During the seminar, “Prohibition is not regulation!”we learned that an understanding that prohibitions do not lower the use of psychoactive substances or peoples want for other vices is evident amongst Latvian society. In the case of smoking here is noticeable support for Tobacco Harm Reduction (THR) policies like switching to non-combustible alternatives or a differentialised tax system (tax is weighted against the evaluated harm the product may cause).
Prohibition of substances deemed unwanted at one time or another sooner or later end up being withdrawn or proved ineffective. This is why an increasing number of countries are leaning towards harm reduction policies that account for our realities – the understanding that there will always be humans who, regardless of the obstacles, will continue to side with their vices. Prohibitions do not lower the numbers of people who use psychoactive substances, but they do change how the market operates – and not for the better. From a public health perspective, it is more effective to support access to less harmful alternatives.
Data from the 2023 SKDS study ‘Societal attitudes towards tobacco and nicotine products and their use’ was discussed at the seminar. Data shows that 48% of Latvian residents believe that one way to lower the harm caused by combustable tobacco smoke is to encourage smokers to fully switch to alternative smokeless products.
46% of the respondents agreed that smokeless products should be taxed less than cigarettes, yet be not so cheap that they would appeal to adolescents or never smokers.
People were also asked what they thought of the plan to ban the sale of flavoured e-cigarettes or nicotine pouches (NP) and to lower the nicotine concentration in NPs so that they would become unappealing to users. 47% of respondents stated that they would continue to buy these products, just now on the online or offline illicit markets, or bring them from abroad. 31% speculated that people would switch or return to cigarettes or other tobacco products. Only 6% believed that this would encourage people quitting these products or abstaining from using the traditional well-known combustable alternatives.
During his presentation, Arnis Kaktiņš (director of SKDS) acknowledged that in the eyes of Latvian society these planned bans are a complete nonsense. Kaktiņš continued to say that society does not believe in the need or in the efficacy of such policies. He highlighted that “This is yet another brick in the wall that is destroying public trust in government that is making itself look ridiculous. Government leaders are demonstrating their incompetency, they are not listening to the experts, nor the public. Leading to unreasonable policy decisions being made. In some way we can compare this to the governmental approach in North Korea. There, decisions are made with no concern for public opinion and with an intent to achieve public control with a variety of prohibitions”.
The survey also showed that 35% of the surveyed residents use nicotine products. Amongst them, 29% use them regularly and 6% occasionally. A typical smoker in Latvia is still the user of traditional cigarettes (they make up approximately two thirds of all nicotine users). Only a small proportion of nicotine users engage with the new generation nicotine products.
Younger people tend to buy nicotine products more from friends and acquaintances, rather than the typical shopping centres or speciality shops. Which would most likely mean that any prohibition or restriction on the market would be easily sidestepped.
In his presentation, Lars E. Rutqvist, talked about the Swedish experience in lowering smoking prevalence. Rutqvist is an internationally acclaimed researcher, doctor of medicine and consultant for oncology. He discussed how the use of positive and thought out stimuli, rather than simple bans and restrictions, are more effective tools. The prevalence of smoking in Sweden has decreased to almost 5% which will allow it to be considered a smokeless society. This was achieved through the utilisation of alternative products (most notably snus, a Swedish chewing tobacco). Snus exhibits a much lower level of risk to health. This is also demonstrated by the low smoking related illness levels in Sweden.
It is interesting to note that this policy support for Snus in Sweden was not initialised by the Swedish government but by citizens themselves. Initially, the government placed Snus in the category with all other tobacco products. However, when Snus’ positive effect on public health was noted, policy was reconsidered. Now in 2024 Sweden plans to reevaluate the tax burden on Snus and nicotine pouches. Rutqvist pointed out that research and experience shows that an evidence-based pragmatic regulation means that the tax should match the harm. The more harmful the product is deemed to be, the higher the tax should be placed on it.
Sociologist, Kristiana Bebre, pointed out that countries with the most stringent drug prohibition policies do not end up with a lower user prevalence when compared to countries with evidence-based policies. Prohibitions do not lower the engagement with illicit substances, they just change the market. As law enforcement increases, so does the market violence which then spills or flows into wider society.
Seminar presentations:
