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  • Full programme and speaker line-up announced for 7th annual UK E-Cigarette Summit on Thursday 14th November 2019 at The Royal Society, London

Programme 2019

To download and print a PDF version of the 2019 programme, please click here.

Registration

08:15 - 08:45

Registration and refreshments

We will be starting at 8.55am sharp, so please ensure you arrive in plenty of time to collect your badge

Evidence, Policy and Research

08:55 - 09:00

Welcome from the Chair

Recent developments

  • Professor Ann McNeill Professor of Tobacco Addiction - UK Centre for Tobacco and Alcohol Studies (UKCTAS), Kings College London
09:00 - 09:15

Opening Address: Harm reduction in Asia – challenges and the way forward

Six out of the ten countries with the highest rate for smoking related deaths are in Asia and yet the climate for tobacco harm reduction is predominantly hostile.  Progress towards acceptance of tobacco harm reduction consequently lags behind that seen in other countries. This session will explore the main challenges and barriers facing this diverse region which are related to political, economic, scientific, regulatory, cultural and social factors. The session will also address how these challenges might be overcome in the future through international solidarity, goodwill and collaboration. While there are unique challenges facing developing countries in Asia, some common challenges with other countries exist and collectively addressing them would benefit greatly from the sharing of experiences in other, mostly developed countries.

  • Prof Tikki Pangestu Visiting Professor - Lee Kuan Yew School of Public Policy, National University of Singapore
09:15 - 09:30

Vaping in America: “Dead or Alive”? The prognosis for harm reduction in the US

Since the release in February 2018 of the American Cancer Society Position Statement on Electronic Cigarettes, the landscape for vaping products has changed dramatically in the US and the controversy surrounding these products has grown more fraught.  This presentation will discuss what is happening in the US and what this could mean for the harm reduction conversation in America.  Cliff Douglas will explore the main controversies and consider how skyrocketing youth vaping has changed the dialogue.  Specifically, this session will explore

  • Federal, state and municipal actions
  • FDA action against JUUL and the upcoming premarket review of vaping products
  • The wave of pulmonary illnesses and its relationship to youth vaping and flavours

Finally, this session will ask how these issues are being addressed in relationship to combustible tobacco product use, both for youth and adults

 

  • Cliff Douglas JD Director, Center for Tobacco Control, American Cancer Society - Vice President, Tobacco Control
09:30 - 09:45

Epidemic of youth nicotine addiction?

In November 2018 US Food and Drug Administration announced restrictions on e-cigarette manufacturers in response to a perceived epidemic of e-cigarette use among high school students. This session will explore if the NYTS data support claims of a new epidemic of nicotine addiction stemming from use of e-cigarettes or concerns that declines in youth tobacco addiction are being reversed after years of progress.

  • Martin Jarvis, OBE Emeritus Professor of Health Psychology, Dep't Behavioural Science & Health - University College London
09:45 - 10:00

The UK approach to e-cigarettes and tobacco harm reduction – Data, policy and evidence

The ASH Smokefree GB survey is the longest running survey of adult and youth e-cigarette use, providing the most up to date evidence available on how vaping is evolving in Britain. The most recent data from Action on Smoking and Health (ASH) shows that as vaping has increased smoking  has continued to decline, although as a cross-sectional survey it cannot prove causality.  In 2019 around half as many Britons now vape as smoke, and the majority are ex-smokers.  Although e-cigarettes are now the most popular quitting aid, the survey finds that in 2019 over a third of the 7.2 million smokers in the UK have never tried vaping. Public perception of the relative risks between smoking and vaping is still very poor and the recent news of an outbreak of serious vaping-related lung disease in the US may be driving vapers back to smoking.  This presentation will look at how the UK should address this in order to support the 7.2 million smokers in the UK to stop smoking and end the tobacco epidemic which still causes nearly 100,000 deaths a year in the UK.

