E-CIGARETTE SUMMIT USA 2021 AGENDA

The full 2021 agenda is now available.  Please click below to open a printable PDF version, or scroll through the program below.  The agenda is scheduled in US Eastern Time.  All presentations will be available to registered participants, 24 hours in advance, so that participants can submit questions for the live panels in advance.  

WELCOME

10:00 am - 10:10 am

Welcome from the Chair

Speaker

Session 1: Science & Evidence

10:10 am - 10:40 am

Keynote: Balancing Consideration of the Risks and Benefits of E-Cigarettes

Regarding e-cigarettes, most US health organizations, media coverage, and policymakers focus on risks to youth. Due to their messaging, much of the public – including smokers – incorrectly consider vaping as dangerous as smoking. Policies intended to reduce adolescent vaping may also reduce adult smokers’ use of e-cigarettes in quit attempts. Because evidence indicates that e-cigarette use can increase the odds of quitting smoking, the health community, media, and policymakers should more carefully weigh vaping’s potential to reduce adult smoking-attributable mortality. This presentation provides an overview of the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youth with the potential benefits of increasing adult smoking cessation.

Speaker

  • Prof Kenneth Warner Professor Emeritus and Dean Emeritus - School of Public Health, University of Michigan

10:40 am - 10:55 am

Assessing the Safety of E-cigarettes: Challenges and Regulatory Implications

Prof Neal Benowitz will explore the current scientific evidence on the safety and health effects of e-cigarettes, including: 1) The nature of cigarette toxicity and health impact 2) Potential toxic exposures from E-cigarettes; comparison to cigarettes 3) The differences by e-cigarette device characteristics 4) long term safety of nicotine 5) Toxicity concerns with flavors. Alongside this summary of the e-cigarette health hazards to date, this session will explore the challenges and unmet needs in epidemiology studies including Animal vs human epidemiology and finally consider the Regulatory implications related to e-cigarette safety.

Speaker

  • Prof Neal L. Benowitz Professor of Medicine and Bioengineering & Theapeutic Sciences - University of California, San Franciso

10:55 am - 11:10 am

The evidence on e-cigarettes for smoking cessation: when is enough enough?

The evidence on the use of e-cigarettes to help adults who smoke quit combustible tobacco is growing year on year. Cochrane reviews are accepted as the gold-standard for investigating the evidence of potential harms and benefits of healthcare interventions. This talk will cover the most recent evidence from the Cochrane living systematic review of e-cigarettes for smoking cessation, highlighting gaps in the evidence as well as areas where certainty is growing. It will also cover other, non-Cochrane evidence, evaluating strengths and weaknesses of the different evidence available, and exploring where research might best serve to move the conversation forward.

Speaker

  • Jamie Hartmann-Boyce Senior Research Fellow and Editor, Cochrane Tobacco Addiction Group - Nuffield Department of Primary Care Health Sciences, University of Oxford

11:10 am - 11:25 am

Break

11:25 am - 11:40 am

A clinician’s perspective: Addressing tobacco cessation and harm reduction in the wake of an “annus horibilis” (or a year like no other)

2020 was a year like no other.  The COVID-19 pandemic affected everyone but especially challenged health care systems.  The social unrest of the “Black Lives Matter” movement led health care systems to increase focus on reducing causes of health disparities and addressing institutional racism.  New research on e-cigarettes and clinical guidelines on tobacco treatment continued to appear but may have been overlooked by distracted clinicians.  After a year like no other, what might a typical U.S. clinician caring for adults be thinking about smoking cessation and e-cigarette use?  Health care systems remain a key conduit for delivering the tobacco cessation and harm reduction treatments needed to reduce tobacco-related morbidity and mortality. This presentation will consider the unprecedented events of 2020—and clinicians’ and health care systems’ responses to them – in order to reflect on opportunities and challenges that might affect the delivery of tobacco cessation treatment to U.S. adults.

Speaker

  • Dr. Nancy A. Rigotti, MD Professor of Medicine, Harvard Medical School - Director, Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston

11:40 am - 12:10 pm

Panel Discussion and Live Q&A: Does current US Policy and discourse discourage adult smokers from viewing e-cigarettes as a harm reduction tool?

Session Responder:  Dr Jasjit S. Ahluwalia, Professor, Behavioural and Social Sciences & Internal Medicine, Brown University, School of Public Health & Alpert School of Medicine
  • Does current US Policy and discourse reflect the evidence on safety and current prevalence of e-cigarette use
  • Are smokers inappropriately discouraged from trying e-cigarettes
  • Have we achieved a point where we can accurately say “E-cigarettes are less harmful than combustible tobacco and are effective for smoking cessation”?

Chair

Session Responder

  • Dr. Jasjit S. Ahluwalia Professor, Behavioural and Social Sciences & Internal Medicine - Brown University, School of Public Health & Alpert School of Medicine

Speakers

  • Prof Kenneth Warner Professor Emeritus and Dean Emeritus - School of Public Health, University of Michigan
  • Prof Neal L. Benowitz Professor of Medicine and Bioengineering & Theapeutic Sciences - University of California, San Franciso
  • Jamie Hartmann-Boyce Senior Research Fellow and Editor, Cochrane Tobacco Addiction Group - Nuffield Department of Primary Care Health Sciences, University of Oxford
  • Dr. Nancy A. Rigotti, MD Professor of Medicine, Harvard Medical School - Director, Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston

12:10 pm - 12:50 pm

Lunch

Session 2: Nicotine, Policy & Regulation

12:50 pm - 12:55 pm

Introduction

Speaker

12:55 pm - 1:10 pm

Can we have a simultaneous compassionate and dispassionate approach to vaping?

Globally, tobacco control researchers, policy makers, advocates etc are passionate and often united in working towards ending the smoking epidemic,  though we choose to take different paths to achieve this ambition. The UK has taken a compassionate approach to vaping, including for groups for whom there is a very high smoking prevalence, such as people who experience mental health problems, misuse substances and those who experience homelessness. However this approach is also evidence based as e-cigarettes have been shown to be beneficial at an overall population level, particularly if youth uptake is constrained. This presentation will discuss why it has been appropriate for England to take a population level approach, as well as a focus on high risk groups at an individual level, to reducing smoking and hence to vaping regulation. It will also give a more personal reflection on responses to nicotine use in society.

Speaker

  • Professor Ann McNeill Professor of Tobacco Addiction - Institute of Psychiatry, Psychology & Neuroscience,, Kings College London

1:10 pm - 1:25 pm

What is the mindset of today’s cigarette smokers?

The tobacco marketplace has changed with the introduction of new nicotine delivery devices. While the public health community has been addressing the dramatic increase of e-cigarette use among youth, FDA recently conducted qualitative research with adult smokers to ascertain their current attitudes and beliefs about cigarettes and other tobacco products. Focus group findings underscore that quitting cigarettes remains difficult. Smokers are often navigating multiple barriers to quitting, including stressors, perceived benefits of smoking, and persistent misperceptions about nicotine and addiction. Findings also revealed an increase in the belief that reducing use is an effective strategy for cessation, and there is low motivation among smokers to abstain from nicotine. While large-scale mass media campaigns and public health cigarette education efforts have contributed to reductions in prevalence rates, an opportunity remains to further educate and address these misperceptions to support long-term cessation. 

Speaker

  • Kathleen Crosby Director, Office of Health Communication & Education - FDA Center for Tobacco Products

1:25 pm - 1:40 pm

Stigma and tobacco harm reduction: what we can learn from other health behaviors

Stigmatizing smoking has been at the heart of tobacco control efforts for decades, which may drive more people to quit but at the same time potentially create new difficulties for smokers, including self-isolation, creation of social groups that might become ‘hardened’ to changing smoking behaviors, and perceptions by the user and society that complete abstinence is the only option.  The stigma associated with a wide variety of behaviors has impeded progress toward improving population health in some cases, such as the reticence in making products and services available that could reduce the risk of communicable disease (eg needle exchanges), as well as harm reduction products that could benefit users and society when an individual addicted to a substance is not able to or chooses not to become completely abstinent (eg NRT, ENDS, smokeless tobacco).  This presentation will explore some of the conflicting aspects of stigma in tobacco control, explore similarities and differences regarding the stigma of using of different addicting substances, and consider some research, practice and policy directions.

