DAY 1: THURSDAY 3RD DECEMBER - Science and Evidence Seminars

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) reviewed the potential toxicological risks from electronic nicotine delivery systems (ENDS). The Committee assessed the absolute risks from use of ENDS to former cigarette smokers, naïve users, and bystander, as well as the relative risks, compared to smoking conventional cigarettes, in those switching products. ENDS are not without risk, although these are substantially less than those of conventional cigarettes. However, the difference in risk will depend 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.

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Cochrane reviews are accepted as the gold-standard for investigating the evidence of potential harms and benefits of healthcare interventions. The Cochrane review of electronic cigarettes for smoking cessation was first published in 2014. A recent update, published in October 2020, now finds increased evidence of benefit for e-cigarettes with nicotine when used to quit smoking. Many policymakers, however, remain reticent to encourage their use for this purpose, citing ongoing uncertainty. This presentation will include a summary of findings from the most recent update, and then compare the Cochrane reviews’ conclusions with that from key national and international policy documents, such as the US Surgeon General’s 2020 report on smoking cessation and recent statements from the World Health Organisation.

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VESUVIUS, the British Heart Foundation-funded clinical trial is believed to have been the largest study undertaken to-date in comparing the impact of  tobacco vs e-cigarettes on cardiovascular health, with the findings published by the Journal of the American College of Cardiology.

The SCHEER preliminary opinion on electronic cigarettes (EC) states that there is strong evidence for the long-term systemic impact of EC on the cardiovascular system. The conclusion drawn by this preliminary report is at odds with the report it purports to reference and the literature review was selective, of poor quality and concerningly unbalanced. The report fails to acknowledge that there are a significant number of human clinical trials that have demonstrated a beneficial effect of switching from tobacco cigarettes to EC as a harms reduction measure.

This discussion will present data on VESUVIUS and discuss the current state of evidence for the cardiovascular impact of e-cigarettes.

The lungs represent a vast interface between the outside world and the human body through which inhaled products can be absorbed. The risks posed by such inhalants have been considered by users, regulators, and researchers in attempts to quantify the risk and come up with sensible policy recommendations and advice on the relative risks and benefits.This discussion will review some of the evidence to date on the pulmonary effects of e-cigarettes.

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For a science press officer in the UK, there was no more boring subject in recent decades than smoking - until around 2013 when e-cigarettes began to take centre stage.  Governments and health bodies were divided, and a subject which had enjoyed almost universal consensus became suddenly controversial.  The UK government signalled their backing to e-cigarettes as a quitting aid and vape shops sprang up on every high street.  Journalists were interested again.  But media coverage has been mixed; editors are always attracted to a juicy scare story and some journalists remain deeply suspicious of the legacy of this new(ish) technology.  How should the scientific community communicate such a divisive and emotive subject to the public?  What does ‘good’ coverage look like when apparently even researchers can't agree?  And what can scientists do to ensure e-cigarettes are reported responsibly and accurately?  Tom Sheldon leads the work on e-cigarettes at the Science Media Centre and he will talk about his experience working with scientists and journalists on this battleground subject.

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