By Dr Delon Human (below, left) & Dr Anders Milton (below, right)
Europe’s Beating Cancer Plan will form a core part of Health Commissioner Stella Kyriakiades’ term in office. A pan-European strategy to combat cancer is long overdue and we welcome Commissioner Kyriakiades’ initiative in tackling what is the second leading cause of death in Europe.
On 10 September, the Commission held a town hall on the Beating Cancer Plan. Unfortunately, this town hall did not fill us with hope – it seems that the Commission may be about to miss out on the chance of a lifetime and fail to sufficiently tackle preventable cancers in Europe.
Not only did the town hall fail to pay heed to the most obvious preventable cause of cancer in smoking, it seemed to disregard the opinion of EU citizens. Of the submissions to the Plan’s public consultation, nearly 20% supported the adoption of harm reduction plans for alcohol and tobacco. One in every six recommended policies which encourage the use of reduced risk nicotine products by smokers, such as e-cigarettes.
Every year, 3.5 million people in the EU are diagnosed with cancer, and 1.3 million die from it, yet over 40% of cancer cases are preventable.
The WHO estimates that one in every two smokers will develop a tobacco-related disease. Approximately 18% of the EU’s 446 million citizens smoke cigarettes on a daily basis. 90% of lung cancers alone can be prevented by eliminating tobacco use in Europe.
What is often forgotten, however, is that smokers consume cigarettes for nicotine but get cancer from the tobacco, tar and thousands of other additives in cigarettes. Nicotine itself is not a carcinogen. This raises the question; what if there was a way to offer smokers the nicotine they desire while removing carcinogens?
Tobacco harm reduction presents the clear and obvious answer to this question. The use of reduced risk products, like e-cigarettes, can potentially eliminate smoking induced cancer in Europe within a generation.
A study of the results of the 2014 Eurobarometer survey by Konstantinos Farsalinos and others emphasized this point. They found that the vast majority of EU citizens consuming e-cigarettes on a regular basis were former smokers or smokers attempting to quit.
Harm reduction policy, particularly tobacco harm reduction, has extraordinary potential to reduce these avoidable smoking induced cancers.
EU countries such as Sweden, which have adopted a science-based approach to try to reduce their smoking prevalence and smoking-related deaths, have shown the way forward to reduce tobacco-induced cancers. Offering tobacco alternatives like snus has helped Sweden to achieve the lowest tobacco-related mortality rate of all EU countries relative to its population size.
While approximately 179,000 EU citizens have died so far as a result of Covid-19, 700,000 die each year from smoking. In an attempt to quell the devastation caused by the pandemic, EU institutions and member state governments immediately turned to science and evidence to inform policy. Lockdowns were implemented and social distancing became normalised.
This sense of pragmatism and efficiency must be mirrored by the Commission’s Beating Cancer Plan.
Harm reduction policy, particularly tobacco harm reduction, has extraordinary potential to reduce avoidable smoking induced cancers. It can save the lives of countless Europeans. We are calling on the Commission to recognize this potential, to hear the voices of European citizens, and leave no stone unturned in the fight to beat cancer.
Delon Human M.B.Ch.B., M.Prax.Med, MFGP, DCH, MBA is a French citizen and physician qualified in family medicine and child health, with an MBA from the Edinburgh Business School. He has acted as adviser to WHO Director-Generals and UN Secretary-General Ban Ki Moon. Formerly, he was secretary-general of the World Medical Association (WMA), the global representative body for physicians and thereafter Secretary General of the International Food and Beverage Alliance (IFBA).
Anders Milton B.Sc., M.D., Ph.D. is the president of ERNA, a member of the government appointed Catastrophe Commission and a consultant within the health care sector. He has previously been both CEO and secretary general of the Swedish Medical Association, chairman of the Council of the World Medical Association, chairman of the Swedish Red Cross and chairman of the Swedish Confederation of Professional Associations (SACO), as well as government appointed co-ordinator of psychiatric services in Sweden.