Speaker

  • Prof Scott Leischow Professor, College of Health Solutions - Arizona State University & Editor-in-Chief, Tobacco Regulatory Science

1:40 pm - 1:55 pm

Advocating Tobacco Harm Reduction in a Hostile Environment

The recent commentary ‘It is Time to Act with Integrity and End the Internecine Warfare Over E-Cigarettes’ addresses the need to achieve a lifesaving rapprochement between the tobacco control mainstream and the tobacco harm reduction community. Failure to end the warfare and reinstate fealty to good science risks millions of additional premature, smoking-related deaths that could otherwise have been prevented. Numerous instances of the undermining of science, and the scientists behind the science, threaten to impede the objective of furthering the development and dissemination of credible evidence and bringing together the major stakeholders for reconciliation and to join in common cause in this vital endeavour. Protecting youth and supporting adults can and must be achieved simultaneously. We must also listen to the pleas of consumers, many from marginalized communities, who have lived experience as smokers who have transitioned off lethal smoked products with the aid of alternative nicotine-containing products and whose voices have been wrongly ignored, distrusted, rejected, and too often dismissed as serving the interests of the “tobacco industry.”

Speaker

  • Cliff Douglas, JD Director, Tobacco Research Network, Adjunct Professor, Department of Health Management and Policy - School of Public Health, University of Michigan

1:55 pm - 2:10 pm

A targeted approach to using electronic cigarettes for harm reduction in adults

As the debate unfolds on how best to prevent adolescents from using electronic cigarettes, we have lost sight of their potential for harm reduction in adult smokers. Despite decades of availability of evidence-based smoking cessation medications, many adults continue to smoke. In some populations, such as people with COPD, mental health diagnoses or HIV infection, rates of smoking remain 2-3 times that of the general population. I will discuss what we know about using electronic cigarettes for harm reduction in specific populations, as well as where we need additional information.

Speaker

  • Prof Scott Sherman Professor of Population Health, Medicine and Psychiatry - NYU Grossman School of Medicine

2:10 pm - 2:45 pm

Panel Discussion and Q&A: What are the public health objectives – Preventing Nicotine use or ending smoking?

• How do we end the toxic culture that has emerged?

Chair

Speakers

  • Professor Ann McNeill Professor of Tobacco Addiction - Institute of Psychiatry, Psychology & Neuroscience,, Kings College London
  • Kathleen Crosby Director, Office of Health Communication & Education - FDA Center for Tobacco Products
  • Prof Scott Leischow Professor, College of Health Solutions - Arizona State University & Editor-in-Chief, Tobacco Regulatory Science
  • Cliff Douglas, JD Director, Tobacco Research Network, Adjunct Professor, Department of Health Management and Policy - School of Public Health, University of Michigan
  • Prof Scott Sherman Professor of Population Health, Medicine and Psychiatry - NYU Grossman School of Medicine

2:45 pm - 3:00 pm

Break

Session 3: Youth and Adult Data - Public Health Policy

3:00 pm - 3:05 pm

Welcome

Speaker

3:05 pm - 3:20 pm

Adolescent e-cigarette use before and after restrictions on flavored cartridges

In early 2020 the FDA finalized its enforcement policy on unauthorized flavored cartridge-based e-cigarettes, such as fruit and mint.  Consistent with this policy, the JUUL vaping brand removed all cartridge flavors other than menthol and tobacco from the market.  In this presentation I present national, U.S. data on adolescent e-cigarette use and attitudes before and after these restrictions on flavored cartridges.  Outcomes include e-cigarette prevalence, perceived availability of flavored e-cigarettes, as well as changes in use of JUUL and other vaping brands.  The presentation concludes with an assessment of the current state of the evidence on flavors and adolescent use of e-cigarettes and avenues for future investigation.

