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Wolfson Institute of Preventive Medicine - Barts and The London

Health and Lifestyle research group

We conduct research in smoking cessation and in weight management.

We have contributed to the development of smoking cessation interventions that are now used worldwide, and guided the development and training of the UK Specialist Stop Smoking Service. Our current focus is on evaluating safety and efficacy of e-cigarettes.

The Health and Lifestyle Research Group covers the Tobacco Dependence Research Unit (TDRU) and the Weight Management Research Unit (WMRU).

TDRU is one of the leading smoking cessation research and treatment centres globally. Its work has informed current clinical practice and guidelines, including the establishment of the national Specialist Stop Smoking Service and series of relevant NICE Guidelines.

WMRU is a more recent addition to the Group’s work, focussing on treatment and research programmes for obesity and weight management. We developed a task-based weight management programme validated in a large randomised trial, and are currently evaluating simple interventions that, if effective, can be disseminated economically on a large scale.

 

Tower Hamlets and Newham stop smoking services

The group also provide local services for smokers and for people who want to lose weight. We run specialist stop smoking services for the boroughs of Tower Hamlets and Newham and provide weight management clinics for QMUL staff and local residents. 

The clinics serve as a basis for studies developing new treatments and enhancing understanding of addictive behaviours and behaviour change.

 

Current research projects

Helping pregnant smokers quit: electronic cigarettes versus nicotine patches

QMUL team lead by Prof. Peter Hajek

Funder : National Institute for Health Research - HTA

2017 to 2021 Grant value: £1,671,212

Background

E-cigarettes are a popular way of stopping smoking, and could be of benefit to pregnant smokers as well. Treatments in pregnancy need to be safe, and the trial is evaluating not just whether e-cigarettes help pregnant smokers quit, but also whether they are safe for them.

Research details

Pregnant smokers were allocated by a computer to receive either advice and support by specialists over the phone alongside nicotine patches, or the same advice and support alongside e-cigarettes. The two groups will be compared in numbers who quit smoking at the end of pregnancy, and in adverse effects and birth and maternal outcomes. The study has recruited 1140 pregnant smokers as planned, and we hope the results will be available early 2021.

 

Do e-cigarettes help smokers quit when not accompanied by intensive behavioural support?

QMUL team lead by Dr. Katie Myers Smith

Funder: National Institute for Health Research - HTA

2021 – 2025 Grant value: £1,356,484.51

Background

We recently showed that e-cigarettes are more effective in helping smokers quit than nicotine replacement treatments (NRT), such as patches or chewing gum (click here for details). E-cigarettes and NRT were used with specialist stop-smoking advice and support, provided every week for four weeks. In this trial, we want to see if e-cigarettes work with less support. 

Research details

Smokers will be randomly allocated to three study arms. 1. Receiving by post an e-cigarette starter pack with advice to purchase further supplies of e-liquid of the preferred strength and flavour themselves; PLUS five weekly support telephone calls from an e-cigarette helpline. 2. The same e-cigarette starter pack and advice, with only the initial one-off telephone advice. 3. Enlisting in the NHS Smokefree Quit Now online programme that provides support for 28 days, and is currently the most economical approach in use. A total of 1,170 smokers will be recruited and we will determine how many in each study arm have stopped smoking 6 and 12 months later.

 

How does dual use of e-cigarettes and conventional cigarettes change over time?

QMUL team lead by Prof. Peter Hajek

Funder: Cancer Research UK

2017 to 2025 Grant value: £103,878

Background

Many smokers who start to use e-cigarettes sometimes smoke and sometimes vape. Little is known about the way such use develops over time, and what influence media stories about vaping may have on this behaviour.

Research details

Dual users are asked questions about their vaping and smoking, and about media stories concerning vaping that they have noticed, at 3-monthly intervals. 503 participants were recruited. The study will continue for 10 years, with twice a year surveys. The results from the first 12 months are complete and we hope to publish them in early 2021.

 

Effects of reduced-risk nicotine delivery products on smoking prevalence and cigarette sales (Gateway into or out of smoking?)

QMUL team lead by Prof. Peter Hajek

Funder: National Institute for Health Research - PHR

2021 – 2023 Grant value: £151,225.69

Background

Several products provide smokers with nicotine without chemicals that make smoking dangerous to health. These include Swedish snus (oral tobacco prepared in a way that minimises health risks), products that heat tobacco rather than burn it, and e-cigarettes. There is a concern that these products encourage smoking (a gateway into smoking); but also the hope that they replace smoking, especially among young people (a gateway out of smoking).

