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Branston JR, Gilmore AB. The failure of the UK to tax adequately tobacco company profits. J Public Health (Oxf) 2020; 42:69-76. [PMID: 30726968 PMCID: PMC7044670 DOI: 10.1093/pubmed/fdz004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/29/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A key driver of the global tobacco epidemic is the massive profit earned from manufacturing tobacco products despite high levels of product taxation. Two of the four major Transnational Tobacco companies are based in the UK, where there is growing evidence of corporate tax avoidance by transnational firms and where there are calls for the industry to pay more towards the harms caused by tobacco products. OBJECTIVES/METHODS UK tobacco company profit and corporation tax data between 2009 and 2016 is obtained from publically available sources. The intention is not to perform a piece of forensic accounting but to establish the broad pattern of profit and taxation in order to inform consideration of tobacco product and firm taxation, and hence public health. RESULTS Very little profit based taxation has been paid in the UK despite high levels of reported profits, both in the domestic market and globally. CONCLUSIONS The UK needs better reporting and corporate taxation standards. Tobacco companies should be made to pay more profit based taxation, such as by extending the surcharge on corporation tax currently paid by UK banks, and by making sure companies pay appropriate taxes when reorganizing corporate structures.
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Affiliation(s)
- J Robert Branston
- School of Management, University of Bath, Bath, UK
- University of Bath, Institute for Policy Research, Bath, UK
| | - Anna B Gilmore
- University of Bath, Institute for Policy Research, Bath, UK
- University of Bath Tobacco Control Research Group, Department for Health, University of Bath and UK Centre for Tobacco and Alcohol Studies, Bath, UK
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2
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Mlinarić M, Schreuders M, Graen L, Lessenich S. Transnational tobacco companies and the mechanism of externalization: A realist synthesis. Health Place 2019; 61:102240. [PMID: 31734138 DOI: 10.1016/j.healthplace.2019.102240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 10/16/2019] [Accepted: 11/01/2019] [Indexed: 11/24/2022]
Abstract
Externalization theory assumes that risks and costs are systematically displaced from high-income countries (HICs) to low- and middle-income countries (LMICs). We review how and why transnational tobacco companies (TTCs) influence the local circumstances of LMICs that trigger externalization mechanisms, leading to tobacco-attributable risk outcomes. Our realist synthesis of scientific evidence and gray literature identifies externalization mechanisms with risk outcomes at the level of health policy, smoking trends, and tobacco production. The results reveal the mediating role of local and global third parties and intermediaries. Externalization mechanisms produce systematic tobacco-attributable inequalities between places located in HICs and those located in LMICs.
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Affiliation(s)
- Martin Mlinarić
- Institute of Medical Sociology, Medical Faculty - Martin Luther University Halle-Wittenberg, Germany.
| | - Michael Schreuders
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Stephan Lessenich
- Political Sociology of Inequalities, Institute of Sociology, Ludwig Maximilians University Munich, Germany
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3
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Haahtela T, von Hertzen L, Anto JM, Bai C, Baigenzhin A, Bateman ED, Behera D, Bennoor K, Camargos P, Chavannes N, de Sousa JC, Cruz A, Do Céu Teixeira M, Erhola M, Furman E, Gemicioğlu B, Gonzalez Diaz S, Hellings PW, Jousilahti P, Khaltaev N, Kolek V, Kuna P, La Grutta S, Lan LTT, Maglakelidze T, Masjedi MR, Mihaltan F, Mohammad Y, Nunes E, Nyberg A, Quel J, Rosado-Pinto J, Sagara H, Samolinski B, Schraufnagel D, Sooronbaev T, Tag Eldin M, To T, Valiulis A, Varghese C, Vasankari T, Viegi G, Winders T, Yañez A, Yorgancioğlu A, Yusuf O, Bousquet J, Billo NE. Helsinki by nature: The Nature Step to Respiratory Health. Clin Transl Allergy 2019; 9:57. [PMID: 31695865 PMCID: PMC6822361 DOI: 10.1186/s13601-019-0295-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. Results The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking “nature” to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. Conclusions In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.
