“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.

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

Experts say WHO needs better understanding of the evidence on e-cigs to inform its international tobacco control treaty.

A new WHO report fails to properly evaluate the evidence on e-cigarettes and could even undermine international efforts to reduce smoking, says a group of UK based academics.

UK academics are calling for better understanding of the potential benefits of e-cigarettes to reducing the smoking pandemic ahead of an international gathering of countries that have signed the World Health Organisation’s Framework Convention for Tobacco Control.

The 7th session of the Conference of the Parties (COP) of the Framework Convention on Tobacco Control (FCTC), a global public health treaty, will be held in Delhi, India from 7th-12th November 2016. At this meeting, Parties to the treaty (countries and other jurisdictions) will discuss whether similar policy measures recommended to reduce tobacco use should be applied to e-cigarettes.

In advance of the COP the World Health Organisation published a report about Electronic Nicotine Delivery Systems (ENDS) and Electronic Non-Nicotine Delivery Systems (ENDDS), also known as e-cigarettes. This aimed to summarise the evidence about these devices.

Academics from the UK Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research Centre of Excellence, have today published a robust critique of the WHO report setting out a series of concerns about the content of the document which, in their view, does not fairly represent existing evidence on e-cigarettes. Their critique examines each element of the WHO report and identifies flaws in the way the evidence is presented and problems with how the report could be interpreted, potentially encouraging countries to adopt excessive restrictions on e-cigarettes which could undermine efforts to reduce smoking.

The UKCTAS critique points to evidence set out in the recent Royal College of Physician’s’ report ‘Nicotine without Smoke’ and subsequent research which recognise that e-cigarettes are far less harmful than smoking and that smokers who find it difficult to stop should be encouraged to use them.

The WHO report fails to accurately present what is already known about e-cigarettes. In particular, it: positions e-cigarettes as a threat rather than an opportunity to reduce smoking; fails to accurately quantify any risks of e-cigarettes compared with smoking; misrepresents existing evidence about any harms to bystanders; discounts the fact that e-cigarettes are helping smokers to quit; does not recognise the place of some promotion of e-cigarettes to encourage smokers to switch to these less harmful products; fails to understand that the flavours in e-cigarettes are useful for people trying to stop smoking; mischaracterises the current e-cigarette market and appears to support very restrictive policies on e-cigarettes without including any good policy analysis. In addition, the WHO report does not acknowledge that significant restrictions on e-cigarettes could lead to unintended consequences, including increases in smoking.

Finally, the researchers point out that the WHO briefing is based on four unpublished papers which are still undergoing peer review, which does not allow for open, transparent scrutiny of the evidence. This does not, therefore, provide a good basis for policy making and risks undermining rather than promoting the aims of the FCTC, which is a treaty that was designed to help countries reduce smoking rates and save lives.

To read the full report click here.

Electronic cigarettes could have a huge effect on public health | Marcus Munafo, University of Bristol

June 20, 2016 2.17pm BST – Marcus Munafo – The Conversation

Tobacco still kills 6m people around the world every year. Despite huge public health efforts to help people quit and prevent young people starting, smoking remains the single greatest cause of ill health and premature death. And even with restrictions on tobacco advertising and smoking in public places, many young people continue to take up smoking. The situation is even worse in poorer countries, where support to stop smoking is limited, and tobacco control policies weaker.

So in light of this, how should we view the increasing popularity of electronic cigarettes?

The gadgets deliver a nicotine hit by heating a nicotine-containing propylene glycol (e-liquid) to create an aerosol (usually called “vapour”), which is inhaled. Put simply, they deliver nicotine almost as effectively as a conventional cigarette, but without the vast majority of other chemicals present in tobacco smoke (either from the tobacco itself, or as a result of the burning process).

A whole culture is emerging around “vaping”. Many devices offer a range of power settings, and a vast array of e-liquids is on offer, with varying nicotine contents and flavours. Enthusiasts often apply modifications to their devices, and engage in “cloud chasing” – competing to produce the largest and most interesting clouds of vapour. And yes, young people are experimenting with e-cigarettes (in the same way that they have always experimented with pretty much everything), although at the moment there is no strong evidence this is leading to subsequent cigarette use, or even long-term e-cigarette use.

The rapid growth in use of e-cigarettes, especially among smokers trying to cut down or quit, has taken the public health community and the tobacco industry by surprise. Both are struggling to catch up. Health professionals are hurrying to carry out research to develop evidence-based guidelines and policies. Meanwhile, the tobacco industry is buying up e-cigarette companies and introducing its own products onto the market.

So how concerned should we be about this emerging and disruptive technology?

Should we encourage existing smokers to use e-cigarettes to help them stop smoking, even if this means they continue using nicotine long-term? In the United Kingdom there is some consensus that smokers should be encouraged to use e-cigarettes if they feel they might help, and the National Centre for Smoking Cessation and Training is supportive of their use. Part of the reason many vapers feel so passionately about the subject (and react strongly when they feel that vaping is being unfairly attacked) is that for the first time, through the use of e-cigarettes, they have felt able to take control of their nicotine habit, stop smoking, and reassert some control over their health, without being medicalised in the process.

