Cancer Grand Challenges is a series of £20 ($25) million awards, that gives international teams of researchers the freedom to think differently, act creatively and explore truly innovative science to take on fundamental problems in cancer.
It is estimated that tobacco smoke causes more than 20% of cancer deaths worldwide. Despite significant health warnings and efforts to reduce the number of people smoking, if current trends of tobacco use continue, it is predicted that it will result in 1 billion deaths in the 21st century.
Smoking cessation is the process of stopping tobacco smoking. This involves both reducing the proportion of younger people who start to smoke and increasing the proportion of established smokers who quit. Nicotine replacement therapies have been an important part of smoking cessation programmes. In the last decade, e-cigarettes, devices that deliver nicotine in the form of a vapour inhaled into the lungs without burning tobacco, have become widely popular. Randomised trials have indicated that e-cigarettes can assist some smokers in quitting, but it is unclear how effective they are for long term smoking cessation. In addition, the full extent of both the short and long-term health risks for e-cigarette users has yet to be fully determined, and the impact at a population level remains uncertain.
Conflict-of-interest free research needs to be accomplished to understand the potential benefits and risks of e-cigarettes at a global scale.
Barriers and opportunities
Cancer organisations, health systems and regulators urgently need to know the risks and benefits of e-cigarettes. These could be impacted by multiple factors, and questions that could be addressed range from the patho-physiological impact to the societal implications of e-cigarette smoking.
This may include but would not be limited to:
How safe are e-cigarettes, and are there long-term health consequences? Can we understand the toxicology of e-cigarettes, the effects of nicotine on the developing and adult brain, on respiratory and cardiovascular health and other health metrics in established e-cigarette users?
Do e-cigarettes enable a reduction in tobacco smoking when accounting for use at the population level taking into account increased uptake amongst teenagers and young adults?
How do consumer preferences, such as delivery systems, nicotine content, and flavours alter the potential long-term effectiveness of e-cigarettes? Note, this should not include studies on cannabidiol (CBD) or tetrahydrocannabinol (THC).
Can we analyse the effectiveness of regulation of e-cigarettes? How effective are e-cigarettes for long-term smoking cessation?
What are the social implications of wide-spread e-cigarette use?
Vision and Impact
At present, research in the field is fragmented and mostly small-scale. Multinational and truly multidisciplinary proposals are needed. Success in this challenge would be to generate evidence that could inform objective, high-quality information on the potential benefits and risks of e-cigarette use for established smokers who wish to quit smoking, and the general public.
This challenge aims to bring together disciplines such as pharmacology, molecular toxicology, molecular biology, immunology, epidemiology, behavioural science, law and health policy to address this issue.
Plain language summary: Why e-cigarettes?
The effects of e-cigarette use on tobacco use behaviour and tobacco-related health outcomes are still emerging and much remains to be learned. This Cancer Grand Challenge invites experts around the world to come together and examine the harms and potential benefits of e-cigarette use from a global perspective.
By bringing these professionals together, we can provide robust answers to crucial questions, including: How do e-cigarettes influence overall tobacco use, including initiation, dual use, and cessation? What are the short and long-term health consequences of e-cigarette use? How does the regulatory context affect the extent of harms and potential benefits of these products?