Sense, not hysteria, from a health professor

Emeritus Professor of Population Health Ruth Bonita writes:

The Government’s decision to introduce a lower excise rate for heated tobacco products (HTPs) has been widely framed as “giving tax breaks to tobacco companies”. It’s a provocative line – and politically potent – but it doesn’t help us have an honest, evidence-informed discussion about how to reduce smoking harm, particularly for the most disadvantaged New Zealanders, or how to deal with conflicts of interest.

Let’s be clear: this isn’t a corporate subsidy, so long as the reduced tax is passed on with cheaper products. It’s an excise adjustment applied to a class of tobacco products that heat rather than burn tobacco. (Like vaping products, HTPs are marketed as smoke-free alternatives to cigarettes, but are not the same thing.)

Combustion is what makes smoking lethal. Cigarettes burn at over 800C, releasing thousands of toxic compounds. Heated tobacco products operate at much lower temperatures and don’t produce smoke – just an aerosol – with far fewer harmful constituents.

Making a reduced harm product cheaper than a greater harm product is a very sensible strategy, that has been proven to work with products such as vaping.

Unfortunately, it appears Philip Morris International hasn’t yet passed on the tax savings to the small number of HTP users in New Zealand – this is the real scandal.

If this is the case, then the trial will probably not result in any reduction in harm as smokers won’t transition. In that case it should not be extended. Decisions should be based on evidence, not hysteria.

Critics argue there’s insufficient evidence that HTPs help people quit, but the UK Office for Health Improvement and Disabilities, the UK Committee on Toxicity, and the US Food and Drug Administration all acknowledge HTPs reduce exposure to toxicants compared with cigarettes. That doesn’t make them harmless – but being less harmful than smoking is enough to warrant a differential tax.

I agree. Do not let perfect be the enemy of good.

The example of Japan is instructive. There, HTPs make up over 30 percent of tobacco sales. Though vaping is banned, cigarette consumption has plummeted by 40 percent in some markets. Surveys suggest many smokers switched completely to HTPs. Youth uptake has been minimal. No policy is perfect, but that’s a shift in the right direction.

Again, lets follow the evidence.

In a country that leads the world with its Smokefree 2025 goal, we should be asking how to accelerate the decline in smoking, not defending a one-size-fits-all excise regime that’s increasingly disconnected from the realities of risk, behaviour, and equity.

If HTPs can help some people switch, pricing them appropriately is not a scandal. It’s a good policy – provided it’s transparent, monitored, and grounded in evidence, and the tax savings are passed on to consumers.

Again, a refreshingly sensible approach.

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