Hollings part of $10M global tobacco study to guide regulatory policies

December 09, 2021
vaping pen under a magnifying glass on top of a stylized map of the world
Hollings is taking a leading role in a new international study that will evaluate the impact of different regulatory approaches to e-cigarettes and other new nicotine products.

Researchers from MUSC Hollings Cancer Center are part of a $10 million five-year global study funded by the National Cancer Institute that will examine how regulatory policies affect smoking, vaping and the use of other nicotine products.

The multicenter study will evaluate the behavioral and long-term health impacts of different regulatory approaches to e-cigarettes and other new nicotine products among youth and adults in seven countries. Other collaborating institutions include Fralin Biomedical Research Institute at Virginia Tech Carilion, Georgetown University, Kings College London, Roswell Park Comprehensive Cancer Center, the University of Melbourne (Australia), the University of South Carolina and the University of Waterloo (Canada).

K. Michael Cummings, Ph.D., one of the study leaders and co-leader of Hollings Cancer Center’s Tobacco Research Program, said 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 nonsmoking youth who might become addicted to them.

K. Michael Cummings 
Dr. Michael Cummings is one of the leaders of the global tobacco study. Photo by Sarah Pack

The study allows researchers to examine what different countries have done to regulate tobacco products and how different regulations affect tobacco use behaviors. Researchers will compare patterns of tobacco use among teens and adults in seven countries selected because of varying regulatory approaches to the marketing and sale of tobacco products. The countries involved in the study include the United States, Canada, England, Australia, New Zealand, South Korea and Japan.

“With the rapid evolution of potentially lower-risk nicotine products now entering the marketplace, the need for evidence to shape regulatory policies is more important than ever,” said Cummings, who also is a professor in MUSC’s Department of Psychiatry and Behavioral Sciences. “To date, most of the policies adopted on e-cigarettes and other new nicotine products have been based on emotion and guesswork. By comparing the experiences of different countries with varying regulatory approaches, the study seeks to inform United States public policy, based upon the best science available to maximize population health.”

Hollings Cancer Center director Raymond N. DuBois, M.D., Ph.D., said the study reflects the diversity of research being conducted at Hollings, ranging from cancer control to population health.

“The policy research on smoking has been one of the main reasons for the positive trends we’ve observed in reduced cancer mortality over the past 60 years. Most people think about smoking and lung cancer, but smoking is the cause of 13 different cancers, accounting for about one-third of all cancer deaths," he said. "The current NCI-funded study will help to guide future evidence-based policies that, if implemented by governments, have the potential to prevent millions of cancer deaths around the globe.”

The five-year study builds on the work of the International Tobacco Control Policy Evaluation Project, known as the ITC project, which for nearly 20 years has conducted research on the impact of the World Health Organization’s Framework Convention on Tobacco Control — 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, contributing to the evidence base to support government mandated product marketing regulations such as health warnings, tobacco taxes, clean indoor air rules and standardized packaging.

Cummings said this study brings together a dream team of experts from around the globe who hold different perspectives about tobacco regulations, so it creates a healthy dynamic for conducting the research that allows the data and science to influence policy.

“The United States has a goal of reducing the number of people smoking to 5% by 2030. Right now, we are sitting at around 14% of the population who smoke. We hope this study helps us to meet that 5% goal and save lives.”
— Dr. Michael Cummings

The global study is divided into four parts. The first project will evaluate the behavioral and long-term health impacts of different regulatory approaches to e-cigarettes and other new nicotine products among adults in the seven included countries.

The second project involves adolescents age 16 to 19 in the U.S., Canada and England. “This study will also include adolescents who don’t currently smoke because we want to know how they pick up the habit in the first place,” Cummings explained. “What makes someone want to start using these products?”

The third project involves controlled laboratory-based experiments, in which a virtual tobacco store is created to allow study participants to indicate their preferences for different products. Cummings said this marketplace allows the researchers to control experimentally how consumers might respond to things like flavor bans, differing prices of products and even product bans that might be implemented by governments.

The fourth project combines data from the above studies with government surveys and industry data to model how different policies may influence tobacco use behaviors and downstream health outcomes.

Cummings said he’s grateful to the NCI, which historically has been the main federal agency funding research on ways to mitigate the harms of smoking. “The United States has a goal of reducing the number of people smoking to 5% by 2030. Right now, we are sitting at around 14% of the population who smoke. We hope this study helps us to meet that 5% goal and save lives.”