Last updated: 31 Jul, 2018

VicHealth is funding projects which aim to reduce the harms from tobacco and help more Victorians live smokefree.

VicHealth is funding projects which aim to reduce the harms from tobacco and help more Victorians live smokefree.

Research is essential to build knowledge and encourage innovative solutions. VicHealth’s Research Grants provide an opportunity for research teams to trial an innovative idea, research a new concept or methodology, or to develop better supporting evidence relevant to the theory, policy and practice of health promotion.

By supporting excellent research that aims to reduce the harms from tobacco, improving the overall skills of researchers, providing networking opportunities for researchers and connecting research to policy and practice, we increase the impact of health promotion and public health programs that have a focus on tobacco.

 

Ongoing research

VicHealth Innovation Research Grant

The SQuARe Trial: Staying quit after release from prison

The SQuARe Trial will test the efficacy of a pre-release brief behavioural intervention on extending prisoners' smoking abstinence following release from smoke-free prisons in Victoria.

Using a randomised design, the intervention group will receive brief counselling, relapse prevention calls form the Quitline, short-acting nicotine replacement therapy, and referral to primary care. 

Research team: 

  • Professor Stuart Kinner
  • Dr Jesse Young
  • Dr Cathy Segan
  • Ms Cheneal Puljevic

Rates of tobacco smoking are extremely high among people cycling through Australian prisons, estimated at 74% of prison entrants in 2015. Prisoners experience disproportionate rates of smoking-related health problems including cancer, chronic obstructive pulmonary disease, and cardiovascular disease; these disparities are often compounded by entrenched socio-economic disadvantage. Correctional authorities in Australia and elsewhere are progressively implementing smoke-free policies that prohibit tobacco smoking on prison grounds for both prisoners and prison staff. However, correctional smoking bans are insufficient to maintain smoking abstinence after release from prison. Interventions to prevent relapse to smoking after release from smoke-free prisons are urgently needed.

The findings of this pilot randomised trial will provide the first high-quality evidence, internationally, of the impact of a smoking relapse prevention support intervention for people exiting smoke-free prisons.

Research status:

The research is currently underway with completion anticipated in late 2019

Other relevant information or research:

Worldwide Prison Health Research and Engagement Network (WEPHREN)

The WEPHREN – Themed Collection: World No Tobacco Day May 2018 which links to a video with Professor Kinner and a literature search conducted in February 2018 on smokefree prisons.

 


 

VicHealth Innovation Research Grant

New solutions for reducing the harm of tobacco smoking with highly addicted smokers: A pilot study of electronic nicotine devices for smoking cessation with drug and alcohol treatment clients

The research will aim to investigate new ways to support cessation with alcohol and other drug (AOD) clients, particularly whether electronic nicotine devices (ENDs) can sustain a quit attempt and prevent relapse. The research will provide pilot data to assist the design and planning of a larger trial.

Research team:

  • Professor Billie Bonevski
  • Professor Dan Lubman
  • Dr Coral Gartner
  • Professor Ron Borland
  • Professor Amanda Baker
  • Dr Cathy Segan
  • Dr Victoria Manning

In Australia, up to 95% of people entering AOD treatment services smoke tobacco, which is five times greater than for the general adult population. Smokers with comorbid substance dependence are more likely to die from tobacco-related causes than from other substance-related causes.

Although smoking prevalence among AOD treatment clients is high, most smokers are interested in quitting and have attempted to quit smoking in the last 12 months. 

While 85% of quit attempts using standard medication and behavioural support fail in the long term among general population smokers, this rate is even higher amongst smokers with AOD use.

New ways are needed to support people with substance abuse disorders to quit smoking to reduce the health effects and the significant financial stress and social isolation amongst this already disadvantaged group.

ENDs are a novel approach with significant potential to increase cessation and reduce tobacco-related harm amongst smokers who have been resistant to other quit smoking interventions. In addition to the provision of nicotine to reduce cravings and withdrawal symptoms, ENDs also address the behavioural aspect of smoking cigarettes.

ENDs allow users to continue taking nicotine without the enormous health-related harms associated with tobacco smoking. Safety and efficacy as a smoking cessation strategy has been demonstrated when compared to other forms of nicotine replacement therapy (NRT) in trials with general population smokers, but the evidence on ENDs is still emerging and there is little research among priority populations, whom may benefit most.

The project will provide essential information for the design of a larger superiority trial which will be powered to assess the safety and efficacy of ENDs compared to NRT use for sustained cessation and harm reduction outcomes in AOD clients.