Research details

A number of countries keep records, year by year, of how many people smoke, and how many use the alternative products. Records also exist on sales of cigarettes and of the other products over time. We will examine how changes in use of alternative nicotine products over time relate to changes in smoking and in cigarette sales. We will also compare countries that allow and countries that ban these products in these time trends. The research is due to start in November 2020.

 

Nicotine delivery and user reactions to IQOS and different types of e-cigarettes

QMUL team lead by Dr. Dunja Przulj

Funder: Cancer Research UK

2018 to 2022 Grant value: £84,197

Background

Different types of e-cigarettes and other alternatives to smoking, such as ‘heat not burn’ products, provide different amounts of nicotine to people that use them. Knowing how much nicotine these products provide can show their potential to help people quit smoking.

Research details

A group of vapers have tested, under the same conditions, different e-cigarettes, the JUUL devices (both US and UK versions with different levels of nicotine), their own cigarettes, and in this latest study, the heat-not-burn tobacco product, IQOS. During testing sessions, participants use the product as they like for 5 minutes, and blood samples are taken for half-hour. Participants also rate the products. Data we already have allow us to compare the products with each other.

The findings from this on-going project which have been published so far can be found by clicking:

Nicotine delivery to users from cigarettes and from different types of e-cigarettes

Initial ratings of different types of e-cigarettes and relationships between product appeal and nicotine delivery

Nicotine delivery and users’ reactions to Juul compared with cigarettes and other e‐cigarette products

Nicotine delivery and users’ reactions Jull EU compared with Juul US cigarettes and other e-cigarette products

 

Health outcomes and relapse rates associated with long-term use of e-cigarettes

Funder: Cancer Research UK (CRUK)

2018-2028, grant value £77,450

Background

The questions of long-term health effects and effects on relapse of a switch from smoking to e-cigarette (EC) use (vaping) are currently key research priorities in this field. Participants from trials of EC provide an opportunity to monitor health outcomes in ex-smokers who quit at a similar time and do or do not use EC.

Research details

In a longitudinal follow-up, participants provide details about their vaping and smoking, their health, and about media stories concerning vaping that they have noticed.

 

Effectiveness of electronic cigarettes as an aid to smoking cessation in comparison with varenicline and the effect of vaping on lung health in patients with chronic obstructive pulmonary disease (E-CaL study)

QMUL in collaboration with University of Birmingham

Funder: National Institute for Health Research – HTA

2021-2024, Total grant value £1,994,974 (£404,326 to QM)

Background

Continued smoking worsens COPD. It is not known whether e-cigarettes can help such smokers, and what effects they might have on patients’ lung function.

Research details

Daily smokers with COPD will be randomised to receive either varenicline or EC alongside weekly telephone behavioural support. Outcomes include smoking cessation and reduction, as well as exacerbations of COPD and measures of lung health at 6 and 12 months.

 

A long-term health data repository of people who have quit smoking with and without using e-cigarettes

QMUL in collaboration with King’s

Funder: Cancer Research UK (CRUK)

2020-2022

Background

To establish the feasibility of obtaining long-term health data from e-cigarette users via centralised national databases like NHS Digital.

Research details

The project is examining the feasibility of establishing a registry that will collect long-term health data from consenting participants in e-cigarette research to allow collection of objective data on long-term effects of vaping on health.

 

E-cigarettes versus nicotine replacement treatments in helping smokers quit (TEC Study)

This NIHR project has been completed (1-3), but its findings are being currently translated into practice and it is included here for the link, at the end of this section, to a document provided to inform the National Stop Smoking Service.

In the project, 886 smokers were randomly allocated to receiving nicotine replacement treatments (NRT) of their choice (mostly nicotine skin patches combined with nicotine inhalator or mouth spray) for up to three months, or a starter pack of a refillable e-cigarette and two bottles of e-liquid with instructions to buy further e-liquid supplies of the strength and flavour of their choice themselves.

Smokers using e-cigarettes had less urges to smoke and were finding quitting easier. At one year, 18% stopped smoking in the e-cigarette group compared to 9.9% in the NRT group (17.7% vs 8% when participants using unallocated product were excluded). An additional 13% reduced smoking by over 50% in the e-cigarette group compared to 7% in the NRT group.

Most of the successful quitters in the e-cigarette group continued to use EC (80%).

