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Harm Reduction

We have a number of projects which come under the heading of harm reduction, aiming to reduce the harmfulness of nicotine use for those who wish to continue using it, or those who cannot stop smoking. 

Longitudinal Online Survey 

Professor Ann McNeill conceived the survey in collaboration with UCL researchers with an aim to exploring in detail the use of electronic cigarettes in a longitudinal cohort of smokers and recent ex-smokers. This survey is conducted with IPSOS Mori in Great Britain using an online panel. It includes a wide range of questions on smoking and electronic cigarettes. The initial wave in November 2012 surveyed 5000 smokers and recent ex-smokers, follow-ups were conducted in December 2013 and December 2014, a replenished wave was carried out in May 2016, and we carried out the fifth wave in June 2017. We have published several papers from this survey to date. Cancer Research UK currently funds this survey through a grant with Principal Investigators Dr Timea Partos (member of the Nicotine Research Group from April 2015-June 2019) and Dr Leonie Brose. PhD and MSc students may also utilise the data. 

International Tobacco Control Policy Evaluation Project (ITC Project) 

The ITC Project was the first-ever international cohort study of tobacco use and provides a systematic evaluation of tobacco control policies (particularly those in the World Health Organisation Framework Convention on Tobacco Control). The ITC Project involves over 100 collaborators worldwide and conducts cohort surveys in more than 25 countries. Professor Ann McNeill (a founding member since 2001) and Dr Sara Hitchman (joined 2006) lead the UK research, and have published 63 papers from the ITC Project. In 2016, we helped secure two prestigious grants to allow our involvement in the ITC Project to continue for the next five years, these include a US NIH grant to fund research in England, Canada, and the US, and an EU Horizon 2020 grant to fund research in seven EU countries, including Hungary and Romania. 

These new grants will focus mainly on the relationship between electronic cigarettes and tobacco cigarettes and the impact of policies on the use of each product and quitting behaviours. Youth surveys in England, Canada and the US are also included, and Dr Sara Hitchman recently won an award in order to evaluate different electronic cigarette policies between Scotland and England. PhD and MSc students may also utilise the data. 

Developing a Tool for Measuring Norms in Smoking and Nicotine Use 

There is widespread concern that the introduction of electronic cigarettes is renormalizing ordinary cigarette smoking and nicotine use, however no tool exists to assess this concern. This project therefore aims to develop a valid and reliable tool to assess norms towards ordinary cigarettes and nicotine use, which can be used over time to determine the influence of electronic cigarettes on smoking norms. It consists of a systematic review to identify existing measures and develop new ones, cognitive testing to establish understanding and refine measures, and pilot testing to establish validity and reliability. 

  • Systematic review 
  • Pilot testing 
  • Proposed toolkit 

We recently published a summary of preliminary work in this area on the PHRC website and the Open Society Institute website. We are encouraging researchers to use our recommended measures and feedback their findings to encourage dialogue in this area. Ms Katie East is further developing this research for her PhD. We have included some of the measures in our other survey. 

Action on Smoking and Health (ASH) Longitudinal Youth Survey 

In collaboration with the charity Action on Smoking and Health, Professor Ann McNeill, Dr Sara Hitchman and Ms Katie East carried out research on a longitudinal survey to support understanding of youth smoking and e-cigarette use behaviour. The findings will be written up for publication. 

Relapse Prevention 

Reduction in relapse following discharge from settings where smoking is prohibited. Professor Ann McNeill is a co-investigator on a relapse prevention project led by Professor Hajek and Dr McRobbie at Queen Mary University of London. Professor Ann McNeill is responsible for the qualitative research component of the trial and is assisted by Dr Catherine El Zerbi. This project is funded by the National Institute of Health Research (NIHR). 

Update to the Public Health England (PHE) evidence review on e-cigarettes – Vaping in England: An evidence update 2019 

In 2019, Professor Ann McNeill, Dr Leonie Brose, Dr Rob Calder, Prof Linda Bauld (University of Edinburgh) and Dr Debbie Robson published an updated report to the 2018 PHE evidence review on e-cigarettes titled Vaping in England: an evidence update

Summary of the 2019 report available here

Public Health England (PHE) evidence review on e-cigarettes and heated tobacco products, 2018 

Professor Ann McNeill, Drs Leonie Brose, Rob Calder and Debbie Robson, in collaboration with Professor Linda Bauld (University of Stirling), Professor John Britton (University of Nottingham) and Professor Peter Hajek (Queen Mary University of London), authored a 2018 PHE evidence review, an update of the landmark 2015 PHE review on health impact of e-cigarettes

Landmark Public Health England (PHE) report on health impact of e-cigarettes, 2015 

Professor Ann McNeill, Drs Leonie Brose, Sara Hitchman and Rob Calder, in collaboration with Professor Peter Hayek (Queen Mary University of London) and Dr Hayden McRobbie (Wolfson Institute for Preventive Medicine), authored a landmark PHE review estimating that e-cigarettes are 95% less harmful than smoking and could potentially help smokers quit. 

The breadth of impact of this report has: 

  • Led to the triggering of NHS trust policies on e-cigarettes in greater Glasgow and Clyde 
  • Led to the public health consensus statement on e-cigarettes by 12 UK public health organisations 
  • Influenced the development of the Yorkshire and Humber Tobacco Control Network's position on e-cigarettes, as set out in Breathe 2025's 'Tobacco Control Consensus on E-Cigarettes' 
  • Influenced the development of the NCSCT's revised briefing for stop smoking practitioners (published in Jan. 2016)