Tobacco industry figures are looking to convince decision-makers that e-cigarettes and vaping are an alternative in the heavy-smoking Middle East.
So far, they have met with tough resistance.
E-cigarettes and vaping products are banned in Egypt, Iran, Kuwait, Lebanon, Oman and Qatar — although they are widely available on the black market — as regulators fear a vaping epidemic among teenagers that is similar to the one in the US.
While the UAE allows the sale of e-cigarettes, regulators do not support their use as part of efforts to encourage smokers to quit, and there are curbs on their promotion and advertising.
Speaking at the World Vape Show in Dubai last week, several key tobacco sector figures said they are pushing for a scenario such as the one in the UK and the US, where vapes are supported as medicinal products and doctors can recommend them to heavy cigarette smokers.
Dr Hugo Tan, regional head of scientific engagement in the Asia-Pacific and the Middle East for British American Tobacco, said: “Tobacco harm reduction [THR] is not new and has been adopted by many other countries like the UK, US, France and Germany.
“What is important is a public health strategy that recognises the health impact of combustible cigarettes.
“It should aim to reduce the risk of smoking cigarettes and empower the user to switch completely to alternative or scientifically substantiated alternatives like vaping or other products.
“It is important to generate local data that represents the local demographics so the potential effects can be assessed to help to shape policy.
“Fundamentally, change is required in this region from an industry perspective to persuade more smokers to adopt alternatives.”
Critics say the jury is still out on vaping. The chemical composition of the vaping fluid is of particular concern.
Last year, an Ohio State University study found that the harmful effects of vaping could be seen within a few months of starting, leading to the risk of gum disease and cancer.
Other countries such as Australia, Canada and Norway have also introduced restrictions on vaping, amid concerns over low-priced disposable vapes and flavours encouraging nicotine addiction in children.
Research published by the University of Ottawa looked at the regulation of e-cigarettes and associated incentives across 97 countries.
It showed smokers had a higher chance of quitting successfully in countries with less restrictive rules on e-cigarettes such as New Zealand and the UK, where there was a common belief that vaping was less harmful than conventional cigarettes.
Option for heavy smokers
Lebanon has the region’s highest smoking rate, with 1,955 cigarettes a year per smoker, followed by Kuwait where the average is 1,849, according to the latest World Tobacco Atlas.
Both countries have banned the use of e-cigarettes.
Dr Tan said tobacco companies were planning to conduct regional studies to educate and encourage support for less harmful alternatives.
“Generally, the adoption of THR policy requires more effort and we want to work hand in hand with local authorities to increase that,” he said.
“It has been very successful elsewhere in the UK, Germany, France and New Zealand — to help to manage the overall harm reduction.
“I am a big supporter of generating local data. We have not conducted local trials, but this is a potential collaboration we would like to explore.”
Are sweet and fruit flavours leading to teen vaping epidemic?
The World Health Organisation has delivered a stark warning about the risks of vaping, stating e-cigarettes are harmful to health.
A 2019 University of Southern California study found that teenagers who vape sweet or fruit-flavoured e-cigarettes are more likely to stick with the habit and vape more heavily, highlighting the role played by flavours in fuelling the vaping epidemic among teenagers.
In 2020, the US Food and Drug Administration placed restrictions on flavours for cartridge-based e-cigarettes such as Juul after a reported surge in uptake by non-smoking teenagers.
Sweet and fruit flavours were banned, limiting the choice to only menthol and tobacco flavours generally preferred by adults.
However, the ban on flavours did not apply to cheaper, disposable e-cigarettes and other vaping devices.
Since then, the FDA has introduced further regulations on companies making e-cigarettes using synthetic nicotine in fruit-flavoured vapes.
Manufacturers must now follow the same federal sales restrictions and age requirements as conventional tobacco products.
Robert Naouss, external affairs director for the Mena region and Europe for RELX, China’s largest e-cigarette manufacturer, said tight regulations could discourage smokers from trying less harmful alternatives.
“The regulatory framework itself is the same for combustible cigarettes as it is for vaping, which is a challenge for companies,” he said.
“We know there is a better alternative to burning tobacco leaves, which is in line with the principle of harm reduction.
“More awareness is needed for alternatives. Yes, they are addictive products and contain nicotine, but they are not as harmful as combustible cigarettes.
“There need to be processes in place to ensure they only reach the target markets, which is adult smokers.
“A huge ecosystem of people are waiting to switch, but the challenge is not affordability but awareness.
“Establishing trust is very important, and working together with authorities to shed more light on the science and show the responsibility of manufacturers would certainly help.”