AGENDA 2022 - coming soon

The E-Cigarette Summit UK, 2022 will take place at the Victoria Park Plaza on 18th November in London at the Victoria Park Plaza.  This will be our 10th Annual Summit and will provide a comprehensive review of what we have learnt over the last decade, the questions we have answered, the questions that remain and the questions we weren’t expecting.  Speakers will be attending in-person but there will be a virtual option for those that cannot travel.

The full agenda will be announced later in September.  We look forward to seeing you again.


The programme and details below are for The E-Cigarette Summit UK, 2021 which was held virtually on 7-8 December. We would like to thank our Chairs and Speakers for their continued support in creating this programme. Below is the full showcase of the 2021 UK Summit including speaker presentations and panel discussions.

To view a printable PDF of the 2021 agenda please click here

2021 PRESENTATIONS & PANELS

DAY 1 – TUESDAY 7TH DECEMBER

SESSION 1: Science & Evidence

10:00 - 10:10

Welcome from the Chair

Chair

  • Prof Ann McNeill Professor of Tobacco Addiction - Institute of Psychiatry, Psychology & Neuroscience,, Kings College London

10:10 - 10:25

OPENING KEYNOTE: What will success look like?

The  public health tobacco goal is to prevent early death and disease caused by burnt tobacco products, especially cigarettes. The WHO Framework Convention on Tobacco Control  (FCTC), which came into force 15 years ago, is central to this endeavour. A first step is for all countries to ensure the effective and equitable implementation of the FCTC, as summarised by the MPOWER interventions. However, this alone is insufficient. Even where these interventions have been fully applied such as in New Zealand and Australia, smoking rates are falling only slowly and most of the progress has occurred in privileged sections of society further marginalising the most vulnerable. The second step is for all countries to embrace tobacco harm reduction (THR) alongside traditional approaches. Innovations in the delivery of nicotine such as e-cigarettes and heat not burn products offer an opportunity to accelerate THR progress. Sweden, with the widespread use of snus and now the lowest rate of smoking in the world, provides proof of the value of THR. Regrettably, the widespread adoption of THR is facing many impediments, notably from WHO and well-funded advocacy groups guided by poor quality science. Success will involve: full implementation in all countries of all available interventions, including THR, with WHO providing evidence-based technical leadership and facilitating dialogue rather than encouraging prohibition of less harmful products. The short-term  measure of success will be for all countries to match the successes of the best performing countries and achieve a very low adult prevalence (<5%) of cigarette smoking by 2040.

Speaker

  • Prof Robert Beaglehole Emeritus Professor - University of Auckland, New Zealand & Chair ASH - Action for Smokefree 2025, NZ

10:25 - 10:40

Depolarizing E-Cigarette Research: The need for epistemic humility

Science is a social activity embedded within a complex research ecosystem, and conducted by highly-trained individuals who are nevertheless human. There are therefore external and internal factors – incentives and cognitive biases – that can shape the behaviour of scientists, the questions they ask, the methods they use, the analytical choices they make, and the conclusions they draw. The factors may be particularly important in research areas where there is considerable uncertainty, and where personal values may come into play. Understanding the nature and impact of these factors, and developing frameworks for arriving at consensus, will be important if we are to make genuinely evidence-based policy recommendations.

Speaker

  • Professor Marcus Munafò Professor of Biological Psychology and MRC Investigator - School of Psychological Science, University of Bristol

10:40 - 10:55

Do e-cigarettes help people quit smoking? A plea to focus on the evidence

Cochrane is a global non-profit, known for producing unbiased and high-quality reviews of healthcare evidence. The Cochrane review of e-cigarettes for smoking cessation was first published in 2014 and has been updated four times since then. Every update brings more evidence showing that e-cigarettes can help people quit smoking, but disagreements persist on interpretation of this evidence base. Perceptions of uncertainty regarding the effectiveness of e-cigarettes for smoking cessation can have wide reaching consequences.

Speaker

  • Dr Jamie Hartmann-Boyce Managing Editor, Cochrane Tobacco Addiction Group & Senior Research Fellow - University of Oxford

10:55 - 11:10

The need to unbias the application of competing interest principles in e-cigarette research

Every researcher can be potentially motivated by factors other than an objective search for truth. The clinical research community has addressed some of these factors by requiring declarations of competing interests. These mostly focus on financial links with companies that may stand to gain or lose from findings or views being presented. The rules are important but, like most rules, they need to be applied diligently and fairly if they are not to do more harm than good. In the field of e-cigarette research, this presentation will argue that unfair application of the rules is leading to significant bias. On the one hand, acceptance by researchers of research products from e-cigarette companies with no financial gain to researchers is judged by opponents of e-cigarettes as grounds for disregarding findings and heaping opprobrium on the researchers concerned. On the other hand acceptance of career-enhancing grants from organisations that are strongly opposed to e-cigarettes does not appear to be regarded as an issue. In this way, competing interest principles are arguably being weaponised in what some regard as a war on tobacco users rather than a war on tobacco. The application of competing interest principles needs to be scrutinised by the scientific and public health community to achieve balance

Speaker

11:10 - 11:25

AM BREAK

11:25 - 11:40

Could e-cigarettes contribute to harm reduction for children as well as adults?

Current policy approaches to e-cigarette regulation in the USA give primacy to the need to protect children from addiction over fostering increased adult smoking cessation.  But, as well as failing to maximise the potential public health gain from adult use of new nicotine delivery products, the focus on minimizing children’s use of e-cigarettes might itself be a net contributor to harm at the population level, by inadvertently favouring the incumbent cigarette and hampering the transition to genuinely reduced risk alternatives. This talk will give data from the Youth Risk Behavior Survey, conducted on a national sample of high school students in the USA, on risk behaviours in a number of domains, including drug use, violence, sexual behaviour, psychological wellbeing, and school attendance and performance.  Current use of e-cigarettes and cigarettes are both associated with the whole range of problem behaviours, with the association being stronger for cigarettes than for e-cigarettes.  Causal pathways between different behaviours cannot be identified, but the occurrence of any one behaviour tends to be positively associated with all of the others, lending support to the notion of shared vulnerability factors, the so-called common liability hypothesis.   On this model, the rise in popularity of e-cigarettes to overtake cigarettes among youth is better understood as product substitution, rather than as a concerning new risk for enticing otherwise innocent youth into cigarette use and nicotine addiction. The talk will also update information from the National Youth Tobacco Survey on nicotine dependence in youth e-cigarette and cigarette users.  It remains the case that indicators of dependence are highest in those who smoke cigarettes, and considerably lower in e-cigarette users.  In 2020 only 254,000 (2.3%) of otherwise tobacco-naïve high school students used e-cigarettes on 20 or more days in the past month.   The estimated overall population burden of nicotine dependence in youth has decreased between 2012 and 2020.

Speaker

  • Prof Martin Jarvis Emeritus Professor of Health Psychology, Department of Behavioural Science & Health - University College London

11:40 - 12:10

Panel discussion and live Q&A

Is scientific evidence underpinning the THR dialogue or is ideological opposition influencing the debate?    

Chair

  • Prof Ann McNeill Professor of Tobacco Addiction - Institute of Psychiatry, Psychology & Neuroscience,, Kings College London

Speakers

  • Prof Robert Beaglehole Emeritus Professor - University of Auckland, New Zealand & Chair ASH - Action for Smokefree 2025, NZ
  • Professor Marcus Munafò Professor of Biological Psychology and MRC Investigator - School of Psychological Science, University of Bristol
  • Professor Robert West Professor Emeritus of Health Psychology - University College London
  • Dr Jamie Hartmann-Boyce Managing Editor, Cochrane Tobacco Addiction Group & Senior Research Fellow - University of Oxford
  • Prof Martin Jarvis Emeritus Professor of Health Psychology, Department of Behavioural Science & Health - University College London

12:10 - 12:50

LUNCH

SESSION 2: THR & Tobacco Control

12:50 - 12:55

Introduction from the Chair

Chair

12:55 - 13:10

Is there a place for low-risk nicotine ‘alternatives’ on the market when smoking is about to disappear?

In some countries, like Norway and Sweden, the level of smoking has reached a minimum – in particular among young adults below the age of 25 where the prevalence of smoking is approximately 2%. Availability to snus in combination with a robust infrastructure for tobacco control are the main reasons. In these markets snus has displaced cigarettes and ever-smokers has made up the majority among snus users. When smoking is about to be eradicated, the largest reservoir of potential snus users – the smokers - will decrease. As a consequence, the future prevalence of snus users will probably decline. However, the decimation of smokers will subsequently also change the user configuration of snus. Never smokers will eventually make up the majority, and – if large enough - tip the net effect on public health effect from positive to negative. In such a situation, the harm reduction function of snus - and e-cigarettes – will be reduced. Still, availability to these products may deter tobacco prone youth in future generations from taking up cigarettes – provided that hunger for nicotine will exist in future generations. I will present the recent trends on tobacco use in Norway and discuss how the new situation will challenge the narrative of THR.

