ICYMI: selected TC research published in July 2022

This post identifies selected articles and books published in July 2022 that should be of interest to the tobacco regulator and which are available to the general public.

Books:

In Quit Smoking Weapons of Mass Distraction, emeritus professor of Public Health Simon Chapman draws on his decades of experience as a researcher and advocate in tobacco control to offer advice on where our attention should - and should not - be focused. This free e-book offers his analysis of the way in which promotion of assisted quitting has been a distraction from more powerful options for reducing smoking. 

His Australian colleague, Mike Daube recommends: “This is a splendid read for anyone interested in what really works to reduce smoking, and what helps to keep Big Tobacco in business. In Simon Chapman’s typically trenchant style, it tells you everything you want to know (and some people won’t want to know) about the myths and realities of smoking cessation and other aspects of tobacco policy. All this alongside lessons learned from a lifetime’s work on tobacco. Top class – don’t miss it.”

Quit Smoking Weapons of Mass Distraction
Simon Chapman
Sydney University Press, July 2022

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Oxford University Press published "Policy Success in Canada", an open-access collection of 22 case-studies where Canadian governments and communities have successfully addressed public concerns through policy change. The editorial team that collected these studies was led by Dr. Evert Lindquist of the University of Victoria. The chapter on Canada's Long March Against Tobacco traces events over the past 100 years -- from the first failed attempts to legislate tobacco in the early 1900 to the more recent successes and challenges. 

Policy Success in Canada Cases, Lessons, Challenges
Edited by Evert Lindquist, Michael Howlett, Grace Skogstad, Geneviève Tellier, and Paul t' Hart. 
Oxford University Press (July 30 2022)

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Articles

Cessation

The article on "Tobacco Addiction" written by Dr. Selby and Dr. Zawertailo and published in the New England Journal of Medicine was profiled in a separate post. This review updates advice to physicians to support quit attempts. Accessing the article is free, but requires registration.

Selby, P and Zawertailo, L. Tobacco Addiction
N Engl J Med 2022; 387:345-354

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The real-life experience of 1,045 English smokers who attempted to quit smoking between 2015 and 2020 was reviewed by a research team lead by Sarah Jackson and the results were published in Real-world effectiveness of smoking cessation aids: A population survey in England with 12-month follow-up. The self-reported success of those who used quitting aids was assessed against that of the 40% who quit on their own. Those who reported using varenicline were more than twice as likely to have quit, but there was no difference for those who used e-cigarettes, prescription NRT, over-the-counter NRT or traditional behavioural support.

Jackson SE, Kock L, Kotz D, Brown J. Real-world effectiveness of smoking cessation aids: A population survey in England with 12-month follow-up, 2015-2020. Addict Behav. 2022 Jul 25;135:107442. doi: 10.1016/j.addbeh.2022.107442. 

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Smoking and vaping behaviours

Tobacco and cannabis.  Among the many articles published this summer by the ITC consortium was one which suggests that 3 in 10 Canadian daily smokers are regular users of cannabis. Shanon Gravely is lead author on the study which found that smokers who use cannabis more than once a week are also "more likely to be younger, have lower income, be experiencing financial stress ...have depressive symptoms, use alcohol more frequently and binge drink, use other tobacco/nicotine products, and perceive smoking cannabis as low health risk and less harmful than smoking cigarettes."

Gravely S, Driezen P, McClure EA, Hammond D, Michael Cummings K, Chan G, Hyland A, Borland R, East KA, Fong GT, Schauer GL, Quah ACK, Ouimet J, Smith DM. Differences between adults who smoke cigarettes daily and do and do not co-use cannabis: Findings from the 2020 ITC four country smoking and vaping survey. Addict Behav. 2022 Jul 21;135:107434. doi: 10.1016/j.addbeh.2022.107434. 

Gravely et al. 

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Tobacco and vaping among adolescents. Data from the longitudinal COMPASS survey were used to explore whether the involvement of public health agencies in school-based programming was associated with differences in substance use in those schools. Trish Burnett was the lead author on this report which found that overall there was no difference in smoking and vaping among schools where local health units were involved and those where they weren't, but that some differences were seen in schools with higher or lower rates of use.  

Burnett T, Battista K, Butt M, Sherifali D, Leatherdale ST, Dobbins M. The association between public health engagement in school-based substance use prevention programs and student alcohol, cannabis, e-cigarette and cigarette use. Can J Public Health. 2022 Jul 21:1–10. doi: 10.17269/s41997-022-00655-3. 

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Vaping among adolescents. Analysts working at Statistics Canada compiled data from three surveys to identify the circumstances associated with higher rates of e-cigarette use. Michelle Rotermann and her colleague identified social (having friends who vaped), behavioural (having used alcohol, cannabis or tobacco and having worked, school performance), family (having parents who did not know where they were) and demographic (being male and Canadian-born) factors were associated with higher rates of vaping. The study also found that among teenagers who both smoked and vaped, e-cigarettes came first for two-thirds.

Rotermann M, Gilmour H. Correlates of vaping among adolescents in Canada. Health Rep. 2022 Jul 20;33(7):24-35. doi: 10.25318/82-003-x202200700003-eng. PMID: 35862070.

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Health effects of tobacco use or vaping 

Health effects of tobacco. The Global Burden of Disease project published a review of the burden of chronic obstructive pulmonary disease (COPD), noting that nearly half of smokers world-wide develop COPD. Of the 3.3 million deaths from COPD world-wide in 2019, there were 8,312 in Canada. The data linked to this paper shows that while deaths from tobacco-caused cardiovascular disease have fallen in Canada since 1990, this has not been the case for COPD or cancers.  (Data is available for non-commercial use upon registration)

Safiri S, Carson-Chahhoud K, Noori M, Nejadghaderi SA, Sullman MJM, Ahmadian Heris J, Ansarin K, Mansournia MA, Collins GS, Kolahi AA, Kaufman JS. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022 Jul 27;378:e069679. doi: 10.1136/bmj-2021-069679. PMID: 35896191.

IMHE: Global Burden of Disease Study data

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Health effects of e-cigarettes. Another review of the health effects of e-cigarettes was published, this one focusing on the differing methodologies used by researchers working in this area. With lead author Nargiz Travis, this research team found that many of the studies did not satisfy AMSTAR-2 criteria. Nonetheless, the report  found "that short-term use of e-cigarettes may be associated with acute cardiopulmonary risks, although to a lesser extent than cigarette use. Long-term e-cigarette use may have pulmonary/respiratory benefits in those who switch from chronic cigarette smoking, particularly in individuals with asthma and chronic obstructive pulmonary disease (COPD). Evidence on intermediate and long-term carcinogenic effects is lacking." The authors recommended more consistency of reporting and more research on newer devices.

Travis N, Knoll M, Cadham CJ, Cook S, Warner KE, Fleischer NL, Douglas CE, Sánchez-Romero LM, Mistry R, Meza R, Hirschtick JL, Levy DT. Health Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations. Int J Environ Res Public Health. 2022 Jul 25;19(15):9054. doi: 10.3390/ijerph19159054. PMID: 35897421; PMCID: PMC9330875.

Travis et al, 2022

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