2025 Session 1 Seminars

The Tobacco and Vapes Bill was introduced in the House of Commons on 5 November 2024 and is currently progressing through the House of Lords. The Bill fulfils the Government's manifesto commitment to ensure that the next generation will never legally be sold tobacco products and that vapes will be banned from being branded and advertised to appeal to children. Martin Dockrell, on behalf of DHSC, will briefly outline the provisions that will be included on the face of the Bill and regulation-making powers requiring subsequent secondary legislation and further consultation. He will also update on the upcoming DHSC call for evidence which covers issues such as vape ingredients, devices, nicotine limits, licensing and registration.

In this year's opening keynote, Professor Lion Shahab will highlight the importance of harm reduction in tobacco control and trace how international approaches to e-cigarettes—particularly in the UK and US—have diverged historically. This divergence has fuelled increasingly polarised debates, shaped by abolitionist and libertarian agendas, that often overshadow balanced evaluation of evidence. The talk will examine how findings on e-cigarette harms and benefits are frequently misrepresented, either understated or overstated, and argue for a rigorous, evidence-led approach to public health policy. In this context, it will also consider the intended and unintended consequences of current proposals in the UK Tobacco and Vapes Bill. The talk will conclude by identifying critical gaps in the literature and setting priorities for future research to understand vaping’s population impact better and support proportionate, effective regulation.

The 21st century rise of noncombustible nicotine products has complicated efforts to determine tobacco and nicotine policies’ health impacts, as cross-product effects can aggravate or mitigate health costs depending on the products’ relative harms. Research on electronic cigarette policies has attempted to address this by assessing effects on combustible tobacco use as well as vaping, but less consideration has been given to potential heterogeneity in effects between groups that are more versus less likely to smoke. In particular, if e-cigarette policies’ effects on smoking and vaping vary by socioeconomic status, such regulations could narrow or amplify disparities in tobacco-related disease. To consider this, Prof. Friedman will present preliminary results from a natural experiment leveraging US e-cigarette policy variation to assess potential implications for socioeconomic disparities in smoking and vaping.

Effective communication of health risks is central to public health, yet the discourse around e-cigarettes has become increasingly muddled. This presentation explores how misinformation has led many smokers to believe that vaping is more harmful than smoking, despite evidence to the contrary. It will examine the principles of risk communication and the importance of tailoring messages to different audiences — promoting vaping as a harm reduction tool for smokers while clearly communicating the potential risks for non-smokers.
A key focus needs to be on the role of trust in public health messaging. In an era marked by declining confidence in science and institutions — particularly since the COVID-19 pandemic — rebuilding trust is essential to ensure that evidence-based messages are heard, understood, and acted upon. Through this lens, we’ll consider how public health can better support informed decision-making and reduce health inequities.

Synopsis for my presentation: In Scandinavia, bio-ceramic tobacco-free nicotine pouches have become the very latest supplement to the nicotine market. However, over the past century, various nicotine products have had successive time-limited periods of market dominance. Plug tobacco for chewing at the start of the century was replaced by pipe smoking from the 1930s, which in turn was replaced by rolling tobacco as the dominant method of use from the 1960s. From the 1980s followed some decades where varieties of manufactured cigarettes (plain, filter, light) dominated the market, only to be replaced by varieties of tobacco-based snus (loose, portions) for oral use from 2015. More recently, tobacco-free cellulose-based nicotine pouches (white snus) have started to outcompete the traditional types of (brown) snus. In addition, non-combustible inhalation products (vapes & heated tobacco) have gained some market share without achieving dominance in the Nordics. This historic product substitutability illustrates the correctness of Professor Michael Russell’s statement in 1971 “One nicotine product has never left the market without being replaced by another”. Neither corporal, economic and social punishment of the users, nor the wide range of supply- and demand regulations (including prohibition) have succeeded in eliminating the appetite for recreational use of nicotine. Starting with a brief historical analysis of the historic development of the nicotine market, we will subsequently narrow our focus on nicotine pouches; the current market situation, the inconsistent international regulations, the assumed harm potential, usage patterns and.…all the knowledge gaps.

The term ‘addiction’ has multiple meanings relating to an acquired ‘need’ for something. In some cases, it refers to a clinical syndrome characterised by a set of signs and symptoms including subjective, behavioural and physical phenomena. In other cases, it refers to a dimension of need that people can experience to varying degrees. The term ‘dependence’ is sometimes used synonymously with ‘addiction’ and sometimes differentiated from it, with addiction referring to a psychological need and dependence referring to a physiological need. These meanings serve different purposes and it is vital to be clear about which meaning one is referring to and to match that meaning to the purpose in hand.
When it comes to nicotine and tobacco addiction, the most important use is to understand and predict the success of quit attempts. Here, the evidence indicates that construing addiction as a dimension of psychological need is the most successful approach, assessed by measures such as the Fagerstrom Test for Cigarette Dependence (FTCD) and the Strength of Urges to Smoke Scale (SUSS). The physiological clinical syndrome approach, as assessed for example by DSM-V tobacco dependence criteria, performs poorly when predicting success of quit attempts. Evidence also indicates that it is crucial to distinguish between different nicotine and tobacco products and the context in terms of societal and population characteristics. It follows from this that the broad concept of ‘nicotine addiction’ as a clinical syndrome lacks empirical validity. Instead we should be focusing on dimensions of psychological need for specific nicotine and tobacco products in specific populations and contexts.

• How can we ensure that vaping and nicotine policies do not widen inequalities?
• What actions are needed to correct misinformation on smoking and vaping?
• Is societal nicotine use inevitable?
• Will nicotine pouches be less controversial than vape products?