2025 Session 3 Seminars

Dr Toll’s presentation will focus on the rise of e-cigarettes as the dominant form of tobacco use in the United States (US) and the need for the development of treatments focusing on e-cigarette reduction and cessation. The supremacy of e-cigarette use by US youths will be briefly discussed, along with data showing that the majority of young adults who use nicotine in the US use e-cigarettes. Preliminary data on nicotine pouch use in US-based youths and adults who use cigarettes, e-cigarettes, and smokeless tobacco will be presented. The US perspective on e-cigarette use will be presented, including views and behaviors regarding adolescent, young adult, and adult use. The relatively cautious stance of the US FDA will be discussed. Data will be presented from multiple pilot studies regarding treatment of adult e-cigarette mono-users and e-cigarette and combusted cigarette dual users, including treatment with varenicline tartrate (for mono-users) and nicotine replacement therapy (for dual users). Very preliminary data on the biological impacts of vaping cessation will be presented.

NENCB ICB has funded an innovative project, the ‘HIVE’ team, to support patients with multiple and complex needs in having equitable access to, experience, and outcomes on our clinical pathways. The team has found a high prevalence of tobacco dependency in the cohort and will share the details underpinning high levels of engagement and positive outcomes with case studies and live outcome data.

The HIVE Programme brings together local clinical knowledge with insight from people with lived experience and the expertise of local authority and community services. The aim is simple yet ambitious: to improve access, experience, and outcomes for those who are often overlooked by traditional services. The work has initially focused on people with respiratory conditions referred through urgent cancer pathways. More than half of those supported are living in our most deprived communities or are in unstable housing, suffer with poor mental health or learning disabilities/ neurodivergence, or are living with addiction or substance dependence.

The Tobacco and Vapes Bill is about to reshape tobacco and vaping policy in the UK, alongside new investment in stop smoking services aimed at reaching ‘priority groups.’ But what does this mean for people with the most challenging lives, such as those with mental health conditions, people who use other substances, and individuals in prison? Tobacco dependence treatment and policy is rarely designed with their needs at the centre and THR is often positioned as what is offered when quitting is judged impossible, rather than as a valid and proactive route to reducing harm. Policies and treatment are frequently misaligned with lived realities, for example, in mental health services where smoke-free policies focus on compliance, in substance use settings where tobacco use has rarely been addressed, or in prisons where vaping is shaped by security and control rather than reducing harm. The needs of people in such services are misperceived, they are often seen as lacking motivation to quit tobacco, or services only treat ‘one addiction at a time.’ What is missing is care designed for the people most affected by smoking. This session will consider how current policy may affect ‘priority’ groups, and whether harm reduction will continue to be sidelined as second best, or recognised as central to reducing inequalities.

In this talk Professor Notley will present evidence of predictors of postpartum relapse using data from a recent RCT recruiting pregnant people who quit smoking for pregnancy and will discuss the impact of misunderstandings, misinformation and misalignment of public health goals. The role of vaping in supporting sustained abstinence will be considered, prioritising the voices, views and experiences of those who used vaping as part of their smoking quit journey. There is evidence of continued misunderstanding of vaping as a harm reduction approach from influential health care professionals, leading to dissemination of misinformation. This suggests a potentially concerning situation where people in the early postpartum may be vulnerable to tobacco smoking relapse due to a perceived need to quit vaping or using other nicotine products, that are portrayed as akin to tobacco smoking. The presentation asks for a focus on clarity in public health goals, that may help address the confusing advice and (mis)information that parents have to negotiate.

Over the past five years, youth vaping has risen significantly, prompting both government and local authorities to respond. In many areas, swift action has led to the roll-out of local anti-vaping initiatives aimed at discouraging young people from taking up vaping. Yet, rapid implementation can sometimes result in ineffective measures and unintended consequences. In this session, Dr Khouja will present findings from a survey of local authorities, showcasing the resources currently in place to tackle youth vaping. She will highlight elements of the initiatives that are more likely to be effective and offer recommendations for improving them. Following this, Louise Ross will explore the potential unintended consequences of local initiatives that overlook adult smokers and vapers, particularly how such approaches may undermine the switch from smoking to vaping among adults.

• Will long-term nicotine use increase health inequalities?
• How can the needs of people who currently smoke be better served in health policy discussions?
• Can discussions on vaping cessation be beneficial to smoking cessation, or is it a distraction?
• Has vaping stigma replaced smoking stigma?