Let's talk e-cigarettes

Jamie Hartmann-Boyce and Nicola Lindson discuss cigarette packaging, flavours and brand names with Eve Taylor, King's College London. Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the new evidence in e-cigarette research and interview Eve Taylor who is working on a PhD in the Nicotine Research Group at King's College London. Eve also works as a research assistant on projects including the International Tobacco Control Project and the Public Health England e-cigarette evidence reviews.

Jamie Hartmann-Boyce interviews Eve Taylor at the E-Cigarette Summit, 16th November at the Royal College of Physicians, London. Eve discusses packaging regulations and the role that cigarette packaging and e-cigarette packaging have on the appeal to young people and adults. She draws on findings from the International Tobacco Control Policy Evaluation Project and Action on Smoking and Health (ASH) survey data. The survey data from ASH shows that young people are less interested in trying e-cigarettes in standardised packaging and colours compared to branded packaging. However, changing the packaging does not affect adults, including adults that use combustible cigarettes. Eve discusses the role of flavour names and brand names. The interview highlights that the consequences of any changes in policy need to be thought through and any changes in regulations need to be clear and easily enforceable.

This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

Our literature searches carried out November 1st 2023 identified: four new ongoing studies (ISRCTN82413824, NCT06063421, NCT06077240, NCT06088862); one linked paper by Prell et al (10.1136/bmjopen-2022-071099) and two reports to be classified.

For further details see our webpage under 'Monthly search findings':

https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

For more information on the full Cochrane review updated in November 2022 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

This podcast is supported by Cancer Research UK.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research interview Associate Professor Natalie Walker from the University of Auckland, New Zealand. Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the new evidence in e-cigarette research and interview Associate Professor Natalie Walker, Faculty of Medical and Health Sciences, Social and Community Health, University of Auckland, New Zealand.

Natalie Walker discusses her study exploring the effectiveness of nicotine salt vapes, cytisine, and a combination of these products, for smoking cessation in New Zealand. This is a three-arm, pragmatic, community-based randomised controlled trial. They have just finished recruiting 800 participants and the results of this study will be published 2024. This study is funded by the Health Research Council of New Zealand. We also hear about the stop smoking policies taking place in New Zealand and about current levels of smoking and e-cigarette use there.

This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

Our literature searches carried out October 1st 2023 identified two papers linked to studies previously identified. The study discussed in the podcast, Walker 2023, Effectiveness of nicotine salt vapes, cytisine, and a combination of these products, for smoking cessation in New Zealand: protocol for a three-arm, pragmatic, community-based randomised controlled trial (10.1186/s12889-023-16665-w) linked to ongoing study NCT05311085. The second linked study is Carpenter 2023 (https://doi.org/10.1016/j.eclinm.2023.102142), see also May 2023 podcast.

For more information on the full Cochrane review updated in November 2022 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

Or our webpage: https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and Ailsa Butler interviews Andrea Leinberger-Jabari from the Public Health Research Center at New York University, Abu Dhabi, United Arab E Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the new evidence in e-cigarette research. Ailsa Butler interviews Andrea Leinberger-Jabari, Assistant Director for tobacco research at the Public Health Research Center at New York University, Abu Dhabi, United Arab Emirates.

Andrea Leinberger-Jabari talks to Ailsa Butler at the Society for Nicotine and Tobacco Research- E annual conference held in London where Andrea was presenting a poster of her work. Andrea describes her study of e-cigarettes and heated tobacco products in people in the United Arab Emirates (UAE). This is part of a larger cohort study at the Public Health Research Center called the UAE Healthy Futures study. Data is collected from Emirati adults residing in the UAE on tobacco use behaviors and, since becoming legal in 2019, on e-cigarettes and heated tobacco. The overall smoking rate is around 30% and men tend to smoke more than women. Of those who smoke combustible tobacco, over half smoke more than one type of combustible tobacco including cigarettes, shisha, pipe tobacco and Doha tobacco. Most e-cigarette users are people who already smoke combustible tobacco, are male, younger and college educated. The views on the perceived harm of e-cigarettes are mixed; people were unsure if they were more or less harmful than combustible tobacco. The top reasons for using e-cigarettes among people who use combustible tobacco, are that they might help them quit, that they are more acceptable than combustible cigarettes and they can be used in places where combustible cigarettes are banned. People not using combustible cigarettes use e-cigarettes out of curiosity and because they taste good. The EC market is new in the UAE and is growing rapidly, so continued monitoring of e-cigarettes and heated tobacco use in this emerging market will inform further policy and regulation The results of this study presented as a poster will be published soon.

