The University of Waterloo is one of the lead institutions in a five-year, $10 million (U.S.) international study funded by the United States’ National Cancer Institute.

The multi-centre study will evaluate the behavioural and long-term health impact of different regulatory approaches to e-cigarettes and other new nicotine products among youth and adults in seven countries.

The market for tobacco products has expanded rapidly in the past decade as e-cigarettes, heated tobacco products, and other new nicotine products are now available in addition to cigarettes and cigars. Countries around the world have taken different approaches to regulating these new products, with some governments encouraging smokers who can’t quit to switch to these products, and others adopting more restrictive policies, hoping to reduce use by non-smoking youth who might become addicted to them.

The five-year study builds on the work of the International Tobacco Control Policy Evaluation Project (ITC Project), which for nearly 20 years has conducted research on the impact of the World Health Organization’s Framework Convention on Tobacco Control (FCTC)—a health treaty adopted by over 180 countries aimed at reducing the global harms of tobacco use. The ITC Project has conducted studies across 31 countries, building the evidence base to support FCTC policies, including health warnings, tobacco taxes, clean indoor air rules, and plain/standardized packaging.  

Geoffrey Fong, founder and chief principal investigator of the ITC Project, is co-leading the grant’s national cohort studies of adult smokers, vapers, and dual users (for example, those who both smoke and vape) in the U.S., Canada, England, Australia, New Zealand, Japan, and South Korea—countries that have very different approaches to cigarettes, e-cigarettes, and other new nicotine products, such as heated tobacco products.

“Governments all over the world need data to guide evidence-based approaches to regulate tobacco products,” said Fong, professor of psychology at Waterloo. “To date, there has been mostly speculation about the impact of policies on e-cigarettes and other new nicotine products. This project allows us to compare the behavioural and potential future health impacts of different regulatory strategies being carried out in different countries with great potential to inform evidence-based approaches to e-cigarettes and other new nicotine products.”

David Hammond, professor and University Research Chair in Public Health in the School of Public Health Sciences at Waterloo, will lead a survey of youth in the U.S., Canada, and England that examines trends in smoking and vaping among youth who smoke and those who have never smoked.

“Understanding the use of these products among both youth and adults is critical to understanding which policies are the most effective in decreasing tobacco use and curbing youth uptake of e-cigarettes,” Hammond said. “The timing of this project is ideal since policies are still evolving in Canada and other countries.”

Waterloo will also lead the data collection design and management across the study sites under the direction of Distinguished Professor Emerita Mary Thompson and professor Changbao Wu, both of the Department of Statistics and Actuarial Science.

“The project will put Waterloo and our collaborators at the forefront of methods to examine changes in patterns of use of various nicotine products over time and to compare data across countries with very different policy approaches,” Thompson said.

Other collaborating institutions include Medical University of South Carolina, Roswell Park Comprehensive Cancer Center, Georgetown University, Fralin Biomedical Research Institute at Virginia Tech Carilion, University of South Carolina, King’s College London, and University of Melbourne.

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