Electronic cigarettes: First time on a Priority Setting Partnership Group

Louise Ross – Clinical Consultant, National Centre for Smoking Cessation and Training.

When I first got the invitation to join the Priority Setting Partnership (PSP) on electronic cigarettes, I had no idea what a PSP was or did, nor had I ever heard of the James Lind Alliance (JLA), the organisation that runs the PSPs.

However, because of what I do, I’m intensely interested in e-cigarettes as a means of stopping smoking and staying stopped, so I read on…

What an opportunity it has been! It’s early days yet, but already we have formed an interactive and lively group – academics, people with lived experience, researchers and practitioners. Our task? To find out what the public want to know about e-cigarettes and vaping.

When I say ‘the public’, this includes anyone who is curious to know more through research – it could be GPs, hospital doctors, vapers, smokers, policy-makers, pregnant women, homeless people, prisoners, stop smoking practitioners – anyone who has thought ‘I really would like to see research done about xxx to do with vaping/e-cigarettes’ can respond to the survey we are sending out in January.

We haven’t got long to road-test the survey, but the team at JLA (who told us at the first meeting about some of the other PSPs they’ve been working on – who knew all this public participation was going on in research circles?) have skilfully guided us through the early steps.

So in early 2019, we will launch the survey and sit back and wait for lots of replies.

Long-term health effects? Useful for stopping smoking? Second-hand vapour? Improvements in asthma?

If you have a burning question that you’d like to see included in the list of research priorities, do fill in the survey.

Then the real work will begin, sifting through the suggestions, and deciding which are the most crucial to answer. I’m confident that we have a well-balanced, engaged and knowledgeable group to tackle this task, and I’m proud to have been included.

Original post on the James Lind Alliance website. 

“The really interesting thing we found was that vaping may also encourage people who don’t even want to stop smoking, to eventually quit” Dr Caitlin Notley | University of East Anglia

Vaping helps people stop smoking – even when they don’t want to, according to new research from the University of East Anglia. A new study, funded by CRUK published today shows that smokers who switch to vaping may be better able to stay smoke-free in the long term. And that even people who didn’t want to stop smoking, have eventually quit because they found vaping more enjoyable.

Lead researcher Dr Caitlin Notley from UEA’s Norwich Medical School said:

“E-cigarettes are at least 95 per cent less harmful than tobacco smoking, and they are now the most popular aid to quitting smoking in the UK. However the idea of using e-cigarettes to stop smoking, and particularly long-term use, remains controversial. We wanted to find out about how people use e-cigarettes to quit smoking – and whether vaping supports long-term smoking abstinence.”

The research team carried out in-depth interviews with 40 vapers. They asked them about their tobacco smoking history and prior quit attempts, and about how they started vaping, their vape set up, preferred flavours and strength, and whether they had switched to vaping in attempt to quit smoking. They also asked them about situations and experiences that caused them to relapse into tobacco smoking.

“We found that vaping may support long-term smoking abstinence,” said Dr Notley. “Not only does it substitute many of the physical, psychological, social and cultural elements of cigarette smoking, but it is pleasurable in its own right, as well as convenient and cheaper than smoking. Our study group also felt better in themselves – they noticed better respiratory function, taste and smell. But the really interesting thing we found was that vaping may also encourage people who don’t even want to stop smoking, to eventually quit.”

While most of the sample group reported long histories of tobacco smoking and multiple previous quit attempts, a minority (17 per cent) said they enjoyed smoking and had never seriously attempted to quit.

“These were our accidental quitters,” said Dr Notley. “They hadn’t intended to quit smoking and had tried vaping on a whim, or because they had been offered it by friends. They went on to like it, and only then saw it as a potential substitute for smoking.”

“Many people talked about how they saw vaping was a no pressure approach to quitting,” she added. While most of the group switched quickly and completely from smoking to vaping, some found themselves using both cigarettes and vaping, and then sliding towards stopping smoking.

“We found that people did occasionally relapse with a cigarette, mainly due to social or emotional reasons, but it didn’t necessarily lead to a full relapse. This study suggests that vaping is a viable long-term substitute for smoking, with substantial implications for tobacco harm reduction.”

Alison Cox, director of cancer prevention at Cancer Research UK, who funded the project said: “The evidence so far shows that e-cigarettes are far safer than tobacco. E-cigarettes do still contain nicotine which is addictive, but it’s not responsible for the major harms of smoking. This is why they have great potential as an aid to help people quit smoking for good. It’s great to see this early indication that e-cigarettes could encourage smokers who weren’t originally thinking of quitting to give up. But more research is needed to understand exactly how e-cigarettes are being used by people who don’t want to stop smoking and how often this results in quitting. E-cigarettes are just one option for quitting – your local Stop Smoking Service can give you free advice on the best method for you, and with their support you’ll have the best chance of success.”