This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

Our literature searches carried out August 1st and September 1st 2023 identified one new (Rose 2023 https://dx.doi.org/10.1007/s00213-023-06401-y), two linked (Przulj 2023 https://doi.org/10.3310/AGTH6901) (Kanobe 2023, https://dx.doi.org/10.3390/toxics11070564) and one new ongoing study (https://clinicaltrials.gov/ct2/show/NCT05960305).

For more information on the full Cochrane review updated in November 2022 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

Or our webpage: https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Assistant Professor Joanna Streck from Massachusetts General Hospital, USA. Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the new evidence in e-cigarette research and interview Assistant Professor of Psychology, Joanna Streck, from the Department of Psychiatry at Massachusetts General Hospital in the US. Joanna Streck talks about her new study looking at the feasibility, acceptability and preliminary effects of switching from combustible cigarettes to e-cigarettes in individuals in treatment for opioid use disorder. The trial name is: Switching Individuals in Treatment for Opioid Use Disorder Who Smoke Cigarettes to the Standardized Research E-Cigarette (SREC).

The goal of this study is to conduct a pilot randomized waitlist-controlled trial to assess the feasibility, acceptability, and preliminary effects of substituting the National Institute for Drug Abuse standardized research e-cigarette (SREC) for combustible cigarettes in people who use medications for opioid disorder and combustible cigarettes who are not ready to quit smoking. A waitlist controlled randomised controlled trial of 40 participants will investigate the impact of SREC provision on: tobacco use behaviour; biomarkers (e.g., carbon monoxide); cigarette dependence and withdrawal; and short-term health effects and tolerability.

This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

For more information on the study see: https://clinicaltrials.gov/show/NCT05881304

Our literature search carried out July 1st 2023 identified two new ongoing studies. The study above and NCT0588794, Impact of E-cigarette Nicotine Concentration on Compensation.

For more information on the full Cochrane review updated in November 2022 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

Or our webpage: https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Associate Sarah Pratt, Department of Psychiatry, Geisel School of Medicine, Dartmouth University, New Hampshire, USA. Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the new evidence in e-cigarette research and interview Associate Professor Sarah Pratt from Dartmouth University. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

Sarah Pratt discusses her research and her study of e-cigarette provision to people with serious mental illness to support them transitioning away from combustible tobacco. This research is funded by the US National Institute on Drug Abuse. An abstract of this work was presented at the Society for Research into Nicotine and Tobacco, SRNT, meeting in 2023 and published in Nicotine & Tobacco Research last year. People with serious mental illness (SMI) have great difficulty quitting and sustaining abstinence, warranting novel harm reduction strategies, including switching to potentially reduced-harm nicotine products, such as e-cigarettes. Sarah Pratt and her team conducted the first-ever trial of e-cigarette provision with instructions on their safe use versus usual care in 240 chronic smokers with SMI. They tested whether substitution of e-cigarettes could reduce harm as measured by the cigarette metabolite and carcinogen NNAL (the nitrosamine (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol). The e-cigarette group had significantly lower NNAL at 4 weeks but the group difference was attenuated at 8 weeks. This study demonstrated rapid short-term harm reduction among chronic smokers with SMI assigned to receive e-cigarettes. The attenuation of this effect at 8 weeks suggests that smokers with SMI require more than e-cigarette provision alone to maintain reduced smoking. Sarah and her team conclude that development of a behavioural intervention in addition to e-cigarette provision seems warranted to prevent morbidity and early mortality in this high-risk group of smokers.

For more information on the study see: Pratt SI, Ferron JC, Brunette MF, Santos M, Sargent J, Xie H. E-Cigarette Provision to Promote Switching in Cigarette Smokers with Serious Mental Illness-A Randomized Trial. Nicotine Tob Res. 2022 Aug 6;24(9):1405-1412. doi: 10.1093/ntr/ntac082. PMID: 35363874; PMCID: PMC9356685.

