A Disrupted Future?

Ian Miles

doi:10.17323/2500-2597.2020.1.6.27

Abstract

The tobacco industry worldwide has annual revenues of hundreds of billions of dollars, and annual smoking-associated death rates in the millions. Electronic cigarettes designed as a less harmful alternative to traditional tobacco products allow users to inhale nicotine, without consuming the products of burning tobacco, thus significantly lowering health risks. These and similar innovative solutions have a potentially disruptive impact on existing markets. Both newcomers and established cigarette firms have been active around these alternatives. However, the health implications of such products are still poorly studied and seemingly ambiguous. Moreover, there is an increasing number of reports on mass diseases associated with vaping. As a result, most countries and international institutions, including the World Health Organization, have adopted negative attitudes towards electronic cigarettes.Do e-cigarettes represent a Trojan Horse that will undermine tobacco control efforts - or are they an effective way to wean users away from cigarettes thus opening the way towards better future? This paper outlines estimates of the future health impacts of cigarette and e-cigarette use, and considers the broader issues surrounding this potentially disruptive innovation. It points to areas requiring further research and suggests how Foresight studies might address the topic.

Highlights

Do e-cigarettes represent a Trojan Horse that will undermine tobacco control efforts – or are they an effective way to wean users away from cigarettes opening the way towards a better future? This paper outlines estimates of the future health impacts of cigarette and e-cigarette use, and considers the broader issues surrounding this potentially disruptive innovation
Many commentators suggest that e-cigarettes are a disruptive innovation, with cigarette smoking patterns being disrupted by new electronic nicotine delivery systems (ENDS)
If ENDS are to be more than a niche innovation, they have to provide the pleasure to the consumer, while reducing the costs

Summary

Introduction

“Disruptive Innovation” (see Box 1) has become a major theme in innovation studies (how can we explain the emergence and features of high-impact innovations?), and in Foresight exercises (how can we anticipate the implications of potential changes and prepare to make the most of them?). The World Health Organization (WHO) estimates that there are currently over a billion cigarette smokers in the world today, leading to a huge premature death toll over the course of the century [WHO, 2008]. Cigarette use is still growing in some regions of the world, though it is generally declining in most industrial countries. Emerging early in this century, types of e-cigarettes have proliferated. The notion that nicotine was addictive might undermine the case about free individual choice, this was contested Such persistent obfuscations created widespread distrust of industry pronouncements, especially among public health officials whose anti-tobacco position hardened. Economic development was represented by per capita GDP adjusted for purchasing power parity, with World Bank forecasts used to project this. 5 “Tobacco use was measured in terms of ‘‘smoking impact’’— that component of observed lung cancer mortality attributable to tobacco smoking ...This indirect measure of the accumulated hazards provides a better measure than do current smoking rates for the overall health impact of tobacco, taking into account lag times as well as important aspects of exposure such as duration, type, amount, and mode of smoking ...Smoking impact was calculated for the historical mortality country–year observations by subtracting nonsmoker lung cancer rates from observed total lung cancer mortality rates in the data. ...”” [GBD, 2017, p. 2014] Country-specific projections of smoking levels were produced from regional estimates developed in earlier studies, with some modeling of age-specific smoking levels

FORESIGHT AND STI GOVERNANCE

A Disruption?

Findings

Notes: