Harvesting Global Learning on Electronic Nicotine Delivery Systems to Inform U.S. Research, Surveillance and Policy JUNE 6-7, 2015 New Zealand A/Professor Marewa Glover Massey University

2 Overview New Zealand uses existing legislation to regulate e-cigarettes: –Medicines Act 1981, and –Smoke-free Environments Act 1990 What policies are in place in your country and what was the rationale for the policy? What potential policies are in play? What surveillance is in place (or planned) for ENDS use? For policy evaluation? What issues are affecting policy making?

3 Product Product design Product ingredients Definitions of the product (e.g., medical device, nicotine product, NRT) ENDS use Initiation Dual/poly use Cessation Intermediate outcomes Patterns of tobacco product use Youth Adults Harms Benefits Policies and regulation Price Cost Long-term outcomes Morbidity Mortality Economic costs Place Product availability Youth access Use restrictions Promotion Distribution channels Claims Labeling Advertising channels and venues

4 Policies and Regulation Product –Product design Nicotine concentrations Child safety considerations –Product ingredients including flavors? –Definitions of the product (e.g., medical device, nicotine product, NRT)

5 Medicines Act 1981 Non-tobacco products containing nicotine are a medicine. The Minister of Health must consent (through an approval process operated by Medsafe) before it is sold, advertised or distributed. If a therapeutic purpose is claimed e.g. that it can be used for smoking cessation, it is a medicine, even if it does not contain nicotine; & consent is required. To date no consent for the sale or distribution of any ENDS product has been given. People can import ENDS for their own personal use.

6 Smoke-free Environments Act 1990 ENDS (with or without nicotine) that resemble a tobacco product or smoker's pipe that can be used to simulate smoking (toy tobacco product) cannot be sold to anyone under 18 years of age. ENDS containing nicotine (derived from tobacco) and not registered as a medicine, are “an oral tobacco product that is not smoked” and therefore it is illegal to advertise, import for sale, sell, pack, or distribute.

7 Product Product design Product ingredients Definitions of the product (e.g., medical device, nicotine product, NRT) ENDS use Initiation Dual/poly use Cessation Intermediate outcomes Patterns of tobacco product use Youth Adults Harms Benefits Policies and regulation Price Cost Long-term outcomes Morbidity Mortality Economic costs Place Product availability Youth access Use restrictions Promotion Distribution channels Claims Labeling Advertising channels and venues

8 Price, Promotion, & Place Price –Cost (taxes) Place –Product availability Youth access –Use restrictions Indoor workplaces/public places Outdoor workplaces/public places Promotion –Distribution channels –Claims –Labeling –Advertising channels and venues

9 Product Product design Product ingredients Definitions of the product (e.g., medical device, nicotine product, NRT) ENDS use Initiation Dual/poly use Cessation Intermediate outcomes Patterns of tobacco product use Youth Adults Harms Benefits Policies and regulation Price Cost Long-term outcomes Morbidity Mortality Economic costs Place Product availability Youth access Use restrictions Promotion Distribution channels Claims Labeling Advertising channels and venues

10 ENDS Use & Outcomes ENDS use –Initiation –Dual/poly use –Cessation Intermediate outcomes –Patterns of use Youth Adults –Harms/Benefits Long-term outcomes –Morbidity/Mortality –Economic costs

11 Adult use in NZ in 2014 Li, J., Newcombe, R., &.Walton, D. (online first 2015). The prevalence, correlates and reasons for using electronic cigarettes among New Zealand adults. Addictive Behaviour.

12 Summary Data on prevalence of nicotine-ENDS use

13 Acknowledgements Thanks to Knowledge Action Change and The Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health and the Schroeder Institute for Tobacco Research and Policy Studies at Legacy for funding to attend the 2nd Global Forum on Nicotine & this meeting. Monique Leerschool, NZ Ministry of Health I have no known conflicts of interest.