Session 3: 2022 Seminars

13:35 - 13:50

PHE, OHID and Tobacco control in England

On the last day of September 2022 Public Health England closed its doors. On the first day of October the Office of Health Improvement started work in earnest. Some may have anticipated a slowing of the pace on e-cigarettes but by the end of the month Secretary of State for Health Sajid Javid was talking of a “vaping revolution.” By the time of OHID’s first birthday its achievements included publication of Khan review and the milestone report Nicotine Vaping in England 2022. Rosanna will look back on OHID’s first year and forward at the emerging issues and opportunities with all the clarity that circumstances allow.


  • Rosanna O’Connor Director, Addictions & Inclusion - Office for Health Improvement & Disparities, Department of Health and Social Care
13:50 - 14:05

Avoiding missteps in nicotine regulation: what can we learn from patterns of nicotine intake from cigarettes?

Policies to shift the market for nicotine from cigarettes to non-combustibles (as, for example, the mooted FDA proposal to reduce the absolute bioavailability of nicotine from cigarettes to non-reinforcing levels) have as an essential component the development of consumer-acceptable alternative novel nicotine products. Regulators may seek to set limits for the nicotine dose available from non-combustibles at their peril, as this may seriously constrain the chances of developing successful alternatives to the cigarette.

This presentation will consider data from major national surveys in the USA (National Health & Nutrition Examination Survey) and UK (Health Survey for England) to examine how patterns of nicotine intake from cigarettes can help guide the specification for new products.  Key themes concern the overriding importance of consumer behaviour, as opposed to product characteristics in determining dose; extreme elasticity of the cigarette in dose titration and response to secular market change, as well as marked variations in preferred dose across ethnic and demographic groups.


  • Prof Martin Jarvis Emeritus Professor of Health Psychology, Department of Behavioural Science & Health - University College London
14:05 - 14:20

The achievability of a UK medicinal licence

A medicinally-authorized e-cigarette has been a topic of discussion since before the first Summit in 2013.  There were those who argued that only medicinally-licensed e-cigarettes should be on the market, while others believed that a medicinal-only marketplace would be accessible only for the big tobacco companies – who arguably had the least incentive to lead a revolution against combustible cigarettes.  MHRA has taken multiple steps to encourage the filing of a medicinal application for an e-cigarette, culminating in late 2021 in the publication of an updated guidance document, announced by the MHRA in a Press Release entitled “E-cigarettes could be prescribed on the NHS in world first.”  The recent Kahn Review has also recommended the addition of medicinally-licensed e-cigarettes, as a vehicle for increasing general practitioner and other healthcare provider confidence in vaping.  Is a medicinally-licensed e-cigarette possible?  Is it, in fact, only the province of big tobacco?  David Graham provides the perspective of an independent company that has successfully navigated FDA’s PMTA process, addressing the achievability of a UK medicinal license and drawing parallels and distinctions between a UK medicinal application and the US PMTA.


14:20 - 14:35

Who would have thought we’d be talking about disposable e-cigarettes at the tenth edition of the London E-Cigarette Summit?

Back in 2013, the disposable e-cigarette was a product type that many of us thought to be in its early death throes.  Advocates and the independent industry alike were certain that it would all be about refillable, reusable and rechargeable open systems from there on in.  We can track the re-birth, understanding the market forces that have carried the growth, examining the spectrum of ethical and moral standards behind active marketing campaigns, and looking in detail at what we can objectively state about “new consumers” of disposable vapour products. We can also compare these newer entrants to vaping with our sector’s existing customers before the arrival of the latest disposable vapes. In short, what are brightly coloured and intensely flavoured new vapes really doing to the overall nicotine market: vaped, smoked or “other”?

