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Exploring possible futures of Tobacco Control in Australia: High tech, low tech and no tech

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In Australia in 2010 around 17% of adults still smoked cigarettes. In this paper we report work that we have done over the past 8 years assessing three types of strategies (hi, low and no tech) for reducing smoking prevalence under 10% by 2020 (a target recently set by the Australian government). The high tech strategies include: improving smoking cessation by screening smokers for polymorphisms that predict responses to pharmacological treatments; vaccinating smokers against the effects of nicotine; attempting to prevent nicotine dependence by screening the population for genetic susceptibility to nicotine dependence and vaccinating non-smoking children against the effects of nicotine. The low technology approach is nicotine harm reduction: encouraging smokers who are unable or unwilling to quit to switch to using non-smoked forms of tobacco such as pharmaceutical nicotine and low nitrosamine oral tobacco products. Among the leading no technology options is a de facto prohibition of smoked tobacco (e.g. by legislating to progressively reduce the nicotine content of cigarettes to zero over a decade). We compare the likely health impacts of these strategies and discuss the ethical and public policy implications that they raise.

This talk is part of the Bradford Hill seminars at the Cambridge Institute of Public Health series.

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