New study finds no clear evidence that nicotine “preloading” helps smokers to quit | University of Oxford

There is insufficient evidence to show that using nicotine patches for four weeks before a quit attempt (known as “preloading”) improves long-term smoking abstinence, finds a trial published by The BMJ this week.

The researchers found that nicotine preloading reduces craving intensity and seems to make quitting easier, but that this beneficial effect may have been masked by a concurrent reduction in the use of varenicline in the period after quit day. As varenicline is the most effective smoking cessation drug, this may have undermined the benefit of preloading.

If it were possible to overcome this unintended consequence, nicotine preloading “could lead to a worthwhile increase in long term smoking abstinence,” they say.

The research was funded by the National Institute for Health Research.

Although there have been several new drugs for tobacco cessation since the 1970s, treatment has remained largely the same, with behavioural support to motivate and strengthen a person’s resolve to remain abstinent and drugs to reduce the strength of urges to smoke after quit day.

Some studies have suggested that using nicotine replacement therapy before a quit attempt is more effective than when used in the conventional way to support abstinence, while other studies suggest preloading has no effect.

A research team from the UK Centre for Tobacco and Alcohol Studies, led by Professor Paul Aveyard at the University of Oxford, set out to examine the effectiveness of a nicotine patch worn for four weeks before a quit attempt.

The Cochrane Tobacco Addiction Group’s 20th anniversary priority setting project report.

The Cochrane Tobacco Addiction Group (TAG) conducts and facilitates systematic reviews and meta-analyses of the research evidence for tobacco cessation and prevention interventions. The group was founded in 1996 and in 2016 they conducted a stakeholder engagement project to celebrate the 20th anniversary of TAG and to identify future research priorities for the group and the wider tobacco control community.

 

A summary of the findings of the CTAG taps project:

 

The objective of the project was to:

• Raise awareness of Cochrane TAG and what has been achieved so far.
• Identify areas where further research is needed in the areas of tobacco control and smoking cessation.
• Identify specific goals for Cochrane TAG
• To explore novel ways to disseminate the findings of tobacco research, and Cochrane TAG’s findings.

The survey and workshop resulted in 183 unanswered research questions in the areas of tobacco, quitting smoking and eight priority research areas, including:

• ‘addressing inequalities’
• ‘treatment delivery’
• electronic cigarettes’
• ‘initiating quit attempts’
• ‘young people’
• ‘mental health and substance abuse’
• ‘population-level interventions’
• ‘pregnancy’

Stakeholders who attended the workshop also discussed ways that the public health community and Cochrane TAG could act to move the field of tobacco control forward.

Through this report, Cochrane TAG want to share the identified unanswered questions with the wider tobacco research community to help them to decide the most important research to focus on in the future, and to decide the most important things to work on for Cochrane TAG.

This will involve updating existing reviews, beginning reviews on new topics, and looking in more detail at Cochrane TAG’s research methods.

Contrary to popular belief there are still many important unanswered questions in the field of tobacco control. In addition, it has been noted that many of the results of tobacco control questions are not always reaching their intended targets. Tobacco control stakeholders provide a rich source of information on how these uncertainties should be prioritised; by using this resource the likelihood that the findings of research are useful and will be implemented is much greater. The project was carried out with the hope that researchers and research funders will be able to use the priorities identified to inform their future practice, in the same way that Cochrane TAG are using them to inform new review topics, updates of reviews and methods development.

Cochrane TAG’s findings and implementation suggestions should be considered alongside the existing evidence base and clinical expertise.

 

Here is the full report of the CTAG taps project!

 

You can open the report and the appendices by clicking on the covers below:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Discussing the future of tobacco addiction research with the Cochrane Tobacco Addiction Group:

The CTAG taps project ran from January-December 2016. Activities carried out from April 2016-December 2016 were funded by the NIHR School for Primary Care Research (SPCR)

New evidence finds standardised cigarette packaging may reduce the number of people who smoke as UK legislation bans the use of branding on all cigarette packets from May 2017.