Speaker

13:10 - 13:25

The tobacco control climate in Germany

The prevalence of tobacco smoking in Germany is still at a very high level (nearly 30%), and the use of alternative nicotine delivery systems (ANDS) has been increasing in the population. The World Health Organisation (WHO) recommends monitoring the use of tobacco and ANDS on a national level to support implementation of the WHO Framework Convention on Tobacco Control and reduce tobacco-related harm. The DEBRA study (German Study on Tobacco Use) addresses this recommendation by tracking key variables of patterns and trends in the use of tobacco and ANDS in Germany. Furthermore, the study collects data on relevant associated factors, such as socioeconomic background, alcohol consumption, and mental health.  This session will explore attitudes towards e-cigarettes by medical/public health organisations and the evidence- and consensus-based view towards harm reduction according to the recently updated German clinical guidelines for treating tobacco. It will provide contextual data on the use of tobacco and ANDS and provide a future outlook, including the strategy for a smoke-free Germany 2040.

Speaker

  • Prof Daniel Kotz Professor in addiction research and clinical epidemiology, Institute of General Practice - Centre for Health and Society, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Germany

13:25 - 13:40

Reconsidering the meaning of tobacco harm reduction

Definitions of THR have evolved since the late 70s and more recently includes targeting people who cannot or don’t want to quit nicotine. Those who cannot or do not want to quit nicotine tends to be people with mental health and substance use problems, but also those in routine and manual occupations, those living in social housing and in certain geographical locations.  There are several challenges and opportunities relating to THR and this presentation will highlight a few of these, such as the need to reconsider how we measure THR, how we incorporate and prioritise what outcomes matter most to people who smoke or vape. The discourse around THR needs to evolve and expand rather than be constricted or silenced.

Speaker

  • Dr Debbie Robson RMN, PhD Senior Lecturer in Tobacco Harm Reduction - National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London

13:40 - 13:55

Australia doubles down on its e-cigarette sales ban

Australia is one of the only English-speaking, high-income countries that has banned the sale of e-cigarettes as consumer products. Until 1 October 2021, smokers could legally import nicotine for personal use with prescription. Most smokers imported nicotine illegally because very few doctors were prepared to prescribe nicotine. The use of e-cigarettes increased among Australian smokers and adolescents despite the sales ban prompting a tougher enforcement of the sales ban. Since 1 October 2021 smokers who import nicotine without a script may face up to a $200,000 fine and imprisonment. This policy has been justified by giving an absolute priority to protecting youth from a ‘vaping epidemic’ that has supposedly occurred. I make some predictions about how the policy may work and what its likely effects will be on Australian vapers and smokers who want to use e-cigarettes to quit smoking.

Speaker

  • Prof Wayne Hall Professor Emeritus, National Centre for Youth Substance Use Research - The University of Queensland

13:55 - 14:10

The new tobacco wars

What hostile and supportive forces are bearing on the transitions to low-risk alternatives to smoking? Are we about to squander the opportunity to avoid millions of premature deaths and cases of disease through a dogmatic refusal to embrace innovation and harm reduction? Or will the fundamentals of risk and personal agency and autonomy ultimately prevail?  An epic battle is underway between the Public Health establishment and the public's health. How will it play out?

Speaker

14:10 - 14:45

Panel discussion and live Q&A

Does tobacco harm reduction (THR) compliment or undermine core tobacco control principles?

Chair

Speakers

  • Dr Karl E. Lund Senior Researcher - Norwegian Institute of Public Health
  • Prof Daniel Kotz Professor in addiction research and clinical epidemiology, Institute of General Practice - Centre for Health and Society, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Germany
  • Prof Wayne Hall Professor Emeritus, National Centre for Youth Substance Use Research - The University of Queensland
  • Dr Debbie Robson RMN, PhD Senior Lecturer in Tobacco Harm Reduction - National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London
  • Clive Bates Director - Counterfactual Consulting Ltd

14:45 - 15:00

PM BREAK

SESSION 3: Tobacco control, regulation and enforcement

15:00 - 15:05

Introduction from the Chair

Chair

  • Martin Dockrell Tobacco Control Programme Lead - Office of Health Improvement & Disparities (OHID)

15:05 - 15:20

MHRA Regulatory Update

The MHRA is the competent authority for a notification scheme for e-cigarettes and refill containers in Great Britain and Northern Ireland and is responsible for implementing the majority of provisions under Part 6 of the Tobacco and related Products Regulations (TRPR) and the Tobacco Products and Nicotine Inhaling Products (Amendment) (EU Exit) Regulations 2020.  The TRPR introduced rules which ensure i) minimum standards for the safety and quality of all e-cigarettes and refill containers (otherwise known as e-liquids) ii) that information is provided to consumers so that they can make informed choices and iii) an environment that protects children from starting to use these.  This session will present recent data and insight in to what the MHRA does and how they do it.  Specifically focussing on: I) Post Brexit E-cigarette notification systems, requirements and challenges in the UK  II) Overview of E-cigarette Yellow card data 2016-2021  III) Disposable E-cigarettes products and compliance with UK notification requirements  IV)  Supporting enforcement in a multi-agency framework.

