attractive. In this regard, tax policy also plays a big role – taxes on harmful products should be higher so that they are less attractive to the population. On the other hand, those that cause less harm should be restricted less and taxed less.
A sad experience with raising taxes on e-cigarettes can be observed in Estonia, where raising taxes pushed these cigarette alternatives into the grey zone and thus became less controllable, although overall consumption did not decrease.
The choice of Great Britain – e-cigarettes
Like Sweden, Great Britain has chosen the innovative harm reduction approach in the fight against smoking. Only unlike Sweden, the British government recommends e-cigarettes as the best way to quit smoking. Researchers in Great Britain have concluded that e-cigarettes can be successfully used as an intermediate step on the way to quitting smoking. In 2019, 59.7% of smokers who replaced regular cigarettes with smokeless alternatives managed to quit smoking, and in 2020, 74% succeeded. To further reduce the prevalence of smoking, Great Britain plans to become the first country in the world where doctors will be able to prescribe licensed e-cigarettes as medical aids for people who want to quit smoking. It is planned that after receiving the medical device license, doctors will be able to prescribe electronic cigarettes to patients as a means of quitting smoking.
Responsibility of traders
At the same time, the experts also stressed the responsibility of traders to reduce the availability of cigarette alternatives for minors. Experts emphasised that the less harmful alternatives are intended for adult cigarette smokers who, for various reasons, cannot or do not want to quit smoking, but still want to reduce its negative impact on their health and and the health of people around them. Therefore, both law enforcement authorities must work actively to record violations and punish dishonest traders, and the traders themselves must also be socially responsible. In Latvia, to limit dishonest traders, a social campaign “Unmask the Soot!” is being launched. It is organised together with cooperation partners by the “Smoke Free Association”, and within the framework of which traders join the memorandum of responsible trade, while the public is invited to report unfair traders to the Center for the Protection of Consumer Rights, the State Revenue Service and the State Police.