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Affiliation(s)
- Tari Haahtela
- 1Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Leena von Hertzen
- 2Department of Dermatology, Allergology and Venereology, Helsinki University Hospital, Helsinki, Finland
| | - Josep M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Chunxue Bai
- Zhongshan Hospital, Fudan University, Shanghai Respiratory Research Institute, Shanghai, China
| | | | - Eric D Bateman
- 6Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Digambar Behera
- 7Dept. of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kazi Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Paulo Camargos
- 9Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Niels Chavannes
- 10Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaime Correia de Sousa
- 11Life and Health Sciences Research Institute, ICVS, School of Medicine, University of Minho, Braga, Portugal
| | - Alvaro Cruz
- 12ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Vitória Da Conquista, Brazil
| | | | - Marina Erhola
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Eeva Furman
- 15Environmental Policy Centre, Finnish Environment Institute, Helsinki, Finland
| | - Bilun Gemicioğlu
- 16Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Peter W Hellings
- 18Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - Pekka Jousilahti
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Nikolai Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD), Geneva, Switzerland
| | - Vitezslav Kolek
- 20Department of Respiratory Diseases and Tuberculosis, University Hospital Olomouc, Olomouc, Czech Republic
| | - Piotr Kuna
- 21Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Stefania La Grutta
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy
| | - Le Thi Tuyet Lan
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Vietnam
| | - Tamaz Maglakelidze
- 24Pulmonology Department, Ivane Javakhishvili Tbilisi State University, Chapidze Emergency Cardiology Center, Tbilisi, Georgia
| | | | - Florin Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - Yousser Mohammad
- 27National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - Elizabete Nunes
- 28Pulmonology Department, Maputo Central Hospital, Maputo, Mozambique
| | - Arvid Nyberg
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland
| | - Jorge Quel
- Hispanic American Allergy Asthma & Immunology Association, Marina Del Rey, California USA
| | - Jose Rosado-Pinto
- 31Immunoallergology Department, Hospital da Luz Lisboa, Lisbon, Portugal
| | - Hironori Sagara
- 32Division of Allergology & Respiratory Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Boleslaw Samolinski
- 33Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Dean Schraufnagel
- 34Department of Medicine, University of Illinois at Chicago, Chicago, USA
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - Mohamed Tag Eldin
- 36Department of Thoracic Diseases, Ain Shams Faculty of Medicine, Abbassia, Cairo, Egypt
| | - Teresa To
- 37The Hospital for Sick Children, Research Institute and Della Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Arunas Valiulis
- 38Clinic of Children's Diseases, Institute of Clinical Medicine, and Department of Public Health, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | | | | | - Giovanni Viegi
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy.,40Istituto di Fisiologia Clinica CNR, Pisa, Italy
| | - Tonya Winders
- Allergy & Asthma Network, Vienna, VA USA.,Global Allergy & Asthma Patient Platform, Vienna, Austria
| | - Anahi Yañez
- Investigaciones en Alergia y Enfermedades Respiratorias (INAER), Buenos Aires, Argentina
| | - Arzu Yorgancioğlu
- 44Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Osman Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - Jean Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, Montpellier, France
| | - Nils E Billo
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland.,Global Alliance Against Respiratory Diseases (GARD), Helsinki, Finland
