Health experts say axing plan to block sales of tobacco products to next generation will cost thousands of lives

  • gila@lemm.ee
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    1 year ago

    Then why is there no sufficient demand for there to be a place in the market for RNT cigarettes currently, if people are willing to smoke separate from the universally accepted purpose of a cigarette as a nicotine delivery device? We aren’t talking about the difference between blues and reds - we’re talking about the difference between an effective nicotine delivery system and an ineffective one. Specifically in a market where effective smokeless nicotine delivery systems are available (and as accessible as cigarettes). If one just stops to think about how things would actually function in that sort of environment, your argument falls apart for me.

    I can’t show you long-term data on the health impact of using RNT cigarettes when they aren’t available in the wild. But sure, here’s a review on shorter-term RCT’s & cohort studies.

    A review of the evidence on cigarettes with reduced addictiveness potential - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8785120/

    As mentioned, nicotine reinforcement and dependence is a key underlying cause of chronic cigarette use. They have a function, whether or not smokers are cognizant of it. When the nicotine is reduced, the cigarette no longer performs this function - no reinforcement, high chance for cessation.

    It suggests this benefit extends to important subpopulations whom have disproportionately high smoking rates. In NZ there is a whole ethnic group that could be described this way: tāngata whenua, Māori people.

    The review also mentioned the potential for adverse effects, including fostering a black market, or product manipulation. These issues are also presented by outright prohibition. Indeed the RNT strategy itself is intended as a mitigation against these problems, and the review shows they are far from a perfect solution. But taking the same behavioural science approach, it is entirely expected that people would seek alternative black market supply when the decision about availability is made for them.

    Even if you consider other positions like the civil liberties argument, what do they want the freedom to do? It sounds like they want the freedom to participate in the act of smoking, more than specifically wanting the freedom to use cigarettes to effectively ingest nicotine. It is understood even among this crowd that nicotine is associated with addiction, which no one desires. At least, RNT’s would sort of reduce their position to “I’m fighting for the freedom to have chronic health problems”. Anyway, they’d still be free to grow their own tobacco legally for personal use, as far as I’m aware.

    I’m still not sure if you meant that you think people would be caused to smoke more generally, or just a few. Either way, I wasn’t being facetious when I asked what the reasons were. I can’t imagine what basis you have for it. Like, the fact we don’t cultivate tomato plants for smoking and regulate them as an 18+ product and have a bunch of complicated strategies to address the harm it causes isn’t because there’s no nicotine in the tomato plant, or because the plant leaves are especially caustic and unpleasant to smoke, or anything like that. It’s because the nicotine concentration and bioavailability isn’t high enough to make that an effective delivery device. That’s why tomato smoking never proliferated in Mayan culture and eventually spread throughout the world following colonisation of the Americas, and that’s the same reason why people won’t continue to smoke cigarettes when they are rendered ineffective.

    It even seems like what you want: prohibition, but in a more roundabout way. How is that possibly worse than the roundabout way they’re cost prohibitive via excessive taxation?

    Sure, in a perfect world we could just ban them, so why have a roundabout? Because the roundabout has specific potential to have a direct impact toward beneficial longterm health outcomes and the elimination of tobacco harm over time, which a more direct approach does not.

    The perfect solution would be to go back and somehow stop tobacco use from ever proliferating, but in lieu of that, it’s here, it’s entrenched in every country and culture and things like “outright prohibition” and “complete elimination” are simply unrealistic. On balance, the doubts about RNT’s are unreasonable because of the stakes involved. Statistically several NZers have died prematurely of tobacco-related illness since our conversation began. We need realistic solutions that don’t exist in a vacuum. RNT’s were one prong of a multi-pronged approach which together constituted our generation’s best shot. The UK, Australia, will have been looking at NZ as a test market for RNT’s and other cessation strategies as they have for many other unproven/disruptive technologies, see these decisions made by the Nats, and use it as additional justification to succumb to tobacco industry whims there as well.