But a problem remains in the lack of information on the possible harm of e-cigarettes. This is unlikely to change any time soon, since the health effects of tobacco use can take several decades to emerge, and it’s probable the same will be true for e-cigarettes. Nothing is entirely risk-free, but the vastly reduced number of chemicals present in e-cigarette vapour compared to tobacco smoke means we can be confident that vaping will be much, much less harmful than smoking.

Heartening evidence

As part of the investigation into the effects of e-cigarettes, we investigated how the cells found in the arteries of the heart, known as human coronary artery endothelial cells, responded when they were exposed to both e-cigarette vapour and conventional cigarette smoke. We found the cells showed a clear stress response from the cigarette smoke, but not from the electronic cigarette. This suggests tobacco smokers may be able to reduce immediate tobacco-related harm by switching from conventional cigarettes to e-cigarettes.

Many people find it difficult to function without their first caffeine hit of the day. But no one is seriously calling for coffee shops to be dismantled or regulated. Nicotine is addictive, but much less so on its own than in tobacco, where other chemicals enhance its effect. At the doses consumed by vapers the harm is likely to be very low (although we need to continue to research this), and many vapers actually gradually move to zero nicotine content e-liquids, even while continuing to vape.

Of course, we may end up with a large population of long-term nicotine users who use e-cigarettes to deliver nicotine rather than cigarettes, but all of the evidence at the moment suggests that this population will almost entirely comprise ex-smokers. This would produce a vast public health gain.

We must be careful not to restrict smokers’ access to e-cigarettes, or over-state the potential harm of their use, if this will put people off making the transition from smoking to vaping. To do so would deny us one of the greatest public health improving opportunities of the last 50 years.

Original post – The Conversation | More on E-cigarettes from UKCTAS

The international symposium looking at Electronic Nicotine Delivery Systems & Smoking Cessation

La Rochelle – France

December 1st & 2nd, 2016

Tobacco will be the leading cause of death in the 21st century, and projections by the World Health Organization (WHO) are nothing short of alarming: 600 million deaths world-wide. The WHO considers smoking as “one of the most serious threats that ever faced mankind”.

The e-cig symposium was created in this context and will present the latest research results on the potential of new electronic nicotine delivery devices in the form of electronic cigarettes, and more broadly, of aerosol therapy. Devices which, for the first time, may reveal potentially effective treatment solutions to stop smoking with confort and pleasure.

The e-cig symposium has clear objectives : gathering medical, scientific, and technical research to review and summarise the studies done on electronic cigarettes, and more globally on electronic nicotine delivery devices used as an alternative to tobacco smoking.

The e-cig event will:

• present the latest research results on the potential of new electronic nicotine delivery devices in the form of electronic cigarettes, and more broadly, of aerosol therapy. Devices which, for the first time, may reveal potentially effective treatment solutions  to quit smoking with comfort and pleasure.
• provide the latest research developments on the effectiveness and safety evaluation methods of electronic cigarettes, as well as on the standards and regulations of these products.
• gather both public and private physicians and researchers working on topics directly or indirectly related to the delivery of nicotine and smoking cessation.

Who’s going to be there?

Call for communications is open: Be part of the e-cig panel speakers : +60 oral communications will be selected from the call for papers. Submit your paper below!

Program at a glance | Submit your abstract | More information

Human heart cells respond less to e-cig vapour than tobacco smoke – University of Bristol

New research has showed substantial differences in the way human heart cells respond to e-cigarette vapour and conventional cigarette smoke.

Researchers from the Medical Research Council Integrative Epidemiology Unit (MRC IEU) at the University of Bristol investigated how the same type of cells as those found in the arteries of the heart, known as human coronary artery endothelial cells (HCAEC), responded when they were exposed to both e-cigarette aerosol and conventional cigarette smoke.

Their results were published in the journal Drug and Alcohol Dependence.

Professor Marcus Munafò, who was part of the study team, said: “The past few years have seen a rapid growth in the use of e-cigarettes, which deliver nicotine via inhaled aerosol. It’s thought that e-cigarettes are unlikely to be as harmful as conventional cigarettes, but little data exists to show their relative harms, or the long term effects of e-cigarette use. Therefore, research into these biological effects is critical. Our study looked at the stress response in heart cells in response to cigarette smoke and e-cigarette aerosol.”

The researchers created cigarette smoke extract from a conventional cigarette and electronic cigarette aerosol extract from an e-cigarette aerosol. Both were passed through a culture of the cells. The researchers then analysed the gene expression patterns of the heart cells to see if the cells exhibited a stress response to either the cigarette smoke or e-cigarette aerosol exposure.

Professor Munafò said: “We found the cells showed a stress response from the cigarette smoke extract, but not from the electronic cigarette aerosol extract. This result suggests tobacco smokers may be able to reduce immediate tobacco-related harm by switching from conventional cigarettes to e-cigarettes.”

‘Cigarette smoke but not electronic cigarette aerosol activates a stress response in human coronary artery endothelial cells in culture’ by Teasdale, Newby, Timpson, Munafo and White in Drug and Alcohol Dependence

Taken from: Bristol University News