The Pharmaceuticalization of the Tobacco Industry Yogi Hale Hendlin, Phd; Jesse Elias, MA; and Pamela M
Annals of Internal Medicine IDEAS AND OPINIONS The Pharmaceuticalization of the Tobacco Industry Yogi Hale Hendlin, PhD; Jesse Elias, MA; and Pamela M. Ling, MD, MPH s developing and legitimizing pharmaceutical-like, The endorsement of health authorities by certifying Ireduced-harm tobacco products giving the tobacco noncombustible products as cessation devices (in the industry a new lease on life? Cigarettes constitute more United Kingdom) or modified-risk tobacco products than 90% of the industry's profits, and the number of (MRTPs) in the United States validates TTC and smokers is increasing worldwide with population e-cigarette company claims and confers public legiti- growth. Smoking prevalence is simultaneously declin- macy. New nicotine products lacking sanction by med- ing, threatening cigarettes' long-term profitability. ical authorities may benefit from a halo effect, whereby Transnational tobacco companies (TTCs) aggressively their resemblance to pharmaceuticals leads consumers promote smoking in low- and middle-income countries to perceive them as such. Without new drug approval, but have also diversified their product lines to in- alternative nicotine products cannot be advertised as clude more socially acceptable alternative nicotine cessation devices; nonetheless, consumers may regard products, marking an industry-wide shift (1, 2). This these as de facto nicotine replacement therapy ana- pursuit of new, standardized, designer, possibly logues. Vaping advocates and some public health or- government-certified nicotine products—a process we ganizations cast e-cigarettes as cessation aids regard- call pharmaceuticalization—may fundamentally change less of certification by drug authorities. As such, the how policymakers and the public perceive both the to- industry assumes the mantle of medical legitimacy by bacco industry and its products.
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