Speaker

  • Craig Copland E-Cigarette Unit Manager - Vigilance and Risk Management of Medicines - MHRA - The Medicines and Healthcare products Regulatory Agency

15:20 - 15:35

The challenge of e-cigarette enforcement

Weights and Measures Authorities in Great Britain have a duty to enforce the Tobacco and Related Products Regulations 2016 and Local Authorities have a duty to consider a programme of enforcement in relation to the Children and Families Act 2014 (prohibition of sale of nicotine products to under 18s). Trading Standards Officers are therefore in principle responsible for protecting the front line between illegal product and (potentially vulnerable) consumer as well as ensuring a level playing field and fair trading environment. But there are ever decreasing numbers of Trading Standards Officers and at least 250 different pieces of legislation to enforce – so how do the protectors decide who or what to protect? How do they prioritise the greatest threats and risks? This session looks at the current challenges for enforcement and the impact this has on manufacturers, retailers, consumers and children

Speaker

  • Kate Pike Co-ordinator - Trading Standards North West - Member of the Department of Health and Social Care National Tobacco Focus Group

15:35 - 15:50

A stitch in time: safeguarding UK market from youth uptake

While youth use of e-cigarettes remains low in the UK, particularly among those who have never smoked, but it could still be lower and there are straightforward ways in which we can strengthen our existing protections.  Avoiding uptake among young people is an important part of a balanced approach to regulation of e-cigarettes. It ensures that young people are protected from potential of harm while ensuring health professionals and others have confidence in promoting products to the smokers who need them. Current loopholes in our laws, such as the ability to hand out free samples to children, and opportunities to ensure packaging does not exacerbate appeal to young people can sensibly reduce the risk of growing youth uptake and preserve the market for smokers who would benefit from switching.

Speaker

  • Hazel Cheeseman Deputy Chief Executive & Policy Director - ASH (Action on Smoking & Health)

15:50 - 16:05

Balancing regulation to achieve intended consequences

Thoroughly evaluating where the regulatory sweet spots lie requires careful critical thinking if the desired outputs, net of unintended consequences, are to be delivered.  All too often, there is inadequate thought given to explore the potential for unintended consequences of regulation, which at face value aim to focus on consumer harm reduction, but often without the nuances that the real world brings.  In this presentation, I will outline some of the more topical areas of regulatory discussion; from flavour bans, to plain(er) packaging, and to advertising and youth vaping, including the use of retail-based EPOS data. In doing so I hope to give a perspective on where sweeter areas may lie. 

Speaker

  • Marcus Saxton Chairman - Independent British Vape Trade Association (IBVTA)

16:05 - 16:20

Unintended market consequences from the regulation of vape products in the US, and the prospects for future regulation in Europe

The vape category is subject to differing regulation across the world, with many governments becoming more restrictive towards the category in the last few years. It is only recently that we have enough data in this very fragmented sector to show clear correlations between the adoption of a restrictive policy and the market and consumer changes which result. I will present our market data in the US showing clear growth in flavoured disposable vape products and synthetic nicotine which correlate to restrictions imposed on flavoured pod products and an increasingly negative outlook for the PMTA process. In Europe, I will present similar data showing market responses to the restrictions brought in by the Tobacco Products Directive. In addition, I will show some initial output from our second survey of European Parliament MEPs to demonstrate their understanding of and attitude towards new nicotine products in the lead up to being asked to vote on policy which will hugely affect the category in the EU in the years to come.

Speaker

  • Tim Phillips Managing Director - ECigIntelligence/TobaccoIntelligence

16:20 - 16:55

Panel discussion and live Q&A

Has the UK created a perfect template for e-cigarette regulation, will other countries follow?

