The principle of a risk-based policy and why this is still controversial for tobacco control and public health

Between 2020 and 2022 the Belgian Superior Health Council undertook an extensive review and consultation on e-cigarettes with a view to providing updated guidance and advice for tobacco policy.  It took 2 years to arrive at this advice and was the result of multi stakeholder engagement from across tobacco control communities, scientific disciplines as toxicology, pneumology, oncology, psychiatry, psychology, sociology …, points of interest such as health promotion and health inequality, and vigorous scientific review. The final advice has been a compromise which highlights the need to focus – with equal attention – on both opportunities and risks.  In this session Stefaan will explore the process and challenges of creating a public health consensus amidst an evolving phenomenon which has highlighted the distinct divides between traditional tobacco control sentiment and harm reduction proponents.  Although there remains some controversy, the advice has provided a framework for developing a risk-based policy and recognises the role that harm reduction can play within public health and what this means for the current framework and approach of smoking and smoking cessation.