The harm reduction strategy in tobacco control - A closer look at tobacco industry tactics on heated tobacco products

BackgroundAfter Thailand enacted laws to ban the import and sale of all types of electronic nicotine delivery systems (ENDS, including e-cigarettes and heated tobacco products (HTPs)) in 2015, pro-ENDS advocacy groups pressured the government to lift the ban, particularly after Philip Morris International (PMI) started promoting its HTP IQOS in 2017.MethodsWe reviewed information related to ENDS in Thailand between 2014 and 2019 from Thai newspaper articles, meeting minutes and letters submitted to government agencies, websites and social media platforms of pro-ENDS networks and Thai tobacco control organisations.ResultsThe tobacco industry and the pro-ENDS groups used five tactics to try to reverse the Thai ban on ENDS: creating front groups, lobbying decision-makers, running public relations campaigns, seeking to discredit tobacco control advocates and funding pro-tobacco harm reduction research. ENDS Cigarette Smoking Thailand (ECST), a pro-ENDS group in Thailand, worked in parallel with Philip Morris Thailand Limited (PMTL) to oppose the ban. The group connected with international coalitions that promote harm reduction through the PMI-funded Foundation for a Smoke-Free World.ConclusionAlthough ECST and PMTL continuously worked to revoke the ban since 2017, the government still kept ENDS illegal as of October 2020. This decision resulted from the strong commitment and collaboration among Thai tobacco control organisations and their shared vision to protect the public’s health from harmful tobacco products. The linkages between the pro-ENDS movement in Thailand and the tobacco companies could inform health advocates and policy-makers in other low and middle income countries facing pressure to market ENDS.

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Erratum for “Misoprostol in women's hands: a harm reduction strategy for unsafe abortion" Contraception 2013 Feb; 87(2): 128–130

Contraception ◽

10.1016/j.contraception.2015.08.011 ◽

2016 ◽

Vol 93 (1) ◽

pp. 87

Author(s):

Alyson Hyman ◽

Kelly Blanchard ◽

Francine Coeytaux ◽

Daniel Grossman ◽

Alexandra Teixeira

Keyword(s):

Harm Reduction ◽

Unsafe Abortion ◽

Reduction Strategy ◽

Harm Reduction Strategy

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Analysis of the tobacco industry’s interference in the enforcement of health warnings on tobacco products in Brazil

Cadernos de Saúde Pública ◽

10.1590/0102-311x00120715 ◽

2017 ◽

Vol 33 (suppl 3) ◽

Cited By ~ 1

Author(s):

Cristina de Abreu Perez ◽

Vera Luiza da Costa e Silva ◽

Stella Aguinaga Bialous

Keyword(s):

Interest Groups ◽

Tobacco Control ◽

Tobacco Industry ◽

Strong Impact ◽

Health Warnings ◽

Tobacco Products ◽

Tobacco Control Policies ◽

The Relationship ◽

Original Information ◽

Regulatory Measure

Abstract: This article aims to analyze the relationship between the Brazilian government’s adoption of a regulatory measure with a strong impact on the population and the opposition by invested interest groups. The methodology involves the analysis of official documents on the enforcement of health warnings on tobacco products sold in Brazil. In parallel, a search was conducted for publicly available tobacco industry documents resulting from lawsuits, with the aim of identifying the industry’s reactions to this process. The findings suggest that various government acts were affected by direct interference from the tobacco industry. In some cases the interventions were explicit and in others they were indirect or difficult to identify. In light of the study’s theoretical framework, the article provides original information on the Brazilian process that can be useful for government policymakers in the strategic identification of tobacco control policies.

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Public Health Implications of Smokeless Tobacco Use as a Harm Reduction Strategy

American Journal of Public Health ◽

10.2105/ajph.2005.075499 ◽

2006 ◽

Vol 96 (11) ◽

pp. 1934-1939 ◽

Cited By ~ 38

Author(s):

David A. Savitz ◽

Roger E. Meyer ◽

Jason M. Tanzer ◽

Sidney S. Mirvish ◽

Freddi Lewin

Keyword(s):

Public Health ◽

Harm Reduction ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Reduction Strategy ◽

Health Implications ◽

Harm Reduction Strategy ◽

Smokeless Tobacco Use

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Heated debates on regulations of heated tobacco products in South Korea: the news valence, source and framing of relative risk/benefit

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056131 ◽

2021 ◽

pp. tobaccocontrol-2020-056131

Author(s):

Jungmi Jun ◽

Sei-Hill Kim ◽

James Thrasher ◽

Yoo Jin Cho ◽

Yu-Jin Heo

Keyword(s):