Chair

  • Martin Dockrell Tobacco Control Programme Lead - Office of Health Improvement & Disparities (OHID)

Speakers

  • Craig Copland E-Cigarette Unit Manager - Vigilance and Risk Management of Medicines - MHRA - The Medicines and Healthcare products Regulatory Agency
  • Kate Pike Co-ordinator - Trading Standards North West - Member of the Department of Health and Social Care National Tobacco Focus Group
  • Hazel Cheeseman Deputy Chief Executive & Policy Director - ASH (Action on Smoking & Health)
  • Marcus Saxton Chairman - Independent British Vape Trade Association (IBVTA)
  • Tim Phillips Managing Director - ECigIntelligence/TobaccoIntelligence

DAY 2 – WEDNESDAY 8TH DECEMBER

SESSION 4: THR & Public Health Policy

10:00 - 10:05

Welcome from the Chair

Chair

  • Martin Dockrell Tobacco Control Programme Lead - Office of Health Improvement & Disparities (OHID)

10:05 - 10:20

Nicotine policy in England: Recent developments and Future plans to make smoking obsolete

The pandemic has resulted in big changes in public health. Not only have structures changed as PHE transitions to the Office of Health Improvement and Disparities (OHID), but smoking behaviours have been in turmoil and the data on a new respiratory virus has had complex implications for smoking and health.  The Summit comes just after the publication of NICE guidance that will offer the clearest advice yet on providing e-cigarettes as a stop smoking aid which will result in revisions to the UK’s  CLeaR Tobacco Control system-led improvement tools. This talk will focus on the role of e-cigarettes in context of the UK’s comprehensive tobacco control environment that looks to maximise the opportunities for smoking cessation while managing risks.  It will look at other developments such as the recent Cochrane review, AJPH paper and John Newton's editorial in response

Speaker

  • Rosanna O’Connor Director, Addictions & Inclusion - Office for Health Improvement & Disparities, Department of Health and Social Care

10:20 - 10:35

England – the frontrunner on vaping, not the outlier

ASH welcomed the MHRA enhanced guidance on medical licensing for e-cigs supported by the Chief Executive of the MHRA. We agreed with the Secretary of State for Health who said, “Opening the door to a licensed e-cigarette prescribed on the NHS has the potential to tackle the stark disparities in smoking rates across the country, helping people stop smoking wherever they live and whatever their background.” However, the new guidance has been criticised from both sides. England was called the “outlier” by some, yet again too “laissez-faire on vaping”, others said that in fact the new guidance was not a step forward but a step back and would make it harder not easier for companies seeking a medicinal licence. This talk will look at why the process is the way it is, and the potential it has to change the shape of vaping, not just in the UK but also worldwide.

Speaker

10:35 - 10:50

The 2021 review of NICE’s tobacco guidelines

NICE – the National Institute for Health and Care Excellence – is an executive non-departmental public body of the Department of Health and Social Care. NICE's role is to improve outcomes for people using the NHS and other public health and social care services and produces evidence-based recommendations developed by independent committees, including professionals and lay members, and consulted on by stakeholders. The NICE Tobacco Guidelines expert committee was chaired by Paul Lincoln, OBE and consolidated 13 previously separate pieces of NICE tobacco guidance and updated areas where there was new research evidence. E-cigarettes was one of the areas of these reviews and the new comprehensive Guidance should be launched on 30 November 2021. In this session Paul will outline the new NICE recommendations on e- cigarettes including updated advice for healthcare professionals on what to say to smokers about vaping and the evidence base and rationale that underpins them.

Speaker

  • Paul Lincoln OBE Chair - Tobacco: preventing uptake, promoting quitting and treating tobacco dependence - (NICE) National Institute of Clinical and Health Excellence -

10:50 - 11:05

Combustible Tobacco Age-of-Sale Laws: An Opportunity?

Tobacco-21 is the law of the land in the United States and appears to be having the beneficial effect of reducing tobacco use among 18-20 year-olds, so is an important improvement over the status quo. However, is raising age of sales laws for all tobacco products optimal, or could additional benefit accrue to raising the age of sale for combustibles only? This concept could take the form of a Combustible-21 only law (similar to some European countries having separate ages for beer and liquor), or a law preventing the legal purchase of combustibles for people born after a certain date (as is currently being considered in New Zealand).

Speaker

  • Dr Michael Pesko Health Economist & Associate Professor - Department of Economics, Andrew Young School of Policy Studies, Georgia State University

11:05 - 11:20

AM BREAK

11:20 - 11:35

The potential role of the cigarette industry in the future of the e-cigarette market

In this session, Prof Levy will discuss the history of the cigarette market vis-à-vis other nicotine products distinguishing the period before and after e-cigarettes became more widely used. The role of the industry in the e-cigarette market will be given special attention. Finally, the current and potential future role of the cigarette industry will be discussed and the factors that are likely to influence that role. Cigarettes have historically not faced any competition. E-cigarettes have forced them to take a different approach.  Has the USA PMTA process handed the monopoly back to the cigarette industry.

