AGENDA 2023

The E-Cigarette Summit UK, 2023 will take place at the Royal College of Physicians on 16th November in London.  We would like to thank all of our speakers for giving their time and advice to develop a thought provoking and evidence based programme.

The next 12 months will be significant for global tobacco control as different countries seek to implement policies to deliver on their smoking end game strategies. The universal public health goal is to reduce smoking rates to below 5%, however a critical question has emerged on where and how reduced risk nicotine products fit.  The UK has been a pioneer in both supporting and integrating tobacco harm reduction, but is experiencing a significant rise in youth use of e-cigarettes, particularly disposables.  The critical question is “Are we  getting it right and do we like the road we have started on?”

PDF PRINT AGENDA 2023

We are pleased to release a pre-recorded video presentation by Tim Philips of ECigIntelligence, that provides a thoughtful overview of the issues and challenges facing vaping and disposables in the UK.

2022 SUMMIT VIDEOS
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SPEAKERS

REGISTRATION & REFRESHMENTS – 8.30am

SESSION 1: Science & Evidence

08:55 - 09:00

Welcome & Introductions

England has seen a rapid increase in the use of disposable vapes particularly by youth. What factors have led to this increase in youth vaping and does England’s approach need changing in response? At one extreme, there are people who believe youth vaping is of little concern, whilst at the other extreme people see youth vaping as a reason to ban vaping altogether. In addition, with 7 years to go, England is adopting new measures to achieve its Smokefree 2030 goal – where and how does vaping fit in and what regulatory framework for vaping will best facilitate achieving this goal? Now, more than ever we need to get together, exchange views on the evidence and potential solutions, and challenge one other.

Chair

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

09:00 - 09:15

Opening Keynote: Are we scapegoating young people and where should collective responsibility lie?

In this keynote talk Professor Notley will discuss and highlight the latest evidence on young peoples use of nicotine containing vapes, specifically disposables. She will draw attention to a missing evidence source in the debate about youth vaping – the voice of young people themselves. Young people have clear views, and are influenced by media messages that are consequential for their behaviour, which is particularly important when many young people view vaping and tobacco smoking as interchangeable behaviours.  This session will challenge “dualisms” (focusing either on youth prevention OR adult cessation) and the impact of wording such as “no long term data” and how this is heard and interpreted.  Finally, Professor Notley will ask if we are scapegoating young people and where should collective responsibility lie.

Speaker

09:15 - 09:30

Complex problems, clumsy solutions and the court of public opinion

The multi-faceted nature of tobacco control and harm reduction, made more complex by industry, media and public opinion requires constant re-evaluation to consider policy options to improve public health. The Royal College of Physicians re-visits this complex problem in a forthcoming report due in 2024, this presentation will discuss its latest assessment.

Speaker

  • Prof Sanjay Agrawal Professor of Respiratory Science, Institute of Lung Health - University Hospitals of Leicester NHS Trust, Special Advisor on Tobacco, Royal College of Physicians

09:30 - 09:45

Do e-cigarettes increase youth smoking? The current state of the evidence

The question of whether the use and/or availability of e-cigarettes leads to more young people smoking than they would have otherwise is a contentious one. Whereas some people say there is clear evidence of vaping acting as a ‘gateway’ into smoking, others argue the exact opposite. In this talk, Jamie will dissect some of the biggest studies out there on this topic, consider the conclusions of existing systematic reviews in this area, and reflect on what could be done better in this research – including the populations studied, and methods used.

Speaker

09:45 - 10:00

Is vaping an effective and safe aid for quitting smoking? The Cochrane review of electronic cigarettes for smoking cessation

The Cochrane review of e-cigarettes for smoking cessation is now a living systematic review, which means that it is updated when new evidence becomes available. The reviews also include data on biomarkers of health and on adverse events. Trials included in the review however have up to now only concerned e-cigarette use for up to two years. The presentation will cover the Cochrane findings and also consider the efficacy and safety of vaping over long term

Speaker

  • Prof Peter Hajek Director of the Health and Lifestyle Research Unit - Wolfson Institute of Population Health, Queen Mary University of London

10:00 - 10:15

Why do countries have different policies on e-cigarettes?

This paper is based on research into the history of policy making and institutions in 3 countries which have taken different approaches to the regulation of e-cigarettes. In the UK the tradition of harm reduction through nicotine has helped form a response which has endorsed e-cigarettes .The US has a cessation only anti tobacco agenda while Australia has effectively banned e-cigarettes. Each country filters its policy making through different histories, regulatory apparatuses, policy players and prioritises the health of different groups within the population. This long-standing context  helps explain differing policy responses.

