2026 Thursday 3 December Seminars

Dr Alex Peck will outline the Government's position in relation to vaping and nicotine products and provide an overview of the actions that it is taking to 1) support adult smokers to quit and 2) prevent youth uptake.

The UK faces considerable and persistent public health challenges. Recent data on healthy life expectancy indicate that, among comparable countries, only the US population spends fewer years in good health than people in the UK. There are multiple reasons for this, including economic factors, obesity and declines in mental health, particularly among young people. Yet the understandable focus on these important causes overlooks a persistent and related one - the ongoing health harms of tobacco and the disproportionate burden borne by particular groups. This presentation will outline why addressing smoking must remain one of our most important public health priorities and why continued efforts are required, alongside vigilance and appropriate policies relating to the emerging health harms from other nicotine products.

The media love to report scare stories about vaping. It’s no wonder so many smokers believe vaping is just as harmful. Who’s to blame?

The Science Media Centre exists to improve media reporting on controversial topics. However, poor-quality science leads to poor reporting; scientific journals provide journalists with a steady stream of weak and misleading studies, sometimes hyped by the press officers promoting them and by researchers themselves.

As public understanding of the relative risks of smoking versus alternative nicotine products continues to be at odds with the best evidence, Tom Sheldon will argue that it remains essential for responsible scientists to engage with journalists, helping them translate evidence for the public in a neutral way and to critically assess the robustness of new findings and claims.

Tom will explore the relationship between science and the media, what we can all do, why it's not always the media's fault, and some of the battles good science has won…as well as those it’s still losing. He'll also try his best to persuade you not to feel too disheartened – but to explain why the fight for accurate media reporting can’t be won until research science gets its own house in order.

As the UK moves towards a smokefree generation, understanding the characteristics and needs of people who continue to smoke becomes increasingly important. This talk will examine the remaining smoking population in England, explore why prevalence may be higher than official estimates suggest, and identify patterns in quitting activity and barriers that may shape future progress towards a smokefree society. Drawing on data from the Smoking Toolkit Study, it will explore patterns of quitting activity, the barriers faced by people who continue to smoke, and where unmet need for cessation support remains greatest. It will consider what these trends mean for efforts to accelerate progress towards a smokefree future, highlighting the importance of addressing persistent inequalities and ensuring that policies designed to prevent future uptake are complemented by effective support for the millions of adults who still smoke.

Few questions in public health are as contested as what to do about e-cigarettes, and much of the conflict arises because four forces are at play, with three crowding out the one that matters most.

Politics concerns the political tensions: harm reduction set against precaution and abstinence, and the divergence between jurisdictions: Britain's comparatively liberal, quit-aid framing and its moves on disposables and a generational sales ban; Australia's prescription-only model; the American authorisation regime; and the perennial tension between protecting young people and helping adult smokers to stop.

Profit relates to the commercial determinants: the tobacco industry's absorption of the category, the independent and disposables sectors, illicit supply, and the way the pursuit of margin shapes not only products (flavours, nicotine salts, devices engineered for appeal) but also the arguments advanced on every side.

Propaganda involves the systematic distortion of the evidence base, including the steady rise in the mistaken belief that vaping is as dangerous as smoking, the misattribution of the US EVALI outbreak, gateway rhetoric and youth moral panic, alongside the overclaiming of vaping's champions.

Public health concerns what arguably should be the focus: what the evidence actually shows, and the fact that good policy here means minimising harm rather than allowing harm in the vain service of eliminating it.

This presentation will explore how, when politics, profit and propaganda are allowed to crowd out the public-health calculus, both smokers and non-smokers lose.

Clinicians increasingly face a strange position regarding alternative nicotine products: recommending products that work but aren't medicines. The evidence for e-cigarettes as a smoking cessation aid is now high-certainty and shows they outperform licensed nicotine replacement therapy in head-to-head trials. Yet the products themselves sit outside the regulatory category clinicians are trained to trust. They are reviewed for population-level benefit rather than approved as safe and effective for the individual patient. That distinction isn't a technicality. It shapes how confident a clinician feels about raising the option, how exposed they feel doing so, and, in some jurisdictions, whether professional guidance actively discourages the conversation altogether.

This talk uses e-cigarettes as the clearest example of a broader and growing problem, one that will only become more pressing as evidence accumulates on nicotine pouches and heated tobacco. Drawing on a recent JAMA position paper and the professional debate it provoked, I will examine why this discomfort exists, how professional bodies and national systems have resolved it differently (the UK and New Zealand embracing these products within cessation pathways, the US and Australia largely resisting), and what underlies much of the disagreement: an unresolved question about whether we are treating nicotine dependence or combustible tobacco harm. I will close with what this means in practice for clinicians navigating patient conversations in the absence of a prescription pad.

