Research Capacity Building

Promoting Evidence Base

Public Health Policy Awareness

Understanding Tobacco Harm Reduction

 

THR Scholarships

Building on the success of last year’s Scholarship programme, Knowledge•Action•Change is pleased to announce the launch of the 2nd K•A•C Global Tobacco Harm Reduction Scholarship Programme.

Apply!

KAC Scholars 2018/2019

Adapting tobacco harm reduction for bidi smokers in India
Samrat Chowdery Show project report
India

Hoping to expand on his work on promoting safer and healthier alternatives to tobacco use, Samrat is conducting a project distributing e-cigarettes to bidi smokers in Mumbai, in order to gauge the user response to, and eventual take-up, of e-cigarettes. In particular, Samrat is evaluating the difficulties and obstacles in take-up of vaping in lower-income smoking communities, and how consumer models for e-cigarette distribution and e-liquid production can be adapted to better suit bidi smokers. Through support from his mentor Professor Rajesh Sharan, Samrat is helping to fill the gap in current knowledge surrounding the complexities and peculiarities of bidi smoker transitions to e-cigarettes.

Full report in PDF format can be downloaded here

Social media and harm reduction in Poland
Miroslaw Dworniczak Show project report
Poland

Miroslaw has been an avid proponent and author of e-cigarette literature since the advent of vaping in the late 2000s, including writing the first ever book on e-cigarettes, “E-cigarettes for beginners”, and has worked as a scientific researcher and freelance scientific journalist since 1979. Through social media and blogging, Miroslaw will spread reliable, factual and scientific information regarding the use of e-cigarettes and e-liquids to an audience of tobacco smokers and those intending to quit tobacco use in Poland. With close help from his mentor, Professor Andrzej Sobczak, Miroslaw sources and collates current scientific data and publications surrounding e-cigarettes, and will be using these as exemplar pieces of scientific research to his vaping and smoking audience.

The aim of my project was creating an information platform for those intending to quit smoking. In July 2018 I registered a new domain – epapieros.edu.pl (e-papieros means e-cigarette in Polish). The webpage addresses novice users of e-cigarettes and those who consider switching from smoking regular cigarettes, cigars, pipe to much less harmful products. The main part of the webpage is my blog, dealing with safety and health issues, debunking fake news in the media, promoting lectures and debates concerning e-cigarettes. There are 75 entries there (50 was planned). There is a manual for the beginners (22 chapters – in Polish) and also a short manual in English. I promoted new entries on a special Facebook group and also on Twitter. I also answered many individual mails, concerning mainly safety issues. The key thing for me was to provide people with reliable information as this is the only way to help people make an informed choice. My webpage is the only site in Poland providing comprehensive information for the beginners. I have up to 2000 unique visitors every month (90% of them Polish). Creating the site and fruitful discussions with readers helped me gather information for a publication in a medical quarterly.

Elevated anxiety sensitivity in smoking populations in the US
Lorra Garey
USA

Personalised feedback, computer-delivered intervention (PFI) is an as yet unrealised potential treatment for the large proportion of smokers who suffer from elevated anxiety sensitivity. It is an alternative to the relatively time-dependent, long term treatments associated with elevated anxiety sensitivity and smoking. Lorra Garey is hoping to fill this gap by staging a randomized control trial of various computer-based PFI treatment plans, studying a population of current smokers as they attempt to quit smoking, and evaluating the success rates of smoking cessation. Through contact with her mentor, Helen Redmond, Lorra has been able to streamline and refine the intervention materials necessary for the proposed treatments, and gain a greater insight into the reduced harm nicotine products currently available. Lorra's full report will be available when data anaysis is complete.

Raising tobacco harm reduction awareness through social media
Will Godfrey Show project report
USA

Will Godfrey is taking an anti-misinformation and increased awareness approach to tobacco harm reduction in the US. Using his online news site, he aims to increase the level of common knowledge of key research and information surrounding tobacco harm reduction to a readership open to the concept of evidence-based policies. Launched in early October 2018, Will’s website, filtermag.org, provides up to date tobacco harm-related content, including pieces by Helen Redmond on the “War on nicotine”, and a variety of media formats including interviews, videos, op-eds and scientific analyses. This content is promoted with the help of social media and republications with larger scale publications. The overarching intent is to facilitate increased awareness for tobacco harm reduction, and facilitate constructive debate around tobacco harm reduction.

The KAC scholarship was of great help to Filter Filtermag.org in terms of expanding, improving and diversifying our tobacco harm reduction coverage in the months following our September 2018 launch.

With the funds provided, Filter was able to assign a range of reports, op-eds and other articles to a diverse mix of journalists, directly impacted people and experts in the US and around the world. These pieces highlighted urgent areas of concern, platformed important policies and interventions, transmitted accurate information about THR, and countered misinformation, among other achievements.

