Nicotine Science & Policy | 17 August 2016
Turkey has for many years implemented stringent efforts to reduce smoking rates. Smoke-free policies, a two hundred per cent price increase on cigarettes and comprehensive stop-smoking services have all been introduced in the last decade; all significant actions from a country known for the saying ”Smoking like a Turk”.
Strangely two important events have taken place that question the sincerity of this fight against smoking.
1. The premier vaping network website in Turkey has been blocked to all Turkish Internet users.
2. In direct violation of FCTC Article 5.3, the makers of the Marlboro and Parliament brands of cigarettes in Turkey are joining a Turkish government delegation on a global road show to promote Turkey as good place to do business.
Whilst the latter in particular seems counterintuitive to the tobacco control measures introduced by the government, the former is evidence of a lack of any support in Turkey for the concept of Tobacco Harm Reduction.
THR in all forms is very much an unseen – even underground - phenomenon in Turkey. For example, there is widespread rural use of a relatively benign smokeless tobacco known as ”Maras otu”. This product exists completely outside the regulatory system in Turkey. To date only the harms and potential harms of the product have been scientifically studied. There has been no assessment on how to develop these smokeless products to better standards. Standards where such products might be viable and substantially lower risk alternatives to cigarette smoking. A model for such scientific investigation is that applied to Swedish snus, acknowledged as a viable harm reduction product that has provided tremendous health benefits in Sweden and Norway.
The logical solution is of course to raise the standards for smokeless everywhere to the best available standards – as one more effective weapon in the fight against smoking – not ban them and force them underground.
The taxation policy adopted in Turkey has failed to produce significant reductions in smoking rates, with the purchase of illicit goods increasing at the same rate as the decline in licit sales, which is a situation mirrored elsewhere, despite WHO continued claims regarding the effectiveness of price increases in delivering lower smoking prevalence.
One would have imagined that a country like Turkey, known for being head-strong, proud, going its own way and resisting unwelcome outside influence, would already have embraced harm reduction, as a cost-free, consumer driven method to curb smoking and improve the health of the population.
Ideally though, we may hope that Turkey is just struggling as best she can to curb smoking, but partly acting on deliberate misinformation from WHO and affiliates. Turkey being what she is though, with correct understanding of the benefits from THR, policy and action could change within months. Let’s hope for that!
Anonymous LMIC “Tobacco Harm Reduction” policy researcher