Delivering a highly interesting keynote speech, moderated by SCOHRE’s President of the Board, Professor Ignatios Ikonomidis, Dr. Stelios Kympouropoulos, Psychiatrist and Former Member of the European Parliament, shared his thoughts concerning the importance of harm reduction tools for improving public health and the need for scientific data-guided respective political and regulatory decisions in the EU.
Harm reduction is a duty when safer, regulated alternatives exist, Dr. Kympouropoulos stated. We need humane, proportionate, and evidence-led policies, he explained, to move adults down the risk curve, while maintaining a declining trend in youth initiation to smoking. Success is defined as fewer cigarettes sold, more successful quits, and decline of youth vaping or smoking.
People living with depression, anxiety, or psychosis show higher smoking rates, he continued. Quitting improves mood, sleep, and energy over time, Dr. Kympouropoulos added, since cessation isn’t only good for the lungs and the heart; it is also good for people’s minds, relationships, work and sense of control.
Tobacco is responsible for more than 7M deaths per year worldwide, and 700K deaths per year in EU. According to scientific data, regulated smoke-free alternatives have lower risk (although not zero) compared to combustion products, the speaker said. “Those who refuse to see the difference, simply ignore reality”, he added. The real-world experience from Sweden, UK, and NZ has shown that consumption of combustible tobacco falls faster when alternatives exist.
For Europe to “turn the science into consistent policy”, as Dr. Kympouropoulos said, regarding Tobacco Control, 5 steps are necessary:
- Risk‑proportionate product rules in the next Tobacco Product Directive: distinguish combustibles from non‑combustibles; mandate product quality & independent post‑market surveillance.
- Excise differentiation in Tobacco Taxation Directive: preserve cessation incentives vs cigarettes; add automatic indexation.
- EU-wide monitoring dashboards: adult cessation, youth initiation, dual‑use, adverse effects—published quarterly.
- Integrate cessation pathways: allow clinicians to discuss regulated vaping for adult smokers within guidelines.
- Trust & ethics package: youth marketing limits, flavour and packaging rules, COI firewalls, second‑hand protections.
Vaping is far less harmful than smoking for adult switchers-Dr. Kympouropoulos said- while youth use can be prevented with proportionate regulation and hard age checks, flavour & retail limits, and rapid monitoring. Unknown long‑term effects are managed with standards, surveillance, and transparency (not denial or hype). Regarding the issue of flavours and their effects on youth, the solution is to restrict youth‑targeted names, packaging and placement, while allowing adult‑oriented options under strict controls. The industry influence can be addressed with setting conflict‑of‑interest firewalls and relying on independent evidence, so decisions are trusted, he added.
Since teens who vape are more likely to smoke later, Dr. Kympouropoulos said, to prevent this, we need to adopt and apply a multi‑level approach. This approach includes the involvement of: law & enforcement (enforced age limits, pricing that ‘bites’ for minors, context‑aware flavour rules); schools (interactive social‑skills curricula with peer leadership; smoke‑free rules; youth‑voiced, vivid communication); community & retail (licensing, routine compliance checks, penalties, location limits near schools, electronic age verification); clinicians & families (quiet screening, support matched to readiness; weekly low‑drama check‑ins; protect sleep). Finally, two cross‑cutting rules should be applied: build for equity and measure constantly to adapt fast as products change.
The implementation demands going from pilot to scale using time‑limited derogations and post‑market conditions; the use of data pipelines, such as common EU indicators; transparent, independent reporting; stakeholder governance (clinicians, patients, youth advocates, independent scientists); strict age limits, retail enforcement, marketing restrictions, and packaging standards, clear risk communication using truthful, non‑promotional relative‑risk labelling, and rapid‑response surveillance to detect spikes in youth uptake and adapt measures.
Ultimately, Dr. Kympouropoulos concluded, the path is simple and human. In order to address the urgency to reduce smoking-related death and disease in EU and worldwide, we must enable proportionate harm‑reduction pathways, and align science, ethics and feasibility. Policies must always follow the evidence.