Speaker

  • Prof Richard Miech Principal Investigator, Monitoring the Future - Institute for Social Research, University of Michigan

3:20 pm - 3:35 pm

The Association Between E-Cigarette Use Among Adolescent Never Cigarette Smokers and Subsequent Cigarette Smoking

This study demonstrates that when controlling for more potential covariates, the strong and positive relationship between vaping by adolescent never smokers and subsequent trial of cigarettes decreases steadily. Using longitudinal data from PATH on U.S. adolescents, ours is the first study to control for both use of other tobacco products and other drugs (marijuana and alcohol in our case), along with commonly included variables. Using earlier waves of PATH data, we report reduced associations between vaping and subsequent smoking, adjusting for these covariates. This association became non-significant when we analyzed the two most recent waves of PATH, wave 4 and wave 4.5. Our study provides empirical evidence that raises questions about the strength of the relationship between youth vaping and subsequent trial of cigarettes.

Speaker

  • Ruoyan Sun Assistant Professor - Dep't of Health Care Organization & Policy, School of Public Health,University of Alabama at Birmingham

3:35 pm - 3:50 pm

21st Century Tobacco Control: Putting Public Health First

A myriad of studies find that tobacco control policies targeting e-cigarettes can increase combustible tobacco use, presumably by reducing incentives to choose vaping over smoking. Given evidence that vaping nicotine is likely far less harmful than smoking combustible cigarettes, these unintended consequences may translate into substantial costs for population health. This presentation will summarize published work on such policies’ intended and unintended effects, present new results estimating effects of banning flavored tobacco product sales, and discuss implications for tobacco control going forward.

Speaker

  • Abigail Friedman Assistant Professor - Dept of Health Policy & Management, Yale School of Public Health

3:50 pm - 4:05 pm

Adolescent substance use: more than e-cigarettes

Adolescents who are frequent users of multiple substances such as alcohol, marijuana, and cigarettes are at significantly higher risk of negative mental, physical, and substance use outcomes in adulthood, but studies often fail to focus on poly substance use, especially among younger adolescents. Dr. Pearson will present recent Youth Risk Behavior Survey data from adolescents ages 11-13 and 14-18 in Nevada, examining patterns of recent poly substance use that account for use of cigarettes, e-cigarettes, alcohol, marijuana, and non-prescription pain medication, and their correlations with mental distress and risk and protective factors that offer potential targets to reduce the prevalence of the riskiest poly substance use patterns.

Speaker

  • Asst. Prof Jennifer Pearson Assistant Professor in Health Administration and Policy, School of Community Health Sciences - University of Nevada, Reno School of Community Health Sciences

4:05 pm - 4:20 pm

Are current e-cigarette policies aligned with health equity goals?

As a new researcher focused on eliminating health disparities, particularly death and disease from combustible tobacco use, how should I feel about tobacco harm reduction?  Working in tobacco control in an area with higher than average smoking prevalence, much of the current tobacco control agenda is focussed on preventing youth vaping. I find that I have more questions than answers: Should our focus be on nicotine addiction or combustible use? Is youth vaping similar to youth marijuana use – an experimental phase that will pass? What is the endgame?

Speaker

  • Jaron King Surveillance Co-ordinator - South Carolina Division of Tobacco Prevention and Control

4:20 pm - 4:55 pm

Panel Discussion and Live Q&A

  • Are we protecting kids or just the “right kind” of kids?
  • Can we de-couple the concern over youth initiation from the concern that youth vaping is a gateway to youth smoking
  • Is youth abstinence more important than adult cessation to achieve a smoke free future
  • Youth use and surveillance – are we asking the right questions and how can this be improved

