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

    People aren’t literally addicted to the habit of smoking, they’re physically addicted to nicotine. It’s pretty much unavoidable. Any smoker who tells you they just like the ritual, has been conditioned to think that by mentally associating the ritual with relief from the physical symptoms of nicotine withdrawal.

    Sure, removing the nicotine isn’t going to be an immediate barrier from continuing smoking. But the point is that once the person can no longer get nicotine from smoking, they will almost certainly make the decision to quit themselves. And that has the potential to be a more profound decision for them than simply having the product taken off the shelves and being told they can’t have it.

    • ColeSloth
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      1 year ago

      They aren’t removing all the nicotine. They were just cutting down how much each cigarette has. So for a smoker to get their nicotine fix, they’d have to smoke three times as many cigarettes.

      • mindbleach@sh.itjust.works
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        1 year ago

        “Their fix” is based on whatever dosage they’re already used to. There’s not some fixed upper bound that everyone achieves after their first cigarette.

        Making cigarettes less addictive would make new addicts less addicted.

        • ColeSloth
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          1 year ago

          At the cost of 50 years worth of current addicts smoking more.

            • ColeSloth
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              1 year ago

              I doubt it. I think for most smokers, one cigarette does them for a while. I don’t see anyone stopping at half a cigarette, so I’d guess it would only get smokers used to taking more nicotine in at a time.

                • ColeSloth
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                  1 year ago

                  Like I said. Mainly because if someone lights up, they’ll smoke the whole cigarette. Not half. But if they didn’t get enough nicotine from one, instead of not smoking again for a couple hours, they may smoke again after just 45 minutes or so. Or even start chain smoking.

      • gila@lemm.ee
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        1 year ago

        It’s still tobacco at the end of the day, you can’t remove all of the nicotine because it occurs naturally. It occurs in many other plants too, but in levels which doesn’t inspire any motivation to remove it. In the same way I think delineating between elimination and reduction of nicotine is a moot point. Smoking is not pleasant, and every smoker has overcome this unpleasantness to become nicotine addicts. There is no reason other than nicotine why it continues to propagate in all countries and cultures today. And with nicotine-reduced cigarettes, smokers must simultaneously engage with that unpleasantness more, and still come to terms with diminished returns vs. the nicotine they previously ingested from 1 cigarette.

        As for the amount the nicotine can be reduced by, I’ve seen a wide range of estimates from 50% to 90+%. I don’t think we’ll ever really know what’s reasonable and scalable without any such product actually on the market.

          • gila@lemm.ee
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            1 year ago

            It reinforces the effect of the nicotine. That’s literally why tobacco companies were adding acetone to cigarettes back when they were publicly denying it was even addictive.

        • fluxion@lemmy.world
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          1 year ago

          If the idea is reducing it to the point where smokers don’t think it’s worth it to smoke anymore, then just ban them. Otherwise you absolutely will have people who will smoke 3-4x more to get their original fix. Or they’ll take deeper draws and hold it longer like people did when lights were introduced (there were studies on this)

          • gila@lemm.ee
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            1 year ago

            Without taking away from your point, I’ll point out that you’re comparing hypothetical isolated cases of pointless and fruitless self-harm to a supposed reduction in tobacco harm generally, which is one of the leading causes of premature death globally, and is also fully preventable (while the actions of irrational persons is not generally preventable). I think the side you land on has more to do with one’s politics generally than the actual issue. Does “do no harm” take priority if the consequence is “generally more death”?

            • fluxion@lemmy.world
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              1 year ago

              No I literally think they should ban them instead of playing stupid games like taking most of the nicotine out and hoping people make the healthier decision vs the more destructive one of smoking more.

              Whether nicotine reduction would even lead to a net reduction in harm is the actual hypothetical here, and there are reasons to believe it wouldn’t, which is all I’m pointing out. It just sounds like a shitty policy, regardless of ideology.

              • gila@lemm.ee
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                1 year ago

                What are those reasons? It sounds like you’re trying to say that tobacco as a cultivated plant for smoking propagating across the world over the past few centuries is because it was trendy.

                Without getting into my personal involvement and anecdotes, ‘introduce RNT products and hope for the best’ is far from an accurate characterisation of NZ Labour’s Smokefree 2025 Action Plan.

                • fluxion@lemmy.world
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                  1 year ago

                  I’m not arguing nicotine isn’t addictive. It’s the whole basis of why there’s good reason to believe people woule just smoke more to get their fix, and all the harm that comes with the added tar consumption that would involve.

                  It also wouldn’t be the first time a political party proposed a poorly thought out policy that sounds good on paper but doesn’t help in practice. If there is some accompanying successful medical study that motivated such a policy then I can be convinced otherwise, but until then let’s stop pretending these doubts are not obvious and reasonable.

                  • 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.