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‘The unique contribution of e-cigarettes for tobacco harm reduction in supporting smoking relapse prevention’ is published in Harm Reduction Journal on June 20, 2018.

Original article: How vaping helps even hardened smokers quit – Eurekalert

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.

Nicotine & Tobacco: Current issues, Policy and Practice / 21st – 24th May 2018 / University of Stirling

Building on our previous CPD courses on tobacco control and alcohol policy, the UK Centre for Tobacco and Alcohol Studies is delighted to be offering our Nicotine & Tobacco CPD course at the University of Stirling in 2018!

Please note: If you book on/before 28th February 2018, the cost is: £499, or £649 for students seeking accreditation. 

The course, successfully introduced in 2015, is aimed at professionals working in a range of organisations who are interested in public health and policy in the UK or internationally. In addition to the topics covered at previous tobacco CPDs, this year we will be examining the current, up to date evidence on tobacco harm reduction, electronic cigarettes and other nicotine-containing devices.

On successful completion of the module, students will be able to:

• Describe and discuss patterns of tobacco consumption, prevalence and addiction and the rise of e-cigarette use.
• Assess key milestones in tobacco and nicotine policy and the contribution of policy in developing and implementing effective interventions.
• Critically discuss the role of commercial interests, including the tobacco industry, in promoting tobacco use and recent controversies regarding the e-cigarette industry.
• Describe and discuss the range of effective interventions to reduce tobacco use and the place of tobacco harm reduction, including e-cigarettes, in addressing tobacco use.
• Assess the potential impact of current and emerging tobacco control priorities on different population groups, including tobacco harm reduction approaches.
• Discuss principles of media advocacy as applied to current issues in tobacco control.

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*NEW FOR 2018*

ADDITIONAL BREAKOUT SESSIONS RELEVANT TO INTERNATIONAL TOBACCO CONTROL!

TAXATION & ILLICIT TOBACCO

Deborah Arnott, Action on Smoking & Health (ASH)

SMOKELESS TOBACCO

Prof. Kamran Siddiqi, University of York

TOBACCO MARKETING

Crawford Moodie, University of Stirling

See the full UPDATED programme on our website here!

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Presentations from the 2017 e-cigarette summit | November 2017

The 5th annual E-Cigarette Summit was held at the Royal Society in London on Friday 17th November 2017. Linda Bauld, Robert West and several other members of the UKCTAS network presented their research at the event to a large audience of other scientists, policy makers, medical and public health professionals and e-cigarette stakeholders. The presentations included the latest evidence on the safety of e-cigarettes for users and bystanders, usage in young people and non-smokers, advertising and marketing, use in public places and the conflicts arising from the tobacco industry’s dual corporate ownership of tobacco harm reduction products and cigarettes.

To view the slides from each presentation and the full list of videos click here.

Robert West (University College London) & Linda Bauld (University of Stirling):

Panel Discussion:

Lion Shahab (University College London) & Jamie Hartmann-Boyce (University of Oxford):

Deborah Arnott (ASH) & Martin Dockrell (Public Health England):

See more information about the event and view each of the lecture slides.

 

Upcoming Tobacco & Alcohol courses now taking applications: limited places available!

“Tobacco Control Interventions”
29th Jan – 2nd Feb 2018
University of Nottingham

Closing date for applications: 16th January 2018

This year we will be discussing important factors in tobacco control including; youth smoking, the role of the tobacco industry, use of mass media for smoking prevention and cessation, smokefree legislation, harm reduction and the neurobiology of nicotine addiction.

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“Alcohol, Problems, Policy & Practice” 
5th – 9th February 2018
Kings College London

Early bird deadline: 21st December 2017

The course is a mixture of blended learning, with face-to-face lectures being held in February 2018. It is open to all UKCTAS researchers as well as students of the MSc in Addiction Studies.

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“Nicotine and Tobacco CPD”
21st – 24th May 2018
University of Stirling

Early bird deadline: 28th February 2018

In addition to the topics covered on our previous tobacco control CPD, we will also be examining in detail the current evidence on tobacco harm reduction, electronic cigarettes and other nicotine-containing devices.