By publishing these articles, we ensured that about 10 percent of our work features THR, consistent with our goal of integrating THR and the wider harm reduction movement. With rapidly growing overall traffic in our first year, we earned a substantial audience for THR subjects. This has seen many people previously unfamiliar with THR, including some influential general harm reduction organizations and advocates, become more aware of THR’s public health and social justice potential.

Involvement in the scholarship program also provided numerous key contacts whose expertise has greatly enhanced Filter’s work and range of coverage. We anticipate that these collaborations will continue long into the future.

“The KAC scholarship program was a remarkable, inspiring experience. I came away feeling supported in executing Filter’s mission, and full of ideas for coverage generated by my interactions with other scholars from around the world. The program was a key element in the early success of my publication.”

Tobacco cultivation in Bangladesh
Khan Mehedi Hasan Show project report
Bangladesh

Tobacco cultivation and processing has become increasingly widespread in Bangladesh, despite multiple economic and logistical factors providing opposition to the shift of traditional crop growing farmers to become tobacco farmers. The reasoning and mentality behind this switch is the basis of Khan’s research, and by interviewing tobacco farmers to analyse the role of tobacco processing companies (TPC) in contracting tobacco cultivation amongst local farmers, Khan hopes to expand upon the current lack of detail regarding research into tobacco cultivator/TPC relationships, and provide future reference for policy making decisions in the region of Khulna in Bangladesh.

Full report in PDF format can be downloaded here

Regulation and transitions to vaping
Yolande Jeffares Show project report
New Zealand

Yolande Jeffares is currently finishing an MS (Psychology) at Massey University. She currently lives in Nelson, New Zealand and studies via distance learning. Yolande was previously awarded a studentship by the Health Research Council of New Zealand to research ethical issues related to vaping and e-cigarette research which gave rise to her concerns regarding how vaping research is conducted and how vapers are often represented. She will be returning to GFN this year to further develop her qualitative research skills through the KAC Scholarship programmes and with the guidance of her mentor Dr Marewa Glover.

AIM This study aimed to determine how Tobacco Harm Reduction related policy options could influence a person’s decision to attempt to stop smoking via vaping. METHOD Nine former smokers who had switched completely to vaping participated. Four vignettes describing different vaping policy environments were read to participants. Participants were asked how a smoker thinking of using vaping to stop smoking might think or feel in each circumstance. Responses were recorded, transcribed and then qualitative content analysis was conducted. The four environments were

  1. permissive and largely unregulated,
  2. somewhat permissive with some regulation,
  3. somewhat restrictive with stringent regulations, and
  4. prohibitionist.

RESULTS Conditions which favoured vaping acted as motivators that supported behavioural change. Conditions that were not supportive of vaping and conditions that were neutral or confusing acted as inhibitors of behavioural change. Strength of motivation and the reasons for considering smoking cessation moderated motivators and inhibitors. Individual differences acted as moderators of decision making.

CONCLUSION Results indicate a distinct gap between proposed vaping related policy in New Zealand and policy that is likely to be most effective in reducing smoking rates. Further , larger scale research, including both current smokers and vapers would be beneficial to strengthen findings and to provide greater insight into decision making processes.

Sampling representative data on societal well-being from the tobacco smoking community
Wilfred Jekete Show project report
Malawi

A social scientist in rural development and extension, researcher and tobacco harm reduction advocate who previously conducted research which was aimed at establishing evidence base on health and the socio-economic impact of Tobacco, and promoting intervention to enhance public understanding on tobacco harm reduction in Malawi.

Full report in PDF format can be downloaded here

Tobacco harm reduction and e-cigarette regulation in India
Michael Joseph
India

Although harm reduction techniques are widespread throughout the world, India has an adverse stance with regards to e-cigarette use. This antipathy (including the banning of e-cigarettes in six States in India) is the subject of Michael Joseph’s research with the aid of the Scholarship programmme. Through a review of the extent of e-cigarette regulation in India, with especial interest in the State of Kerala, and analysis of civil society group involvement in public health choice and information provision, Michael Joseph hopes to provide a greater information base for civil society groups to oppose e-cigarette bans and reverse the anti-harm reduction messages currently dissipated by the Indian public health system. So far Michael Joseph has contacted policy makers and experts in Kerala, and with the help of his mentor, Professor Rajesh Sharan, has contacted further people in tobacco harm reduction in Delhi.

Vaping and regulation in Estonia
Ingmar Kurg
Estonia

Ingmar Kurg is expanding on his work as founder and Chairman of the E-cigarette Sellers and Users Union of Estonia to conduct a survey of over 700 e-cigarette consumers. He will investigate how successive government regulations on e-cigarettes have impacted on vaping consumers in Estonia. Analysis of this survey will provide a wealth of information regarding trends in the change in user uptake of e-cigarettes related to legislative change and provide further information for law makers in Estonia to enact future regulation changes. An e-cigarette conference in the Estonian Parliament house in November 2018 provides a unique opportunity to further discuss reduced harm products for ex- and current- smokers. Ingmar is being mentored by Konstantinos Farsalinos.

