Transdisciplinary Topical Discussions (TTDs)
Wednesday, March 8, 3:30 p.m. - 4:45 p.m.
TTDs are interactive sessions at the SRNT conference on current and highly debated topics of great importance to the field. The sessions are open to all conference attendees from the various fields of nicotine and tobacco research, thereby allowing for a maximum of interaction and diversity in the discussion. The sessions' content will be based on discussion points raised and agreed by the moderator and attendees.
TTD 1: E-health smoking cessation interventions: do they really work?
Moderator and chair: Saul Shiffman, University of Pittsburgh, USA
E-health interventions for smoking cessation are increasingly popular, due to technological advances and facilitation by Internet and mobile technologies. Such interventions can reach many smokers with great convenience and at low cost, and their flexibility enables personalised tailored support, potentially enhancing the reach and efficacy of treatment. On the other hand, e-health interventions may invoke less engagement and adherence than face-to-face behavioural interventions. As they can be developed and maintained at relatively low cost, there is a host of interventions – especially smartphone apps - available. However, very few have been evaluated for effectiveness, and evaluating such interventions presents methodological challenges.
TTD 2: NRT bought over the counter: are gums and patches possibly not effective in the real world?
Moderator and chair: Ann McNeill, King’s College London, UK
Evidence from over 150 randomised controlled trials clearly demonstrates the efficacy of nicotine replacement therapy (NRT) for smoking cessation. NRT in its various forms of delivery (gum, patch etc.) are the most frequently used licensed pharmacotherapy for smoking cessation. In many countries, NRT is also available over the counter (i.e., without prescription and behavioural support from a health professional). Due to its efficacy and popularity, NRT bought over the counter seems to be a powerful method to improve population health. However, recent studies have raised concerns about the effectiveness of NRT bought over the counter in the real world, outside of clinical trials. Understanding this may also have lessons for other widely available products for smoking cessation.
TTD 3: Polysubstance abuse: how to treat tobacco alongside other addictions?
Moderator and chair: Carla Berg, Emory University Woodruff Health Sciences Center, Atlanta, USA
Tobacco addiction is strongly associated with other addictions, in particular alcohol use disorders. The health risks of single addictions are many and may be amplified by polysubstance abuse, highlighting the need for effective cessation treatments. Currently each addiction is usually treated independently, but it may be advantageous to treat multiple co-occurring addictions simultaneously. However, there are challenges to this approach, which include insufficient knowledge on how to develop new, effective, multi-target treatments with interacting treatment components and how to implement these in patient care.
TTD 4: Financial incentives for quitting tobacco: an effective and ethical approach?
Moderator and chair: Stephen Higgins, University of Vermont, USA
Quitting tobacco is vital to reduce health risks, but also very difficult due to the addictive nature of nicotine. There are evidence-based behavioural and pharmacological treatments for smoking cessation, but their success rates are limited. Recent studies have investigated whether providing financial incentives might increase smoking cessation rates, particularly in specific subgroups of the smoking population such as pregnant smokers and smokers with low socioeconomic status. There are concerns, however, about the long-term effectiveness beyond the period of rewardand the ethics of paying people to change their behaviour, as well as who should defray associated costs.
TTD 5: Making the delivery of tobacco cessation treatment routine in health care systems: what are the challenges?
Moderator and chair: Nancy Rigotti, Massachusetts General Hospital and Harvard Medical School, Boston, USA
Tobacco use remains a leading preventable cause of morbidity and mortality. During the past decades, various effective and cost-effective behavioural and pharmacological smoking cessation treatments have been developed and tested. Clinical guidelines recommend clinicians to offer evidence-based treatment to every smoking patient. Yet, far too few smoking patients receive competent smoking cessation advice and the offer of evidence-based treatment when consulting their health care provider. It seems that, despite the necessity to routinely deliver evidence-based treatment, implementation in our health care systems remains challenging.
TTD 6: Vape shops: just another tobacco product retailer or a smoking cessation service?
Moderator and chair: Maciej Goniewicz, Roswell Park Cancer Institute, USA
Stores that sell electronic nicotine delivery systems (ENDS) as their primary product are an emerging phenomenon. Such "vape shops" provide consumers a place to purchase and discuss e-cigarettes and offer an environment that serves as a place of recreation with customers lounging once inside. Their growing presence and marketing raise important questions about how these shops might potentially affect the public's health. They may attract novice ENDS users and non-smokers alike, and may influence social norms around ENDS use, particularly around acceptability for use indoors. On the other hand, vape shop owners are in a unique position to serve as frontline consumer educators regarding the benefits and risks of ENDS. This unique context highlights the importance of understanding the interactions between vape shop owners, workers and customers.
TTD 7: How do we reduce children’s exposure to secondhand tobacco smoke globally?
Moderator and chair: Megan Passey, University of Sydney, AUS
Exposure to secondhand tobacco smoke (SHS) has been causally linked with mortality and morbidity in non-smokers and disproportionately affects the health of children. Globally, hundreds of millions of children are regularly exposed to SHS, especially in their home. New evidence is emerging on how to reduce children's exposure to SHS, but there are still significant gaps in knowledge, especially in resource poor settings, and there is discussion about future directions in research and policy.