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More information about these courses can be found on our website @ UKCTAS.net

E-Cigarette Summit 2017 – Friday 17th November | Royal Society, London

Since the inaugural meeting in November 2013, The E-Cigarette Summit has been at the forefront of taking forward the scientific and public health debate around e-cigarettes and broader harm reduction debates. The Summit has established itself as a neutral environment for scientists, policy makers, medical and public health professionals and stakeholders to come together and look at the latest scientific research and evidence on e-cigarettes and debate their impact. In 2013, the conversation was UK centric as the public health and policy communities sought to find an appropriate regulatory system for e-cigarettes that would reflect the opportunities for smokers without ignoring potential harms. In the intervening years, the UK has emerged as an active proponent for tobacco harm reduction alongside stringent tobacco control measures and now five years on the Summit welcomes scientists, public health professionals and policy makers from around the world who are looking to establish their own regulatory framework in the face of new nicotine products.

Alongside the latest evidence on the safety of e-cigarettes for users and bystanders, The E-Cigarette Summit will continue to address broader debates including evidence on “gateway” for youth and non-smokers, advertising and marketing, use in public places and the conflicts arising from the tobacco industry’s dual corporate ownership of tobacco harm reduction products and cigarettes. The role that e-cigarettes could play in ending or extending the smoking epidemic will remain one of the most fiercely fought debates in public health history.

For governments and policy makers/advisors, the weight of making the right decision cannot be underestimated. From outright bans, advertising restrictions to higher taxation; the way that each country introduces, interprets and implements legislation, including consumer and medical licensing routes, will have far reaching consequences. Setting the regulatory bar at the correct level, will be vital to harnessing the opportunities that e-cigarettes and reduced harm nicotine products could offer while remaining responsive to a tobacco control manifesto to reduce smoking related harm.

What questions will be explored?

The E-Cigarette Summit will include high level briefings from experts and encourages interaction through panel debates and open floor discussions. Questions will be explored in a balanced and objective environment allowing attendees to build their knowledge and share their viewpoints.

This year the summit will explore the latest research and evidence on the following areas:

• The Continuum of Harm Reduction and different policy/regulatory approaches.
• E-Cigarette safety and research
• Nicotine health impacts including addiction
• Dual use – how concerned should we be?
• Heat not Burn and E-cigarettes – similarities and differences
• Advertising restrictions – how to reach smokers and protect youth?
• Medicinal Licensing – is this a viable route and where are the products?
• What does the evidence say about gateway?
• Are there health risks through second hand vapour for non-users?
• If e-cigarettes are so good, why aren’t all smokers using them?

Who Should Attend?

In particular, this event will be relevant to:

• Regulators and policy advisors
• Scientific/research community
• Smoking cessation practitioners/services
• Health providers, health charities and health campaigners
• Local Authorities and Environmental Health
• Public health professionals and academics
• Medical and health professionals
• e-cigarette industry and broader stakeholders groups

This years summit welcomes many researchers from around the world, including many who are part of the UKCTAS network. Including; Professor Linda Bauld from the University of Stirling, Professor Ann McNeill from King’s College London, Dr Jamie Hartmann-Boyce from the University of Oxford and Professor Robert West from University College London. The summit will also feature inputs from the Department of Health, Public Health England and many more public health organisations. To see the full list of speakers click here.

Early Bird Rates are valid until Friday 20th October!

To register for this event or to find out more information, click here!

• Previous e-cig summit report from UKCTAS
• Latest UKCTAS press release on Ecigs

Society for the Study of Addiction – Annual Conference 2017

9th – 10th November 2017
Crowne Plaza, Newcastle, UK

Confirmed sessions include:

• Sport & exercise in addiction and recovery with personal reflections from Clarke Carlisle.
• End of life care for people with substance problems.
• The psychedelic renaissance in addiction treatment.
• Pathways to amphetamine type stimulant use.

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NEW for 2017: The ADDICTION DEBATE

‘This Society believes it is appropriate to expand the concept of addiction to behaviours such as internet use’

With Professor Robert West & Professor Mark Griffiths

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SSA PhD Symposium 2017

New for 2017, the SSA’s PhD Symposium will be held the day before our annual Conference, in the same venue.

The SSA’s symposium for PhD students is now in its ninth year. This event aims to bring together PhD students studying addiction-related topics so they can network, present their work in a low-key, supportive environment and share their ups and downs. It welcomes full and part-time students, studying in a range of disciplines including social sciences, laboratory sciences and health services research. The day includes presentations from students at various stages in the PhD process and some close to or who have recently submitted their thesis.

There is a social event in the evening of the PhD Symposium, and throughout the day there is plenty of opportunity to talk to other delegates.