South Korea ◽

Tobacco Control ◽

Tobacco Industry ◽

Warning Labels ◽

Tobacco Products ◽

News Stories ◽

Time Period ◽

Significant Difference ◽

Tv News ◽

The Government

BackgroundWe analyse news representations of the regulation of heated tobacco products (HTPs) in South Korea, the country where HTP use is among the highest in the world despite conflicts between the government and the HTP manufacturers.MethodsWe analysed a total of 571 print and TV news covering HTP regulations, published between 2017 and 2018, the time period when HTPs were introduced to the country and various regulations of HTPs were proposed and implemented. We assessed the prevalence and associations among specific types of HTP regulations that were discussed, valence towards regulation, sources, framing of the relative health risks/benefits of HTPs compared with conventional cigarettes.ResultsTaxation (55.2%) and warning labels (25.7%) were two regulation topics covered the most. Almost equal proportions of pro-regulation (2.5%) and anti-regulation valence (2.2%) were found in taxation-related news, while pro-regulation valence appeared more frequently for other restrictions, including warning labels (pro=9.5% vs anti=1.4%), marketing restrictions (pro=6.9% vs anti=0%) and integration of HTPs into smoke-free policies for cigarettes (pro=8.7% vs anti=0%). The government (59%), followed by the tobacco industry (39.4%), was the source cited most often across news stories while the presence of tobacco control advocates was low (4.9%). As for framing, there was no significant difference in the prevalence of stories mentioning reduced harm (31.7%) and equal or more harm (33.6%) of HTPs compared with cigarettes.ConclusionsWe provide implications for governments and tobacco control advocates on building consensus for applying cigarette equivalent taxes and pictorial warning labels to HTPs.

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Performance-Enhancing Substances in Sports

10.1093/oso/9780190130640.003.0019 ◽

2021 ◽

pp. 266-275

Author(s):

Kaveri Prakash

Keyword(s):

Harm Reduction ◽

Level Playing Field ◽

New Approach ◽

Reduction Strategy ◽

Playing Field ◽

Ethical Frameworks ◽

Harm Reduction Strategy ◽

Practice Of Medicine ◽

Performance Enhancing Substances ◽

Performance Enhancing

Given that the current strategies focusing on deterrence and punishment are increasingly ineffective worldwide, is there a radically different approach to ensuring a level playing field? This essay explores the growing discourse on alternate approaches to controlling the use of performance enhancing substances (PES) in sports and reflects on the fact that social and cultural behaviour patterns, plus a lack of ethics in the practice of medicine are the issues that need to be tackled urgently in this eagerness to ensure a level playing field in sports. Kaveri Prakash cautiously argues for adopting a relatively new approach, under wide discussion, centring on a harm reduction strategy, that would allow performance enhancing substances to be administered under supervision. However, this will only be successful if regulatory and ethical frameworks in related areas are strengthened and current practices are systematically reviewed and either discarded or reformed. Moreover, India needs to pay serious attention to its sporting population, on and off the field, in order to gauge its response to regulation.

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The Ethics of Tobacco Harm Reduction: An Analysis of E-Cigarette Availability From the Perspectives of Utilitarianism, Bioethics, and Public Health Ethics

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa198 ◽

2020 ◽

Cited By ~ 1

Author(s):

Rebecca Thomas ◽

Lisa S Parker ◽

Saul Shiffman

Keyword(s):

Public Health ◽

Harm Reduction ◽

Biomedical Ethics ◽

Public Health Ethics ◽

Individual Autonomy ◽

Tobacco Harm Reduction ◽

Reduction Strategy ◽

Ethics Framework ◽

Health Ethics ◽

Harm Reduction Strategy

Abstract Much evidence suggests e-cigarettes are substantially less harmful than combustible cigarettes. Assuming this is true, we analyze the ethical case for a policy of e-cigarette availability (ECA) as a tobacco harm reduction strategy. ECA involves making e-cigarettes available to allow smokers to switch to them, and informing smokers of the lower risks of e-cigarettes vis-à-vis smoking. After suggesting that utilitarian/consequentialist considerations do not provide an adequate ethical analysis, we analyze ECA using two other ethical frameworks. First, ECA is supported by a public health ethics framework. ECA is a population-level intervention consistent with respecting individual autonomy by using the least restrictive means to accomplish public health goals, and it supports equity and justice. Second, ECA is supported by four principles that form a biomedical ethics framework. By reducing smokers’ health risks and not harming them, ECA fulfills principles of beneficence and non-maleficence. Because ECA allows smokers to make informed health decisions for themselves, it fulfills the principle requiring respect for persons and their autonomy. Here, we consider whether nicotine addiction and thus ECA undermine autonomy, and also discuss the ethical warrant for special protections for youth. Finally, ECA can also advance justice by providing a harm reduction alternative for disadvantaged groups that disproportionately bear the devastating consequences of smoking. Policies of differential taxation of cigarettes and e-cigarettes can facilitate adoption of less harmful alternatives by those economically disadvantaged. We conclude that public health and biomedical ethics frameworks are mutually reinforcing and supportive of ECA as a tobacco harm reduction strategy. Implications Making e-cigarettes and information about them available is supported as ethical from multiple ethical perspectives.

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