Up to 280,000 Czech lives could be saved by 2060 by a strategy to replace cigarettes with nicotine alternatives
We smoke too much, especially Czech women
These are not exactly flattering figures: in the Czech Republic, more than 33% of men and 26% of women smoke, which puts us among the countries with a high proportion of smokers and, unfortunately, one of the highest proportions of female smokers. Cigarettes are responsible for around 18 000 premature deaths a year. Smoking is a key factor in the development of coronary heart disease, chronic obstructive pulmonary disease and stroke. Women in the Czech Republic are twice as likely to die from lung cancer than from the dreaded breast cancer.
Although the number of smokers is falling, it is still not fast enough. It is therefore clear that neither the anti-smoking campaign in the form of warnings on cigarette packs nor the increase in cigarette prices is producing the results that are needed with regard to the health of Czech men and women. At the beginning of the year, excise duty on cigarettes, cigars and smoking tobacco was increased by 5%, so smokers will pay at least CZK 140 per pack of cigarettes and even more in future years. But even this will not deter many.
A starting point, according to a study by Global Health Consults, could be consistent support for the Tobacco Harm Reduction (THR) strategy.
Nicotine yes, but in an alternative form
The THR strategy focuses on replacing conventional cigarettes with alternatives that allow users to continue to ingest nicotine but without exposure to the deadly toxins in tobacco smoke. In other words, smokers do not lose nicotine, they just ingest it in less harmful ways: for example, through nicotine sachets, e-cigarettes or in heated tobacco. It is nicotine alternatives that are increasingly popular as a way of quitting smoking. They are a less risky way of ingesting nicotine and can be an effective aid on the road to complete nicotine-free status.
Nicotine alternatives can save thousands of lives
Nicotine alternatives are gaining popularity among Czechs, and this supports the study's optimistic estimates: if the THR strategy could be fully implemented, it could save up to 280,000 lives in the Czech Republic by 2060. Moreover, this is not an exaggerated estimate, as nicotine alternatives are very effective in smoking cessation. The benefits for smokers are numerous: nicotine alternatives do not stain fingers or teeth, they do not smell, nicotine sachets, for example, can be used anytime and anywhere, and they are less expensive. According to a study by Global Health Consults, vaping (i.e. using an electronic cigarette) can be almost twice as effective as conventional nicotine replacement therapy in helping people quit smoking.
THR is a pathway to both prevention and harm reduction
The THR strategy is not new, even in the Czech Republic. Although we are slowly approaching the end of the defined period, we are still only sticking to the basics. Czech legislation supports the THR strategy by lowering the tax burden on nicotine alternatives: e-cigarettes and nicotine sachets have also been subject to excise duty since last year, which is 5 CZK/ml for e-cigarette refills and 0.8 CZK/g for nicotine sachets. Although the tax will increase over the next two years, the tax burden on nicotine alternatives will still be lower than on conventional cigarettes. For example, refills for heated tobacco devices such as glo are tens of crowns cheaper than conventional cigarettes even at the new prices. Smokers who switch to heated tobacco can save up to CZK 10 000 a year.
But financial benefits alone are not enough. With more support from the government, but also from independent scientific and consumer organisations or doctors, better results could be achieved. For proof, we can go to Japan or Sweden, for example. There, consistent support for steps towards a 'smoke-free' society has succeeded in reducing the proportion of smokers to less than 5%.
