Session 1: 2022 Seminars
OPENING KEYNOTE: Tobacco is a public health emergency
It has been 60 years since the ground-breaking report 'Smoking and Health' was published by the Royal College of Physicians, at a time when smoking prevalence was close to 70% for men and 40% for women. Whilst that report laid the foundations of tobacco control and great progress has been made in reducing smoking prevalence, there is much more to do if we are to prevent the annual global tobacco related death toll of 8 million people. The COVID-19 pandemic illustrated the collaboration and effectiveness with which the global scientific, public health and medical communities can come together to tackle a public health emergency and it is in this same spirit that the tobacco control community must overcome the devastation that tobacco leaves in its wake
Independent review on nicotine vaping in England: an overview of what we said and why
The report is the last in a series of independent reviews commissioned by the Office for Health & Disparities (formerly Public Health England). The purpose of the reports is to inform government and policy makers about prevalence and characteristics of vaping among adults and young people in England and each year we cover at least one additional topic in depth. This year’s report included systematic reviews on the health risks of vaping compared with smoking, and vaping compared with non-use, as well as harm perceptions about vaping and smoking. It also puts the findings in the context of the series of evidence reviews since 2015. This presentation will provide an overview of the report; it will explain how we came to the conclusions that vaping poses a small fraction of the risk of smoking but is not risk free. The talk will also discuss some of the implications of the review findings.
Speaker
Dr Debbie Robson RMN, PhD Senior Lecturer in Tobacco Harm Reduction - National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London
Flavours in e-cigarettes: Public health issues and regulatory challenges
Flavours in e-cigarettes exert multiple points of influence across a range of health-relevant issues, from youth initiation to discontinuation of tobacco use among adults. Flavours also continue to be an important consideration in regulatory approaches to vaping products. National and subnational jurisdictions around the world have various regulatory authorities to address flavoured e-cigarettes in a number of ways, ranging from packaging and labelling rules, to restricting the use of specific flavourings via product standards, and as far as banning characterising flavours in all vaping products. This presentation will bring together timely multi-disciplinary research findings on how flavours in e-cigarettes impacts product appeal (especially to youth), user behaviour (including initiation of product use among non-users and transitions from smoking to vaping among current smokers), chemistry and toxicity of flavoured products, and short/long-term health outcomes
Speaker
Prof Maciej L. Goniewicz Professor of Oncology, Department of Health Behavior, Division of Cancer Prevention and Population Studies - Roswell Park Comprehensive Cancer Center
The Absolute and relative risks of electronic cigarettes in a wider public health context
Cigarette smoking is a significant public health concern, despite stringent regulation. Switching smokers to a less harmful product would therefore mitigate some of this harm. Few alternatives have proven attractive to smokers. Electronic nicotine delivery systems (ENDS or e-cigarettes) deliver nicotine in a way similar to that of conventional cigarettes and hence potentially provide an acceptable alternative. The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) was asked to review the relative toxicological risks from ENDS, compared to smoking conventional cigarettes, and the absolute risks from use of ENDS. ENDS are substantially less harmful than conventional cigarettes, although the difference varies with the health effect. There is little evidence that short to medium term use of ENDS causes major harm, but the effects of long-term use are uncertain, though still likely to be less than those of conventional cigarettes. Use of ENDS by non-smokers is potentially associated with adverse health effects to which they would not otherwise have been subject. This information should not be considered in isolation, but in the wider context of the public health consequences of cigarette smoking.
Speaker
Prof Alan Boobis, OBE Emeritus Professor of Toxicology & Chair - UK Committee on Toxicity - Imperial College London
Cochrane review updates
The Cochrane review of e-cigarettes for quitting smoking was updated this year, and new studies have important implications for certainty of key outcomes. A companion piece, also recently out, investigates biomarkers of potential harm in people who smoke who are given e-cigarettes, but do not successfully quit (dual users). This session will cover key findings from both pieces of work, and also consider the mixed standards used when describing the ‘certainty’ of evidence about the benefits and harms of e-cigarettes.
Speaker
Dr Jamie Hartmann-Boyce Associate Professor and Editor Cochrane Tobacco Addiction Group - Nuffield Department of Primary Care Health Sciences, University of Oxford
Smoking vs nicotine use in late pregnancy: Can e-cigarettes be recommended to pregnant smokers?
E-cigarettes have emerged as a more popular quitting aid among pregnant smokers than traditional NRT. Such use of e-cigarettes has been condoned in the UK but advised against in the US. In this session, Prof Hajek will look at some of the evidence regarding nicotine effects in pregnancy, specifically the existing human data, as opposed to animal studies. He will also present the data from a large, randomised trial that compared smoking cessation and pregnancy outcomes in pregnant smokers allocated to e-cigarettes or NRT. Finally, the session will discuss whether switching from smoking to e-cigarettes poses any risks to pregnancy outcomes and the significance of the findings for clinicians, service providers and pregnant smokers.
Panel Discussion and Open Floor Q&A: Vaping, nicotine and health effects – what do we know and need to find out?
- Given the known harms of smoking, how do we communicate uncertainty?
- What health harms are we anticipating in the future from long term use of e-cigarettes?
- If we remove flavours from e-cigarettes, would there be a net public health gain?
- Is there a toxicological basis for excluding flavours?
- What are the health effects of nicotine use – harms and/or benefits?
Speakers
Dr Debbie Robson RMN, PhD Senior Lecturer in Tobacco Harm Reduction - National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London
Prof Maciej L. Goniewicz Professor of Oncology, Department of Health Behavior, Division of Cancer Prevention and Population Studies - Roswell Park Comprehensive Cancer Center
Prof Alan Boobis, OBE Emeritus Professor of Toxicology & Chair - UK Committee on Toxicity - Imperial College London
Dr Jamie Hartmann-Boyce Associate Professor and Editor Cochrane Tobacco Addiction Group - Nuffield Department of Primary Care Health Sciences, University of Oxford