 

10:00 - 10:15

ITC and the Four Countries summary

An extraordinary natural experiment is going on worldwide given the different regulatory frameworks in place for e-cigarettes. The International Tobacco Control Policy Evaluation Project (ITC), set up originally to evaluate the implementation and impact of tobacco control policies, has adapted to be able to now also examine the impact on smoking, vaping and nicotine use of e-cigarette policies as well. Prof. Borland will focus in particular on how Australia, which prohibits nicotine vaping products, and Canada, which recently liberalised their e-cigarette policies, are faring compared with England and the US. He will examine issues such as patterns of e-cigarette use and smoking, accessibility, and impact across the four countries.

  • Prof Ron Borland Professor of Psychology - Health Behaviour - University of Melbourne, Australia
10:15 - 10:35

Panel Q&A: Tobacco harm reduction – past, present and future

  • How much of the conversation is about science, opposed to emotion and politics?
  • Is the WHO position on e-cigarettes leading or following the debate?
  • Can tobacco harm reduction and reduced risk products survive the current climate?

  • Prof Tikki Pangestu Visiting Professor - Lee Kuan Yew School of Public Policy, National University of Singapore
  • Cliff Douglas JD Director, Center for Tobacco Control, American Cancer Society - Vice President, Tobacco Control
  • Deborah Arnott Chief Executive - Action on Smoking and Health (ASH)
  • Prof Ron Borland Professor of Psychology - Health Behaviour - University of Melbourne, Australia
  • Prof John Newton Director of Health Improvement - Public Health England
  • Martin Jarvis, OBE Emeritus Professor of Health Psychology, Dep't Behavioural Science & Health - University College London
10:35 - 10:55

Morning refreshment break

 

 

 

 

 

Science, Safety and Health Effects

10:55 - 11:10

Practical solutions to the problem of low quality in e-cigarette research

Much e-cigarette research is of low quality with claims being made that are not warranted given the data collected. Findings are then being communicated and interpreted in ways that compound the problem so that national polices are being formed on the basis of misinformation. This presentation proposes two of a number of practical steps that should be taken that could mitigate this. The first is adoption of what have been termed ‘Open Science’ principles. This includes compulsory declaration of whether a given finding comes from a pre-registered analysis or after a succession of analyses not all of which are being reported. The second is adoption of a ‘controlled vocabulary’ when describing key constructs such as ‘vaping’, ‘current e-cigarette use’, ‘cardiovascular damage’, ‘youth uptake’ etc. Everyone involved in producing, interpreting, communicating or using e-cigarette research should make it absolutely clear what they are referring to and what inferences have been made to get there. An ‘E-Cigarette Ontology’ is currently being developed that will facilitate this.

11:10 - 11:25

Vaping and lung disease

The recent outbreak of serious and in some cases fatal lung disease, predominantly lipoid pneumonia, among vapers in the USA has caused widespread alarm among vapers, health professionals, advocates and political leaders in the USA and elsewhere around the world. In this presentation Prof Britton will summarise the available evidence on the likely cause or causes of this outbreak, the reported occurrence of other similar or potentially related severe lung disease outside this recent outbreak, and discuss the relevance of the outbreak to electronic cigarette policy and regulation.

  • Prof John Britton Professor of Epidemiology, Diretor UK Centre for Tobacco & Alcohol Studies - University of Nottingham
11:25 - 11:40

Vaping and cardiovascular health

Synopsis to follow: Presentation on the association between cardiovascular disease (heart attacks) and e-cigarette use

 

11:40 - 11:55

Do e-cigarettes and “dual use” undermine quitting

Concerns have been raised that the widespread availability and popularity of e-cigarettes may undermine smokers’ desire to quit. In this talk, I will discuss the evidence around these concerns, exploring (i) whether e-cigarettes are ‘renormalising’ smoking in public places, thus undoing some of the progress that has been achieved by Smokefree legislation, and (ii) whether dual use of e-cigarettes and tobacco perpetuates nicotine addiction, making smokers who vape less likely to try to quit.

  • Dr Sarah Jackson Senior Research Fellow - Dep't of Behavioural Science & Health, University College London
11:55 - 12:10

E-cigarettes, smoking cessation and smoking initiation

The key issue concerning the impact of EC on public health is whether they promote or reduce smoking - in the population generally, and among young people in particular. The presentation will review existing evidence with focus on new data.

