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Francesca Pesola, Anna Phillips-Waller, Emma Beard, Lion Shahab, David Sweanor, Martin Jarvis & Peter Hajek.

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Francesca Pesola ¹, Anna Phillips-Waller ^1,*, Emma Beard ², Lion Shahab ², David Sweanor ³, Martin Jarvis ², Peter Hajek ¹

¹ Wolfson Institute of Population Health, Queen Mary University of London, London, UK
² University College London, Tobacco and Alcohol Research Group, Department of Behavioural Science and Health, London, UK
³ Faculty of Law and Centre for Health Law, Policy and Ethics, University of Ottawa, Ottawa, Canada
^* Corresponding author Email: a.phillips-waller@qmul.ac.uk

Disclosure of interests of authors

Full disclosure of interests: Completed ICMJE forms for all authors, including all related interests, are available in the toolkit on the NIHR journals Library report publication page at https://doi.org/10.3310/RPDN7327.

Primary conflict of interest:

Peter Hajek has provided consultancy to and received research funding from Pfizer.

Lion Shahab has received honoraria for talks, an unrestricted research grant and travel expenses to attend meetings and workshops from Pfizer and an honorarium to sit on an advisory panel from Johnson&Johnson, both pharmaceutical companies that make smoking-cessation products. He has acted as paid reviewer for grant-awarding bodies and as a paid consultant for health-care companies. Other research has been funded by the government, a community-interested company (National Centre for Smoking Cessation) and charitable sources.

David Sweanor has received travel expenses for conferences to the Tobacco Harm Reduction – Challenges and Opportunities in the 21st Century conference (Tbilisi) and The Global Forum on Nicotine conference (Warsaw). He is an unpaid member on committees for pedestrian and cyclist issues and civil liberties. He is Chair of the advisory board of the Centre for Health Law, Policy and Ethics at the University of Ottawa, an adjunct law professor at the same university, on a global advisory committee for the Boston University School of Public Health, and belongs to/advises/funds groups working on a wide range of topics (e.g. nicotine, public health, transportation policy, homelessness, active transportation: all unpaid).

All other authors have no conflicts to disclose.

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Responses to this report

Response by Matthew Peters on 24 September 2023 at 11:20 AM
Data cutoff excludes critical recent information from Australia that better answers key questions
This is an interesting compilation of data, albeit rather out of date, for what it does not show. The very different approaches to EC policy taken before 2019 scarcely show a difference between the countries studied. There is little, if anything, to clearly substantiate the proposed benefits of EC nor to support the ongoing enthusiasm of these authors and some others for a Public Health benefit for a liberal approach to EC availability and use. Tobacco affordability has a much tighter correlation with changes in smoking prevalence in the UK and should have been part of a thorough analysis. Plain packaging and aversive imaging separately contribute to reduction in smoking and were not concurrently implemented. In the interests of fulsome and robust discussion in the academic realms of Public Health, current references to Australia should be based on the most up to date information. In a series of surveys that extended beyond the 2019 cutoff in this study, it was shown that, between early 2020 and 2023, past month EC use in 14-17 year olds increased from 1% to 17% at the same time as past month smoking rose from 2% to 13%[1]. Nothing in the youth tobacco control landscape in Australia has changed other than the widespread (illegal) sale and use of cheap disposable vapes. Most youth do not vape but a significant minority and without a foreseeable benefit. This extent of EC use is not substitutive for teenage smoking and exposes large numbers of young people who would never have smoked to thus far incompletely understood and quantified harms. In future, honest discourse, one expects that any references to this published paper and the conclusions drawn are qualified by the up to date Australian data [1] Wakefield M, Haynes A, Tabbakh T, Scollo M, Durkin S; Centre for Behavioural Research in Cancer; Cancer Council Victoria. Current vaping and current smoking in the Australian population aged 14+ years: February 2018-March 2023. Canberra: Department of Health and Aged Care; 2023. Available online at: https://www.health.gov.au/resources/publications/current-vaping-and-smoking-in-the-australian-population-aged-14-years-or-older-february-2018-to-march-2023?language=en