Communicating tobacco harm reduction in Malawi
Chimwemwe Ngoma Show project report
Malawi

Chimwemwe Ngoma is a social scientist and a tobacco harm reduction advocate, and is implementing an information dissemination project on tobacco harm reduction and nicotine science in Malawi. He leads a group of 24 tobacco harm reduction volunteer ambassadors in Malawi and Zimbabwe. Chimwemwe has worked as a Project and Resource Mobilisation Officer at Drug Fight Malawi. Whilst in college he undertook a research study on “The prevalence of drug and substance abuse in Malawian colleges”.

Full report in PDF format can be downloaded here

Effect of vaping on oral health in Romania
Mihaela Raescu Show project report
Romania

Prof. Dr Mihaela Raescu is a PhD in Medical Sciences who teaches Oral and Dental Prevention at the Titu Maiorescu University School of Dentistry in Bucharest, Romania since 2003 and is a tenured University Professor since 2015, in addition to being an active practitioner and primarius doctor. She is the Erasmus coordinator and the President of Ethical Committee. She has authored and co-authored numerous studies and publications and has been a guest speaker at various professional conferences. She conducted several research projects in the dentistry field and product development as a project manager (European projects and private lab projects). In 2018 she received a KAC Foundation scholarship regarding research in the THR field.

Full report in PDF format can be downloaded here

E-cigarette use amongst people who are homeless
Florian Scheibein
Ireland

Florian Scheibein is a PhD Candidate studying "Novel Psychoactive Substance Injecting in Ireland: Practices, Health Implications and Service Utilisation". He currently helps teach a Substance Misuse module as part of the third year Psychiatric Nursing curriculum at the Waterford Institute of Technology. He is an active member of the International Working Group (IWG) of Youth RISE with whom he is currently working on 'law enforcement and youth' and general best practice guidelines. He recently helped develop a homeless support health needs guidebook/online health needs support library, and delivered harm reduction workshops whilst working as a Community Integration Officer for Depaul Ireland. Florian's full report will be available after publication.

Success rates of THR products amongst the general populace of the United States
Lindsey Stroud
USA

Through the lens of THR4Life, a platform dedicated to giving vapers informed and valuable opinions and science regarding vaping and e-cigarettes, Lindsey is seeking to assess the success rates of several different alternatives to smoking-based nicotine consumption, including nicotine replacement therapies, heat-not-burn products and e-cigarettes. In order to achieve this goal, Lindsey is utilising an online questionnaire to determine several factors indicative of successful smoking cessation (with the aid of nicotine products other than smoked tobacco), methods used to quit smoking and length of time spent attempting to quit smoking, amongst a US population. Ideally THR4Life will also examine the longer term health effects of the use of reduced harm nicotine products.

Investigating nicotine acetylcholine receptors
S Thangminlal Vaiphei Show project report
India

In his research project, S Thangminlal Vaiphei hopes to evaluate and explore the nicotine acetylcholine receptor proteins within the human body to further discover if therapeutic drugs can be developed that target these nicotine binding sites, possibly paving the way for a pharmacological and therapeutic route for reducing nicotine dependence and addiction. This project will also enable the creation of tools for detection of tobacco toxicants and biomarkers to evaluate the possibilities of alternate nicotine delivery systems. Regular contact with his mentor, Professor Rajesh Sharan, has enabled the pace of the project to intensify, and Rajesh has given insightful knowledge for ways to improve the project.

The main objective of this project is in silico approach to study the structural diversity of the nicotinic acetylcholine receptors (nAChRs) in the human population. The reason for choosing nAChRs is that the biological action of nicotine is initiated in the body when nicotine interacts with this receptor on the target cells in human initiating a cascade of downstream cellular events. These physiological events form the basis of nicotine dependence or addition. Since the intensity of nicotine dependence/addiction is highly variable in the population, it is hypothesized that structural diversity of nAChRs may be the cause of the observed diversity of nicotine dependence/addiction. Our primary objective may provide opportunity of molecular drug designing to modulate human nicotine dependence/addiction. Based on the sequence information, structural modeling was undertaken to predict the 3-D structure of this ion channel protein and the structural information has been employed to predict the ligand binding sites. The ligand-binding site of the Cys-loop receptor is formed by the loops at the interface between two adjacent subunits that help in maintaining the structure of the binding pocket or channel opening. The ligand binds to one of the aromatic side chains in this pocket that leads to change in movement of binding pockets. Since, in silico methods are limited to predicting the precise orientations of amino acid side chains and docked ligands, nicotine receptor-based drug targeting strategy requires a thorough understanding of the molecular interactions and therefore, further validations and confirmations by experimentation is required.