SRNT 2023, abstract PPS22-5, RCT assessing the effect of e-cigarettes versus usual smoking on NNAL among chronic smokers with serious mental illness.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Professor Matthew Carpenter, Medical University of South Carolina, USA. Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Professor Matthew Carpenter. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

In the May 2023 episode Jamie Hartmann-Boyce talks with Professor Matthew Carpenter from the Medical University of South Carolina (MUSC) in Charleston SC, and co-leader of the Cancer Control Program within MUSC Hollings Cancer Center. Matthew Carpenter's primary research interests relate to tobacco use: craving and nicotine dependence, clinical trials for smoking cessation, and public health policy for effective tobacco control. Jamie interviews Matthew at the US E-cigarette Summit in Washington DC and asks about his Naturalistic E-Cig Trial (CONNECT) funded by National Cancer Institute. In this randomised controlled trial 638 participants who use combustible cigarettes are allocated to either: a control arm where they can continue using combustible cigarettes; or given an NJOY electronic cigarette to sample and can continue smoking their usual cigarettes as much or as little as they would like. The study gathered information on e-cigarette product use, purchasing of e-cigarettes and cessation of use of combustible cigarettes at 6 months. The study found an increase in quit attempts and an increase in smoking cessation of combustible cigarettes in the intervention arm. We will include the results in our Cochrane review when these become available.

For more information on the study see: https://clinicaltrials.gov/ct2/show/NCT03453385

Our literature searches carried out between February 2023 and May 2023 found 2 new studies (Kanobe 2022, DOI 10.1038/s41598-022-25054-z & NCT03453385) 5 linked studies and 1 new ongoing study (NCT05703672) which may be relevant to our review when it is completed.

For more information on the full Cochrane review updated in November 2022 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

Or our webpage: https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.

In this episode Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the emerging evidence in e-cigarette research and interview Professor Jonathan Foulds, Penn State College of Medicine. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches. In the January 2023 episode Jamie Hartmann-Boyce interviews Professor Jonathan Foulds from the Center for Research on Tobacco & Health, Penn State College of Medicine. Professor Foulds discusses his randomised controlled study of the effect of electronic nicotine delivery systems (ENDS) or e-cigarettes on combustible cigarette abstinence in people who use combustible cigarettes with no plans to quit. Their study had 520 adult participants who were interested in reducing but had no plans to quit using combustible cigarettes. The participants received brief advice and were randomized to one of four 24-week conditions, receiving either an eGo-style ENDS paired with 0, 8, or 36 mg/ml nicotine liquid (double-blind) or a cigarette-shaped tube, as a cigarette substitute (CS). Self-reported daily cigarette consumption and exhaled carbon monoxide (CO) were measured at all study visits. At 24 weeks, significantly more participants in the 36 mg/ml condition (10.8%) than in the 0 mg/ml condition (0.8%) and the CS condition (3.1%) were abstinent. The abstinence rate in the 8 mg/ml condition was 4.6%. Their randomized trial found study that few participants quit combustible cigarettes in the short term. However, if participants continued to use an ENDS with cigarette-like nicotine delivery, a greater proportion of participants completely switched to ENDS, as compared with placebo or a cigarette substitute.

Jamie and Nicola also bring us up to date with the literature search conducted in January 2023. The searches identified 1 new ongoing study NCT05639790. We will include the studies we have found in future updates of the Cochrane review.

For more information on the study see the full paper DOI: 10.1093/ntr/ntab247

For more information on the full Cochrane review updated in November 2022 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

Or our webpage: https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.

In this episode Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the emerging evidence in e-cigarette research and summarise the findings of the newly published update to the Cochrane review of e-cigarettes f This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

In the November 2022 episode Jamie Hartmann-Boyce and Nicola Lindson bring us up to date with the latest findings from our Cochrane review of e-cigarettes for smoking cessation. The latest Cochrane Review finds high certainty evidence that nicotine e-cigarettes are more effective than traditional nicotine-replacement therapy (NRT) in helping people quit smoking. Jamie and Nicola summarise their research led by the University of Oxford, and funded by Cancer Research UK, which has found the strongest evidence yet that e-cigarettes, also known as 'vapes', help people to quit smoking better than traditional nicotine replacement therapies, such as patches and chewing gums. The new evidence published in the Cochrane Library finds high certainty evidence that people are more likely to stop smoking for at least six months using nicotine e-cigarettes, or 'vapes', than using nicotine replacement therapies, such as patches and gums. Evidence also suggested that nicotine e-cigarettes led to higher quit rates than e-cigarettes without nicotine, or no stop smoking intervention, but less data contributed to these analyses. The updated Cochrane review includes 78 studies in over 22,000 participants - an addition of 22 studies since the last update in 2021.

