Editors Choice

It’s Time for New Tools to Overcome Smoking

Recently we marked the 36th year that the world observed World No Tobacco Day. This relatively obscure milestone masks a stalled effort to curb consumption of combustible cigarettes and other nicotine-related products. It’s unlikely most people paid any attention.

But the impact of smoking is all around us, even if we don’t see it. Statistics rarely tell a provocative story to compel people to action. The numbers behind the global smoking epidemic are so stark, however, they are almost incomprehensible. Behind every data point, a real person, family or community is impacted.

Let’s start with the challenge: More than 1.3 billion people – 17 percent of the global population – smoke cigarettes or consumes other tobacco products. Since the first World No Tobacco Day in 1987, nearly 300 million people have died from smoking-related illnesses, including tens of millions who died or suffered respiratory or cognitive impairment from second-hand smoke. If the average day is any gauge, thousands of children took up smoking yesterday, including the fastest rising of all groups: teenage girls. Beyond the impact of lives lost or harmed, smoking costs the global economy roughly $2 trillion in economic damage every year.

With that money, with those lives lost, what could be done to improve the world? A lot, as it turns out. That sum would fund the attainment of many of humanity’s most ambitious sustainability and poverty alleviation goals. We could facilitate an equitable transfer to cleaner energy technologies for industrialized and emerging markets. And to be blunt, we would have an honest shot at dramatically reducing cancer rates and chronic disease when a massive chunk of the world’s people isn’t inhaling products that contain more than 7,000 different chemicals with each puff.

Perhaps eliminating smoking is a pipe dream. Governments have imposed stiff taxes against tobacco products; research is being used to counter cigarette advertising; social stigma has built in many countries and health systems have made smoking habits increasingly punitive. But that hasn’t slowed the epidemic. We need better tools.

Around 60 percent of smokers globally – 780 million people – say they want to quit, but only 30 percent have access to resources to help them achieve that goal. That represents a massive market opportunity for the right solutions. Education and support networks are essential. However, smokers need access to more powerful cessation products to deliver a knockout punch. Fortunately, there is some good news on that front.

While smoking cessation products have been available for nearly two decades, they can have serious side effects and rebound rates. Last week, results for a confirmatory Phase 3 clinical trial – ORCA-3 – showed statistically significant results over six and 12 weeks. The study features a new cessation treatment called cytisinicline, a plant-derived alkaloid.

Most of the trial’s participants have been smoking for more than 30 years and have tried to quit on average four times. In the study, cytisinicline demonstrated a six-fold increase in the odds of maintaining continuous smoking cessation at six months compared to the placebo.

The new cessation treatment also produces far fewer side effects than routinely reported by people using other smoking cessation products. This is particularly important since compliance with treatment is a significant barrier that keeps millions of people from following through with their goal of quitting.

Cytisinicline opens a new front in the war to end smoking. The task is to ensure it and other tools reach the people who need it most. Advocacy groups and government agencies can help with this important next step by breaking down the barriers to access that frequently inhibit people from acting on the dream of kicking their smoking habit. It’s time to lend them a hand.

Richard Hatzfeld

Richard Hatzfeld is a global communications leader and public health champion who has led campaigns in Africa, Asia, Europe and the Americas to confront many of the most urgent health issues of our time. Richard is a senior partner at Finn Partners, leading the firm's global public health group from Washington, DC. He was previously a senior leader at Ogilvy, where he advised multinational companies, foundations and NGOs on global health issues, including infectious and parasitic diseases, maternal and child health, immunization, pandemic preparedness, and antimicrobial resistance. Before Ogilvy, Richard was communications director at the Sabin Vaccine Institute and led communications activities for their vaccine development, infectious disease and advocacy efforts, as well as the Global Network for Neglected Tropical Diseases and its award-winning END7 Campaign. Richard began his global public health career pioneering the development of the first reproductive health product line and a nationwide network of maternal/child clinics in the Democratic Republic of the Congo on behalf of USAID.

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