Erku Daniel A, Kisely Steve, Morphett Kylie, Steadman Kathryn J, Gartner Coral E
School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Queensland, Australia.
School of Medicine, University of Queensland, Herston Road, Herston 4006, Queensland, Australia.
Int J Drug Policy. 2020 Apr;78:102699. doi: 10.1016/j.drugpo.2020.102699. Epub 2020 Feb 18.
To compare the policy positions of health and medical organisations across Australia, New Zealand, and the UK as they relate to sale and supply of nicotine vaping products (NVPs) and evaluate factors that have informed the differences in policy recommendations among these countries.
We used mixed methods to analyse data from position or policy statements published by health and medical organisations regarding NVPs (n = 30) and consultation documents submitted to government committees regarding policy options for the regulation of NVPs (n = 26). Quality assessment of included documents was conducted using the six-item Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers, and findings were presented narratively. Qualitative data were coded using NVivo 12 software and analysed using thematic analysis.
An overwhelming majority of health bodies, charities and government agencies in the UK and New Zealand portrayed NVPs as a life-saving harm reduction tool. In contrast, concerns about addicting non-smoking youth to nicotine, a perceived lack of clear and convincing evidence of safety and efficacy and the potential to undermine tobacco control progress continues to define attitudes and recommendations towards NVPs among Australian health and medical organisations. Although the profoundly divided views among stakeholders seem to arise from empirical uncertainties and disagreements over the level and credibility of evidence, the source of most of these disagreements can be traced back to the fundamental and irreconcilable differences in the framing of the NVP debate, and varied tolerability of risk trade-offs associated with NVPs.
Progress in resolving the controversy surrounding NVP policy requires stakeholders to be frame-reflective and engage in a meaningful dialogue of risk trade-offs, as well as both intended and unintended consequences of proposed policies.
比较澳大利亚、新西兰和英国卫生与医学组织在尼古丁电子烟产品（NVPs）销售和供应方面的政策立场，并评估导致这些国家政策建议存在差异的因素。
我们采用混合方法分析了卫生与医学组织发布的关于NVPs的立场或政策声明（n = 30）以及提交给政府委员会的关于NVPs监管政策选项的咨询文件（n = 26）中的数据。使用六项乔安娜·布里格斯研究所（JBI）文本和观点论文批判性评价清单对纳入文件进行质量评估，并以叙述方式呈现研究结果。定性数据使用NVivo 12软件进行编码，并采用主题分析进行分析。
英国和新西兰的绝大多数卫生机构、慈善机构和政府机构将NVPs描述为一种挽救生命的减少危害工具。相比之下，澳大利亚卫生与医学组织对NVPs的态度和建议仍然受以下因素影响：担心非吸烟青年对尼古丁上瘾、认为缺乏明确且令人信服的安全性和有效性证据以及担心其可能破坏烟草控制进展。尽管利益相关者之间存在严重分歧的观点似乎源于经验上的不确定性以及对证据水平和可信度的分歧，但这些分歧大多可追溯到NVPs辩论框架的根本且不可调和的差异，以及与NVPs相关的风险权衡的不同容忍度。
要解决围绕NVPs政策的争议，利益相关者需要进行框架反思，参与关于风险权衡以及拟议政策的预期和非预期后果的有意义对话。