Unexpectedly, using e-cigarettes seems to have reduced coughing and producing phlegm. Chemicals in e-cigarette aerosol (propylene glycol and vegetable glycerol) are known to kill bacteria and viruses. It is possible that vaping protects users from airborne infections, but more data are needed to verify this.

In collaboration with HTA, we organised a series of workshops for the stop-smoking services to help translate the study findings into clinical practice. The outline of key issues for service commissioners and clinicians is here:

TEC Study Q&A [PDF 321KB]

TEC Summary [PDF 85KB]

 

References

1- Hajek, P., Phillips-Waller, A., Przulj, D., Pesola, F., Myers Smith, K., Bisal, N., Li, J., Parrott, S., Sasieni, P., Dawkins, L. and Ross, L., 2019. A randomized trial of e-cigarettes versus nicotine- replacement therapy. New England Journal of Medicine, 380(7), pp.629-637

2 - Hajek P, Phillips-Waller A, Przulj D, Pesola F, Myers Smith K, Bisal N, et al. E-cigarettes compared with nicotine replacement therapy within the UK Stop Smoking Services: the TEC RCT. Health Technol Assess 2019;23(43).

3 - Li J, Hajek P, Pesola F, Wu Q, Phillips-Waller A, Przulj D, Myers Smith K, Bisal N, Sasieni P, Dawkins L, Ross L, Goniewicz ML, McRobbie H, Parrott S. Cost-effectiveness of e-cigarettes compared with nicotine replacement therapy in stop smoking services in England (TEC study): a randomized controlled trial. Addiction. 2020 Mar;115(3):507-517. doi: 10.1111/add.14829. Epub 2019 Dec 4. PMID: 31597207; PMCID: PMC7318206.

Unit Research

ANANINA, Irina -- Unit Administrator -- 0207 882 8231 -- i.ananina@qmul.ac.uk 

HAJEK, Peter (Director) -- Professor of Clinical Psychology -- 0207 882 8232 -- p.hajek@qmul.ac.uk

LADMORE, Daniella -- Research Health Psychologist -- 0207 882 5948 -- daniella.ladmore@qmul.ac.uk

McALPINE, Kirsten -- Specialist Stop Smoking Advisor -- 0207 882 8224 -- kirsten.mcalpine@qmul.ac.uk

McROBBIE, Hayden -- Professor of Public Health Interventions -- 0207 882 5721 -- h.j.mcrobbie@qmul.ac.uk

PESOLA, Francesca, Dr -- Research Fellow in Statistics -- 0207 882 5722 -- f.pesola@qmul.ac.uk

ORZOL, Marzena -- Research Health Psychologist -- 0207 882 8227 -- m.orzol@qmul.ac.uk

PHILLIPS-WALLER, Anna -- Research Manager -- 0207 882 5747 -- a.phillips-waller@qmul.ac.uk 

PRZULJ, Dunja, Dr -- Research Fellow -- 0207 882 5949 -- d.przulj@qmul.ac.uk

SMITH, Katie, Dr  -- Senior Research Fellow -- 0207 882 8245 -- katie.smith@qmul.ac.uk

Quit Right Team

AHMED, Sabir -- Administrator and Communications Officer -- 0207 882 3265/ 8230 -- sabir.ahmed@qmul.ac.uk

BEGUM, Shajue -- Tobacco Cessation Practitioner and Administrator -- 0207 882 8669/ 8230 -- shajue.begum@qmul.ac.uk 

BEGUM, Shamsia -- Service Manager -- 0207 882 3264 -- s.begum@qmul.ac.uk 

COPPACK, Simon, Dr -- Clinic locum via Lucy Connolly x 3230 on Tues  -- 0207 882 2369 -- s.w.coppack@qmul.ac.uk

DESAI, Farah -- Tobacco Cessation Practitioner/Pregnancy Specialist -- 0207 882 8246 -- f.desai@qmul.ac.uk

GHOSH, Dipul -- Tobacco Cessation Practitioner -- 0207 882 8660 -- d.ghosh@qmul.ac.uk 

MONTERO, Emma -- Tobacco Cessation Practitioner -- 0207 882 6607 -- e.montero@qmul.ac.uk 

NAHAR, Kamrun -- Tobacco Cessation Practitioner -- 0207 882 7374 -- k.nahar@qmul.ac.uk

CLINIC PHONES

Clinic Reception  --  0207 882 8230

Clinic Freephone --  0800 169 1943

Clinic Fax --  0207 791 1774