Chair

Speakers

  • Prof Richard Miech Principal Investigator, Monitoring the Future - Institute for Social Research, University of Michigan
  • Asst. Prof Jennifer Pearson Assistant Professor in Health Administration and Policy, School of Community Health Sciences - University of Nevada, Reno School of Community Health Sciences
  • Ruoyan Sun Assistant Professor - Dep't of Health Care Organization & Policy, School of Public Health,University of Alabama at Birmingham
  • Abigail Friedman Assistant Professor - Dept of Health Policy & Management, Yale School of Public Health
  • Jaron King Surveillance Co-ordinator - South Carolina Division of Tobacco Prevention and Control

4:55 pm - 5:00 pm

Closing remarks

Speaker

Session 4: Tobacco Harm Reduction & Industry Regulation

10:00 am - 10:05 am

Welcome from the Chair

Speaker

10:05 am - 10:20 am

The US “signal-to-noise” ratio: given all the talk, what is happening in the US market post the PMTA deadline in September 2020?

The US market is now on the path to developing a regulated market as the FDA considers applications for approval to market millions of vape products, and starts to enforce against those not engaged in the process. There is so much talk about tighter enforcement, further flavour bans and a mountain of proposed legislation on a state and local level that it is difficult to identify what is likely to happen. But meanwhile, the US nicotine market is continuing to develop and change. In vape, flavour profiles are changing, consumers are moving towards smaller open and closed system pod devices, and disposables are very much still a big part of the market. Synthetic non-tobacco derived nicotine is starting to be offered. New reduced risk products are growing in popularity; nicotine pouches, which may be a disruptor to the chew tobacco market as vape was to combustible cigarettes, are becoming prevalent, and we believe heated tobacco will be rolled out nationally very shortly. This presentation will take a look at some of the latest consumer and market data from ECigIntelligence and TobaccoIntelligence for the US, and discuss some of the market issues which will be important not just for the development of the US, but will impact the market for tobacco harm reduction products globally.

Speaker

10:20 am - 10:35 am

What will a regulated marketplace look like in the United States?

Currently, the e-cigarette marketplace is only partially regulated.  But, FDA has received millions of applications from manufacturers who want to continue to market their e-cigarettes.  The U.S. Courts have required e-cigarette manufacturers to have a marketing authorization from FDA to continue marketing their products after September 9, 2021.  So, what is FDA doing to create a regulated e-cigarette marketplace by September?  How will FDA address youth initiation of e-cigarettes?  For example, how will FDA determine which flavors and e-cigarette types (e.g., open e-cigarettes) will receive marketing authorization?  In addition, to minimizing youth initiation of e-cigarettes, how is FDA going to help adult combusted cigarette smokers have access to e-cigarettes that allow them to switch away from smoking to vaping?

Speaker

  • Matthew R. Holman Director, Office of Science (OS),Center for Tobacco Products (CTP) - U.S. Food and Drug Administration

10:35 am - 10:50 am

The Transition to a Regulated Marketplace – an Applicant Perspective

With the PMTA process for ENDS now fully underway, the United States is on the verge of a transformed ENDS marketplace – one in which the products lawfully on the market are there because FDA has reviewed the scientific evidence and found their availability to be appropriate for the protection of public health (APPH), and company marketing is subject to heightened oversight by FDA.  The combined efforts of FDA and PMTA applicants have created increased potential for such ENDS determined to be APPH to be embraced by the evidence-based public health community as preferable alternatives to combustion cigarettes – and help make smoking history.

Speaker

10:50 am - 11:05 am

The Endgame Revisited

How can we get a spectacular public health win at negligible cost? To paraphrase Lewis Carroll, "if you don't know where you are going, any road will get you there." To see where we could and should be heading, this presentation looks at five clarifying ideas that will set a pro-health direction for tobacco and nicotine policy. We need clarity about: overall goals; evolving technology; human behavior; youth and risk; the information environment; and policy and regulation.?

