University College London team:

Population and individual approaches to smoking cessation

UCL team led by Prof. Jamie Brown

Funder: Cancer Research UK

Background

This is a series of surveys that started in 2006 and has collected data from over 280,000 adults in England across 160 surveys.

Research details

These surveys continue to look, among other things, at use of e-cigarettes among the population in England, and how e-cigarette use is related to smoking rates, quit attempts and quit success. The survey was recently expanded to Scotland and Wales, and also includes questions relating to COVID-19. Results up to now can be found here: http://www.smokinginengland.info/

E-cigarettes and novel nicotine products for smoking cessation and harm reduction

UCL team led by Harry Tattan-Birch

Funder: Public Health England

Background

E-cigarettes and other products which deliver nicotine without the harmful substances found in cigarette smoke have become increasingly popular among smokers wanting to quit or cut down. More data are needed on how these products are perceived and used and how they impact upon smoking behaviour.

Research details

This project will investigate the use of e-cigarettes and other cigarette alternatives, using interviews and a nationally-representative survey. It will examine how and why individuals select, use and discontinue using these products, how the products are viewed, how such views change over time, and the extent to which these products help people to cut down or quit smoking.

The benefit of offering an e-cigarette starter kit to smokers attempting to stop smoking with Champix

UCL team led by Prof. Lion Shahab

Funder: Global Research Awards for Nicotine Dependence (GRAND, supported by Pfizer) & Cancer Research UK

Background

The experience from English stop smoking services suggest adding e-cigarettes to stop-smoking medications and support could improve quit rates.

Research details

Smokers who attend stop smoking services will be allocated by computer to receive one of two interventions. 1. Usual care consisting of the stop smoking medicine Champix together with support (N=633), or 2. The same treatment plus a refillable e-cigarette starter kit (N=633). The study will compare quit rates in the two study arms at three months.

London South Bank University Team

E-cigarettes versus usual care to help smokers attending homeless centres

LSBU Team led by Prof. Lynne Dawkins

Funder: National Institute for Health Research - PHR

Background

E-cigarettes can help smokers quit, but the cost may put off people who are hard up. In this first preliminary study, we wanted to know if smokers who are homeless would be interested in switching from smoking to using e-cigarettes.

Research details

Four homeless centres were asked to provide either standard advice on smoking and referral to local stop smoking service, or an e-cigarette starter pack and 4-weeks supply of e-liquid. The initial project showed that it is feasible to recruit and retain participants in homeless centres, and that e-cigarettes were considered helpful. We now plan a full trial to see how many smokers at homeless centres can be helped by e-cigarettes, compared to usual care.

Tailored interventions to assist smokers to stop smoking using e-cigarettes (TASSE)

LSBU Team led by Prof. Lynne Dawkins

Funder: Medical Research Council - PHIND

Background

E-cigarettes are now the most popular method for quitting smoking, but many smokers who try e-cigarettes don’t continue, because they do not find them satisfying. Vapers often say that it may take some experimentation to find the right device, nicotine strength and flavour. This study is testing the effectiveness of offering advice to first time e-cigarettes buyers, compared to what smokers usually do – i.e. making their own choice about what to purchase.

Research details

We have previously developed tailored advice on choice of e-cigarette device, nicotine concentration in e-liquid and flavour; and also on providing information on e-cigarettes reducing harms from smoking, and technical support and smoking cessation advice delivered via mobile phone text messages. We will now explore which component (or combination of components) of this approach is associated with quit rates at 3 months. The elements of the advice that seem effective will then be examined in a randomised trial. To date, 1,184 participants have been recruited, and we are currently collecting 3 month follow up data.

Testing JUUL: Is the EU-TPD (Tobacco Product Directive)-compliant JUUL sufficiently satisfying to UK smokers?

LSBU Team led by Dr. Catherine Kimber

Funder: Cancer Research UK

Background

JUUL is a novel nicotine delivery device available in the US with a high nicotine content, but in Europe, it is allowed to have only low nicotine levels. It is not known whether the EU version helps smokers to switch from tobacco smoking, or whether higher nicotine concentrations should be recommended.

Research details

The study will recruit 20 participants who will use, on two separate occasions, the EU and the US versions of Juul. We will measure blood nicotine, craving relief, subjective experiences and liquid consumed. Following the lab sessions, participants will be given the EU JUUL and 2-weeks’ supply of TPD compliant pods to take away. After 2 weeks we will interview them to ask about their cigarette smoking, JUUL use, quit attempts, and experiences of using the device both in and outside the lab. Data collection is on hold due to the covid-19 pandemic.

National and local audit of smoking, e-cigarette and cessation support policies at homeless services

UCL/LSBU Team led by Dr. Sharon Cox

Funder: Cancer Research UK

Background

Homeless charities vary greatly in how they treat smoking. Some have clear smoking and vaping polices and links with stop smoking services; others do not.

Research details

We are gathering information about smoking and e-cigarette policies and support offered across homeless charities in the UK. We will use the information to develop the best policies and ways of helping homeless smokers to quit. We are currently recruiting 100 local homeless centres to complete an online survey.

