2022- Session 4 Seminars

“Smokefree” means smokefree, not vapefree – New Zealand’s harm proportionate plans to end smoking.

Vaping has had a profound impact on reducing smoking rates in New Zealand in recent years. Even though this has been accompanied by youth uptake, the Government has not been deterred from seeing vaping as an important tool for reducing the disproportionate toll of smoking on public health.

In late 2021, the New Zealand Government published their smokefree plan to get adult smoking rates under 5% by 2025.  The plan is notable in that it considers harm reduction and vaping a perquisite for success, declaring: “We will not achieve our goal of Smokefree 2025, however, until our current regulatory settings reflect a more risk-proportionate framework. We can ensure this by making smoked tobacco products more regulated and less available than vaping products”.

Plans to dramatically reduce nicotine content, additives, flavourings and severely limit access will focus exclusively on combustibles, with the deliberate intention to ensure vaping products remain more affordable, accessible, and ultimately the main source of non-pharmacological nicotine for adult users.

This presentation will unpack New Zealand’s approach to vaping and smoking, the evidence, experiences and ideologies that have informed it, and how harm reduction has become a cornerstone of our plans for a smokefree nation.

England’s current tobacco control plan ends in 2022 and plans and consultations are underway to inform the next one which is due to be published in the spring. Last autumn the Medicines and Healthcare products Regulatory Agency published updated guidance on e-cigarettes with an intent of facilitating and expediting progress on making licensed e-cigarettes available. Also the last evidence update of e-cigarettes commissioned by the Office for Health Improvement and Disparities is underway and will be the largest ever, covering health effects of e-cigarettes as well as the usual chapters on current use among adults and youth, and health perceptions. This talk will update on these new developments and  their implications.

In the often-contentious debate about the potential risks and benefits of e-cigarettes, the smokers, who are dying now of their combustible tobacco use, tend to be forgotten.  Speaking on their behalf and from a clinician’s perspective, Dr. Rigotti will offer her perspective on newer evidence and policy proposals, including information covered in today’s symposium, about the balance of health risks and benefits of e-cigarettes and how we can use our imperfect but advancing knowledge to reduce toll of combustible tobacco use.

In the closing keynote Dr Vaughan Rees will explore the success and failures of global tobacco control over the last 5 decades and discuss the impact of policies and current evidence-based interventions.  Examining both adult and youth trajectories from different countries, using systematic reviews, Dr Rees will consider the impact of smoking cessation interventions on population prevalence and health disparities.  The session will look at the challenge, opportunities and urgent need to chart a future path to change the trajectory of tobacco-related harm in the 21st century.

• Why has smoking cessation been so ineffective for disadvantaged communities?
• Is devaluing combustible products essential to deliver the full potential of reduced risk products or vice-versa
• Is a medicinal pathway alongside the consumer pathway preferable or possible in the US?
• Could VLNC be the beginning of the end for big tobacco?
• Why has a consensus in the US been so hard to achieve?
• If we want to reframe the public health conversation away from "Supporters/Opponents" can we agree on what we agree on?