All in the Mind – Tobacco Reporter


A successful HCHE, according to the white paper, resembles a consumer buying model in which informed buyers express demands that support their well-being and stakeholders succeed in recognizing and responding to those demands. The paper identifies three players that can have a significant impact on NCDs: insurers, retailers and technology.

Insurers can contribute to the HCHE by providing medical assistance, for example, through health coaching, paying health care claims, and offering incentives, such as rewards to encourage quitting tobacco. They can also provide information about achieving and maintaining health, including health risk assessments, biometric screening, and education.

In addition to increasing their stocks of healthy items, retailers, which are the main source of consumer products and therefore have a particularly powerful influence on the quality of food, can provide access to certain health services, such as on-site vaccinations, and working with policy makers to develop pricing policies that encourage the consumption of healthier foods and beverages. In the case of tobacco, the white paper recommends reduced inventory, citing the example of CVS Caremark, a US retailer that in 2014 stopped selling cigarettes.

As CVS Caremark sales declined over the next year, its decision reduced total cigarette sales by 1% in 13 US states, while nicotine patch purchases increased by 4%. immediately after the end of tobacco sales.

Health-related technology, the third component mentioned in the report, refers to the application of knowledge and skills organized in the form of devices, drugs, vaccines, procedures and systems developed to solve or prevent a health problem and improve the quality of life.

For patients with chronic obstructive pulmonary disease or asthma, for example, tracking the use of inhalers that deliver lifesaving drugs can be difficult. It is estimated that 70-90% of patients use their inhaler improperly, delivering insufficient levels of medicine to their lungs. In late 2018, the US Food and Drug Administration approved the first digital inhaler with built-in sensors that detect when the inhaler is in use and measure breathing. The sensors connect to a smartphone app, recording data that can be shared with doctors who can assess a patient’s inhaler usage. There are many ways to adapt these technologies to e-cigarettes, combustionless heaters and related products.

The tech sector is also where reduced-risk tobacco products (RRPs) come into play, as the gap between recreational and therapeutic inhalers is narrowing. Among recently published patents for nicotine vapor devices and heated tobacco products, most cover therapeutic innovations, including vaping products using sensors (see “In preparation”, page 20).

The combination of new technologies and behavioral economics makes healthy choices the easier choices. Laws that regulate products in proportion to their risk complement and support this.

Properly integrated into the HCHE, RRPs could lead to significant advances in public health. The private sector has already understood the potential of RRPs as a smoking cessation tool. It is time for regulators to follow their lead.

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