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Levy DT, Yuan Z, Li Y, Alberg AJ, Cummings KM. A modeling approach to gauging the effects of nicotine vaping product use on cessation from cigarettes: what do we know, what do we need to know? Addiction 2019; 114 Suppl 1:86-96. [PMID: 30548714 PMCID: PMC7466949 DOI: 10.1111/add.14530] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS The long-term population health impact of nicotine vaping products (NVPs) use among smokers is unknown, and subject to a range of plausible assumptions about the use and health consequences of NVPs. While NVPs use may substitute for cigarette smoking and thereby aid in quitting cigarette use, it is also possible that smokers who would have otherwise quit would instead delay quitting cigarettes. We aimed to develop a cohort-specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL). DESIGN A cohort-specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL) was developed by gender for two birth cohorts, aged 30 and 50 years in 2012. Extensive sensitivity analyses were conducted. SETTING United States. PARTICIPANTS Smokers in two birth cohorts, aged 30 and 50 years in 2012. MEASUREMENTS Data were from the 1965-2012 National Health Interview Surveys and the 2014/15 Tobacco Use Supplement of the Current Population Survey. The model incorporated a range of plausible assumptions from published literature about transition rates from regular smoking to exclusive NVP and dual use, from dual use to exclusive NVP use and from exclusive NVP use to no use. FINDINGS Compared with the no-NVP scenario, the male (female) model projected 17.8% (19.3%) fewer PDs and 22.9% (26.6%) fewer LYL for the 1982 cohort and 5.4% (7.3%) fewer PDs and 7.9% (11.4%) fewer LYL for the 1962 cohort. These gains were sensitive to NVP use over time, age of initial NVP use, transitions from smoking to dual, exclusive NVP and no use and relative NVP mortality risks. CONCLUSIONS Nicotine vaping product (NVP) use in the United States is projected to have a net positive impact on population health over a wide range of plausible levels of NVP use, transitions to dual, exclusive NVP and no use and NVP risks. However, net impact is sensitive to parameter estimates.
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Affiliation(s)
- David T. Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Zhe Yuan
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Yameng Li
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Anthony J. Alberg
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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Affiliation(s)
- Ron Borland
- Nigel Gray Fellowship Group, Cancer Council Victoria, Melbourne, 3004, Victoria, Australia
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Levy DT, Lindblom EN, Sweanor DT, Chaloupka F, O'Connor RJ, Shang C, Palley T, Fong GT, Cummings KM, Goniewicz ML, Borland R. An Economic Analysis of the Pre-Deeming US Market for Nicotine Vaping Products. TOB REGUL SCI 2019; 5:169-181. [PMID: 32864395 PMCID: PMC7454013 DOI: 10.18001/trs.5.2.8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Public health policies are often enacted without adequate consideration of the existing market structure or their impacts on that market structure. This paper provides context for the potential impact of regulations on nicotine vaping products (NVP) use by providing a structural analysis of competition in the US NVP market before FDA regulation. METHODS A literature review was conducted with the aim of providing a framework for analysis that: 1) defines the market; 2) evaluates market concentration; 3) identifies entry barriers; and 4) examines firm conduct. RESULTS The NVP market includes retail, internet sellers and vape shops. Although conventional retail became more concentrated after the major cigarette companies entered the NVP market, the vape shop and internet sectors remain substantially less concentrated, producing an overall low market concentration, with few entry barriers and competitive behavior. CONCLUSIONS The largely unregulated US NVP market has been highly competitive, with a high degree of innovation. However, new FDA deeming regulations as applied to NVPs could make it difficult for smaller companies to remain in the market and could discourage new companies and new product innovations from entering the market.