  • Peter Hajek Professor of Clinical Psychology - Queen Mary University of London
12:10 - 12:25

A randomized trial of e-cigarettes to reduce harm in smokers

Tobacco is the leading cause of preventable death in the the world. Smoking cessation medications should be tried in all tobacco users. For those not wanting to quit, or desiring to reduce harm, the option to utilize electronic cigarettes exists. We conducted a randomized clinical trial (n=182) in the Midwest and southern California using JUUL, a 4th generation e-cigarette to see if those substituting e-cigarettes for combustible cigarettes would reduce NNAL levels, be able to completely switch to e-cigarettes, result in a change in cotinine levels, and reduce the number of cigarettes smoked. The presentation will also include some findings regarding dual users that are intriguing and hypothesis generating.

  • Prof Jasjit S. Ahluwalia Professor, Behavioural and Social Sciences and Internal Medicine - Brown University School of Public Health and Alpert School of Medicine
12:25 - 12:45

Panel Q&A: Vaping and health

  • Has the US lung illness epidemic caused irreversible damage to tobacco harm reduction?
  • How can regulators minimise any risks of vaping?
  • Has the European TPD 20mg nicotine limit been a positive health intervention?
  • Do flavours introduce an unnecessary risk to vaping products?

  • Professor Robert West Professor of Health Psychology - Dep't of Behavioural Science and Health,UCL
  • Prof John Britton Professor of Epidemiology, Diretor UK Centre for Tobacco & Alcohol Studies - University of Nottingham
  • Dr Konstantinos Farsalinos M.D Research Fellow - Onassis Cardiac Surgery Greece, Department of Pharmacology, University of Patras, Greece
  • Dr Sarah Jackson Senior Research Fellow - Dep't of Behavioural Science & Health, University College London
  • Peter Hajek Professor of Clinical Psychology - Queen Mary University of London
  • Prof Jasjit S. Ahluwalia Professor, Behavioural and Social Sciences and Internal Medicine - Brown University School of Public Health and Alpert School of Medicine
12:45 - 13:25

Lunch

Industry, Regulation and Tobacco Control

13:25 - 13:35

Scandal in the US and global implications

This presentation will look at the impact of the recent vaping deaths on the e-cigarette market in the US and worldwide.  It will explore why the existing US cannabis vape market has been less affected than the nicotine vaping sector and how the conflation of numerous distinct issues are at play, specifically youth use, flavours and the shortened timetable for PMTA regulation.  Finally it will consider what the likely implications will be for global policy and the future of the vaping sector.

13:35 - 13:50

‘I had given up giving up’ – how smokers have reacted to a new gateway out of smoking

Louise Ross draws on her experience as a Stop Smoking Service manager to illustrate the effect that tobacco harm reduction can have on individuals and whole families, many of whom thought they would probably smoke forever. Louise encourages people who have switched from smoking to vaping to tell their healthcare worker too, to change resistant mindsets and undo the harm that professional prejudice can cause. This session will also consider what message current regulation sends to consumers and would-be switchers?

13:50 - 14:05

Regulation and product standards – current controversies for the vape industry

Why are flavours important, and what considerations need to be made for a producer to satisfy themselves objectively that unnecessary risks are not presented to the consumer? Should such considerations be entirely optional, defined in formal standards, or enshrined in law? How is it that things have gone so badly wrong for THC vape products in the USA? Where did the popularity of nicotine salt rise from; are salt formulations of genuine benefit in a TPD regulated market? Can an independent vape industry survive in markets where prohibitions so firmly favour tobacco and pharmaceutical industry offerings? All of these controversies will be considered from the perspective of an independent e-cigarette business with the interest of its customers, almost all of whom are ex-smokers or smokers intending to quit, at the heart of everything it does.

14:05 - 14:20

The UK approach to tobacco harm reduction – the pillars that guide regulation and policy

The UK’s approach to tobacco harm reduction is based on a number of important pillars relating to science and policy. The priority is to support adult smokers to quit while protecting non-smokers and particularly children from any unintended consequences related to vaping products being available on the market. In order to achieve this, the first pillar is research and surveillance to ensure we have adequate, robust and transparent information about the products, health effects, patterns of use and changes in any of these through time. Proportionate regulation is the second pillar, focusing on safety but also access for groups who need the products and those for whom access needs to be restricted. The third is communication with the public and professionals to ensure accurate information is conveyed about risks and benefits. The relationship between these three elements is poorly understood and subject to challenge, particularly in an international context. This presentation will review why each is important, what is working and what can be improved in the UK, with lessons for other jurisdictions.

  • Prof Linda Bauld Bruce and John Usher Professor of Public Health - The University of Edinburgh
14:20 - 14:40

The Foundation for a Smoke Free World after 2 years

The Foundation for a Smoke Free World (FSFW) was launched 2 years ago and is supported by a grant from Philip Morris International (PMI). Professor Etter will discuss the FSFW’s scientific output after 2 years, how was the money spent, who are the grantees and the board of directors, whether the FSFW was able to collaborate with mainstream tobacco control scientists, how were some grantees treated by the tobacco control community, whether the FSFW acts independently from PMI, and what are the perspectives for the FSFW.

14:40 - 14:55

What could possibly go wrong? E-cigarette regulation and unintended consequences

In 2016, the Royal College of Physicians (London) set out this problem: “A risk-averse, precautionary approach to e-cigarette regulation can be proposed as a means of minimising the risk of avoidable harm. However, if this approach also makes e-cigarettes less easily accessible, less palatable or acceptable, more expensive, less consumer friendly or pharmacologically less effective, or inhibits innovation and development of new and improved products, then it causes harm by perpetuating smoking” In this session Clive Bates will discuss the importance of getting this balance right and how regulators have been getting it wrong

14:55 - 15:15

Panel Q&A: Intended and unintended consequences of regulation

  • Is research funding politicised and are conflicts of interest measured appropriately?
  • Are the US lung injuries a result of poor regulation and what measures would prevent this for the future?
  • Will open tank systems and the independent vape sector survive in America?
  • How do we prevent tobacco industry domination of the vaping industry whilst encouraging big tobacco to move away from combustibles?

15:15 - 15:35

Afternoon refreshment break

Public Health, Policy & Tobacco Harm Reduction

15:35 - 15:50

Children and adolescents’ perceptions and use of e-cigarettes

While the harms of e-cigarettes are contested, there is consensus that they are less harmful than smoking. Hence supporting smokers to switch from tobacco to e-cigarettes offers an important harm reduction potential. However, there are concerns that e-cigarettes might act as a gateway to nicotine addiction, and future smoking, among children and adolescents who would not have otherwise smoked. There are also concerns that the growing visibility of e-cigarettes might act to renormalize smoking. This presentation will draw on data from two ongoing studies to understand recent trends in perceptions and use of tobacco among children and adolescents in the UK. The first is a study of secondary school-aged adolescents, focused on smoking and e-cigarette use before and after Tobacco Products Directive regulations. The second combines a new survey of primary school-aged children’s perceptions of tobacco and e-cigarettes with historical datasets to understand perceptions of tobacco and e-cigarettes among younger children from 2007 to 2019.

  • Dr Graham Moore Reader, School of Social Sciences and Health & Deputy Director DECIPHer - Cardiff University
15:50 - 16:05

Long term smoking relapse prevention – understanding trajectories of e-cigarette use

In this presentation Dr Notley will discuss pathways through smoking cessation by vaping, considering switching, patterns of dual use and more gradual approaches to cessation. Dr Notley is a social scientist who has led the ‘E Cigarette Trajectories’ (ECtra) project, initially funded by Cancer Research UK, alongside research with vape shops and a wider programme of work focused on developing interventions for relapse prevention. Collecting longitudinal mixed methods data this study has used qualitative data to understand and describe the user experience of stopping and staying stopped from smoking by switching to vaping. The study draws on the nuances of individual patterns of behaviour, identity transitions in quitting smoking, interactions with developing technology, and the fundamental importance of social context in supporting long term relapse prevention.

  • Dr Caitlin Notley Senior Lecturer in Mental Health, Addiction Research Group Lead - Medical School, University of East Anglia
16:05 - 16:20

Vape shops and their role in public health

One of the biggest obstacles facing e-cigarettes is the misinformation and understanding of nicotine.  Tobacco control campaigns have often demonised the addictiveness of nicotine rather than the devastating health consequences of combustion.  Consequently most smokers fear nicotine, a fact that has also been seen in the past with NRT.  The consequences were often under-dosage and a too short period of use.  In order to avoid relapse and dual use, Jacques Le Houezec has spent the last four years training vape shop owners and staff and health professionals about effective strategies for helping smokers understand the importance of adequate dosing and utilising the unique public health resource that vape shops can offer smokers to achieve smoking cessation.

  • Dr Jacques Le Houezec Independent Consultant in Public Health and Tobacco Dependence - Scientist, Smoking Cessation Specialist, Trainer, Rennes, France
16:20 - 16:35

Widening access to e-cigarettes for people with mental health and/or substance use problems

Historically, we have not offered a way out of smoking that appeals to people with a mental health condition and/ substance use problem. We have often excluded them from tobacco control research and indeed, smoking has often been facilitated to reward and punish behaviour.  It’s important that we don’t repeat history by excluding these groups from research, but also from the potential vaping has to offer whilst at the same time, managing risks that may arise. Debbie will discuss the evolution of an e-cigarette friendly smoke-policy in mental health and substance use settings over the last 5 years. She will also discuss how smokers are enabled to find the support that’s right for them at what is one of the most difficult times in their lives.

  • Dr Deborah Robson Senior Post Doctoral Researcher in Tobacco Addiction - Kings College London
16:35 - 16:50

Keynote: Science, compassion, health and human rights – a 21st century drug war in the making?

So much of the current fight over e-cigarettes and tobacco harm reduction reminds me of the struggles over illicit drugs policy that were the focus of my life for the past three decades:  concerns about adolescent drug use driving calls to prohibit all sales, even for adults; widening gaps between scientific research conclusions and public perceptions; indifference to the human rights of drug consumers as well as the ways in which poor people and disfavored minorities can be harmed by paternalistic policies; and failure to understand how bans undermine the ability of governments to regulate markets and protect the health of its citizens.

Both advocates and opponents of tobacco harm reduction may benefit from better understanding both how punitive prohibitionist drug policies often proved ineffective, costly and counter-productive, and how advocates of illicit drug harm reduction and drug policy reform prevailed on a variety of fronts.

  • Ethan Nadelmann Founder and Former Executive Director - Drug Policy Alliance
16:50 - 17:10

Panel Q&A: Tobacco Harm Reduction – reaching the right people in the right way at the right time

  • Smoking is not an equal opportunities killer- does current policy support disadvantaged smokers?
  • Are we learning from the mistakes made in the illicit drugs field?
  • How do we optimise the chances of smokers' stopping smoking by vaping?

  • Dr Graham Moore Reader, School of Social Sciences and Health & Deputy Director DECIPHer - Cardiff University
  • Dr Caitlin Notley Senior Lecturer in Mental Health, Addiction Research Group Lead - Medical School, University of East Anglia
  • Dr Jacques Le Houezec Independent Consultant in Public Health and Tobacco Dependence - Scientist, Smoking Cessation Specialist, Trainer, Rennes, France
  • Dr Deborah Robson Senior Post Doctoral Researcher in Tobacco Addiction - Kings College London
  • Ethan Nadelmann Founder and Former Executive Director - Drug Policy Alliance
  • Louise Ross Vice Chair - NNA
17:10 - 17:15

Closing remarks and end

  • Professor Ann McNeill Professor of Tobacco Addiction - UK Centre for Tobacco and Alcohol Studies (UKCTAS), Kings College London
17:15 - 18:00

Post Summit networking drinks