Queen Mary University of London Team

Helping pregnant smokers quit: electronic cigarettes versus nicotine patches

QMUL team lead by Prof. Peter Hajek

Funder : National Institute for Health Research - HTA

Background

E-cigarettes are a popular way of stopping smoking, and could be of benefit to pregnant smokers as well. Treatments in pregnancy need to be safe, and the trial is evaluating not just whether e-cigarettes help pregnant smokers quit, but also whether they are safe for them.

Research details

Pregnant smokers were allocated by a computer to receive either advice and support by specialists over the phone alongside nicotine patches, or the same advice and support alongside e-cigarettes. The two groups will be compared in numbers who quit smoking at the end of pregnancy, and in adverse effects and birth and maternal outcomes. The study has recruited 1140 pregnant smokers as planned, and we hope the results will be available early 2021.

Do e-cigarettes help smokers quit when not accompanied by intensive behavioural support?

QMUL team lead by Dr. Katie Smith

Funder: National Institute for Health Research - HTA

Background

We recently showed that e-cigarettes are more effective in helping smokers quit than nicotine replacement treatments (NRT), such as patches or chewing gum (click here for details). E-cigarettes and NRT were used with specialist stop-smoking advice and support, provided every week for four weeks. In this trial, we want to see if e-cigarettes work with less support.

Research details

Smokers will be randomly allocated to three study arms. 1. Receiving by post an e-cigarette starter pack with advice to purchase further supplies of e-liquid of the preferred strength and flavour themselves; PLUS five weekly support telephone calls from an e-cigarette helpline. 2. The same e-cigarette starter pack and advice, with only the initial one-off telephone advice. 3. Enlisting in the NHS Smokefree Quit Now online programme that provides support for 28 days, and is currently the most economical approach in use. A total of 1,170 smokers will be recruited and we will determine how many in each study arm have stopped smoking 6 and 12 months later.

How does dual use of e-cigarettes and conventional cigarettes change over time?

QMUL team lead by Prof. Peter Hajek

Funder: Cancer Research UK

Background

Many smokers who start to use e-cigarettes sometimes smoke and sometimes vape. Little is known about the way such use develops over time, and what influence media stories about vaping may have on this behaviour.

Research details

Dual users are asked questions about their vaping and smoking, and about media stories concerning vaping that they have noticed, at 3-monthly intervals. 503 participants were recruited. The study will continue for 10 years, with twice a year surveys. The results from the first 12 months are complete and we hope to publish them in early 2021.

Effects of reduced-risk nicotine delivery products on smoking prevalence and cigarette sales (Gateway into or out of smoking?)

QMUL team lead by Prof. Peter Hajek

Funder: National Institute for Health Research - PHR

Background

Several products provide smokers with nicotine without chemicals that make smoking dangerous to health. These include Swedish snus (oral tobacco prepared in a way that minimises health risks), products that heat tobacco rather than burn it, and e-cigarettes. There is a concern that these products encourage smoking (a gateway into smoking); but also the hope that they replace smoking, especially among young people (a gateway out of smoking).

Research details

A number of countries keep records, year by year, of how many people smoke, and how many use the alternative products. Records also exist on sales of cigarettes and of the other products over time. We will examine how changes in use of alternative nicotine products over time relate to changes in smoking and in cigarette sales. We will also compare countries that allow and countries that ban these products in these time trends. The research is due to start in November 2020.

Nicotine delivery and user reactions to IQOS and different types of e-cigarettes

QMUL team lead by Dr. Dunja Przulj

Funder: Cancer Research UK

Background

Different types of e-cigarettes and other alternatives to smoking, such as ‘heat not burn’ products, provide different amounts of nicotine to people that use them. Knowing how much nicotine these products provide can show their potential to help people quit smoking.

Research details

A group of vapers have tested, under the same conditions, different e-cigarettes, the JUUL devices (both US and UK versions with different levels of nicotine), their own cigarettes, and in this latest study, the heat-not-burn tobacco product, IQOS. During testing sessions, participants use the product as they like for 5 minutes, and blood samples are taken for half-hour. Participants also rate the products. Data we already have allow us to compare the products with each other.

The findings from this project which have been been published so far can be found by clicking:

Nicotine delivery to users from cigarettes and from different types of e-cigarettes

Initial ratings of different types of e-cigarettes and relationships between product appeal and nicotine delivery

Nicotine delivery and users’ reactions to Juul compared with cigarettes and other e‐cigarette products

UK Research

Current e-cigarette research

24/09/20 Anna Phillips-Waller

The US version of electronic cigarette Juul delivers higher and faster nicotine levels than other e-cigarettes

24/09/20 Anna Phillips-Waller

Helping smokers quit by giving out e-cigarettes costs less and achieves better results than giving out NRT

24/09/20 Anna Phillips-Waller

E-cigarettes are more effective than nicotine replacement treatments in helping smokers quit

08/09/20 Anna Phillips-Waller