The presentation will begin with results from the Cochrane review of ‘E-cigarettes for smoking cessation’, focusing on our new outcome of long-term e-cigarette and combustible tobacco use among people who have used e-cigarettes to help them quit smoking. It will then consider what longer-term vaping means in practice, including why people may continue to use e-cigarettes longer than other cessation aids, the potential benefits of this approach for underserved groups, and the importance of avoiding premature vaping cessation, which could increase the risk of returning to smoking. The presentation will recognise that long-term vaping is not necessarily the preferred outcome for everyone, and that concerns about prolonged use could discourage some people from choosing vapes as a cessation aid in the first place. It will conclude by focusing on data from the ‘Interventions for quitting vaping’ review, presenting evidence on strategies to help people stop vaping, while also considering potential unintended consequences and the need for continued monitoring and updating of the evidence.

Population-level smoking and vaping trends are central to how we understand tobacco use, evaluate policy and identify who is being left behind. But what if the evidence we rely on does not tell the whole story?

This talk brings together two strands of our work that show how our understanding of tobacco use can be distorted in different ways. First, I will consider the debate over whether e-cigarette use acts as a gateway to smoking. Using triangulation of evidence across different study designs and analytical approaches, we will examine whether the observed relationship between vaping and subsequent smoking initiation is consistent with a causal gateway effect. I will explore what these different sources of evidence tell us, where they converge and where important uncertainties remain, emphasising the need to look beyond any single study or apparent association when addressing complex causal questions. I will then turn to a less visible problem: the people who are missing from the data altogether. Our recent research estimates that around 1.9 million adults in the UK live outside the sampling frames of household surveys, including people living in communal establishments and those experiencing homelessness or temporary accommodation. Smoking prevalence in these populations is substantially higher than in the general population, meaning their exclusion may lead us to underestimate both the scale of smoking and the inequalities associated with it. Together, these examples raise a broader question: what do we need to consider when interpreting the evidence we use to guide tobacco control? I will argue that we need to look beyond headline prevalence estimates and apparently straightforward associations, paying greater attention to causality, population coverage, measurement and who is, and is not, represented in our data. If we want tobacco control to reduce inequalities rather than simply improve averages, we need to understand not only what the data tell us, but also what they might be missing.

The portrayal of nicotine as harmful and the focus on youth vaping has distracted us from what should still be our number one public health priority: stopping smoking. The Tobacco and Vapes Act introduces a generational ban on tobacco sales and puts the aim of making smoking history within our grasp. But as smoking prevalence continues to fall at a population level, it remains stubbornly high in priority groups, and this presents us with our biggest challenge: to make sure that nobody is left behind. This presentation will address these two distinct but related challenges.

Eve will present policy options for the regulation of packaging, flavour names and point-of-sale displays of vapes and other nicotine products, from the perspective of the UK's Tobacco and Vapes Act 2026. Drawing on new evidence, the talk will examine how these measures could influence product appeal and perceived harm among both young people and adults. Findings from recent studies will be used to assess the potential of packaging and marketing restrictions to reduce youth appeal while preserving the attractiveness of less harmful nicotine products for adults who smoke.

Tim Phillips from Tamarind Intelligence reviews the changing regulatory landscape for nicotine products globally, and the wide-ranging impact of regulatory and policy decisions on innovation, product mix, marketing and ultimately consumer behaviour. He asks whether there is a fundamental misalignment between regulatory frameworks and market realities - often leading to ineffective regulation and the development of illicit channels - and whether that could be remedied by better data and understanding within regulatory authorities.

Risk communication scholar Peter Sandman famously proposed that Risk = Hazard + Outrage. According to Sandman, the outrage component, that is, the degree to which people are emotionally concerned about a risk, is often only weakly correlated with the magnitude of the hazard itself. He argued that individuals frequently perceive something as dangerous because they are upset about it, rather than becoming upset because it is objectively dangerous. Consequently, efforts to correct risk misperceptions may be more successful when they focus on reducing excessive public concern, an approach Sandman termed outrage management, than when they rely solely on communicating quantitative evidence regarding absolute risk, although such evidence may itself constitute an important component of outrage management.

However, researchers who seek to correct exaggerated risk perceptions may be reluctant to engage in outrage management for fear of being perceived as aligned with, or sympathetic to, the industry that originally generated public concern. As a result, much of the field of risk communication is left to well-intentioned actors who, in an effort to discourage youth uptake, deliberately amplify perceptions of risk. Drawing on the concept of the “careorist”, we describe how such risk amplification can emerge even when motivated by public health objectives.

In this presentation, we first illustrate how Sandman’s framework can be applied to risk communication in the field of nicotine products. We then examine several Norwegian examples of risk amplification relating to snus. Finally, we present empirical evidence on how public perceptions of the risks associated with different nicotine products have evolved in a setting where non-combustible products have come to dominate the nicotine market.