Speaker

  • Prof Virginia Berridge Professor of History and Health Policy, Centre for History in Public Health - London School of Hygiene & Tropical Medicine, London, UK

10:15 - 10:30

The strategic vision for ending smoking in the UK and future policy discussions

In  October the Prime Minister announced the most comprehensive government plan to reduce smoking in 20 years. Addressing the latest challenges and opportunities it uncouples age of sale of tobacco products and safer nicotine products and embeds “Stop to Swap” as a key part of our plan to help smokers to quit and combines this with regulations to reduce the risk of nicotine naïve youth starting to smoke. As in New Zealand, so in England we believe we are in a unique year by year, to make smoking obsolete.

Speaker

10:30 - 10:50

Panel Discussion and Q&A: Has England interpreted the evidence differently?

  • What are the research gaps around population impact?
  • Have countries who have followed a more prohibitive route on vaping fared better?
  • Based on our interpretation of the evidence, the UK has taken a different path than many other countries – do we need to change?
  • How do we balance smoking and vaping policies between children and adults?
  • Has vaping facilitated a more radical tobacco control policy?

Chair

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

Speakers

  • Prof Caitlin Notley Chair of Addiction Sciences - University of East Anglia
  • Prof Sanjay Agrawal Professor of Respiratory Science, Institute of Lung Health - University Hospitals of Leicester NHS Trust, Special Advisor on Tobacco, Royal College of Physicians
  • Prof Peter Hajek Director of the Health and Lifestyle Research Unit - Wolfson Institute of Population Health, Queen Mary University of London
  • Assistant Prof Jamie Hartmann-Boyce Assistant Professor in Health Promotion and Policy - University of Massachusetts Amherst
  • Prof Virginia Berridge Professor of History and Health Policy, Centre for History in Public Health - London School of Hygiene & Tropical Medicine, London, UK
  • Prof John Newton, OBE FRCP FFPH FRSPH Director of Public Health Analysis - Office for Health Improvement and Disparities (OHID)

10:50 - 11:10

MORNING REFRESHMENT BREAK

SESSION 2: Policy & Research

11:10 - 11:25

Disposable Vapes in Great Britain: Impact and Implications

Since mid-2021, vaping prevalence has been rapidly increasing in Great Britain. This rise has been most pronounced among younger age groups, driven by the popularity of modern disposable vapes such as “Elf Bar”. Concerns about youth vaping and environmental damage have promoted proposals for an outright ban on disposable vapes. However, some argue that a ban would be challenging to enforce, leading to a thriving black market and other unintended consequences. In this talk, Harry will examine the impact that modern disposable vapes have had on smoking, vaping, and inhaled nicotine use in Great Britain — drawing on recent data from the Smoking Toolkit Study. He will examine the potential effects, both good and bad, of a disposable vape ban and other policy options on public health.

Speaker

11:25 - 11:40

Will a change in packaging policy reduce youth e-cigarette use in the UK?

An increase in youth use of e-cigarettes has coincided with an sharp increase in the market and visibility of brightly coloured and packaged devices.  In this presentation, Eve will share the results of a recent research project that looked at how both young people and adults responded to current packaging and flavour descriptors, and the impact that restrictions had on their perceptions.  This talk will explore how standardization of packaging elements for e-cigarettes may reduce the appeal of products to youth and consider the question of unintended consequences. Eve will also discuss a need for cohesion of policy across nicotine products.

Speaker

  • Eve Taylor MSc PHD Student and Research Assistant - Nicotine Research Group - King's College London (KCL)

11:40 - 11:55

Risk perceptions of e-cigarettes

A substantial body of evidence shows that e-cigarettes are both effective for smoking cessation and much less harmful than combustible cigarettes. But many people (including some vapers) still believe vaping is equally or more harmful than smoking – and perceptions are worsening, rather than improving, over time. This talk will look at how risk perceptions of e-cigarettes have changed over the past decade, discuss the likely causes of these changes, and outline potential implications for public health.

Speaker

  • Sarah Jackson Principal Research Fellow Behavioural Science and Health - University College London (UCL)

11:55 - 12:10

Restricting Flavoured E-cigarette Sales: Policy Effects & Alternatives

Over 375 US localities and 7 states have adopted permanent restrictions on sales of flavored e-cigarettes as a means to reduce youth use and improve public health. But do these policies improve public health? To address this, I will present new evidence on flavor restrictions’ effects on both e-cigarette and combustible tobacco sales and use, and describe other policy options that hold promise for a UK context

Speaker

12:10 - 12:25

Harm reduction beyond e-cigarettes: how do heated tobacco products compare?

