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

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.

 

Are you a vaper who also smokes? Would you be willing to help with an important study at QMUL?

How does dual use of e-cigarettes and conventional cigarettes change over time?

The Study:

This study is being run by the Health and Lifestyle Research Unit at Queen Mary University of London, and is funded by Cancer Research UK (CRUK).

Many people who smoke conventional cigarettes also use an e-cigarette and this is called ‘dual use’. Little is known about the way such use develops over time. Most dual users aim to stop smoking altogether, but many people continue using both products. It is not clear at present how many of these dual users stop smoking, at which time point, and what factors help them to stop.

We are inviting up to 500 dual users to take part in a study which aims to gain a greater understanding of these issues. If you take part, we will ask you questions about your vaping and smoking over the telephone or internet at 3 monthly intervals, over a 12-month period. The surveys should take approximately 10 minutes each to complete. You will receive a £15 voucher as compensation for your time. The study is funded for 1 year initially, but if we obtain further funding, we will extend the follow-up period to 10 years.

We hope that the results of this trial will inform what advice doctors and other health professionals give on e-cigarettes in the future.

Who can take part?

You will be able to take part if you are:

• Aged 18 years or over.
• Currently using both an e-cigarette and conventional cigarettes either on the same or separate days for at least one day a week, and practiced such use for at least one month.
• Willing to provide data on your vaping and smoking at baseline, 3, 6, 9 and 12 months.
• Are not currently taking part in another conflicting study.

Thank you for your interest in this study. It is important that you understand what is involved before you consent to take part. There is information at the end of the information leaflet on how to contact the study organiser if you have any questions or concerns. Your participation is completely voluntary and will not affect any access to treatment or services that you may be currently receiving.

If you are interested in taking part please call: 0207 882 5747 (lines are open Monday-Friday, 9-5pm) Or click the link to email us: health-research@qmul.ac.uk

For more information and to apply to take part in this study click here!

 

 

 

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

UKCTAS comment on the latest tobacco control plan for England: “Towards a smoke-free generation”

The new tobacco control plan, ‘Towards a smoke free generation’ is a welcome restatement of the government’s commitment to reduce the prevalence, and hence the burden of death and disability caused, by smoking. The recognition that harm reduction strategies can play a key role in achieving these ambitions is applauded, and puts the UK at the forefront of global tobacco policy. However, the ambition to reduce adult smoking in England from 15.5% to 12% by 2022, representing as it does a reduction of 0.5 of a percentage point per year, is modest given that smoking prevalence has fallen by 2.9 percentage points in the last three years.

Recognising reducing smoking in pregnancy as a priority, and aiming to reduce prevalence in pregnancy to 6% or less, is welcome but will not be achieved without adequate resources, improved care pathways and addressing significant gaps in training for midwives and obstetricians. The commitment to make NHS inpatient mental health settings smoke-free by 2018 is long overdue, but it is disappointing that the same strong commitment is not extended to other NHS settings.

The ambition to make stop-smoking services more available is also welcome, but like the commitments to NHS settings and for pregnancy requires funding: when public health budgets are being slashed, how will local authorities afford to increase their smoking service provision?

What matters now is delivery: Action to achieve and exceed these ambitions is the next and crucial step

PDF of the Press Release

Prof Linda Bauld on E-cigarette use during pregnancy at GFN 2017

Global Forum on Nicotine 2017 – ‘Reducing Harm, Saving Lives’

E-cigarette use during pregnancy – What do we know?

At the June Global Forum on Nicotine event Professor Linda Bauld from the University of Stirling and Deputy Director of the UK Centre for Tobacco and Alcohol Studies, presented an update on e-cigarette use during pregnancy. In the presentation Linda highlights the latest research, a brief overview of smoking in pregnancy and why pregnant women who are still smoking should be encouraged to switch to e-cigarettes.

External link for video: E-cigarette use during pregnancy – Professor Linda Bauld

Other links:

Smokefree action’s info-graphic on e-cigarettes in pregnancy

To see other presentations from the conference click here.

Latest press release from UKCTAS:

Vaping may help explain the record fall in UK smoking rates

 

Vaping may help explain the record fall in UK smoking rates – Press Release with comments from UKCTAS Directors

UK smoking rates showed a record annual fall between 2015 and 2016 of 1.5 percentage points, based on new statistics released today [Link]. The prevalence of smoking among people aged 18 and above in 2016 was 15.8%, the lowest on record. This dramatic reduction is also the second largest annual fall in the last 40 years.

The UK is an international leader in smoking prevention policy, having introduced high tobacco taxes, a comprehensive advertising ban, prohibited smoking in public places, taken tobacco products out of sight in shops, establishing specialist stop-smoking services and a range of other measures. These policies have caused a sustained downward trend in adult smoking prevalence over the past two decades. Over the past five years, however, the rate of decline has increased substantially, falling by 4.4 percentage points, from 20.2%, since 2011.

Today’s new figures indicate UK smoking is falling faster than would be expected from conventional tobacco control approaches. While all the policies put in place will have made a difference, the most likely explanation for the recent rapid decline is the increasing use by smokers of electronic cigarettes as a substitute for tobacco. Data released by ASH last month estimated that there are now 1.5m people in the UK who used to smoke but now instead use electronic cigarettes.

Professor John Britton said:
“Electronic cigarettes were patented in 2004 but we began to see their use in the UK from around 2010. Since then the proportion of smokers using them has risen steadily. They have rapidly become the most popular aid to stopping smoking, and are now used in more than one third of quit attempts. At first we were unsure what their impact on smoking rates would be, but today’s figures suggest that alongside established tobacco control policies, they may have significantly accelerated the downward trend in smoking”

“Overall these findings vindicate UK policy on vaping: and that doing more to encourage more smokers to make the switch could generate huge benefits in public health: especially among those groups in society where smoking remains common.”

Professor Ann McNeill said:
“Since the millennium the UK has implemented a comprehensive tobacco control strategy to encourage and support smokers to stop and to deter young people from taking up smoking. This strategy included encouraging smokers to switch from deadly cigarettes to less harmful forms of nicotine including electronic cigarettes. It is really important that the new government continues this comprehensive approach and publishes its new Tobacco Control Plan as soon as possible, particularly given the need to tackle inequalities in smoking rates across society. In times of austerity, tobacco control is a good investment, as it benefits not just smokers and their families, but services like the NHS which bear the enormous costs of treating smoking-related illnesses”

Professor Linda Bauld added:
“The UK has taken a liberal approach to vaping, supporting the use of these consumer products for smokers who choose to use them. This has been controversial, and other countries have taken a much more restrictive approach. These new prevalence figures for adults, alongside steady declines in youth smoking uptake, suggest that electronic cigarettes may turn out to be a game changer for tobacco control. However, we know that many smokers are still wary of these products and think they are as harmful as tobacco. That needs to change if the positive trend we see from today’s figures is to be maintained.”

• Adult smoking habits in the UK: 2016 – Released 15 June 2017 External Link

• Smoking statistics in England – 15 June 2017 – Latest smoking compendium report signposting to all the up-to-date smoking data. External Link

 

Download the PDF version of this Press Release

 

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)