From an industry viewpoint, this leads very directly to regulation. In November 2013 the discussion was focused on Europe, and the wheel has since then turned full circle from TPD2 to TPD3. With 8 years’ hindsight, what were the strengths and weaknesses of Directive 2014/40/EU’s impact on the diverse e-cigarette markets that it touched? How much of the enduring diversity in those markets is due to variation in regulations? Is the UK’s advanced position in reducing smoking through a nicotine harm-reduction approach engineered, “nudged,” or just a happy accident? How is it that the French, German and UK vape markets have so many clear differences? Finally, as an industry sector, what pleas to policy makers and regulators are in the best interests of our customers, present and future?


14:35 - 14:50

The principle of a risk-based policy and why this is still controversial for tobacco control and public health

Between 2020 and 2022 the Belgian Superior Health Council undertook an extensive review and consultation on e-cigarettes with a view to providing updated guidance and advice for tobacco policy.  It took 2 years to arrive at this advice and was the result of multi stakeholder engagement from across tobacco control communities, scientific disciplines as toxicology, pneumology, oncology, psychiatry, psychology, sociology ..., points of interest such as health promotion and health inequality, and vigorous scientific review. The final advice has been a compromise which highlights the need to focus - with equal attention - on both opportunities and risks.  In this session Stefaan will explore the process and challenges of creating a public health consensus amidst an evolving phenomenon which has highlighted the distinct divides between traditional tobacco control sentiment and harm reduction proponents.  Although there remains some controversy, the advice has provided a framework for developing a risk-based policy and recognises the role that harm reduction can play within public health and what this means for the current framework and approach of smoking and smoking cessation.


  • Stefaan Hendrickx Senior Staff Member Tobacco - Flemish Institute for Healthy Living
14:50 - 15:05

E-cigarette legislation in Ireland. The good, the bad and the ugly

Smoking kills 6,000 people in Ireland every year and many thousands more suffer from smoking related illnesses that will eventually be a significant contributor to their early demise. The Department of Health has targeted 2037 as the year when Ireland will be smoking free. In order to reach that target it is imperative that no smoker who wants to quit encounters any barriers that might prevent them from doing so. With that in mind, there are an estimated 200,000 people using e-cigarettes, almost all of which are using them to quit smoking. This method of smoking cessation is fast growing and research shows e-cigarettes are at least twice as effective as traditional NRT. Despite these impressive statistics Ireland’s health service, the HSE, does not recommend vaping as a smoking cessation intervention on the basis there is not enough evidence of either effectiveness or safety.

Concern has been exclusively focused around adolescent e-cigarette use (about 4% of youths who vape do so in a daily or near daily manner). Plans are afoot by the Government to ban flavours as these are viewed as attractive to adolescents. This presentation examines the current legislation in Ireland around e-cigarette use and availability and takes a close look at the medical profession’s attitude towards vaping as a smoking cessation tool. It also highlights some of the media debates that have occurred between pro vaping and anti-vaping doctors. Dr Garrett will also present some case studies of smokers and their experiences in trying to quit and the advice they have received from various health professionals.


15:05 - 15:25

Panel Discussion and Open Floor Q&A: Public health, tobacco control and industry regulation – what next?

  • Which problems are we primarily trying to solve – smoking or nicotine dependence?
  • Has risk communication been appropriate to the scale of the problem?
  • What are the greatest barriers to improving the quality of the harm reduction debate
  • What role would/could a medicinal product have in reducing smoking and changing the harm reduction debate?
  • What next for e-cigarettes – are disposables the last evolution and what role does regulation play?
  • Has restricting nicotine levels in e-cigarettes been beneficial?


  • Rosanna O’Connor Director, Addictions & Inclusion - Office for Health Improvement & Disparities, Department of Health and Social Care
  • Prof Martin Jarvis Emeritus Professor of Health Psychology, Department of Behavioural Science & Health - University College London
  • David Graham Chief Impact Officer - NJOY
  • Liam Humberstone Technical Director at Totally Wicked - IBVTA
  • Stefaan Hendrickx Senior Staff Member Tobacco - Flemish Institute for Healthy Living
  • Dr Garrett McGovern GP and Medical Director - Priority Medical Clinic
15:25 - 15:40

Afternoon Refreshment Break