Speaker

11:05 am - 11:20 am

Break

11:20 am - 11:35 am

Public Health, Politics, & Broken Trust: The Current State of Tobacco Harm Reduction in the U.S

The COVID-19 pandemic has taken the lives of more than 550,000 people in the U.S. since March 2020. This number we are told could have been far larger without the public policy interventions to date, which involved a heavy intervention by public health professionals informed largely by an all-or-nothing tolerance for harm. Meanwhile, nearly half a million lives are lost every year in the United States from cigarette smoking, and the majority of policies we see states and federal lawmakers considering vis a vis tobacco control would actually move more people away from and not toward less harmful products like e-cigarettes. This session will explore the current state of harm reduction politics in the U.S., and examine the resurgence of cigarette use over the past twelve months as a result of these trends.

Speaker

11:35 am - 12:10 pm

Panel Discussion and Live Q&A: Will the transition to a regulated marketplace be a gamechanger?

  • As FDA issues marketing granted orders in response to e-cigarette PMTAs, how should FDA and CDC explain the meaning of such orders and their implications for smokers
  • What will the change in U.S. administrations and leadership at the FDA and CDC mean to the future of ENDS
  • If the PMTA does not conclude by the September deadline, what will happen next?
 

Chair

Speakers

12:10 pm - 12:50 pm

Lunch

Session 5:Tobacco Control and Regulation

12:50 pm - 12:55 pm

Introduction

Speaker

12:55 pm - 1:10 pm

Smoking prevalence and regulatory effects – a global 4 country comparison

Professor Levy will discuss the vaping and smoking regulatory regimes and smoking prevalence trends in Australia, England, Canada and the US.  Applying the SimSmoke tobacco control simulation model, he will present estimates of the effects of vaping on smoking prevalence for each of the countries, and discuss how these results depend on the regulations in effect.

Speaker

  • Prof David Levy Professor of Oncology - Lombardl Comprehensive Cancer Center, Georgetown University

1:10 pm - 1:25 pm

In Search of the New Social Justice for Smokers: Do they have the Right to Harm Reduction?

On November 27, 2001, Dr Cheryl Healton, president and CEO of the American Legacy Foundation, addressed the National Conference on Tobacco or Health on the subject, “Tobacco as a Social Justice Issue.” Dr Healton described the excess burden that tobacco places on society’s poor and underserved populations and recommended ways to expand access to cessation services. She called upon the federal government to hold the tobacco industry accountable for decades of deceptive business practices. And she urged the states to fulfill their moral obligation to use Master Settlement Agreement funds to protect their citizens from future harm from tobacco. 20 years on, Dr Healton will consider what has been achieved and what has changed.

Speaker

  • Dr Cheryl Healton DrPH Dean and Professor of Public Health Policy and Management - School of Global Public Health, New York University

1:25 pm - 1:40 pm

Will New Zealand’s vaping regulations enhance or hinder harm reduction

New Zealand has taken a progressive approach to tobacco harm reduction with the Government actively promoting the role of vaping as a harm reduction tool. In particular for populations experiencing health inequities. Currently, an estimated 5% of NZ adults vape regularly, increasing to 8% for the most deprived. Legislation to control and regulate reduced harm tobacco products and e-cigarettes was passed in mid 2020.  The intent being to balance the benefits of vaping and smokeless tobacco products (as compared to smoking) with concerns about children’s and young people’s access to these products. The legislation favours a more flexible regulatory to vaping controls and will bring some clarity to what has been a totally unregulated e-cigarette market up until now. However, proposed regulations risk undermining the governments objectives, and tip the balance back in favour of smoked tobacco. This presentation will summarise the major changes to the vaping market as a result of recent legislation, and explore whether it will enhance or hinder the goal to reduce tobacco harms and inequities.

