2024 - Session 4 Seminars

The most serious potential adverse consequence of vaping by adolescents would be future mortality associated with long-term vaping itself or with vaping-induced cigarette smoking – the gateway effect. Whether the gateway effect exists remains a contentious issue. For the purposes of this analysis, we will assume that it does. We assume, as well, that vaping by smokers increases their odds of quitting smoking. While simulation analyses have examined the net impact of vaping on population-level mortality, most finding a net reduction in premature mortality, no study to date has investigated how vaping would affect the future mortality associated with vaping within a single birth cohort of adolescents. The present study employs a simulation model to evaluate the mortality impact, over their entire lifetimes, of vaping by members of the cohort of 12-year-olds in 2016. Findings indicate that, under some assumptions, vaping will reduce the cohort’s lifetime premature mortality, while under others, it will increase premature mortality. In all cases, however, the impact of vaping on the cohort’s lifetime mortality will be minuscule.

In this presentation, Professor Ron Borland will question if the conventional goal of many in public health to eliminate all nicotine use is achievable, and whether a transition to the use of harm-reduced nicotine products is inevitable.  Furthermore, given the enormous cost of smoking, should governments look to facilitate this transition rather than inhibit it?

Prof Borland will present data, specifically looking at levels of smoking in young adults in countries where they have been exposed to strong anti-smoking messages all of their lives, including countries such as Australia, where access to vaping products is technically illegal.  Prof Borland will examine the potency of conventional tobacco control armoury tools, such as health warnings and price, both before and after vaping started to become popular.  Finally,  given the enormous costs of allowing people to continue to smoke, or effectively forcing them to because of a lack of access to viable alternatives, Prof Borland will consider the frameworks that will most rapidly achieve a transition away from smoked tobacco, while at the same time minimizing the inevitable use by adolescence.

E-cigarettes have been the most commonly used tobacco product among adolescents in the United States for nearly a decade. There is broad consensus that adolescents should not use any form of tobacco product, and yet there are no published studies of vaping cessation interventions for teens. This presentation will describe the results of a randomized, controlled clinical trial conducted from October 2021 to October 2023 that compared a text message intervention to an assessment-only control among a diverse and high-risk sample of 1,503 U.S. teens ages 13-17. Results from this trial will be placed in the context of ongoing national public education efforts to disseminate the intervention, which have yielded uptake among more than 700,000 teens and young adults since the program launched in January 2019.

Widespread misperceptions of the health risks of nicotine undermine use of nicotine replacement therapy for smoking cessation, and potentially, switching from combusted to non-combusted tobacco and nicotine products. They may also impact the public health benefits of FDA’s actions, including modified risk tobacco product (MRTP) authorizations and a reduced nicotine product standard for cigarettes. Dr. Villanti will present findings from a national randomized controlled trial testing the effects of nicotine corrective messaging on beliefs about nicotine, nicotine replacement therapy (NRT), e-cigarettes, and reduced nicotine content (RNC) cigarettes.

• Is ending smoking and nicotine use at the same time a realistic public health goal at the population level?
• How can THR be successfully incorporated into tobacco control?
• What are the influencing factors that impact public risk perceptions on both smoking and nicotine use and how can messages to promote vaping cessation encourage quitting without relapse to smoking?
• What does the future look like for youth who currently vape? 

"It was the best of times, it was the worst of times..." is the famous opening line of Charles Dickens’ historical novel, set during a period of revolution and change.  In this session, Tom Glynn will lead a conversation with Ann McNeill and Robin Mermelstein exploring the scientific, cultural and policy questions that e-cigarettes and novel nicotine products pose for governments, scientists, and the public health community.  Drawing on their experiences of working in countries with very different approaches, they will consider the array of paradoxes that have emerged in the fight to end smoking.