2025 Session 4 Seminars

Building on insights from the COP and recent European regulatory proposals, Tim Phillips from ECigIntelligence will analyse the changing nicotine product landscape, global regulations, and the rise in enforcement worldwide. Tim will highlight where product development is occurring and consider what this could mean for the adoption of new nicotine products over the next decade.

Nicotine use in England is evolving rapidly. Among younger adults, daily cigarette smoking has fallen sharply, with vaping now more common than smoking. In contrast, older adults continue to follow more traditional smoking patterns and are more uncertain about the relative harms of e-cigarettes – despite evidence that these products work just as well for them in supporting smoking cessation. Drawing on the latest evidence, this talk will explore age-specific trends in nicotine use over the past decade, highlight the unique barriers facing older adults, and consider the policy challenges of striking the right balance: ensuring that people who smoke can access less harmful alternatives while limiting uptake among those who would otherwise remain nicotine-free.

The evidence is clear that switching from smoking to vaping reduces health risks and can save lives. Though more preliminary, evidence on oral nicotine pouches suggests the same. But as evidence grows in this space, public opinion continues to move in the opposite direction, with valuable opportunities to reduce the burden of tobacco use missed due to misinformation and misunderstandings. These preventable deaths warrant swift action and well thought through policies, but with science – and public health – under threat in some areas of the world, how do we move forward? This presentation will cover the latest Cochrane evidence on vaping and pouches, and recent research into policy-making challenges in this space.

Aotearoa New Zealand was one of the first countries to run clinical trials of e-cigarettes, evaluate relative risk, and endorse their use to stop smoking. An early commitment to objective, evidence-based approaches made New Zealand an early adopter of vaping for harm reduction. Easy access, low prices and support from the government for stopping smoking saw significant uptake of vapes, correlating with record declines in smoking, especially for Māori women, for whom smoking rates halved from 32% to 14.8% in only 4 years. Access to much less harmful nicotine alternatives was even a factor in enabling New Zealand’s abandoned tobacco denicotinization laws.

However, concerns about youth vaping uptake, misinformation about nicotine, and stigma about addiction have seen tobacco harm reduction increasingly labelled as a public health crisis rather than a success. Not to mention international pressure to downplay the role of vaping. This talk will reflect on why increased hostility to tobacco harm reduction is drowning out the story of New Zealand’s success. Are the lessons from New Zealand under threat from public opinion, activist science and political gesturing?

In this session, Martin will reflect on his 20 years in tobacco control and the 20 preceding years in HIV prevention, drawing lessons for the current challenges in nicotine policy. He will explore the importance of fully utilising the evidence, maintaining public trust, and promoting public health with clear-sighted prioritisation.
Martin will talk about his “pilgrim's progress” on a mission to end HIV transmission and to end smoking, and what he learnt along the way and how those lessons shaped new priorities and values.
Public health is indeed a moral crusade, but not one of conformity. It is a journey alongside people to help them live their healthiest and happiest lives.

• The UK and NZ approach has been controversial. Is there an alternative model that has worked better?
• What would the role of tobacco control be in a post-smoking era?
• How will we know when — or if — we get things right— what are the measures of success?