Some trade-off must be made between objectives 1 and 2 harm reduction and harm – prevention. Making products more accessible for smokers to switch to a safer alternative also increases the likelihood that non-smokers will use new products and potentially also go on to smoke tobacco, increasing their health risks. This is particularly of concern for those who would not otherwise have gone on to smoke, in the absence of the introduction of the new product. The Ministry of Health considers that e-cigarettes set a benchmark and that any products approved in future should have a similar risk to benefit profile as ecigarettes. One study has modelled the impact of e-cigarettes using four different levels of risk ranging from 2.5 percent to 25 percent relative to the risk of smoking (ie, 97.5 percent to 75 percent safer than smoking). Under this model, using a 5 percent risk estimate, there is a net public health benefit associated with e-cigarettes, resulting in 21 percent fewer smoking-attributable deaths and a 20 percent reduction in life years lost (Levy et al 2016). For people in this model who would never have started smoking, over 80 percent would have to seriously try e-cigarettes (ie, not just puff on someone else’s device) for net harms to appear, assuming a 5 percent level of health risk associated with e-cigarette use (Levy et al 2016; McRobbie 2016). The net benefit of any new product depend on the level of risk associated with its use. However, it is expected that in order for a product to be approved or suitable to be notified, it should be broadly similar to the harm associated with the use of e-cigarettes.
Some trade-off must be made between objectives 1 and 2 – harm reduction and harm prevention. Making products more accessible for smokers to switch to a safer alternative also increases the likelihood that non-smokers will use new products and potentially also go on to smoke tobacco, increasing their health risks. This is particularly of concern for those who would not otherwise have gone on to smoke, in the absence of the introduction of the new product. The Ministry of Health considers that e-cigarettes set a benchmark and that any products approved in future should have a similar risk to benefit profile as ecigarettes. One study has modelled the impact of e-cigarettes using four different levels of risk ranging from 2.5 percent to 25 percent relative to the risk of smoking (ie, 97.5 percent to 75 percent safer than smoking). Under this model, using a 5 percent risk estimate, there is a net public health benefit associated with e-cigarettes, resulting in 21 percent fewer smoking-attributable deaths and a 20 percent reduction in life years lost (Levy et al 2016). For people in this model who would never have started smoking, over 80 percent would have to seriously try e-cigarettes (ie, not just puff on someone else’s device) for net harms to appear, assuming a 5 percent level of health risk associated with e-cigarette use (Levy et al 2016; McRobbie 2016). The net benefit of any new product depend on the level of risk associated with its use. However, it is expected that in order for a product to be approved or suitable to be notified, it should be broadly similar to the harm associated with the use of e-cigarettes.
ris-regulation-smokeless-tobacco-and-nicotine-delivery-products.docx