scholarly journals Ethical issues for e-cigarette control policies in Australia

2021 ◽  
pp. 01-05
Author(s):  
Soumyadeep Bhaumik

Although tobacco smoking in Australia is at a historical low, electronic cigarette (e-cigarette) use, especially among the youth is increasing. Policies around e-cigarette control in Australia are currently evolving, even during the pandemic, thus demonstrating its priority status. The current article discusses ethical issues for e-cigarette control policies in Australia using a public health ethics framework. The article is structured using the domains of the WHO-MPOWER framework of tobacco control to enable a comprehensive coverage of all elements of e-cigarette control policies in Australia. It highlights several ethical issues, from different stakeholder perspectives, and indicates moral and ethical tensions in different public health actions that might be considered in framing policies around e-cigarette control.

Author(s):  
David B. Resnik

This chapter provides an overview of the ethics of environmental health, and it introduces five chapters in the related section of The Oxford Handbook of Public Health Ethics. A wide range of ethical issues arises in managing the relationship between human health and the environment, including regulation of toxic substances, air and water pollution, waste management, agriculture, the built environment, occupational health, energy production and use, environmental justice, population control, and climate change. The values at stake in environmental health ethics include those usually mentioned in ethical debates in biomedicine and public health, such as autonomy, social utility, and justice, as well as values that address environmental concerns, such as animal welfare, stewardship of biological resources, and sustainability. Environmental health ethics, therefore, stands at the crossroads of several disciplines, including public health ethics, environmental ethics, biomedical ethics, and business ethics.


2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 123-124
Author(s):  
Cristian I. Meghea ◽  
◽  
Oana Blaga ◽  
Marina Dascal ◽  
Teodora Fratila ◽  
...  

"Tobacco smoking is especially harmful for women because, in addition to its effects on mortality and morbidity, it negatively impacts pregnancy, reproductive, and health of the offspring. Data from our work in Romania revealed that pregnant tobacco smokers are seeking information and clinical advice related to e-cigarette use as a tobacco cessation approach. E-cigarette use increased rapidly in the recent years in the US and in other countries, including LMICs. The tobacco control field is deeply divided on how to respond to the increase in e-cigarette use. Additional evidence on the ethical issues related to e-cigarette use and tobacco cessation will inform our mHealth and other pregnancy tobacco cessation interventions and will guide future tobacco control policy direction. The objective of this study is to identify ethical concerns and associated attitudes and perceptions related to e-cigarette use for tobacco cessation during pregnancy among pregnant smokers, their life partners, medical professionals, and other stakeholders. We will interview (N=20) and conduct two focus groups with women who smoke (one focus group, N=10) and women who quit during pregnancy (one focus group, N=10); interview life partners (N=10) of such women; interview ObGyn physicians (N=10) and nurses (N=10); and interview (N=10) and conduct one focus group (N=10) with perinatal educators. Other relevant stakeholders will be also interviewed including the leadership of 2035 Tobacco Free Romania, the national Stop Smoking program, the Pure Air consortium, the Romanian Pneumology Society, the SAMAS NGO focused on maternal and child health and rights, and others. With respect to expected outcomes, the proposed application is anticipated to advance understanding of the smokers’ and other stakeholders’ ethical concerns and associated attitudes and perceptions related to e-cigarettes use for tobacco smoking cessation. The in-depth new knowledge will have a positive impact on the cessation of prenatal and postnatal tobacco smoking and will inform future tobacco control policy directions. Results will be available and will be presented at the time of the conference. This work is based on research partly funded through six NIH-funded projects (grant no. K01TW009654, R21TW010896, 5R21TW010896-02S1, 5R21TW010896-02S2, 1R21HD103039-0, 1R25TW010518-01A1). "


Author(s):  
Rebecca Thomas ◽  
Lisa S Parker ◽  
Saul Shiffman

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.


PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198942 ◽  
Author(s):  
Papia Sultana ◽  
Md. Tahidur Rahman ◽  
Dulal Chandra Roy ◽  
Shamima Akter ◽  
Jenny Jung ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Schiavone ◽  
C Anderson ◽  
U Mons ◽  
V Winkler