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Affiliation(s)
- David T Levy
- Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Eric N Lindblom
- Tobacco Control and Food & Drug Law, O'Neill Institute for National & Global Health Law, Georgetown University Law Center, Washington, DC
| | - David T Sweanor
- Adjunct Professor, Faculty of Law, University of Ottawa, Canada
| | - Frank Chaloupka
- Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Ce Shang
- Department of Pediatrics and Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | | | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Maciej L Goniewicz
- Department of Health Behavior, Division of Cancer Prevention and Population Studies, Roswell Park Cancer Institute, Buffalo, NY
| | - Ron Borland
- Nigel Gray Distinguished Fellow in Cancer Prevention, Cancer Council Victoria, Melbourne, Victoria, Australia
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7
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de Andrade M, Angus K, Hastings G, Angelova N. Hostage to fortune: an empirical study of the tobacco industry's business strategies since the advent of e-cigarettes. CRITICAL PUBLIC HEALTH 2018; 30:280-293. [PMID: 32536808 PMCID: PMC7254526 DOI: 10.1080/09581596.2018.1552778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 11/20/2018] [Indexed: 11/27/2022]
Abstract
The tobacco market has been transformed by the arrival of e-cigarettes and array of alternative nicotine delivery systems (ANDS). Public health has struggled to cope with these changes and clear divisions are apparent, but less is known about the tobacco industry (TI) response. This first empirical study to examine TI and independent ANDS companies' business strategies fills this gap. Primary data were collected through 28 elite interviews with senior/influential TI and independent stakeholders, triangulated with a documentary analysis of company reports, investor analyses, market research, and consultation responses (1022 documents). A deliberately emic analysis shows that tobacco multinationals were initially disconcerted by ANDS, but logic provided by the fiduciary imperative is enabling them to turn a potential threat into profitable opportunities. Interviewees argue market changes played to their strengths: customer links, expertise in nicotine, and enormous financial resources. This enabled portfolio diversification in which combustible and ANDS coexist; providing potential to develop robust scientific and regulatory positions and hope of retrieving corporate reputations. The principal threat for major tobacco players comes from the independent sector, which is prepared and able to satisfy bespoke consumer needs. Multinationals by contrast need to turn ANDS into a genuinely mass-market product appealing to its global customers. They are making progress. Given the continued buoyancy of the combustibles market, they have extensive resources to continue their efforts. Disruptive innovations are not unique to tobacco control. Equivalent technological solutions - with concomitant business opportunities - are emerging in obesity and alcohol fields with implications for public health.
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Affiliation(s)
- Marisa de Andrade
- School of Health in Social Science, Counselling, Psychotherapy and Applied Social Sciences, University of Edinburgh, Edinburgh, UK
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), UK
- Group for Research on Inequalities and Tobacco (GRIT), University of Edinburgh, Edinburgh, UK
| | - Kathryn Angus
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), UK
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Gerard Hastings
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), UK
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
- Centre for Tobacco Control Research, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
- The Open University Business School, Milton Keynes, UK
- Ecole des hautes études en santé publique (EHESP), Rennes, France
| | - Nikolina Angelova
- School of Health in Social Science, Counselling, Psychotherapy and Applied Social Sciences, University of Edinburgh, Edinburgh, UK
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Levy DT, Borland R, Lindblom EN, Goniewicz ML, Meza R, Holford TR, Yuan Z, Luo Y, O'Connor RJ, Niaura R, Abrams DB. Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tob Control 2017; 27:18-25. [PMID: 28970328 PMCID: PMC5801653 DOI: 10.1136/tobaccocontrol-2017-053759] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 07/11/2017] [Accepted: 08/05/2017] [Indexed: 12/14/2022]
Abstract
Introduction US tobacco control policies to reduce cigarette use have been effective, but their impact has been relatively slow. This study considers a strategy of switching cigarette smokers to e-cigarette use (‘vaping’) in the USA to accelerate tobacco control progress. Methods A Status Quo Scenario, developed to project smoking rates and health outcomes in the absence of vaping, is compared with Substitution models, whereby cigarette use is largely replaced by vaping over a 10-year period. We test an Optimistic and a Pessimistic Scenario, differing in terms of the relative harms of e-cigarettes compared with cigarettes and the impact on overall initiation, cessation and switching. Projected mortality outcomes by age and sex under the Status Quo and E-Cigarette Substitution Scenarios are compared from 2016 to 2100 to determine public health impacts. Findings Compared with the Status Quo, replacement of cigarette by e-cigarette use over a 10-year period yields 6.6 million fewer premature deaths with 86.7 million fewer life years lost in the Optimistic Scenario. Under the Pessimistic Scenario, 1.6 million premature deaths are averted with 20.8 million fewer life years lost. The largest gains are among younger cohorts, with a 0.5 gain in average life expectancy projected for the age 15 years cohort in 2016. Conclusions The tobacco control community has been divided regarding the role of e-cigarettes in tobacco control. Our projections show that a strategy of replacing cigarette smoking with vaping would yield substantial life year gains, even under pessimistic assumptions regarding cessation, initiation and relative harm.
