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Do You Smoke These Alternatives To Cigarettes? In Malta, You May Be Breaking The Law

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Heat-not-burn tobacco products are illegal in Malta and there seems to be no plan by the government to overturn the ban.

Ahead of today’s World No Tobacco Day, the Health Ministry told Lovin Malta smokeless tobacco was totally banned in Malta since 1988, and this was reconfirmed in 2016 by Legal Notice 67. According to the law, smokeless tobacco is defined as “a tobacco product not involving a combustion process, including chewing tobacco, nasal tobacco and tobacco for oral use”.

Tobacco companies in Malta are currently lobbying the government to regulate heat-not-burn technology which they claim could reduce the public health consequences of smoking since their products do not require combustion for nicotine delivery. 

But while heat-not-burn technology has been introduced in almost every EU country, Malta seems adamant against it, arguing that smokeless tobacco products could still cause harm, are equally addictive, and could be used as a gateway for new smokers.  

“Tobacco products consumed in a process not involving combustion (such as smokeless tobacco products), are relatively new developments and research on their health effects is limited and related to emissions rather than long-term health effects,” the Health Ministry said.

“While the industry claims heat-not-burn tobacco products release no smoke because the tobacco does not combust and the tobacco leaves are only heated, the harmful components of tobacco cigarette smoke are products of incomplete combustion (pyrolysis) and the degradation of tobacco cigarettes through heat (thermogenic degradation),” the ministry added.

The ministry referred to a 2017 study which found the smoke emitted from IQOS, the flagship product of big tobacco company Philip Morris International, contained 84% of the nicotine found in conventional cigarettes and also featured volatile organic compounds, polycyclic aromatic hydrocarbons and carbon monoxide. 

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“In another study published in the journal ‘Circulation’, rats were exposed via nose cone to IQOS aerosol, Marlboro cigarette mainstream smoke, or air. The study concluded that acute exposure to IQOS aerosol can substantially impair endothelial function in rats comparably to cigarette smoke despite the absence of combustion and that the use of HNB tobacco products does not necessarily avoid the adverse cardiovascular effects of smoking cigarettes.”

The ministry also highlighted another risk of smokeless tobacco products such as IQOS. 

“New products with attractive labelling and flavours are being introduced in the market aiming to take advantage of new market opportunities created by national laws regulating conventional tobacco products (such as prohibiting smoking in public places (smoke-free environments), prohibiting flavours, specific labelling requirements, etc.”

“Such products can act as an entry gate for new tobacco consumers especially young persons eager to try innovative things. Marketing of such products does in fact target youths portraying the use of such products as trendy. Such marketing messages contaminate markets even where such messaging is banned such as Malta… A study by Kowitt SD et al lured cigarettes were perceived to be less harmful, more appealing, and looked like ‘candy sticks’.”

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But how does Philip Morris International respond?

Philip Morris International refers to the products as “heat-not-burn”, rather than smokeless tobacco.

“There is growing global support for the idea that products that don’t burn tobacco are a better alternative for smokers. In Malta, in spite of existing tobacco control efforts to help them quit or not to start, thousands of Maltese people continue to smoke who could benefit from this approach.”

“The government in Malta, in contrast to virtually all other countries in the EU, is not allowing these smoke-free products for current adult smokers. We believe that by working together with the government to responsibly permit these better alternatives on the market, we can help address one of the largest public health challenges: to make Malta smoke-free.”

According to the latest research, smoking in Malta only decreased by 0.2 per cent between 2008 and 2014. Daily male smokers decreased by 2.1 per cent, while the population of daily female smokers went up by 1.2 per cent. 

The good news is that the strongest decrease was registered among 15 to 16-year-old children who reported smoking in the last 30 days. This age bracket saw a drop of seven per cent between 2012 and 2016. A drop of six per cent was also registered between 2006 and 2014 among 16-year-olds who took up regular smoking.  

The Health Ministry warned of these possible harmful effects regarding smokeless tobacco products:

1. These products contain nicotine as a major constituent and are addictive. Nicotine can have adverse effects during pregnancy and may contribute to cardiovascular disease. Although nicotine itself is not a carcinogen, it may function as a “tumour promoter”.  Nicotine also seems involved in fundamental aspects of the biology of malignant diseases, as well as of neurodegeneration.

2. Users may be exposed to toxins different from cigarettes.

3. Due to the addictive nature of the products, cessation is difficult, as it is for smoking tobacco.

4. Tobacco manufacturers encourage use of smokeless products by smokers on occasions when they are not permitted to smoke. Promoting smokeless products may encourage individuals to adopt smokeless tobacco use in addition to continuing smoking.

5. Youth are especially vulnerable to trying new innovative experiences. Furthermore, smokeless tobacco use is more socially acceptable than smoking and it is usually easy to practice without detection. 

6. Use of smokeless tobacco has been reported to increase the chances of subsequent initiation of smoking i.e. persons who experiment with them often develop a pattern of regular daily use and over time, many users increase amounts they consume.

7. Smokeless tobacco is allowed to have characterising flavour and may therefore facilitate initiation of tobacco consumption, especially in young people. Flavouring is an effective tactic introduced by the tobacco industry to attract new and retain existing smokers. A study by Kowitt SD et al lured cigarettes were perceived to be less harmful, more appealing, and looked like “candy sticks”.

8. Consumption of such products, especially if promoted with smoking cessation claims, undermine the positive developments that have taken place in reducing smoking. They may especially undermine efforts to ‘De-normalise’ tobacco use.

Featured Image Original Photo by thefrenchperson

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Christian is an award-winning journalist and entrepreneur who founded Lovin Malta, a new media company dedicated to creating positive impact in society. He is passionate about justice, public finances and finding ways to build a better future.

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