Speaker

  • Prof David Levy Professor of Oncology - Lombardl Comprehensive Cancer Center, Georgetown University

11:35 - 12:10

Panel discussion and live Q&A

Is the UK a trailblazer or outlier - how will we know?

Session Responder

  • Louise Ross Interim Chair and Mental Health Lead for the New Nicotine Alliance - Business Development Manager - Smoke Free - Quit Smoking Now

Chair

  • Martin Dockrell Tobacco Control Programme Lead - Office of Health Improvement & Disparities (OHID)

Speakers

  • Rosanna O’Connor Director, Addictions & Inclusion - Office for Health Improvement & Disparities, Department of Health and Social Care
  • Deborah Arnott Chief Executive - Action on Smoking and Health
  • Dr Michael Pesko Health Economist & Associate Professor - Department of Economics, Andrew Young School of Policy Studies, Georgia State University
  • Prof David Levy Professor of Oncology - Lombardl Comprehensive Cancer Center, Georgetown University

12:10 - 12:50

LUNCH

SESSION 5: Research & Public Health Policy

12:50 - 12:55

Introduction from the Chair

Chair

12:55 - 13:10

E-cigarette research: Misinterpretation and selective use of evidence guiding regulatory decisions

Evidence-based decisions are necessary in order to tackle public health issues. Policy makers mostly rely on scientists and scientific organizations in order to come up with the best possible regulatory framework for smoking. E-cigarettes have been the focus of intense and conflicting debate over several years, with opposing views about being part of the problem or of the solution. In this presentation, I will focus on how evidence has been misinterpreted and selectively used in order to support statements that e-cigarettes are of similar or higher risk to smoking. Studies have been largely ignored, other studies have been over-emphasized while replication studies have failed to reproduce previous findings that were largely creating a misleading image about the absolute or relative risk of smoking. The presentation will end with a clear message that the totality of evidence should be carefully examined in order to provide balanced and reliable information to smokers and regulators about e-cigarettes, so that personal choices and policies will promote individual and public health.

Speaker

  • Dr Konstantinos Farsalinos M.D External Research Associate - University of Patras, Department of Public and Community Health, University of West Attica, Greece

13:10 - 13:25

Absolute and relative risks of electronic cigarettes

Despite the major impact of tobacco regulation on smoking prevalence, smoking conventional cigarettes continues to pose a significant public health concern. Among continuing efforts to mitigate this harm, methods to aid smoking cessation have an important role to play. Electronic nicotine delivery systems (ENDS or e-cigarettes) deliver nicotine at a rate and extent similar to those of conventional cigarettes and hence potentially provide an effective nicotine replacement. On request from the Department of Health and Social Care (DHSC) and Public Health England (PHE), the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) was asked to review the potential toxicological risks from ENDS to assist in the assessment of the possible public health benefit of these products. The Committee therefore assessed the relative risks, compared to smoking conventional cigarettes, in those switching products, as well as the absolute risks from use of ENDS to former cigarette smokers, naïve users, and bystander. ENDS are not without risk, although these are substantially less than those of conventional cigarettes, although the difference in risk depends on the health effect in question. There is little evidence that the short to medium term use of ENDS causes major harm, but there are significant data gaps, particularly on the effects of long-term use. In addition, the use of ENDS de novo by non-users of tobacco products is likely to be associated with some adverse health effects to which the user would not otherwise have been subject. The risks to bystanders for most health effects will be low in conventional exposure scenarios, although exposure to nicotine may result in pharmacological effects in some individuals. It is important that this information is not considered in isolation, but in the wider context of the public health consequences of smoking conventional cigarettes.

Speaker

  • Prof Alan Boobis, OBE Emeritus Professor of Toxicology & Chair - UK Committee on Toxicity - Imperial College London

13:25 - 13:40

Nicotine and pregnant smokers:

One of the controversies surrounding e-cigarettes (EC) is their use by pregnant smokers. Animal studies have demonstrated that nicotine on its own can damage pregnancy, but such studies typically use very large nicotine doses.  It is not clear to what extent doses used by human nicotine users affect pregnancy outcomes. The risk is considered much less than risks of smoking and nicotine patches are widely used to help pregnant smokers quit. Data from such use indicate the same or even better pregnancy outcomes in women using nicotine patches (NRT) compared to placebo, but NRT has only limited efficacy in pregnant smokers. E-cigarettes (EC) may represent a more effective option, but their safety and efficacy in pregnancy need checking. The presentation will review effects of nicotine on its own, without combustion chemicals from tobacco smoke, on pregnancy outcomes and consider the potential of EC to help pregnant smokers reduce or quit smoking.    