Recent device and flavour restrictions announced by various governments will likely reduce e-cigarette use and may encourage some smokers and ex-smokers to switch to alternative harm reduction products, including heated tobacco products. This talk will present latest research from individual- and population-level studies on the effectiveness and safety of these products compared with e-cigarettes to assess their potential impact on public health should shifts in the harm reduction market occur.

Speaker

  • Prof Lion Shahab Professor of Health Psychology, University College London - Co-Director of the UCL Tobacco and Alcohol Research Group

12:25 - 12:40

Why is the MHRA E-cigarette notification scheme essential for the short and long-term protection of public health?

In this session Craig Copland will outline the regulatory processes that the MHRA undertake, including how notification data supports an important regulatory and enforcement purpose.  Craig will discuss factors contributing to the rapid rise of disposable e-cigarettes and the essential  collaborative relationship with Trading Standards and other regulatory bodies including European regulators.  Finally this session will highlight the broader work of the MHRA, from assessment to safety surveillance and tackling the black market and enforcement wins.

Speaker

  • Craig Copland Head of E-Cigarettes, Healthcare, Quality and Access Group - MHRA - The Medicines and Healthcare products Regulatory Agency

12:40 - 13:00

Panel Discussion and Q&A: What next for vaping in the UK?

  • Is youth vaping a communication, regulation, or enforcement challenge - or all of these?
  • Would  prohibition make enforcement easier?
  • What are the influencing factors that impact risk perception
  • There are regulatory approaches on the table to address youth vaping: What are the critical considerations before deciding between them?
  • How could retail compliance be improved and are there any existing regulatory models that could be used to tackle youth access?

Chair

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

Speakers

  • Dr Harry Tattan-Birch Research Fellow - University College London (UCL)
  • Eve Taylor MSc PHD Student and Research Assistant - Nicotine Research Group - King's College London (KCL)
  • Sarah Jackson Principal Research Fellow Behavioural Science and Health - University College London (UCL)
  • Assoc Prof Abigail S. Friedman Department of Health Policy & Management - Yale School of Public Health
  • Prof Lion Shahab Professor of Health Psychology, University College London - Co-Director of the UCL Tobacco and Alcohol Research Group
  • Craig Copland Head of E-Cigarettes, Healthcare, Quality and Access Group - MHRA - The Medicines and Healthcare products Regulatory Agency

13:00 - 13:45

LUNCH

SESSION 3: THR, Nicotine & Public Health

13:45 - 14:00

Swap to Stop – Going for a million

The UK's Prime Minister has announced the most ambitious and comprehensive tobacco control Plan in 20 years. Vaping policy is at the heart of the plan fully embracing the goals of maximising the opportunity for smokers to quit while guarding against youth uptake. In this presentation Martin Dockrell will set out how the Government is honouring the pledge to offer 1 million smokers in England a vape as part of a smoking quit attempt, the first national Swap to Stop scheme anywhere in the world. He will outline some of the innovative schemes already underway and set out the opportunities for the year to come

Speaker

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

14:00 - 14:15

Opportunities and dilemmas- how Fresh is addressing vaping within a collective shared vision for a Smokefree Future

Since 2005 the North East in England has had a comprehensive tobacco control programme in place and overall smoking rates have more than halved - the biggest drop of any region. The session will look at core components for this and what the vision for the future is. Ailsa will focus on youth vaping issues set within a broader context around tobacco and other related harms and measures to strike the best-balanced approach. Hazel Cheesman from ASH will reflect on how the rest of the country is approaching the question of vaping, how other regions are following the lead from the North East and they progress being made to develop coherent approaches to maximising the opportunities from vaping for adult smokers while minimising the risks to teenagers.

Speakers

14:15 - 14:30

The North East North Cumbria’s approach to vaping and a respiratory clinician’s perspective

Rachel McIlvenna will present an overview of the North East North Cumbria approach to vaping within the NHS context, the key enablers and how a recent pilot of smoking cessation with NHS staff led to 75% uptake of vapes in the first year. Dr Ruth Sharrock will present her insight as a respiratory clinician in the North East North Cumbria and provide case study examples of patients and staff with serious clinical conditions where vaping presents the most accessible and tangible tool for use to stop smoking. She will also highlight how navigating personal and professional opinions is crucial and the i role that the evidence base plays.

