Policy Studies Harm Reduction

Modeling the Potential Public Health Impact of E-Cigarette Legalization in Thailand

Key Points

An abundance of evidence indicates that e-cigarettes are less harmful than combustible cigarettes.
To date, the tobacco control efforts in Thailand have stalled, showing only small annual decreases in smoking prevalence.
Findings suggest that the legalization of e-cigarettes in Thailand is likely to reduce the burden of tobacco use and help the nation achieve its public health goals.

Over the last two decades, the landscape of tobacco products has changed with the introduction of electronic cigarettes (e-cigarettes), and most recently heat and not burn devices. In part, the impetus for the development of these products was to offer alternatives to combustible cigarettes that mitigate the health consequences of smoking. In fact, a review from Public Health England estimated that e-cigarettes are 95 percent less harmful than combustible cigarettes. Likewise, the U.S. Food and Drug Administration (FDA) recently designated the Philip Morris International (PMI) heat and not burn product IQOS as a modified risk tobacco product, thus acknowledging IQOS to be less harmful than combustible cigarettes.

This spectrum of harm among tobacco products, anchored by combustible cigarettes as most harmful and new Alternative Nicotine Delivery Systems (ANDS)—such as e-cigarettes and heat not burn devices—as less harmful, suggests that converting cigarette smokers who otherwise are unable or unwilling to quit to these less-harmful products would, in the long run, yield benefits to the overall population health. Modeling the impact of switching to e-cigarettes on cigarette smokers in the United States, one study concluded that over a 10-year period, replacing cigarettes with e-cigarettes would prevent over 1.6 million premature deaths. Similar research reported that smokers who switch to e-cigarettes potentially gain an extra two years of life, and vaping is likely to decrease the overall mortality associated with cigarettes.

While these studies were based on the analysis of U.S. public health data, the analysis presented in this paper models the potential impact of smokers in Thailand switching to e-cigarettes. Unlike the United States, Thailand is one of 44 countries that currently ban the sale of e-cigarettes and other vaping products. Therefore, this paper models the potential public health impacts of introduction and legalization of e-cigarettes in Thailand based upon secondary data analysis and a review of the existing, relevant literature.

Press release: Thai Government Should Reexamine E-Cigarette Ban as it Pursues Goal to Reduce Smoking Rate

Image credit: Hazemmkamal

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