Speaker

  • Prof Peter Hajek Professor of Clinical Psychology - Wolfson Institute of Public Health, Queen Mary University of London

13:40 - 13:55

Depression causes vaping!

In this talk Professor Notley will discuss the latest evidence exploring associations between nicotine use and common mental health conditions, including depression. Complex intersectional relationships between nicotine use in different forms and depression will be explored, with consideration of alternative interpretations of observed associations in epidemiological datasets. Interpretive assumptions will be drawn out, including inappropriate claims of causal relationships between vaping and depression. The pleasure enhancing and beneficial self-soothing effects of using nicotine via different routes of administration, through smoking versus vaping, will be considered to underpin the thesis that habitual nicotine use can serve an important function in individuals lives, and that supporting those who are unable to stop using nicotine to use it in less harmful ways, is a social justice issue.

Speaker

13:55 - 14:10

The impact of the COVID-19 pandemic on e-cigarette and tobacco use in the UK

The COVID-19 pandemic led to strict lockdowns in the UK throughout 2020 and 2021, which impacted both access to tobacco-related services (e.g., Stop Smoking Services) as well as retail outlets (e.g., Vape Shops). Further, it is likely that the presence of a potentially deadly respiratory virus will have influenced smokers and vapers views on their product use. This talk will use data from the Smoking Toolkit Study as well the HEBECO study to assess the impact of the pandemic on e-cigarette and tobacco use in the UK, in terms of prevalence of use, attitudes, quitting activities, and support provided to smokers. It will argue that the pandemic has slowed down the decline in smoking prevalence, underlining the need for more action in relation to harm reduction to achieve the 2030 ‘smokefree’ target.

Speaker

  • Prof Lion Shahab Professor of Health Psychology - Department of Behavioural Science and Health, University College London

14:10 - 14:55

Panel discussion and live Q&A

Nicotine research in a politicised landscape - how do we maintain scientific integrity?

Chair

Speakers

  • Dr Konstantinos Farsalinos M.D External Research Associate - University of Patras, Department of Public and Community Health, University of West Attica, Greece
  • Prof Alan Boobis, OBE Emeritus Professor of Toxicology & Chair - UK Committee on Toxicity - Imperial College London
  • Prof Peter Hajek Professor of Clinical Psychology - Wolfson Institute of Public Health, Queen Mary University of London
  • Prof Caitlin Notley Chair of Addiction Sciences - University of East Anglia
  • Prof Lion Shahab Professor of Health Psychology - Department of Behavioural Science and Health, University College London

14:45 - 15:00

PM BREAK

SESSION 6: Nicotine Policy & Public Health

15:00 - 15:05

Introduction from the Chair

Chair

  • Prof Ann McNeill Professor of Tobacco Addiction - Institute of Psychiatry, Psychology & Neuroscience,, Kings College London

15:05 - 15:20

Shifting the Paradigm: Tobacco Control and Tobacco Harm Reduction are Scientifically Complementary Approaches to Reducing Illness and Saving Lives

The US Food and Drug Administration’s recent authorization of certain e-cigarettes and other non combustible tobacco products under its premarket tobacco products application process confirmed the agency’s understanding that e-cigarettes and other alternative nicotine-containing consumer products are significantly less harmful than tobacco products that are burned. The FDA determined that these products can be good for the protection of public health, potentially helping millions of addicted adult smokers quit smoking. While imperfect, the PMTA process is now facilitating the transition to a new era in which adult consumers have access to far less harmful alternatives and develop greater, more accurate understanding regarding the risks and benefits of nicotine. The essence of this process is objective, nonpoliticized scientific inquiry and review. The scientific research community must take advantage of this new opportunity to disseminate credible scientific findings to better educate the public, the public health and medical communities, the media and decision-makers.

Speaker

  • Cliff Douglas JD Director, Tobacco Research Network, Adjunct Professor, Dep't of Health Management and Policy - University of Michigan School of Public Health

15:20 - 15:35

Parents: The Untapped Resource for Balancing Cessation and Prevention Needs:

This presentation will discuss the potential for parents to be the untapped link between smoking cessation and prevention of youth use of e-cigarettes and other tobacco products. Although there is substantial evidence for the association of parental smoking and youth smoking, less is known about ripple effects of parental smoking cessation on youth tobacco and e-cigarette use. This presentation will discuss how a refocus on parental smoking cessation may help to achieve the dual aims of reducing smoking and preventing underage e-cigarette use.