 

For more information about this event please visit: www.addiction-ssa.org/symposium

 

10th annual Global Research Awards for Nicotine Dependence (GRAND) program

GRAND is a Pfizer-supported independently reviewed competitive grants program awarding individual grants of up to $200,000 from a total fund in 2017 of $1 million to support projects which directly advance the use of pharmacotherapy for treating users of any nicotine or tobacco product in clinical practice. Of 486 applications received since 2008, 62 grants have been awarded.

Pfizer has called for Clinical research proposals that aim to increase the understanding of the mechanisms of tobacco and nicotine dependence and its treatment. The overall mission of the GRAND program is to advance the pharmacological treatment of tobacco and nicotine dependence.

Each proposal should fall into one of the following areas:

• Human laboratory (e.g., pharmacokinetics, pharmacodynamics, cravings, withdrawal);
• Pharmacotherapy of smoking cessation and relapse, and / or its interaction with behavioral support;
• Characterization of subtypes of smokers; suitability for appropriate interventions.

Research projects should aim to provide information that could directly advance the use of pharmacotherapy for treating users of any nicotine or tobacco product in clinical practice. Examples could include:

• Observational or interventional studies of pharmacotherapy
• Optimization of the use of currently available medication
• Effectiveness of pharmacotherapy in real-life settings
• Development or use of new medications for cessation or harm reduction
• Specifically designed pharmacotherapy in subtypes of tobacco/nicotine users
• Use of existing databases to inform the clinical use of pharmacotherapy
• Policy interventions to increase use of pharmacotherapy.

The intent of the program is to fund at least 6 awards of between $50,000 and $200,000 in value, totaling $1.2 million. The awards are open to all investigators and they would strongly encourage applications from junior investigators.

Applications will be formally assessed by, and only by, the GRAND Review Committee, an independent committee comprising internationally prominent researchers in the field. The final responsibility for selection of Awardees rests with the Co-Chairs of the Review Committee, John Hughes and Karl Fagerstrom. The whole process is completely independent of Pfizer, including the final selection of Awardees.

GRAND is open to all investigators from around the world holding an MD, a PhD, or equivalent.

Application deadline: July 3, 2017

To apply for the grant and for more information on the application process click here!

 

Clearing the air around e-cigarettes

Fears that “vaping” is a gateway to tobacco smoking are unfounded, shows a comprehensive review of available evidence on the harms and benefits of electronic or e-cigarettes and vapour devices, released today by University of Victoria’s Centre for Addictions Research of BC (CARBC) in a report called “Clearing the Air.”

Researchers surveyed the rapidly increasing academic literature on e-cigarettes and found evidence that vaping is replacing—rather than encouraging—the smoking of tobacco cigarettes among young people. The CARBC researchers identified 1,622 articles on the topic, of which 170 were relevant to their review. Evidence shows that tobacco use by youth has been declining while use of vapour devices has been increasing.

“Fears of a gateway effect are unjustified and overblown,” says principal investigator Marjorie MacDonald. “From a public health perspective, it’s positive to see youth moving towards a less harmful substitute to tobacco smoking.”

Among their other observations, CARBC researchers found strong evidence that the vapour from e-cigarettes is less toxic than tobacco cigarette smoke. Vapour devices do not release tar, and vapour emissions contain only eighteen of the 79 toxins found in cigarette smoke, including considerably lower levels of certain cancer causing agents and volatile organic compounds (VOCs). Almost all substances tested were substantially lower, or not detected, in vapour devices compared to cigarettes.

In addition, vapour from electronic devices is airborne for less than 30 seconds compared to 18 to 20 minutes for tobacco smoke, substantially reducing the time of second-hand exposure.

Researchers caution, however, that some vapour devices may contain potentially concerning levels of metals and particulate matter, noting that there has been insufficient research regarding some significant carcinogens that may still be present.

Finally, they found encouraging evidence that vapour devices could be at least as effective as other nicotine replacements as aids to help tobacco smokers quit.

“The public has been misled about the risks of e-cigarettes,” concludes Tim Stockwell, CARBC director and co-principal investigator. “Many people think they are as dangerous as smoking tobacco but the evidence shows this is completely false.”

A media kit containing author photos, full report (for media only, not for publication), and an infographic is available on Dropbox. An executive summary is available here.

Click here to read the original story on University of Victoria’s website.

Media contacts:

Tim Stockwell (Director, UVic’s Centre for Addictions Research) at 250-472-5445 or timstock@uvic.ca

Marjorie MacDonald (Scientist, UVic’s Centre for Addictions Research/Nursing) at 250-472-4399 or marjorie@uvic.ca

Suzanne Ahearne (University Communications + Marketing) at 250-721-6139 or sahearne@uvic.ca