Understanding experts’ conflicting perspectives on tobacco harm reduction and e-cigarettes: An interpretive policy analysis

Klein, Daniel Eisenkraft; Hawkins, Benjamin; Schwartz, Robert

doi:10.1016/j.ssmqr.2022.100197

Cited by 6 publications

(3 citation statements)

References 40 publications

(38 reference statements)

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“…The reason for our vigilance for spin bias is because the use of e-cigarettes is a controversial and divisive field [ 7 – 9 ]. We, along with other researchers, are deeply concerned that “polarized stances on e-cigarettes will threaten the integrity of research” [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying spin bias of nonsignificant findings in biomedical studies

et al. 2023

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Objective The purpose of this research note is to share a technique for the identification of spin bias that we developed as part of a living systematic review on the cardiovascular testing of e-cigarette substitution for cigarette smoking. While some researchers have remarked on the subjective nature of ascertaining spin bias, our technique objectively documents forms of spin bias arising from the misrepresentation of nonsignificant findings and from the omission of data. Results We offer a two-step process for the identification of spin bias consisting of tracking data and findings and recording of data discrepancies by describing how the spin bias was produced in the text. In this research note, we give an example of the documentation of spin bias from our systematic review. Our experience was that nonsignificant results were presented as causal or even as significant in the Discussion of studies. Spin bias distorts scientific research and misleads readers; therefore it behooves peer reviewers and journal editors to make the effort to detect and correct it.

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Section: Introductionmentioning

confidence: 99%

Identifying spin bias of nonsignificant findings in biomedical studies

et al. 2023

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“…Another systematic review is unlikely to make a significant contribution until more experimental studies are published. Our purpose for conducting an umbrella review is to provide the widest overview of the clinical evidence on the use of ENDS and their impact on cigarette smoking abstinence for an audience of researchers and clinicians highly polarized over the use of ENDS [ 8 - 10 ]. An umbrella review systematically searches and retrieves systematic reviews, critically appraises them, and synthesizes their results [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

e-Cigarette Use and the Cessation of Tobacco Cigarette Smoking: Protocol for an Umbrella Review

O’Leary

Polosa

2023

JMIR Res Protoc

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Background Electronic nicotine delivery systems (ENDS), commonly called e-cigarettes, have been examined in clinical studies for their effects on tobacco smoking cessation. In the past 2 years, a dozen or more systematic reviews on ENDS and cigarette smoking cessation have been published that present differing conclusions and recommendations on the use of ENDS. Objective Our umbrella review aims to synthesize the findings from current systematic reviews to investigate the quit rates and the percentage of participants abstinent from cigarette smoking using ENDS. Additionally, we will examine the quit rates with ENDS in comparison to other established cessation treatments. Methods The search will retrieve systematic reviews that include both clinical trials and experimental studies on the use of ENDS for smoking cessation. We will also include nonrandomized cohort studies that track ENDS use and the subsequent abstinence from smoking. Databases searches will be conducted in Embase, Scopus, PubMed, and 7 additional registries. Secondary searches will include reference checking, citation chasing, and consultations with topic experts. Two reviewers will perform a title and abstract exclusion followed by a full-paper inclusion process. Data extraction will be conducted by 1 reviewer and completely checked by a second reviewer. Each systematic review will be assessed by 2 reviewers for methodological quality using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews, version 2) and for reporting bias using categories from the Centre for Evidence-Based Medicine’s Catalogue of Bias. Unreported discrepancies between the protocol and the published review will be identified. Results The umbrella review started on March 1, 2023. At the time of publication, the study selection was being conducted and the pilot testing of the data extraction and bias assessment forms were in progress. The review is expected to be completed by December 31, 2023, followed by the submission of the review for journal publication. A second-order meta-analysis will calculate the range and average of quit rates for ENDS. A vote counting of the direction of effect, based on quit rates, will be used to present the relative effectiveness of ENDS for smoking cessation compared to other cessation treatments (including no treatment). A citation matrix will list primary studies with their bias ratings from all the systematic reviews. The effect of overlapping studies between the systematic reviews will be calculated using the corrected coverage area analysis. A sensitivity analysis will examine the impact of the intensity of cessation treatment on quit rates. Depending on the availability of data, subgroup analyses will be conducted based on participants’ gender, age, prior quit attempts, and nicotine dependence. The strength or weakness of the evidence synthesis will be assessed using a stratification of evidence technique. Reporting bias will be presented with a tabulation of bias indicators. Publication bias will be assessed. Conclusions The use of ENDS for smoking cessation is a highly controversial subject. Through an exhaustive synthesis of the available data, we will present the quit rates of cigarette smoking cessation obtained with ENDS and how they compare to quit rates obtained from other established cessation treatments. The critical quality and bias assessment of the systematic reviews will indicate the most reliable sources to inform treatment considerations and policy development. Trial Registration PROSPERO CRD42023406165; https://tinyurl.com/4ekzpbrj International Registered Report Identifier (IRRID) PRR1-10.2196/47711

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“…Fourthly, regulatory measures should be informed by evidence rather than by values, ideology, politics and opinion [22].…”

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confidence: 99%

How should nicotine vaping be regulated in Australia?

Mendelsohn¹,

Wodak

Hall

2023

Drug and Alcohol Review

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In Australia, nicotine vaping products are regulated as prescription‐only medicines which can only be sold from a pharmacy, with the aim of preventing youth access and allowing use by adult smokers with a doctor's support. The Therapeutic Goods Administration has acknowledged that this policy has not achieved its goals. Instead, a thriving black market has developed which sells unregulated vape products to children and adults. Very few adult vapers use the legal prescription pathway. Regulation should find the optimal balance between facilitating legal access for adult smokers while restricting access by youth. The preferred approach is a tightly regulated consumer model with nicotine vaping products sold by licenced retail outlets with strict age‐of‐sale verification. Regulations should be proportionate to risk and reflect the lower harms of vaping relative to smoking. A consumer model would bring Australia into line with other Western countries and improve population health.

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Understanding experts’ conflicting perspectives on tobacco harm reduction and e-cigarettes: An interpretive policy analysis

Cited by 6 publications

References 40 publications

Identifying spin bias of nonsignificant findings in biomedical studies

Identifying spin bias of nonsignificant findings in biomedical studies

e-Cigarette Use and the Cessation of Tobacco Cigarette Smoking: Protocol for an Umbrella Review

How should nicotine vaping be regulated in Australia?

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