Speaker

  • Prof Robin Mermelstein Distinguished Professor of Psychology & Director, Institute for Health Research and Policy - University of Illinois, Chicago

15:35 - 15:50

Greater Manchester is making smoking history: Meeting people where they are and not where we think they should be

Greater Manchester’s Making Smoking History strategy was launched in 2017 to tackle inequalities by reducing smoking prevalence across the population. Since then, it has helped to improve the health, wellbeing, and wealth of thousands of residents and their families and is currently leading the way for tobacco control in England. Campaigns have focused on hard hitting, engaging, positive, non-patronising messages with a GM voice and feature local people telling their stories about stopping smoking and living with smoking related harm. Creating fair and equitable access to an integrated stop smoking system is still a work in progress. This includes universal access to advice, support and to stop smoking medications, Nicotine Replacement Therapy (NRT) and e-cigarettes.  E-cigarettes have been an important part of successful quit attempts and that has been promoted actively.  Most importantly, GM smokers are using e-cigarettes and want their quit attempts to be supported and reinforced.

Speaker

  • Andrea Crossfield MBE Independent Public Health Consultant and Population Health Policy Specialist - Greater Manchester Health and Social Care Partnership

15:50 - 16:05

The key role of vaping in medical practice. Time for doctors to get on board.

Smoking cessation is a core responsibility of medical practice, however traditional treatments have low long-term success rates. Tobacco harm reduction with safer nicotine products such as vaping nicotine is an additional, evidence-based tool for helping smokers quit and often works where other treatments have failed. However, doctors have been slow to embrace vaping and many remain misinformed about it and about the safety of nicotine. Medical practitioners have a duty of care to provide the best possible management at each patient encounter. Withholding a legitimate treatment option that could prevent a life-threatening illness is a breach of that obligation. This is especially important in disadvantaged populations for whom smoking is a major cause of health and financial inequalities. Vaping may have a special role in this population that is currently being left behind as we hasten slowly toward the endgame.

Speaker

16:05 - 16:20

CLOSING KEYNOTE: Covid-19 and tobacco harm reduction: are there lessons from the pandemic for the way ahead?

At various points since early 2020 it has become apparent that there are similarities between some of the challenges faced in tobacco harm reduction research and policy and those we've encountered during the Covid-19 pandemic. Both involve using complex and often conflicting sources of data and evidence to inform public health interventions. Both have particular effects on disadvantaged and marginalised groups. Each elicits strong opinions about personal autonomy, collective responsibility and the role of the state in public health. How individuals respond has been shaped by social norms and heavily influenced by the role of the media.  Levels of trust in government and in national and international public health organisations have influenced behaviour and the regulatory context. For both tobacco harm reduction and Covid-19, there have been vigorous and often heated debates between groups of scientists, and vested interests have sought to influence those debates. Attempts at consensus have had mixed success. This closing plenary will reflect on these similarities and differences from the perspective of a researcher who has worked with public health agencies, the media and governments on both issues. Are there any key lessons we can take from the pandemic for tobacco harm reduction now and in the future?

Speaker

  • Prof Linda Bauld, OBE Bruce and John Usher Chair in Public Health in the Usher Institute - College of Medicine, University of Edinburgh

16:20 - 16:50

Panel discussion and live Q&A

Why has THR been such a polarised area of science and policy - what could improve it?

Chair

  • Prof Ann McNeill Professor of Tobacco Addiction - Institute of Psychiatry, Psychology & Neuroscience,, Kings College London

Speakers

  • Cliff Douglas JD Director, Tobacco Research Network, Adjunct Professor, Dep't of Health Management and Policy - University of Michigan School of Public Health
  • Prof Robin Mermelstein Distinguished Professor of Psychology & Director, Institute for Health Research and Policy - University of Illinois, Chicago
  • Andrea Crossfield MBE Independent Public Health Consultant and Population Health Policy Specialist - Greater Manchester Health and Social Care Partnership
  • Prof Linda Bauld, OBE Bruce and John Usher Chair in Public Health in the Usher Institute - College of Medicine, University of Edinburgh
  • Dr Colin Mendelsohn MB BS (Hons) General practitioner, Founding Chairman - Australian Tobacco Harm Reduction Association

16:50 - 17:00

Closing Remarks from the Chair

Chair

  • Prof Ann McNeill Professor of Tobacco Addiction - Institute of Psychiatry, Psychology & Neuroscience,, Kings College London