A Cochrane Review published today finds standardised tobacco packaging may lead to a reduction in smoking prevalence and reduces the appeal of tobacco.

According to the World Health Organisation, tobacco use kills more people worldwide than any other preventable cause of death. Global health experts believe the best way to reduce tobacco use is by stopping people starting to use tobacco and encouraging and helping existing users to stop.

The introduction of standardised (or ‘plain’) packaging was recommended by the World Health Organisation, Framework Convention on Tobacco Control (WHO FCTC) guidelines. This recommendation was based on evidence around tobacco promotion in general and studies which examined the impact of changes in packaging on knowledge, attitudes, beliefs and behaviour. Standardised tobacco packaging places restrictions on the appearance of tobacco packs so that there is a uniform colour (and in some cases shape) with no logos or branding apart from health warnings and other government-mandated information, and the brand name appears in a prescribed uniform font, colour and size.

From next month, UK legislation on standardised packaging for all tobacco packs comes into full effect.

Australia was the first country in the world to implement standardised packaging of tobacco products.  The laws, which took full effect there in December 2012, also required enlarged pictorial health warnings.

A team of Cochrane researchers from the UK and Canada have summarised results from studies that examine the impact of standardised packaging on tobacco attitudes and behaviour. They have today published their findings in the Cochrane Library.

University of Oxford PhD Studentship ~ Developing and testing peer-led interventions to promote switching from smoking to vaping.

Developing and testing peer-led interventions to promote switching from smoking to vaping.

PhD Studentship ~ Closing date: 26th May 2017

Applications are invited from individuals with a strong academic record who wish to develop a career in behavioural or primary care research. The student will join the thriving Health Behaviours team in the Nuffield Department of Primary Care Health Sciences who are working on range of interventions to support harm reduction and smoking cessation.

The project: The rise in popularity of electronic cigarettes (‘e-cigarettes’) in recent years has been accompanied by a growth in the number of virtual ‘vaper’ communities, with people sharing their advice and experiences of e-cigarettes with peers on internet support groups and discussion forums, many of which address ways of reducing or stopping smoking. The rise of peer to peer support is unique to e-cigarettes; no other means of stopping or reducing smoking attracts such passionate engagement from members of the public. This raises the possibility that we could better harness this peer support to enable more people to reduce or stop smoking using e-cigarettes and this project examines this.

Have your say: What should Tobacco Addiction Research focus on next?

Are there any questions in tobacco control you would like to see answered?

The Cochrane Tobacco Addiction Group would like to ask you where you would like to see further research, or where you feel that there is still uncertainty about ways to prevent or treat tobacco addiction. The prioritisation survey will be the first of its kind to identify pressing unanswered questions about the prevention and treatment of tobacco addiction.

Your questions can be in any order of importance, and they can be about policies or interventions for smoking tobacco, smokeless tobacco (e.g. snus, chewing tobacco) or waterpipe tobacco use (e.g. hookah, shisha).

The views gathered in this survey will be published in a reputable journal, and will be used to inform the future research priorities for the entire tobacco addiction research community.

Find out more about the project here.

Complete the online survey to see your questions answered!

 

2016 is the 20th anniversary of the Cochrane Tobacco Addiction Group.

The Cochrane Tobacco Addiction Group forms part of The Cochrane Collaboration, an international not-for-profit and independent organisation which produces and disseminates systematic reviews of healthcare interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. The major product of the Collaboration is the Cochrane Database of Systematic Reviews which is published monthly as part of The Cochrane Library.

The Tobacco Addiction Group reviews the evidence on interventions to prevent and treat tobacco addiction.  We include interventions for smoking cessation, for preventing uptake, and public policy interventions to reduce smoking prevalence. We also provide editorial support for a limited number of reviews that do not fit the remit of other Cochrane Review Groups.

The co-ordinating editor is Dr Tim Lancaster, Reader in Primary Health Care, University of Oxford. The other editors of the group are Professor Robert West, Cancer Research UK Health Behaviour Unit, Dr Paul Aveyard, University of Oxford and Professor John Hughes, University of Vermont.