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Affiliation(s)
- David T Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Ron Borland
- Nigel Gray Distinguished Fellow in Cancer Prevention, VicHealth Centre for Tobacco Control, The Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Eric N Lindblom
- O'Neill Institute for National & Global Health Law, Georgetown University Law Center, Washington, District of Columbia, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Division of Cancer Prevention and Population Studies, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Rafael Meza
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Theodore R Holford
- Department of Biostatistics, Yale University, New Haven, Connecticut, USA
| | - Zhe Yuan
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Yuying Luo
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Richard J O'Connor
- Department of Health Behavior, Division of Cancer Prevention and Population Studies, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Raymond Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, District of Columbia, USA
| | - David B Abrams
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia, USA.,Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, District of Columbia, USA
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Saboga-Nunes L, Levin-Zamir D, Rabius V. Tobacco still a major killer-will we achieve the end game? Eur J Public Health 2017; 27:22-25. [PMID: 29028240 DOI: 10.1093/eurpub/ckx161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The game of tobacco use began in Europe in 1560 when the first tobacco seeds were sent from Lisbon to the king of France, by Jean Nicot. From kings' and nobles' exclusive use, it gradually and progressively became popular among the public, as a new player. Eighty-eight years ago (1929), Fritz Linkint, an extraordinary researcher in Germany, while reviewing existing evidence regarding a wide range of cancers potentially caused by smoking, indicated that smoking was a cause of respiratory disease. Despite the overwhelming accumulated evidence of the negative effects of nicotine intake, the prevalence of tobacco use is not expected to decline in the near future. What have we missed thus far in the game that claims more than seven million deaths annually worldwide? Although tobacco use is recognized as a major health problem, the persistent habit creates a dissonance between public health initiatives to reduce tobacco consumption and the choices citizens are making. To understand this dissonance, consideration first must be given to the social meaning attributed to smoking. Second, the political dissonance between health imperatives and social agendas is discussed with regard to relevant theory. Third, health promotion strategies can make a strong contribution to win the game from a negentropic perspective, that is to say, a public health vision that is structured towards an overarching goal.
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Affiliation(s)
- Luis Saboga-Nunes
- Centro de Investigação em Saúde Pública (CISP), National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Institute of Sociology, University of Education Freiburg, Freiburg, Germany
| | - Diane Levin-Zamir
- Department of Health Promotion and Education, Clalit Health Services; School of Public Health, University of Haifa, Haifa, Israel
| | - Vance Rabius
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, USA
- School of Public Health Austin Regional Campus, The University of Texas, Austin, USA
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Abstract
Some supporters of electronic cigarettes have argued that they should be considered a form of harm reduction, analogous to that which has been successful with narcotics. In this viewpoint, we contend that this argument is based on highly selective use of the evidence, coupled with a fundamental misunderstanding of a comprehensive harm minimisation strategy. This includes not only harm reduction but also reduction in demand and supply-two elements that are explicitly rejected by many advocates of electronic cigarettes. We contend that, in the absence of all three elements, there is a danger that electronic cigarettes will delay the achievement of a tobacco-free world.
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11
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Kozlowski L, Sweanor D. Withholding differential risk information on legal consumer nicotine/tobacco products: The public health ethics of health information quarantines. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 32:17-23. [DOI: 10.1016/j.drugpo.2016.03.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/23/2016] [Accepted: 03/25/2016] [Indexed: 02/07/2023]
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