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Ethics and ENDS

As debate persists over regulating electronic nicotine delivery systems (ENDS), those favouring liberal ENDS policies have advanced rights-based arguments privileging harm reduction to people who smoke over harm prevention to children and never-smokers. Recent ethical arguments advocate regulating E...

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Autores principales: Fenton, Elizabeth, Robertson, Lindsay, Hoek, Janet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423514/
https://www.ncbi.nlm.nih.gov/pubmed/35338090
http://dx.doi.org/10.1136/tobaccocontrol-2021-057078
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author Fenton, Elizabeth
Robertson, Lindsay
Hoek, Janet
author_facet Fenton, Elizabeth
Robertson, Lindsay
Hoek, Janet
author_sort Fenton, Elizabeth
collection PubMed
description As debate persists over regulating electronic nicotine delivery systems (ENDS), those favouring liberal ENDS policies have advanced rights-based arguments privileging harm reduction to people who smoke over harm prevention to children and never-smokers. Recent ethical arguments advocate regulating ENDS to prioritise their harm reduction potential for people who currently smoke over any future harm to young never-smokers. In this article, we critically assess these arguments, in particular, the assumption that ethical arguments for prioritising the interests of young people do not apply to ENDS. We argue that, when the appropriate comparators are used, it is not clear the weight of ethical argument tips in favour of those who currently smoke and against young never-smokers. We also assert that arguments from a resource prioritisation context are not appropriate for analysing ENDS regulation, because ENDS are not a scarce resource. Further, we reject utilitarian arguments regarding maximising net population health benefits, as these do not adequately consider vulnerable groups’ rights, or address the population distribution of benefits and harms. Lastly, we argue that one-directional considerations of harm reduction do not recognise that ENDS potentially increase harm to those who do not smoke and who would not otherwise have initiated nicotine use.
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spelling pubmed-104235142023-08-14 Ethics and ENDS Fenton, Elizabeth Robertson, Lindsay Hoek, Janet Tob Control Special Communication As debate persists over regulating electronic nicotine delivery systems (ENDS), those favouring liberal ENDS policies have advanced rights-based arguments privileging harm reduction to people who smoke over harm prevention to children and never-smokers. Recent ethical arguments advocate regulating ENDS to prioritise their harm reduction potential for people who currently smoke over any future harm to young never-smokers. In this article, we critically assess these arguments, in particular, the assumption that ethical arguments for prioritising the interests of young people do not apply to ENDS. We argue that, when the appropriate comparators are used, it is not clear the weight of ethical argument tips in favour of those who currently smoke and against young never-smokers. We also assert that arguments from a resource prioritisation context are not appropriate for analysing ENDS regulation, because ENDS are not a scarce resource. Further, we reject utilitarian arguments regarding maximising net population health benefits, as these do not adequately consider vulnerable groups’ rights, or address the population distribution of benefits and harms. Lastly, we argue that one-directional considerations of harm reduction do not recognise that ENDS potentially increase harm to those who do not smoke and who would not otherwise have initiated nicotine use. BMJ Publishing Group 2023-08 2022-03-25 /pmc/articles/PMC10423514/ /pubmed/35338090 http://dx.doi.org/10.1136/tobaccocontrol-2021-057078 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Special Communication
Fenton, Elizabeth
Robertson, Lindsay
Hoek, Janet
Ethics and ENDS
title Ethics and ENDS
title_full Ethics and ENDS
title_fullStr Ethics and ENDS
title_full_unstemmed Ethics and ENDS
title_short Ethics and ENDS
title_sort ethics and ends
topic Special Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423514/
https://www.ncbi.nlm.nih.gov/pubmed/35338090
http://dx.doi.org/10.1136/tobaccocontrol-2021-057078
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