Speakers

  • Rachel McIlvenna Smokefree NHS Strategic Manager - North East and North Cumbria ICB
  • Dr Ruth Sharrock Clinical Lead for Tobacco Dependency for the North East & North Cumbria ICS - Respiratory Consultant, Queen Elizabeth Hospital - Gateshead

14:30 - 14:45

Implementation of a Generation End Game (GEG) in Malaysia: Evolution in tobacco policies

In this session Dr Sharifa Ezat Wan Puteh will discuss smoking prevalence in Malaysia and the West Pacific Region (WPRO-China as the biggest supplier of tobacco to the Asian region) and consider the implementation of a Generation End Game (GEG) in an upper middle income country which has grappled with tobacco control for many years. Despite signing the FCTC in 2005, Malaysia has not been able to reach its target and is compounded by the ill-effects of black market tobacco. Dr Sharifa will present & discuss data on the prevalence of tobacco smokers, prevalence of e-cigarette use, and heated tobacco products, burden of disease and current policies to fight the detrimental effects of smoking.  This talk will discuss the potential impacts of the GEG Tobacco Bill (coming soon in Nov 2023).  Finally this session will explore the relationship between tobacco control and harm reduction policies and consider the barriers for both, including concerns about health hazards of nicotine containing products and how harm reduction policies in one country may affect the equilibrium in another country.  

Speaker

  • Dr Sharifa Ezat Wan Puteh Professor of Hospital Management and Health Economics and Deputy Dean (Relation & Wealth Creation) - Faculty of Medicine, UKM Medical Centre

14:45 - 15:00

Swap to Stop: how vaping has become mainstream

Why did vapes create such a breakthrough in the English Stop Smoking Services? What was it about this people-driven innovation that brought us to the point where vapes will be given by the government to a million people who smoke? Is it a treatment, or something else entirely? Louise Ross, who launched the first vape-friendly stop-smoking service, looks at how switching to vaping has become not only possible but is supported by and enabled through national policy. She will look at the obstacles that still need to be overcome and the benefits that could be gained.

Speaker

  • Louise Ross Clinical Consultant, NCSCT - Chair and Mental Health Lead, New Nicotine Alliance

15:00 - 15:20

Panel Discussion and Q&A: How do we balance treatment for tobacco dependence and the desire for recreational use of nicotine?

  • Should we be using public money to support people who use nicotine products across the spectrum to quit?
  • What are the pros and cons of the “prescription only model” for e-cigarettes, as proposed and enacted in other counties?
  • Why is harm reduction a recognised tool for many societal issues, but so controversial in tobacco control?
  • Have vaping and THR debates facilitated or distracted from the focus on ending the smoking epidemic?
  • Has the UK approach targeted the right people with the right message?

Chair

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

Speakers

  • Martin Dockrell Tobacco Control Programme Lead - Office of Health Improvement & Disparities (OHID)
  • Rachel McIlvenna Smokefree NHS Strategic Manager - North East and North Cumbria ICB
  • Dr Ruth Sharrock Clinical Lead for Tobacco Dependency for the North East & North Cumbria ICS - Respiratory Consultant, Queen Elizabeth Hospital - Gateshead
  • Dr Sharifa Ezat Wan Puteh Professor of Hospital Management and Health Economics and Deputy Dean (Relation & Wealth Creation) - Faculty of Medicine, UKM Medical Centre
  • Louise Ross Clinical Consultant, NCSCT - Chair and Mental Health Lead, New Nicotine Alliance
  • Hazel Cheeseman Deputy Chief Executive & Policy Director - ASH (Action on Smoking & Health)

15:20 - 15:40

AFTERNOON REFRESHMENT BREAK

SESSION 4: Tobacco Control & Regulation

15:40 - 15:55

E-cigarettes and tobacco control in Great Britain: Where are we now and why

Alongside an historic plan to create a smokefree generation, the UK Prime Minister has announced an 8-week public consultation to consider actions to crack down on youth vaping and ensure the law is enforced.  The consultation will run until 12 December and will consult on several options to deliver the most appropriate and impactful steps.  In this session Deborah Arnott will share a comprehensive analysis of the ASH response to the consultation including reasoning and considerations behind their recommendations.