Speaker

  • Ben Youdan Director - Youdan Consulting - New Zealand

1:40 pm - 1:55 pm

Will Australia slowly move from hostility to support for tobacco harm reduction

Australia was an early and vigorous adopter of what is now conventional international tobacco control policy. Cigarette taxes were increased 9 times in the last 10 years and Australian cigarette prices are now the highest in the world. Harm minimisation, defined as comprising supply, demand and harm reduction, has been the official national drug policy since 1985. Harm reduction is explicitly supported in the National Tobacco Strategy and the 2003 Framework Convention on Tobacco Control (which Australia has signed). Yet of all High Income Countries (HIC), Australia has been the most hostile in response to tobacco harm reduction, including vaping. It is the only HIC to require a doctor’s prescription for nicotine liquid for vaping. Almost all major Australian health organisations strongly support this approach. Further restrictions, not yet announced in detail, will be introduced on 1 October. Twenty eight government backbenchers, representing 25% of all government members of parliament, publicly criticised proposed new restrictions in June 2020 and December 2020, forcing the Health Minister to retreat. Australian smoking rates have missed official targets twice in recent years and have been almost flat since 2013. New drug harm reduction interventions such as methadone treatment, needle syringe programs and drug consumption rooms were also bitterly resisted for many years before being accepted and acknowledged as effective, safe and cost effective. Like tobacco harm reduction products, they were also strongly supported by compelling and increasing evidence. The significant decline in share price of major tobacco companies in recent years with the impressive growth in companies committed only to tobacco harm reduction products suggests that economic factors will also powerfully influence government policy in Australia and other countries. There is good reason to anticipate a political correction although this will probably take some time and involve many incremental steps.

Speaker

1:55 pm - 2:10 pm

Will the abolition of Public Health England change the UK’s position on e-cigarettes?

At the beginning of April 2021, the UK Government set out its plans for the transformation of public health after the abolition of Public Health England. The vision is ambitious stating that “Health will no longer only be the business of the DHSC, but a core priority for the whole of government. “The vision will be delivered by rolling the national functions of Public Health England back into the Ministry of Health within an Office of Health Promotion (OHP), due to be up and running by October 2021.   The OHP will have a broad remit to drive “action across government on prevention and the wider determinants of health”. The reorganisation is taking place as a new Tobacco Control Plan is under development. Public Health England has played a leading role in establishing the UK’s considered and evidence-based policy position on e-cigarettes. This presentation examines what the impact of its abolition and the reorganisation of public health are likely to be on the UK’s e-cigarette policy going forward.

Speaker

2:10 pm - 2:45 pm

Panel Discussion and Live Q&A: Have e-cigarettes highlighted the different factions, motivations and priorities that exist between tobacco control and public health.

  • Is smoking a social justice issue – are we supporting those that need it the most
  • Does tobacco harm reduction compromise core tobacco control principles?

Chair

Speakers

  • Prof David Levy Professor of Oncology - Lombardl Comprehensive Cancer Center, Georgetown University
  • Dr Cheryl Healton DrPH Dean and Professor of Public Health Policy and Management - School of Global Public Health, New York University
  • Ben Youdan Director - Youdan Consulting - New Zealand
  • Dr Alex Wodak President - Australian Drug Law Reform
  • Deborah Arnott Chief Executive - Action on Smoking and Health (UK)

2:45 pm - 3:00 pm

Break

Session 6:Tobacco Harm Reduction and Public Health

3:00 pm - 3:05 pm

Introduction

Speaker

3:05 pm - 3:20 pm

E-cigarettes as an adaptive relapse prevention/recovery strategy: A missed opportunity?

Cigarette smoking is commonly viewed as a chronic, relapsing problem requiring long-term, repeated attention and multiple quit attempts. Yet the question of whether e-cigarettes may assist with cessation is often examined with a binary, single event, “all or nothing” lens. There may be advantages of using e-cigarettes within a relapse prevention/recovery of smoking abstinence framework when more adaptively used in targeted, individually tailored situations. This presentation will discuss potential approaches of how e-cigarettes can be used in sequential quit attempts to promote abstinence following smoking lapses; the potential role of transitions in self-identity away from being a “smoker”; and research designs to maximize more targeted and tailored approaches to help identify a role for e-cigarettes.

Speaker

3:20 pm - 3:35 pm

Are we Eroding Trust in Tobacco Control?

Successful public health campaigns rely on establishing and maintaining the public’s trust in the recommendations that are given.  This presentation highlights concerns that I have about the erosion of trust in tobacco control that appears to be happening because previously trusted public health officials are staking out policy positions that distort the truth about lower risk alternative nicotine products.  

