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.

Nicotine patch

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. Continue reading

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Stubbing out the public health problem of an era | Blog piece by Tim Coleman | #myresearchlegend

Sir Richard Doll had an illustrious career. Through his efforts, the world learned much about the causes of cancer and the dangers of asbestos, radiation and, of course, smoking. Following his research into smoking and lung cancer during the 1950s, the realisation dawned that tobacco use was the public health problem of the era and not a harmless pastime. We all know what’s happened since. How many other 20th century epidemiologists have had such a transformative impact on peoples’ understanding of the determinants of disease?

myresearchlegendricharddollblog

To what extent do I consider Sir Richard Doll to be a research ‘legend’? I’m not sure I’ve earned the right to bestow that honour, so I’ve taken advice. The Cambridge English Dictionary says a ‘legend’ is “someone very famous and admired, usually because of their ability in a particular area”. Just considering the one area of Doll’s work emphasised above, this is a no-brainer; ‘legend’ threshold is clearly surpassed. Don’t take my word for this, though, Google ‘Richard Doll’ and see if you can find reason to disagree.

Am I hasty in allocating ‘legend’ status? Doll certainly changed the world’s knowledge of many illnesses; shouldn’t an NIHR research legend demonstrate clear NHS impact too? Fortunately Doll’s influence here doesn’t disappoint, even if one again only considers smoking. I am a GP. How would this be different if Sir Richard had never lived? Firstly, I’d probably smoke. A pipe would give me more gravitas than cigarettes and I’d have to either smoke in my consulting room, like some doctors did, or schedule regular ‘pipe breaks’ into my day. I would be blissfully ignorant about harms from smoking and more likely to offer patients cigarettes than help with stopping, even if they developed lung cancer or heart disease.

Smoking Kills

Thankfully, Sir Richard did exist. Although I tried smoking as a teenager, a friend’s mum made me think again and I didn’t ever fully adopt the habit. Immature, teenage me was saved from smoking because Doll had shown how harmful smoking is. Fast forward to my GP work in 2018; again due to Doll, I fully realise that smoking kills my patients and wrecks their lives.

crop.jpgAlso, due to research which was only possible because of his early work, I can offer smokers numerous types of cessation support. It’s even possible to refer on to Stop Smoking Services (SSS) for specialist help, though a major cloud on the horizon is that these vital services are no longer universal; they are endangered.

Through their work at the Statistical research Unit of the MRC, Doll and Hill demonstrated that smoking causes lung cancer; before this smoking was ubiquitous across social classes and many doctors smoked. By 1954, the government accepted the link and the middle classes started quitting in droves. When he died in 2005, Doll would very likely have been delighted that UK smoking rates were falling fast. However, improvements were chiefly amongst the better off, so smoking had become disproportionately concentrated amongst society’s poorest. Given his well-documented non-conformist views, my bet is that he would have been saddened that those with most to gain benefited least from such massive social change. Nevertheless, he might have been heartened by the government’s national and vigorous action against smoking. Back then, although SSS were a very new NHS entity, it was mandatory for Primary Care Trusts to deliver them and SSS were closely performance-managed by the then Department of Health. Any smoker could access services’ evidenced-based support to increase their chances of permanent cessation.

Smoking Prevention

Worldwide, legions of researchers, including me, have followed Doll by trying to find ways of treating or preventing smoking. Few epidemiologists have caused such a seismic shift in the international research agenda. Take a look at the thousands of randomised controlled trials (RCTs) reviewed in the tobacco section of the Cochrane Library. All of these studies test interventions against smoking. This necessary work continues today and NIHR is a leading supporter funding, for example, the largest ever RCTs of Nicotine Replacement Therapy used in pregnancy* or for ‘preloading’.

The NHS is 70. Celebrating research legends is a great idea but it’s important we remember what they did and why they are lauded. It took almost half a century after Doll and Hill’s landmark paper for the NHS to implement national treatment services for smokers, and sadly less than 20 years later these have become an optional extra with patchy coverage across the country. Smoking is less prevalent than in the past but there are still millions of UK citizens who want to stop and can’t manage this alone. Smoking is still a national problem and requires a national NHS response. A crucial component of this response should be to help quitters by giving them the very best support.

Sir Richard’s work has had a great impact, as all research should. The demise of SSS suggests we risk forgetting this when instead we should continue to build on his significant achievements.

*More information on the trial: Double-blind, randomised, placebo-controlled trial of nicotine replacement therapy (NRT) in pregnancy – SNAP is available on the NIHR Journals Library website.

Tim Coleman, Professor of Primary Care, Faculty of Medicine & Health Sciences
University of Nottingham and NIHR Senior Investigator

The NIHR is highlighting seven research legends whose work has shaped the NHS, as part of its celebrations for the NHS’s 70th birthday and the NIHR’s I Am Research campaign.

Original post on NIHR website. – Posted: 04 May 2018

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.


*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

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

nottingham

“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.


