10 Research Priorities

Posted 20th March 2019 by Dave Cross
The UK Centre for Tobacco and Alcohol Studies (UKTAS) launched an e-cigarette Priority Setting Partnership survey in January. Interested parties were asked for their opinions in identifying the top 10 unanswered questions for future research. Tobacco harm reduction expert Clive Bates has offered his personal take.

UKTAS said: “Smoking is the leading cause of preventable death. Although not yet available on the NHS, electronic cigarettes are now the most popular aid to smoking cessation, with 37% of smokers using them for quit attempts, and approximately 2.6 million adults currently using them. However, as the popularity of electronic cigarettes have increased, so has the controversy associated with using them, and media scare stories may deter their use. The current evidence base is small and there is much we do not know.”

Researchers wanted people to contribute ideas to help identify priority areas for vape research. This is to be boiled down to the top 10 unanswered questions on electronic cigarettes, helping to guide funders and make sure that researchers focus on the most urgent questions.

Clive Bates, a leading harm reduction advocate, has offered his personal list of the top priorities:

Practice

Clive believes we need to define the barriers to smokers switching to vaping. This covers aspects such as technology, usability, experience, perceptions, and commercial practices/legislation. Also, little is learnt from those who tried vaping but gave up – and could give a great insight into how to boost switching.

He feels that we need to expand upon the evidence and experience-based advice that can be given to smokers. Starting vaping can be a very confusing experience, trying to find out which products to buy and what liquids work. This carries implications for the kind of conversation GPs, pharmacists, newsagents, smoking cessation professionals need to be having with clients.

The third are concerns heated tobacco products and whether there are smokers who would benefit from trying these instead of vaping. This raises questions over “how we characterise the difference between e-cigarettes and heated tobacco products to best inform consumers of risks and opportunities.”

“Should they be more or less treated as the same – and how should smoking cessation professionals deal approach heated products?”

Risks and benefits

“How can we make judgements about long-term risk,” Clive asks, “without waiting for decades of epidemiology – given we would now today that cigarettes are dangerous without waiting for actual cancers to develop, can gain similar insights into the relative safety of vaping?”

Fifth, Clive believes we need to keep an eye on any possible gateway effects, but asks: “By what methods could we know if there was a gateway effect from vaping to smoking and what does the evidence tell us so far?”

The same approach should be applied to assessing the population health impact.

Policy

Bates reckons we need to address the impact of legislation and policies in order to check for beneficial impact or harmful unintended consequences. This would cover things such as strength limits, advertising bans, tank or container volume limits, indoor vaping bans, taxes, and flavour bans.

“What is the effect of tobacco taxation or other anti-smoking policies on economically, mentally ill or otherwise disadvantaged smokers and how can e-cigarettes relieve harmful economic and other impacts on smokers that arise from tobacco control policies?”

As the UK is likely to comply with EU law, albeit with a limited voice in its development post-Brexit, he feels we need to identify “what scientific work needs to be done to prepare for the next iteration of the EU Tobacco Products Directive”.

Research funding

Finally: “By what mechanism could independent researchers leverage far greater funds by influencing and/or peer-reviewing the pipeline of projects developed by the Foundation for a Smoke-Free World – without taking funds from the Foundation?”

The Foundation is committed to aiding research but universities are reluctant to take money from this source due to fears about being accused of accepting tobacco company money.

Planet of the Vapes will bring you the findings from UKTAS when they’re published.

 

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 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker