The Past is Prologue: Why bad health effects research leads to bad policy decisions

During this talk, Dr Steve Cook will discuss how many of the methodological problems found in cross-sectional studies on the health effects of e-cigarette use are at risk of being repeated for any nicotine or tobacco product marketed as a ‘safer alternative’ to cigarettes. Using nationally representative cross-sectional data from Wave 7 of the Population of Tobacco and Health (PATH) Study from the United States, Dr Cook will provide an example of a seemingly robust but spurious association between oral nicotine pouches and chronic obstructive pulmonary disease (COPD) and will discuss why all cross-sectional health effects studies should be interpreted with extreme caution unless they examine dose-response relationships and account for temporality and cigarette smoking confounding. The session will conclude by emphasizing the importance of developing a best practice framework to ensure that poorly constructed health effects research doesn’t lead to bad tobacco regulatory decision-making.