The motivation of a think tank’s report promoting alternative tobacco products to reduce smoking harm while ‘dismissing’ public health steps is being questioned by tobacco-free researchers.

The New Zealand Initiative this morning released its report Smoke and Vapour: the changing world of tobacco harm reduction which argues that quit smoking policies have too long punished smokers through tax rather than giving smokers the ability to switch to less harmful tobacco alternatives like ‘snus’ and ‘heat-not-burn’ products.

“Over ten years ago, the Ministry of Health was satisfied from the research at hand that snus is less harmful than smoking, but New Zealand continues to ban the sale of snus,” said the report’s author Jenesa Jeram. “Meanwhile in Sweden where snus-use is prolific, smoking prevalence has reduced to around 7%.” She added that vaping using e-cigarettes was also a good example of smokers choosing to cut down or quit smoking on their own terms.

But public health professors Richard Edwards and Janet Hoek, co-directors of the University of Otago’s Aspire 2025 tobacco free research centre, say while Jeram’s report correctly notes new measures are required to support smokers to quit smoking it also focuses on promoting greater availability of alternative tobacco products to combustible cigarettes.
“The NZ Initiative report recommends introducing products of uncertain effectiveness and toxicity with minimal regulation of advertising, availability and packaging,” said the pair. They said snus and ‘heat-not-burn’ products were relatively expensive and as a result would have minimal effect on disadvantaged smokers, including many Māori and Pacific smokers. “The dismissal of effective public health measures is perhaps unsurprising for a group funded in part by the three largest tobacco companies operating in New Zealand (British American Tobacco, Imperial Tobacco and Philip Morris),” said the pair.

Jeram said her report’s release coincided with major regulatory changes being underway including a recent court decision concluding it was not illegal for ‘heat-not-burn’ products to be sold and a private members bill seeking to legalise the sale of nicotine e-cigarettes in New Zealand.

She said that snus (reformulated tobacco pouches placed under the gum) had a strong history in Sweden, where snus-use has overtaken smoking rates. Heat-not-burn products (reformulated tobacco that is heated to release nicotine and flavour without combustion) were relatively new but uptake has been significant in Japan.

Edwards and Hoek pointed people to the Achieving Smokefree Aotearoa by 2025 plan for a comprehensive, multi-faceted approach to reducing smoking including public health steps and making nicotine-containing e-cigarettes and e-liquids widely available to smokers who want to quit as well as those who cannot or do not wish to quit.

Another health researcher, Dr Penelope Truman said she welcomed the policy input from the Initiative as although New Zealand had been at the forefront of tobacco control initiatives the decreases in smoking rates had slowed for some groups including Māori.

She said National and Labour have both been interested in developing better legislation around harm-reduced products such as e-cigarettes and heat-not-burn devices and that process was underway, with the full support of the Ministry of Health, with the legalisation of nicotine e-cigarettes likely to be first.

“In the meantime, we have over 600,000 New Zealand smokers, who have not yet stopped smoking in spite of all the pressure to do so. The indications currently are that many might stop or reduce smoking if vaping were to become more readily available as a substitute, while very few non-smokers will take up vaping, beyond short-term experimentation.”

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