Smoking is a significant global health problem. According to the World Health Organisation (WHO), in 2020, 22.3% of the global population used tobacco, despite it killing up to half of its users. Stopping smoking reduces the risk of lung cancer, heart attacks and many other diseases. Though most people who smoke want to quit, many find it difficult to do so permanently. Nicotine patches and gum are safe, effective and widely used methods to help individuals quit. E-cigarettes heat liquids with nicotine and flavourings, allowing users to 'vape' nicotine instead of smoking. Data from the review showed that if six in 100 people quit by using nicotine replacement therapy, eight to twelve would quit by using electronic cigarettes containing nicotine. This means an additional two to six people in 100 could potentially quit smoking with nicotine containing electronic cigarettes.

For more information on the full Cochrane review updated in September 2021 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

Or our webpage https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.

In this episode Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the emerging evidence in e-cigarette research and summarise the findings of the newly published update to the Cochrane review of e-cigarettes for smoking cessation. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

In the November 2022 episode Jamie Hartmann-Boyce and Nicola Lindson bring us up to date with the latest findings from our Cochrane review of e-cigarettes for smoking cessation. The latest Cochrane Review finds high certainty evidence that nicotine e-cigarettes are more effective than traditional nicotine-replacement therapy (NRT) in helping people quit smoking. Jamie and Nicola summarise their research led by the University of Oxford, and funded by Cancer Research UK, which has found the strongest evidence yet that e-cigarettes, also known as 'vapes', help people to quit smoking better than traditional nicotine replacement therapies, such as patches and chewing gums. The new evidence published in the Cochrane Library finds high certainty evidence that people are more likely to stop smoking for at least six months using nicotine e-cigarettes, or 'vapes', than using nicotine replacement therapies, such as patches and gums. Evidence also suggested that nicotine e-cigarettes led to higher quit rates than e-cigarettes without nicotine, or no stop smoking intervention, but less data contributed to these analyses. The updated Cochrane review includes 78 studies in over 22,000 participants - an addition of 22 studies since the last update in 2021.

Smoking is a significant global health problem. According to the World Health Organisation (WHO), in 2020, 22.3% of the global population used tobacco, despite it killing up to half of its users. Stopping smoking reduces the risk of lung cancer, heart attacks and many other diseases. Though most people who smoke want to quit, many find it difficult to do so permanently. Nicotine patches and gum are safe, effective and widely used methods to help individuals quit. E-cigarettes heat liquids with nicotine and flavourings, allowing users to 'vape' nicotine instead of smoking. Data from the review showed that if six in 100 people quit by using nicotine replacement therapy, eight to twelve would quit by using electronic cigarettes containing nicotine. This means an additional two to six people in 100 could potentially quit smoking with nicotine containing electronic cigarettes.

For more information on the full Cochrane review updated in September 2021 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7/full

or our webpage https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.

Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the emerging evidence in e-cigarette research and interview Dr Leonie Brose, King's College London. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches.

In the October episode Jamie Hartmann-Boyce interviews Dr Leonie Brose, Reader in Addiction Education and Nicotine Research at King's College London. Leonie Brose talks about the findings of a randomised controlled trial carried out with Dr Markos Klonizakis and the team at Sheffield Hallam University on the medium- and longer-term cardiovascular effects of e-cigarettes in adults making a stop-smoking attempt. The study compared cardiovascular effects in smokers attempting to quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). The study concluded that smokers attempting to quit experienced positive cardiovascular impact after both a 3- and 6-month period. None of the groups (i.e., nicotine-containing and nicotine-free e-cigarettes or NRT) offered superior cardiovascular benefits to the others. https://doi.org/10.1186/s12916-022-02451-9

Dr Brose also discusses the findings of the report by the Office for Health Improvements and Disparities (OHID) on Nicotine vaping in England: 2022 evidence update summary. The report aims to summarise the evidence on vaping products and to inform policies and regulations. It is a large body of work with 16 chapters covering policy and regulation, vaping and youth and presents the evidence on biomarkers of exposure and biomarkers associated with cancer, respiratory, cardiovascular and other health outcomes. The report also has chapters on fires, poisons and explosions linked to ECs, heated tobacco products and perceptions of harm. The headline from the report was that vaping poses only a small fraction of the risk of smoking combustible cigarettes.

Jamie and Nicola also bring us up to date with the literature search conducted in October 2022. The October search identified 1 new study (https://doi.org/10.1186/s12916-022-02451-9), 3 ongoing studies and 1 record linked to a previously identified study. We will include the studies we have found in future updates of the Cochrane review.

OHID Report: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1107701/Nicotine-vaping-in-England-2022-report.pdf

https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidence-update-summary

For more information on the full Cochrane review updated in September 2021 see: https://doi.org/10.1002/14651858.CD010216.pub6 or our webpage

https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1

This podcast is supported by Cancer Research UK.