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UKECRF Research Roundup

The UK Electronic Cigarette Research Forum has published its latest monthly roundup of vaping and harm reduction related research and picked four for comment

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The UK E-Cigarette Research Forum (UKECRF) is an initiative developed by Cancer Research UK in partnership with Public Health England (PHE) and the UK Centre for Tobacco and Alcohol Studies (UKCTAS). Among other things, it brings together genuine experts to look at research related to vaping and tobacco harm reduction.

A Qualitative Exploration of Consumers’ Perceived Impacts, Behavioural Reactions, and Future Reflections of the EU Tobacco Products Directive (2017) as Applied to Electronic Cigarettes – Ward et al. – [link]

The study was conducted by Emma Ward, Claudia Anholt, Sarah Gentry, and Caitlin Notley from the University of East Anglia, London South Bank’s Lynne Dawkins, and Richard Holland at the Leicester Medical School.

The authors found: “Awareness of the TPD among consumers was not universal. Participants’ smoking behaviour did not appear to be influenced by the legislation. Participants were reassured by manufacturing regulations and requirements for ingredients labels. Participants responded negatively to changes perceived to cause inconvenience and extra plastic waste. The product restrictions prompted some participants to purchase non-compliant products illegally, potentially putting their safety at risk.”

They concluded: “E-cigarette regulation should focus on ensuring product safety. Raising awareness of the TPD among consumers and smokers could be beneficial.”

UKECRF commented: “Participants were predominantly white males meaning the results may not be representative of the wider population. They were also mostly from the UK, meaning the findings might not be relevant to other EU member states. Most participants had successfully quit smoking using e-cigarettes so the findings might not be relevant to other e-cigarette users who had relapsed and current smokers.”

It also thinks that due to the nature of recruitment and over-recruitment, there was a disparity between how people were interviewed, and that selection bias may have impacted the findings.

Healthcare professionals’ beliefs, attitudes, knowledge and behaviour around vaping in pregnancy and postpartum: A qualitative study” by Hunter et al. – [link]

The research team was made up of a number of established experts in tobacco harm reduction. They found, “discussing vaping as a tool for quitting smoking in pregnancy was prevented by a lack of capability (limited knowledge of ECs, lack of training in smoking cessation); lack of opportunity (restricted by organisational policies and guidelines, lack of time and financial issues impacting on training), and negative social influences (sensationalist media and stigma associated with vaping in pregnancy); and lack of motivation (fear of future litigation and comebacks should adverse effects from vaping arise).”

They concluded: “Factors related to capability, opportunity and motivation were identified that influence HCPs attitudes and behaviours towards vaping in pregnancy. Gaps in knowledge and training needs were identified, which could inform the development of targeted vaping training.”

UKECRF warned that the sample of healthcare professionals who took part was “opportunistic” and the participants “may” have been more motivated to talk about vaping and therefore unrepresentative of the attitudes of the wider healthcare population.

Investigating the added value of biomarkers compared with self-reported smoking in predicting future e-cigarette use: Evidence from a longitudinal UK cohort study” by Khouja et al. – [link]

The team was mainly made up of researchers at the University of Bristol, an establishment that receives millions of pounds from anti-vape billionaire Michael Bloomberg.

They concluded: “Cotinine levels consistent with active smoking in adolescence are associated with later e-cigarette use even after adjusting for some measures of self-reported smoking behaviour. This could have implications for studies assessing the gateway hypothesis that rely on self-report measures of smoking behaviour. Future studies investigating prediction of e-cigarette use should investigate use of more detailed self-report and objective measures.”

From a non-scientific perspective, it is a struggle to hold any store in a paper that cites work by Jessica Barrington-Trimis to support its conclusion. Barrington-Trimis has been behind some of the shoddiest studies looking at vaping, flavours, and teen use.

UKECRF pointed out: “The study cannot determine causality between smoking at 15 years and e-cigarette use at 22 years for both cotinine determined and self-reported smoking status. E-cigarette and tobacco landscapes have changed significantly since 2006-2008 when participants were initially approached, so the association observed may not apply to young people today.

Measurement error may explain the residual association between continue determined smoking and later e-cigarette use after adjusting for self-reported smoking status. Self-reported and cotinine determined smoking status were recorded an average of 15 months apart. This time gap was adjusted for in a sensitivity analysis and was found to be unlikely to have an effect. However, this may have resulted in measurement error.”

Cotinine’s half-life is very short, UKECRF adds, which would impact on smoking status measurements. Not just that, but passive smoke exposure could have introduced further errors and was not accounted for.

UKECRF goes on to add that they failed to account for the use of other tobacco products, “therefore, adjusting for ever smoking or smoking transitions may not be expected to attenuate the association.”

Association of the US Outbreak of Vaping-Associated Lung Injury With Perceived Harm of e-Cigarettes Compared With Cigarettes” by Tattan-Birch, Brown, Shahab, and Jackson – [link]

The authors said: “After the US outbreak of vaping-associated lung injury, views on e-cigarettes among smokers in England deteriorated. The proportion perceiving e-cigarette use as less harmful than cigarette smoking decreased, and the proportion perceiving e-cigarette use as more harmful increased by over one-third.”

They went on to warn: “The effects that these worsened harm perceptions will have on population health is unclear. It is possible that people who had quit smoking cigarettes through vaping might now return to smoking, and cigarette smokers might be deterred from using e-cigarette devices to help them quit. On the other hand, young people who have never smoked may be dissuaded from ever trying e-cigarettes.”

While the UKECRF said, “the study examined an association rather than a causal link,” any findings demonstrating a worsening of attitudes towards vaping and tobacco harm reduction is troubling and worthy of monitoring on an ongoing basis.

Vaping and harm reduction studies this month:

Patterns of use




Harms and harm reduction



Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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