Let's talk e-cigarettes

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, 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 interview Professor Jonathan, 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 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.

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.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Harry Tattan-Birch. In the September episode Jamie Hartmann-Boyce interviews Harry Tattan-Birch from the Department of Behavioural Science and Health, University College London. Harry Tattan-Birch talks about their team's recent randomised controlled trial examining whether, in adults receiving behavioural support, offering e-cigarettes together with varenicline helps more people stop smoking cigarettes than varenicline alone. Tentative evidence suggests that offering e-cigarettes alongside varenicline to people receiving behavioural support may be more effective for smoking cessation than varenicline alone. https://doi.org/10.1093/ntr/ntac149 Harry Tattan-Birch also discusses his research into heated tobacco products. This work was funded by the Oxford University Public Policy Challenge Fund and Cancer Research UK. Jamie and Nicola also bring us up to date with the literature search conducted between July and September 1st 2022. The July, August and September searches found 6 new studies. We will include the studies we have found in future updates of the Cochrane review. 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

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Dr Francesca Pesola. In the June episode Jamie Hartmann-Boyce talks with Francesca Pesola from the Wolfson Institute of Population Health Queen Mary University of London. Dr Francesca Pesola talks to Associate Professor Jamie Hartmann-Boyce about the results from the trial comparing e-cigarettes to nicotine patches for smoking cessation in pregnant women. Professor Tim Coleman discussed this study in the May 2021 podcast and the results have now been published in Nature Medicine, Hajek et al 2022 (DOI: 10.1038/s41591-022-01808-0). Dr Pesola outlines the need to identify smoking cessation aids to help women quit during pregnancy. Dr Pesola discusses the results of their randomised control trial of 1,140 participants comparing refillable e-cigarettes with nicotine patches. In this trial pregnant women who smoke were randomized to e-cigarettes or nicotine patches. Dr Pesola reports that the unadjusted analysis of the primary outcome of validated quit rates at the end of pregnancy were not found to be significantly different between the e-cigarette and nicotine patch arms. However, Dr Pesola explains that some people in the study used non-allocated products, for example people in the nicotine patch group were also found to be using e-cigarettes. This meant that if they then quit there was uncertainty as to whether the quitting behaviour was due to the nicotine patches or to the e-cigarettes. The study team had anticipated this behaviour and pre-specified that they would exclude people who were abstinent and who had used non-allocated products. Dr Pesola reports that after doing this e-cigarettes were found to be more effective than patches. The safety profile was similar for both study products, however, low birthweight (

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Neal Benowitz. In this episode Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the emerging evidence in e-cigarette research and interview Professor Neal Benowitz. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches. Long description In the May episode Jamie Hartmann-Boyce talks with Neal Benowitz, Emeritus Professor at the University of California San Francisco, Professor Benowitz practices medicine, cardiology and clinical pharmacology and has a particular interest in tobacco as a major risk factor for cardiovascular disease. Professor Neal Benowitz talks to Associate Professor Jamie Hartmann-Boyce about the toxicological data from studies of e-cigarettes. He stresses the importance of comparing e-cigarette use to combustible cigarette use, as the exposure to biomarkers that we can measure is much lower in people who vape than in people who use combustible cigarettes. Professor Benowitz points out that many e-cigarette users have been long-term combustible cigarette users so it is difficult to separate out the effects of each. He highlights the need for longitudinal studies among people who have only used e-cigarettes and have not used combustible cigarettes. Professor Benowitz also discusses the need to look at the different types of e-cigarettes, there are many different products and toxicity will vary between the different e-cigarette devices. Jamie and Nicola discuss recent work comparing biomarkers of harm. Exclusive e-cigarette use was associated with lower levels of biomarkers of harm than exclusive use of combustible tobacco, or use of a combination of combustible tobacco. This work was funded by the Oxford University Public Policy Challenge Fund and Cancer Research UK. Jamie and Nicola also bring us up to date with the literature search conducted on May 1st 2022. The May search found 2 new studies, 3 new ongoing studies and 2 records linked to previously identified studies. We will include the studies we have found in future updates of the Cochrane review. 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

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Alex Liber. In the April episode Jamie Hartmann-Boyce talks with Assistant Professor Alex Liber, Department of Oncology at Georgetown University's School of Medicine, Washington DC, USA. Alex Liber discusses his work at the intersection between markets, public policy, and public health. Alex Liber discusses global tobacco control policy research and tax and price policy. He talks about why different countries react differently to policies and to why tobacco control is seen as the battle of politics, business, and health. He discusses the need for comparative regulatory language. Alex discusses the different e-cigarette policies adopted around the world. Turning to flavours Alex tells us about his work with his colleagues at Georgetown and the University of Michigan on the potential effects of a ban on the sale of menthol cigarettes in the United States. He expanded this work to on menthol cigarettes to look at European sales data and to the effect of the European Union's menthol cigarette ban of menthol cigarette sales in Poland. He reports that although the share of menthol cigarettes sales was 30% in Poland, cigarette sales overall did not drop. He explains that tobacco companies were able to convert their menthol cigarette smokers into standard flavour cigarette smokers, via rebranding cigarettes and flavouring cards. Alex is interested in documenting industry responses. Alex also discusses work looking at e-cigarette flavour bans and temporary bans in the US. Jamie and Nicola also bring us up to date with the literature search conducted on April 1st 2022. The April search found 4 new ongoing studies. We will include the studies we have found in future updates of the Cochrane review. For more information on the full Cochrane review updated in September 2021 see: https://doi.org/10.1002/14651858.CD010216.pub6 or our webpage