Centre for History in Public Health Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Centre for Youth Substance Abuse Research, The University of Queensland, St Lucia, QLD, Australia.
Addiction. 2021 Sep;116(9):2577-2585. doi: 10.1111/add.15391. Epub 2021 Jan 19.
The United Kingdom and Australia have developed highly divergent policy responses to electronic nicotine delivery systems (ENDS). To understand the historical origins of these differences, we describe the history of tobacco control in each country and the key roles played in setting ENDS policy in its early stages by public health regulations and policy networks, anti-smoking organizations, 'vaper' activist networks and advocates of harm reduction policies towards injecting drug use.
We analysed key government reports, policy statements from public health bodies and non-government organizations (e.g. cancer councils and medical organizations) on ENDS; submissions to an Australian parliamentary inquiry; media coverage of policy debates in medical journals; and the history of tobacco control policy in Australia and England. Key discourses about ENDS were identified for each country. These were compared across countries during a multi-day face-to-face meeting, where consensus was reached on the key commonalities and divergences in historical approaches to nicotine policy. This paper focuses on England, as different policy responses were apparent in constituent countries of the United Kingdom, and Scotland in particular.
Policymakers in Australia and England differ markedly in the priority that they have given to using ENDS to promote smoking cessation or restricting smokers' access to prevent uptake among young people. In understanding the origins of these divergent responses, we identified the following key differences between the two countries' approaches to nicotine regulation: an influential scientific network that favoured nicotine harm reduction in the United Kingdom and the absence of such a network in Australia; the success of different types of health activism both in England and in Europe in opposing more restrictive policies; and the greater influence on policy in England of the field of illicit drug harm reduction.
An understanding of the different policy responses to electronic nicotine delivery systems (ENDS) in England and Australia requires an appreciation of how actors within the different policy structures, scientific networks and activist organizations in each country and region have interpreted the evidence and the priority that policymakers have given to the competing goals of preventing adolescent uptake and encouraging smokers to use ENDS to quit smoking.
英国和澳大利亚对电子尼古丁传送系统（ENDS）制定了截然不同的政策回应。为了了解这些差异的历史起源，我们描述了每个国家的烟草控制历史，以及公共卫生法规和政策网络、反吸烟组织、“电子烟”活动家和减少注射吸毒危害政策的倡导者在早期设定 ENDS 政策中所扮演的关键角色。
我们分析了有关 ENDS 的政府报告、公共卫生机构和非政府组织（如癌症协会和医学组织）的政策声明；澳大利亚议会调查的意见书；医学期刊中政策辩论的媒体报道；以及澳大利亚和英格兰的烟草控制政策历史。为每个国家确定了关于 ENDS 的关键话语。在一次为期多天的面对面会议上，对这些话语在国家间进行了比较，会上就尼古丁政策的历史方法的主要共同点和分歧达成了共识。本文重点关注英格兰，因为联合王国的组成国家，尤其是苏格兰，采取了不同的政策回应。
澳大利亚和英格兰的政策制定者在使用 ENDS 促进戒烟或限制吸烟者获取以防止年轻人开始吸烟方面的优先级上存在显著差异。为了理解这些不同回应的起源，我们确定了两国在尼古丁监管方法上的以下关键差异：在英国，有一个有影响力的科学网络支持尼古丁危害降低，而在澳大利亚则没有这样的网络；在英格兰和欧洲，不同类型的健康活动家成功反对更严格的政策；以及在英格兰，非法药物危害降低领域对政策的影响更大。
要理解英国和澳大利亚对电子尼古丁传送系统（ENDS）的不同政策回应，需要了解每个国家和地区的不同政策结构、科学网络和活动家组织内的行为者如何解释证据，以及政策制定者优先考虑防止青少年使用和鼓励吸烟者使用 ENDS 戒烟的竞争目标。