The work of the group is supported by the UK Department of Health Research & Development Programme.

20th anniversary of Cochrane Tobacco Addiction Group! @CochraneTAG

The Cochrane Tobacco Addiction Group (TAG) was founded in 1996, making 2016 their 20th anniversary!!

To hear more about the history of the Cochrane Group Click here!

The group will be using this year to look back on the last twenty; by highlighting their achievements, holding various promotional events and planning for the future! 

“More specifically our plans for 2016 are:

• To disseminate our work and achievements more through blog posts, other social media, journal editorials and promotion at conferences.

• We are putting together a programme of conference promotion & dissemination. For more information on what we are getting up to and the outcomes click here.

• We are happy to announce that we have won funding from the NIHR School for Primary Care Research to carry out a project called CTAG taps. CTAG taps stands for Cochrane TAG twentieth anniversary priority setting project. For more information about this project, which will run throughout 2016 please click here

• A one day priority setting workshop at the University of Oxford on Friday 17th June 2016. This workshop is part of the CTAG taps project and will bring together tobacco control experts across research, policy making, commissioning, clinical practice and the public. The aim of the workshop is to celebrate and publicise the work of the group so far,  but most importantly to help guide the aims of Cochrane TAG so our reviews meet a wide range of needs, are relevant to current trends in smoking, and therefore create the highest possible impact, whilst guarding against research wastage. For more information on our workshop please click here“

Click here for more information and to keep up to date with Cochrane’s 20 year anniversary!

Promoting Evidence Based Practice at UKNSCC 2015 by Nicola Lindson-Hawley

Nicola Lindson-Hawley – Managing Editor for the Cochrane Tobacco Addiction Group, University of Oxford

Earlier this month (11th – 12th June) I attended the UK Nicotine and Smoking Cessation Conference (UKNSCC) 2015 in Manchester to promote the Cochrane Tobacco Addiction Review Group (TAG). The Cochrane TAG team support authors to identify relevant clinical trial evidence to answer research questions regarding the efficacy of smoking prevention and cessation interventions, and synthesise this into a literature review, and meta-analysis if possible. So far the group have over 70 reviews, which can be found here: http://goo.gl/TBW2zn. Many of the attendees at UKNSCC are smoking cessation service providers and counselors who are one of the key audiences for these reviews, so that they can use the findings to support their clinical practice and ensure that they are using the most efficacious evidence based methods. Conference attendees visiting the Cochrane stand were able to take away two page summaries of five of our reviews on pharmacological treatments, combination behavioral and pharmacological support, the prevention of weight gain after stopping smoking, reduction versus abrupt quitting and electronic cigarettes.

Whilst at the conference I also attended lots of interesting sessions and there were plenaries by UKCTAS members Robert West, Linda Bauld and Andy McEwan.  There was (perhaps non-surprisingly) a large emphasis on electronic cigarettes at the conference and it was great to get the perspective of an avid vaper- Lorien Jollye- in the session ‘What we’ve learnt from service users who vape’.   Another highlight was hearing Deborah Arnott of Action on Smoking and Health (ASH) discussing their very recently published report, ‘Smoking Still Kills’. The aim of the report is to keep tobacco issues high on the public health agenda. Deborah reported that on the day the report was published (10/06/2015) shares in tobacco companies fell. Now, that’s impact! One of the key proposals made is that tobacco companies should be made to pay a levy on all their profits to contribute to the cost of the harm caused by their industry. Click here for more information.

UKNSCC provided a great opportunity to get the findings of our reviews out there to the people who matter most- those actually implementing the interventions we investigate- whilst also giving me the time to get up to date with what is going on in the practical world of smoking cessation support.

If you’d like a copy of any of the summaries we created for UKNSCC 2015 please email me at nicola.lindson-hawley@phc.ox.ac.uk, and for more information about Cochrane TAG and our reviews keep up to date on Twitter @CochraneTAG.