Researchers at the University of Waterloo have been awarded a grant of $8.8 million from the U.S. National Cancer Institute to evaluate the public-health impact of government policies to regulate tobacco products, including e-cigarettes and other vaporized nicotine products.

This grant is the latest research program of the International Tobacco Control Policy Evaluation Project (ITC Project), based at the University of Waterloo. Over the past 14 years, the ITC Project has conducted extensive studies to evaluate the impact of national-level tobacco control policies in 28 countries, covering more than two-thirds of the world’s tobacco users. 

Some of the ITC Project’s research findings were critical to the government of Uruguay’s victory over Philip Morris International (PMI) last week. The tobacco giant filed an international complaint over Uruguay’s move to increase the size of warning labels on tobacco packaging. Several experts affiliated with the Waterloo-based ITC Project supported Uruguay’s defense. Their research provided evidence demonstrating that the proposed increase in the size of the warnings from 50 per cent of the pack to 80 per cent led to significant increases in effectiveness, which directly refuted PMI’s claim.

Waterloo and the Medical University of South Carolina are the two lead institutions in the larger research grant involving 11 institutions totalling $20 million. It includes five inter-related studies designed to guide governments on best practice in regulating current and emerging nicotine products in ways that help smokers to quit and minimize risk to non-smokers, especially youth.

“The University of Waterloo is pleased to be one of two lead institutions in this large-scale international project that will leverage research expertise and partnerships to further the strides already made in public health related to tobacco products, as well as evaluate the impact of government policies on public health,” said D. George Dixon, vice-president, university research at Waterloo.

Waterloo will conduct two studies that will measure trends in the use of e-cigarettes and other nicotine products as well as perceptions of risks and benefits. Geoffrey T. Fong, professor of psychology at Waterloo, who is founder and chief principal investigator of the ITC Project, is heading one study across three countries—Canada, the U.S. and England—that focuses on patterns of use of e-cigarettes among adult smokers and ex-smokers. The study led by Professor Fong, who is also senior investigator at the Ontario Institute for Cancer Research, measures the impact of tobacco control policies and e-cigarette policies on the use of e-cigarettes. David Hammond, associate professor in the School of Public Health and Health Systems at Waterloo, is leading a second study also across Canada, the U.S. and England focusing on the uptake of e-cigarettes among youth.

“With so many new nicotine products being introduced into the marketplace, we are in new and uncharted terrain, and in urgent need of data to understand the strengths and weaknesses of different policy options,” said Professor Fong, a co-principal investigator of the overall grant. “The findings from this project will help guide decision-makers and ultimately governments as to the most prudent course of action under this complex set of circumstances.” 

The proposed research utilizes both experimental and observational methods to explore the impact of policies on tobacco use behaviors in four countries in all:  the U.S., Canada, Australia and England. There is vigorous debate in public health communities and governments throughout the world about whether e-cigarettes will prove to have a net positive or negative impact on population health.

“The timing of this project is ideal since policies regulating e-cigarettes and conventional tobacco products are evolving in different countries, including in several Canadian provinces,” said Professor Hammond. “Now is the time to gather the evidence of the impact of these policy changes to help guide effective policy development throughout the world.”

Collectively, the proposed set of studies is designed to examine how different policies are likely to influence the use of e-cigarettes and smoked tobacco products, with the goal of developing forecasting models to predict the population health impact of different policies and regulations.

In addition to the University of Waterloo and the Medical University of South Carolina, institutions included in this research consortium are Roswell Park Cancer Institute, Georgetown University, Virginia Tech, University of Illinois at Chicago, The State University of New York, University of South Carolina, and Susquehanna University from the United States, King’s College London from the United Kingdom, and The Cancer Council Victoria from Australia.

Waterloo will also lead the data collection design and management across all 11 study sites under the direction of Professor Mary Thompson, distinguished professor emerita, Department of Statistics and Actuarial Science and director of the ITC Project’s Data Management Centre at Waterloo.

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