Session 1: Science and Evidence Seminars

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.

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.

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.

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.

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”?
  

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