Speaker

15:55 - 16:10

The smoking endgame and youth vaping in New Zealand

Regular adult smoking rates in New Zealand have declined almost 40% between 2019 and 2022 to only 9% of adults, tripling the rate of decline achieved over the previous 10 years. These dramatic declines have been accompanied by a rapid rise in vaping, and there are now more people who vape in New Zealand than smoke; the vast majority are former smokers. In 2022, the New Zealand parliament voted for smoking endgame policies, including all cigarettes to be very low nicotine by 2025, to reduce cigarette sales outlets by 90% in 2024, and introduce a smokefree generation policy. Easy access to safer alternatives played a key role in giving lawmakers the confidence to end smoked tobacco and minimise the risk to people who still smoke. With the smoking endgame now policy, vaping has become a hot political issue. Public reaction to youth vaping and aggressive policy against vaping in Australia are driving tensions, with youth vaping being framed as a ‘crisis’ and creating a ‘generation hooked on nicotine’. The debate has become a battle between youth prevention and reducing adult smoking. This talk will examine the impact vaping has had on smoking in New Zealand, and why we can’t afford a culture war on vaping that hurts both young people and adults, and risks undoing harm reduction efforts as policymakers scramble to respond to public concerns.

Speaker

16:10 - 16:25

Tobacco Harm Reduction: too serious a matter to be left to the tobacco industry

The WHO/FCTC defines tobacco control as resting on three pillars: tobacco demand reduction, tobacco supply reduction and tobacco harm reduction (THR). While the treaty amply covers the first two (with articles and guidelines for their implementation), it is silent on the third, THR. This has created a vacuum that the tobacco industry has opportunistically exploited, claiming ownership of THR and turning it into a marketing and public relations tool, using it to divide the tobacco control community. The speaker will analyse this phenomenon and offer his views on how to remedy the situation, with a view to giving back THR the place it should always have had in tobacco control.

Speaker

16:25 - 16:40

Tobacco Harm Reduction in Southeast Asia-Challenges and Opportunities

Many Southeast Asian countries continue to struggle with the epidemic of smoking. While evidence for tobacco harm reduction (THR) interventions are compelling, they have not been effectively and widely adopted by the countries in the region for a variety of reasons. At the policy level, some countries have banned THR products outright while others have implemented a range of policies often lacking in consistency and rationale, while the use of these products continues to rise in many countries. Complex economic, political and ideological factors come into play in the policy responses but opportunities are on the horizon to mitigate the largely negative attitude towards THR in the region.

Speaker

  • Prof Tikki Pang Former Director, Research, Policy & Cooperation, World Health Organization - Geneva, Switzerland

16:40 - 16:55

The end of what?

"If you don't know where you are going, any road will get you there" (Lewis Carroll). This strategy advice given by Alice to the Cheshire Cat should be inscribed on every tobacco law, policy document, and activist pamphlet. The emergence of the 'endgame' strategies begs the question, the end of what? And what does that look like? Is it the end of smoking and smoking-related disease? Or is it the end of nicotine? Or is the former just a milestone in the pursuit of the latter? How do youth vaping and banning flavours fit into an endgame logic? We'll take a hard look at the endgame, where it all might end up, and what could possibly go wrong (and right).

Speaker

16:55 - 17:10

Closing Keynote: Keeping our eyes on the prize in nicotine and tobacco policy

Public health professionals care about tobacco use because it is so harmful to health. It is our job to discover ways to achieve reduce it to the lowest possible level, ideally zero, in ways that are acceptable to the public and policymakers. In my view it is not our job to be guardians of public morality. Neither is it our job to tell the public what it should think. There are considerable risks attached to confusing moral and health objectives in public health, not the least of which is that if the public see us as preaching to them, they lose trust in us when we make scientifically sound statements about health harms and propose policies and interventions to combat these. Arguably, in discourse about e-cigarettes, moral views about what people should and should not enjoy have led to misleading claims from some highly influential public health professionals and health organisations. We are at yet another crossroad in policy choices about e-cigarettes and public health professionals must be self-reflective and humble in pronouncements about the potential harms and benefits of particular policies – always doing our best to use modern ‘systems thinking’ to estimate the impacts of different policy choices taking into consideration the political and commercial landscape.

Speaker

17:10 - 17:30

Panel Discussion and Q&A: Who wins with THR?

  • How does supporting THR impact the image of the tobacco industry?
  • Can THR be successfully incorporated into global tobacco control?
  • Will the desire and demand for nicotine always outstrip the ability of countries to enforce bans?

Chair

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

Speakers

POST SUMMIT DRINKS – END 6.30pm