Abstract Background Second-hand smoke (SHS) is still an important public health problem. With joining the Framework Convention on Tobacco Control (FCTC), all parties acknowledged the health risks of SHS and agreed to implement policies to protect their populations from SHS in public places. The aim of this study was to explore the SHS exposure in restaurants and bars as well as its associations with smoke-free legislation in the European Union. Methods Data of Eurobarometer surveys 2014 and 2017 were used to estimate prevalence of SHS exposure. We also extracted data on individual confounders such as smoking status, gender, sex, age and information on social economic status. Additionally, we collected data on country specific data on smoking regulations in restaurants and bars from the Tobacco Control Scale to analyse associations with SHS exposure using multilevel logistic regression. Smoking regulations were categorized into the following three categories: partial ban, comprehensive ban with minor exceptions, and complete ban. Results Preliminary results on the prevalence of SHS in restaurants showed a decrease from 11.8% (95% confidence intervals (CI) 11.2-12.5) in 2014 to 8.8% (95% CI 8.3-9.3) in 2017. The crude multilevel model controlling only for smoking prevalence resulted in an odds ratio of 0.39 (95% CI 0.19-0.77) for comprehensive ban with minor exceptions and 0.28 (95% CI 0.16-0.50) for complete ban versus partial ban. Odds ratios remained at significant levels when controlling for all available confounders. Conclusions Between 2014 and 2017, SHS exposure in restaurants decreased significantly. Furthermore, strong associations with smoking regulations were observed suggesting a high compliance. Many tobacco control policies have been introduced during the last years but several countries need to strengthen their smoke-free tobacco control policies to further reduce SHS exposure preventing death, disease and disability. Key messages SHS exposure remains a significant public health challenge. The implementation of effective measures could be strengthened through a convergence of tobacco control strategies and policies among European Union member states.


Author(s):  
Maria W. Merritt ◽  
Adnan A. Hyder

This chapter relates public health ethics to selected questions regarding health systems ethics and provides overviews of chapters in the section of The Oxford Handbook of Public Health Ethics dedicated to health systems. National and subnational health systems aim chiefly to improve population health. Public health is a collective good whose promotion takes government action, raising ethical issues in stewardship, governance, and accountability. Moral justifications for public health activities, including overall benefit, collective efficiency, distributive fairness, and harm prevention, are considered by way of examining global human resources for health, with an eye to efficiency, equity, rights, and other ethical issues. Worldwide interest in health systems strengthening has boosted investment in health systems research, taking traditional research ethics to the population level in the field of health systems research ethics. The idea of a learning health care system (LHCS) represents a dynamic interface where health care delivery can be continuously improved through systemic data collection undertaken in conjunction with clinical care, posing new system-level ethical opportunities and ethical challenges.


2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Eric T. Juengst ◽  
Annelies Van Rie

AbstractInfectious disease control is experiencing a paradigm shift, as pathogen sequencing technologies and digital applications are increasingly implemented for control of diseases such as tuberculosis, Ebola, and COVID-19. A new ethical framework should be a critical part of this emerging paradigm to ensure that the benefit of precision public health interventions based on advances in genomics research is not outweighed by the risks they pose to individuals, families, and vulnerable segments of the population. We suggest that the ethical framework guiding practice in this domain combines standard precepts from public health ethics with emerging ethics principles from precision medicine.


2021 ◽  
pp. tobaccocontrol-2020-056159
Author(s):  
Summer Sherburne Hawkins ◽  
Claudia Kruzik ◽  
Michael O'Brien ◽  
Rebekah Levine Coley

BackgroundIn the USA, many states do not pre-empt municipalities from enacting stricter tobacco-control policies than state or federal laws. Several municipalities in Massachusetts have passed progressive local laws aimed at reducing adolescent tobacco use. We exploited this variability to examine the associations between county-level flavoured tobacco product restrictions, tobacco 21 policies and smoke-free laws prohibiting e-cigarettes with adolescent cigarette and e-cigarette use in Massachusetts, and to assess whether policy effects varied by age.MethodsWe conducted difference-in-differences models to link changes in county-level tobacco-control policies to changes in adolescents’ use of cigarettes and e-cigarettes using 2011–2017 biennial Massachusetts Youth Health Surveys.ResultsCounties with greater implementation of flavoured tobacco product restrictions were associated with a decrease in the level of cigarette use among users (incidence rate ratio −1.56; 95% CI −2.54 to −0.58). A significant interaction (p=0.03) revealed the largest reductions among 14 and 18 year olds. Increasing flavoured tobacco product restrictions were also associated with reductions in the likelihood of e-cigarette use (OR −0.87; 95% CI −1.68 to −0.06). Increasing tobacco 21 restrictions were associated with decreases in cigarette use only among 18 year olds, while there was no evidence of associations between smoke-free laws with use of either tobacco product.ConclusionsAdolescents in Massachusetts decreased their use of cigarettes and e-cigarettes in response to local restrictions that limited the sale of flavoured tobacco products to adult-only retail tobacco stores. Local legislation can reduce adolescent tobacco use and municipalities should enact stricter tobacco-control policies when not pre-empted by state law.


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