A Decision-Theoretic Public Health Framework for Heated Tobacco and Nicotine Vaping Products

Levy, David T.; Cadham, Christopher J.; Li, Yameng; Yuan, Zhe; Liber, Alex; Oh, Hayoung; Travis, Nargiz; Issabakhsh, Mona; Sweanor, David; Sánchez-Romero, Luz María; Meza, Rafael; Cummings, Michael

doi:10.3390/ijerph192013431

Cited by 3 publications

(1 citation statement)

References 134 publications

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“…o Study scientific evidence, international best practices, and commission studies on how HNBs can be used as a harm reduction tool and smoking cessation aid, including statistical models to compare public health outcomes of different interventions (Levy et al 2021) and decision-theoretic frameworks (Levy et al 2022). Overall, this would result in more nuanced policy with greater impacts on public health.…”

Section: Adapting a Risk-balancing Framework For Indiamentioning

confidence: 99%

Does India's Ban on Electronic Cigarettes Improve Public Health Outcomes?

Gowda

Thangiah²

2023

IPPR

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In 2019, India banned Electronic Nicotine Delivery Systems (ENDS) – a broad category that includes electronic cigarettes, vaping devices, and Heat Not Burn (HNB) devices – because of concerns about health impacts, youth vulnerability, and their potential to undermine tobacco control efforts. This is a missed public health opportunity to reduce tobacco consumption, if ENDS actually help reduce and wean users off nicotine dependency in less harmful ways. This paper applies a risk analysis framework to examine whether India’s ban on ENDS improves public health outcomes, or whether an alternative approach such as regulation would be more effective. It studies global responses and compares how public health goals are served in the United States of America and the United Kingdom, based on four key parameters of concern – health impacts, normalisation of ENDS usage among non-smokers, appeal among youth, and device safety. This comparison demonstrates that the United Kingdom’s regulation-focused approach delivers superior outcomes across all four parameters. Thus, the evidence-based recommendation for India would be to regulate at least HNB devices under the Cigarettes and Other Tobacco Products Act (as they utilise tobacco), as this can help reduce harm and promote innovation in devices that can wean users off nicotine dependence.

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Section: Adapting a Risk-balancing Framework For Indiamentioning

confidence: 99%

Does India's Ban on Electronic Cigarettes Improve Public Health Outcomes?

Gowda

Thangiah²

2023

IPPR

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Summary and Concluding Remarks: Patterns of Birth Cohort‒Specific Smoking Histories

Levy¹,

Tam²,

Jeon³

et al. 2023

American Journal of Preventive Medicine

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Potential Implications for Tobacco Industry Transformation of the Acquisition of Swedish Match by Philip Morris International

Levy

Warner

Liber

et al. 2023

Nicotine and Tobacco Research

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Philip Morris International's recent purchase of Swedish Match may prove to be a vital tobacco industry development. We focus on PMI's potential progress in moving from primarily selling cigarettes towards primarily selling non-combustible nicotine delivery products (NCNDPs). We also consider the potential contribution of the acquisition to industry transformation whereby other cigarette firms may potentially move towards primarily selling NCNDPs. We examine the potential impact on non-combustible nicotine delivery product use, including nicotine pouches (a major Swedish Match product), e-cigarettes, heated tobacco products, and, most importantly, on sales of the industry’s staple, combustible cigarettes. We focus on the US as a special case, where PMI is limited from entering the cigarette market. Implications: Philip Morris International’s purchase of Swedish Match and policies regarding nicotine pouches (NPs) have been overlooked in the tobacco control literature. The acquisition indicates the importance of the NP market to the largest nonstate-owned tobacco company. The acquisition has the potential through pricing and marketing tactics to either encourage or discourage the use of NPs, e-cigarettes, heated tobacco products, and most importantly cigarettes. Due to its inability to sell cigarettes in the US, PMI will have incentives to use its alternative nicotine delivery products, including its newly-acquired NPs, to reduce the sale of cigarettes by other companies. However, the potential effects in other countries, where PMI does sell cigarettes, are less clear. Monitoring and analyzing tobacco company acquisitions is essential to studying future transitions in using different kinds of tobacco products, especially from cigarettes to lower-risk alternative nicotine delivery products.

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A Decision-Theoretic Public Health Framework for Heated Tobacco and Nicotine Vaping Products

Cited by 3 publications

References 134 publications

Does India's Ban on Electronic Cigarettes Improve Public Health Outcomes?

Does India's Ban on Electronic Cigarettes Improve Public Health Outcomes?

Summary and Concluding Remarks: Patterns of Birth Cohort‒Specific Smoking Histories

Potential Implications for Tobacco Industry Transformation of the Acquisition of Swedish Match by Philip Morris International

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