Speaker

  • Prof Mike Cummings Professor, Dep't Psychiatry & Behavioural Sciences - Medical University of South Carolina

3:35 pm - 3:50 pm

Tobacco harm reduction, human rights, and public health paternalism

Human rights have been invoked strategically as motivation to oppose tobacco industry activities. Analysis of human rights can also be applied to tobacco harm reduction with, arguably, more support. This involves close examination and identification of the limits of public health paternalism, respect for human autonomy and agency, and advocacy for those who are marginalized in society. I will review current public health political dynamics that have placed THR in a subordinate role, and suggest some strategies to level the playing field.

Speaker

  • Dr Ray Niaura Professor of Social & Behavioural Health & Co-Director of the Tobacco Research Lab - School of Global Public Health, New York University

3:50 pm - 4:05 pm

What do we know about the effects of e-cigarette taxes?

The American Lung Association lists as one of their legislative priorities to “raise the tax on e-cigarettes to parity with cigarettes.” In late 2019, the US House of Representatives passed such a tax, and in the current Congressional session legislators have introduced similar bills in both the House and the Senate. Meanwhile, 28 states have enacted e-cigarette taxes of varying magnitudes, with some actually exceeding the cigarette tax equivalency. In this presentation, I summarize the quasi-experimental research on e-cigarette taxes to date. These studies generally find across a variety of populations and data sets, that e-cigarette taxes sharply reduce e-cigarette use and sharply increase more dangerous cigarette use, suggesting that these taxes may overall harm public health. I suggest an alternative legislative priority instead of increasing taxes on alternative combustible tobacco products like cigars, whose taxes are in many cases overdue for raising.

Speaker

  • Dr Michael Pesko Associate Professor, Dep't of Economics - Andrew Young School of Policy Studies, Georgia State University

4:05 pm - 4:20 pm

We’ve seen this before: Tobacco harm reduction opponents mimicking old drug war tactics and rhetoric:

The ways in which those who oppose tobacco harm reduction mimic the tactics of those who opposed reform of illicit drug policies is profoundly disturbing.  Politicians and public health officials ignore the voices and concerns of consumers and others who would most benefit from harm reduction policies.  Government and philanthropic funders focus almost entirely on potential harms and little if at all on benefits, or the role of pleasure, or personal agency, choice and human rights.  Powerful activist groups adapt the rhetoric and lies used by now discredited anti-marijuana groups.  Bans on harm reduction devices are justified in terms of protecting children notwithstanding evidence that they actually fail to protect young people while endangering adults.  Scant attention is given to the potential downsides and unintended consequences of overly restrictive regulations and prohibitions.  Medical associations and professionals accept and propagate claims that have no basis in scientific evidence.  None of this is consistent with responsible public health, good public policy or ethical standards of communication, public advocacy and serious political leadership.  Those who mimic the rhetoric, tactics and abuses of now discredited drug war proponents need to be called out and discredited.

Speaker

4:20 pm - 4:55 pm

Panel Discussion and Live Q&A: What’s the end game?

  • Have the socio-economic disparities in smoking been sacrificed for preventing youth uptake
  • Has tobacco control become an anti-vaping movement?
  • From flavor bans to increasing taxation – what are the intended and unintended consequences

Chair

Speakers

  • Dr Robin Mermelstein Professor of Psychology and IHRP Director - University of Illinois, Chicago
  • Prof Mike Cummings Professor, Dep't Psychiatry & Behavioural Sciences - Medical University of South Carolina
  • Dr Ray Niaura Professor of Social & Behavioural Health & Co-Director of the Tobacco Research Lab - School of Global Public Health, New York University
  • Dr Michael Pesko Associate Professor, Dep't of Economics - Andrew Young School of Policy Studies, Georgia State University
  • Ethan Nadelmann Founder - Drug Policy Alliance

4:55 pm - 5:00 pm

Closing remarks

Speaker