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

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


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

 

UKCTAS researchers awarded multi-million pound grant to tackle tobacco-related harm in Asia & Africa

UKCTAS and the Global Challenges Research Fund

UKCTAS researchers have been awarded a £3.4million grant from Research Councils UK to address tobacco-related harm in Asia and Africa. The programme will run for four years and aims to build capacity for tobacco control research in seven countries in South Asia and Africa.

GCRF-infographicLed by Professor Linda Bauld, UKCTAS Deputy Director based at the University of Stirling, this Global Challenges Research Fund grant provides an example of how UKCTAS is able to bring together members of the UK tobacco control research community to respond to an opportunity to address tobacco use in low and middle income countries.It involves six of the academic teams within the UKCTAS consortia and Cancer Research UK, one of the UKCTAS funders. CRUK is already very active in international tobacco control research.

Professor Bauld said:
Linda_Bauld_UKCTAS.png“UKCTAS has made an important contribution to informing policies and new developments to reduce smoking rates in the UK over the past decade, culminating in the very significant prevalence reductions we’ve seen in the past few years. This is testament to the links we have worked hard to forge with government, NGOs, advocacy groups, professionals and the public who have helped translate our research into practice. Our work on smokefree public places, tobacco taxation, mass media, smoking cessation & stop smoking services, electronic cigarettes & tobacco harm reduction, and our monitoring of tobacco industry activity has all fed into these changes.

Now through this GCRF programme we have a unique opportunity to help build capacity in 7 other countries, all in South Asia and Africa, adding to individual projects and links that UKCTAS members had already forged with some of these teams in recent years. A core element of our Centre has always been training and research development, from PhD through post-doctoral level, training professionals and engaging with stakeholders in the UK and Europe. Now we will be extending this through a substantial new programme of research and capacity building with a particular focus on tobacco taxation, the illicit trade and tobacco industry influence on policy. We will be working with the following list of senior researchers and their teams (below), as well as Alison Cox and her colleagues at Cancer Research UK, over the next four years. We are grateful to Research Councils UK for this opportunity.”

The UK co-applicants on the grant include: Professors John Britton and Andrew Fogarty (Nottingham), Professor Kamran Siddiqi and Dr Steve Parrot (York), Professor Jeff Collin (Edinburgh), Professor Anna Gilmore (Bath) and Professor Ann McNeill (Kings College).

International co-applicants include:

– Dr Wakgari Deressa, Addis Ababa University, Ethiopia
– Dr Muralidhar Madhav Kulkarni, Manipal University, India
– Professor Umberto Dalessandro, MRC Unit, the Gambia
– Dr Monika Arora, Public Health Foundation of India
– Dr Ellis Owusudabo, Kwame Nkrumah University of Science and Technology, Ghana
– Kellen Nyamurungi, CTCA, Makerere University, Uganda
– Dr Rumana Hugue, the ARK Foundation, Bangladesh
– Professor Corne van Walbeek, University of Cape Town, South Africa

 

Collaboration info-graphic showing the different organisations involved in the project:

GCRF-UKCTAS-Presentation-diagram

About the GCRF:

The Global Challenges Research Fund (GCRF) GCRFfullcolourResearch Councils UK Collective Fund is supporting projects in the range of £2 – 8 million over four years. It aims to build upon research knowledge in the UK, and strengthen capacity overseas, to help address challenges, informed by expressed need in the developing countries.

 

Jo Johnson, Minister for Universities and Science, said:
“From healthcare to green energy, the successful projects receiving funding today highlight the strength of the UK’s research base and our leadership in helping developing countries tackle some of the greatest global issues of our time.

“At a time when the pace of scientific discovery and innovation is quickening, we are placing science and research at the heart of our Industrial Strategy to build on our strengths and maintain our status as science powerhouse.”

More information about this grant can be seen on the UKCTAS website.

Notes to editors

· Full list of research partners:
o UK Centre for Tobacco and Alcohol Studies (UKCTAS): Universities of Stirling, Nottingham, York, Edinburgh, Kings College London and Bath.
o Cancer Research UK
o The ARK Foundation, Bangladesh
o Manipal University, India
o The Public Health Foundation of India
o The University of Cape Town, South Africa
o Makerere University, Uganda
o The MRC Unit, The Gambia
o Addis Ababa University, Ethiopia
o Kwame Nkrumah University of Science and Technology, Ghana

· More details on each of the 37 grants can be found in the Growing research capability to meet the challenges faced by developing countries brochure.

· Find out more about the Institute of Social Marketing: www.stir.ac.uk/health-sciences-sport/research/groups/social-marketing.

· Find out more about the UK Centre for Tobacco and Alcohol Studies: ukctas.net

· Find out more about Cancer Research UK’s international tobacco control programme: http://www.cancerresearchuk.org/funding-for-researchers/applying-for-funding/funding-committees/international-tobacco-advisory-group

· Find out more about tobacco consumption via the World Health Organisation: www.who.int/mediacentre/factsheets/fs339/en/

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