Blogs by Gera E Nagelhout

Report from the SRNT Europe 2019 conference in Oslo


Last week, the SRNT Europe conference was held in Oslo which is about research on nicotine and tobacco. I really enjoyed and learned from the presentations and interactions at the conference and on Twitter. Here, I give a brief overview of my takeaways from the conference.

A large part of the conference was dedicated to e-cigarettes. Two keynote speakers (Lynne Dawkins and Robert West) focused on this topic and several of the sessions had this focus. Although the media were talking about the recent deaths that may have been caused by e-cigarettes, most of the speakers at the conference talked mainly about the benefits of e-cigarettes for people who want to quit smoking tobacco. Speakers at the conference worried about the lack of knowledge among the public about nicotine. Many people incorrectly believe that nicotine is the ingredient in tobacco that is causing most of the harms of smoking. This belief makes people assume that e-cigarettes are equally or more harmful than tobacco, which is not true and makes it less likely that people will benefit from the harm reduction potential of e-cigarettes. The other side of the coin was also highlighted in a meta-analysis on e-cigarettes as a possible gateway to smoking among youth. There was a strong association found between e-cigarette use among youth and later tobacco use, but conclusions about causality cannot be made.

Another interesting theme at the conference was preference-based treatment for smoking cessation. Instead of only following evidence-based guidelines for the best aids and ways to quit smoking, we should also listen more to how people want to quit smoking themselves. If adherence to a certain treatment is low this might mean that we need better treatment rather than better adherence, said Peter Hajek. Although e-cigarettes are not that different from other nicotine replacement therapies, some people have a clear preference for one aid over the other. Also, some people may want to quit gradually by reducing the number of cigarettes they smoke per day instead of quitting abruptly. An updated Cochrane review presented at the conference showed that quitting abruptly does not result in superior quit rates than gradual quitting and thus both can be advised, depending on peoples’ preferences. How all this will work in practice remains the question, as preference-based treatment on top of evidence-based treatment asks more from health professionals.

There were not a lot of sessions and only one keynote presentation (by Niamh Shortt) about inequalities in smoking. However, although it was not an important theme of the sessions, the topic did come up a lot during questions to speakers. Many conference delegates asked the presenters how their research relates to the group of smokers with a lower socioeconomic position. This is becoming the most relevant target group in many countries as smoking rates are mainly dropping among people with a higher socioeconomic position. For example, gradually reducing the number of cigarettes per day until you have quit smoking may be more feasible for people with a lower socioeconomic position (who are often more addicted to smoking) than abrupt quitting. In the keynote speech about inequalities, the importance of the environment was stressed and the potential of policies reducing the number of tobacco outlets for decreasing inequalities in smoking.

With the latest Tobacco Products Directive, all EU countries now have pictorial warning labels and many move to the implementation of plain packaging. The research presented at the conference covered these policies and several studies also went a step further by examining new possible packaging policies such as dissuasive cigarettes, efficacy labels (instead of health warning labels), or cigarette pack inserts. First results of studies about these new policies are promising and could be the way forward for a new European Tobacco Products Directive.

Finally, it was nice to see all the activity on the conference hashtag #SRNTE2019 on Twitter. More than 30 delegates were actively tweeting what they heard and learned at the conference. You can see a selection of those tweets below.

Were you also present at the conference? Feel free to add your takeaways from the conference in the comments section below!