This research will contribute to the evidence base to inform policy development regarding the adoption of harm reduction approaches for tobacco within the AOD treatment setting. Harm reduction is an approach commonly used within the AOD treatment setting, however it has not been tested for tobacco smoking.

Research status:

The research is currently underway with completion anticipated in late 2018.

Other relevant information or research:

Are Electronic Cigarettes an Effective Aid to Smoking Cessation or Reduction Among Vulnerable Groups? A Systematic Review of Quantitative and Qualitative Evidence

 


Completed research

NHMRC Partnership Grant 2010-11

Which types of emotions in anti-smoking ads motivate smokers to quit, especially disadvantaged smokers?

VicHealth was a proud industry partner on this successful National Health and Medical Research (NHMRC) Partnership Grant which aimed to investigate the optimum levels and types of emotion evoked by anti-smoking ads about the health effects of smoking in the broad population.

The partnership project also examined the impact of emotion in anti-smoking ads among those smokers experiencing disadvantage to inform whether campaign messages need to be tailored for disadvantaged groups.

Research Findings:

The research findings suggest that for anti-tobacco advertisements targeting the whole population, messages that elicit fear should be used and messages that evoke sadness should be avoided. If the aim of the advertisement is to specifically motivate those living in lower socioeconomic status areas where smoking rates are higher, multiple negative emotion messages, but not hope-evoking messages, may also be effective.

Research team:

  • Associate Professor Sarah Durkin
  • Professor Melanie Wakefield
  • Dr Megan Bayly
  • Dr Lois Biener

Published papers from the research:

Fear, Sadness and Hope: Which Emotions Maximize Impact of Anti-Tobacco Mass Media Advertisements among Lower and Higher SES Groups?

 


 

Understanding how people make inferences about harm in relation to nicotine products and implications for smoking cessation

This research project aimed to increase our knowledge of smokers’ beliefs about how conventional cigarettes differ in harmfulness and addictiveness relative to other forms of nicotine.

Research Findings:

The research findings suggest that many people who smoke:

  • were unaware that cigarettes were the most harmful and addictive form of nicotine
  • mistakenly believe that nicotine was a poisonous substance that made cigarettes dangerous
  • mistakenly perceived budget or cheap cigarettes were more harmful than a premium brand or more expensive cigarettes.

The findings highlight the need to be mindful of how we communicate with the public about the risks of smoking compared to using other nicotine products. We need to communicate in ways that allow people who smoke to make more informed decisions about the risks of smoking compared to using nicotine replacement therapies to help them to quit smoking.

Research team:

  • Mr Bill King,
  • Professor Ron Borland
  • Dr Hua Yong

Published papers from the research:

Smokers’ risk perceptions and misperceptions of cigarettes, e‐cigarettes and nicotine replacement therapies

 


 

Scoping the opportunities to expand access to and use of nicotine replacement therapy to improve smoking cessation

Alfred Health led a scoping study that explored the existing research and evidence about the effectiveness of the extended use (dose and duration) of nicotine replacement therapy (NRT) to support smoking cessation.

In undertaking the study, Alfred Health reviewed the structural policy, guideline and clinical practice limitations that may prevent effective extended use of NRT being available in Australia.

Research Findings:

Evidence about NRT use

  • Combination therapy (use of nicotine transdermal patch with an intermittent form of NRT) is strongly evidenced in the literature and is highly supported by expert opinion.
  • Higher dose and longer duration of NRT is evidenced by some degree in the literature, and strongly supported by expert opinion (there is a limited set of high quality studies in the areas of higher dose and longer duration of NRT).

    Therapeutic Goods Administration (TGA) indications and evidence about NRT use

  • There is evidence to support the use of NRT beyond the current TGA indications.
  • Existing TGA indications are directly informed by submissions made by Australian sponsors. Any change to existing NRT products, including indications or dosage regimen, requires the evaluation of data by the TGA via formal application from each corresponding Australian sponsor.

Clinical practice using NRT

 Clinical practice in the area of smoking cessation and NRT use is highly variable.

Clinical guidelines are highly significant in informing health professional practice in the use of NRT for smoking cessation; where clinical guidelines are suboptimal, clinical practice is likely to be suboptimal.

There is demand for clinical guidelines in smoking cessation that are reflective of best available evidence regarding use of NRT.

Consumer use of NRT

 Consumer medicines information is based on TGA indications and therefore is also not reflective of best available evidence.

Consumer use of NRT is heavily influenced by the consumer medicine information which is based on TGA indications.

Research team: 

  • Emma Dean
  • Kirstan Corben
  • David Ruschena
  • Professor Michael Dooley
  • Professor Andrew Way

 


 

Further information:

For information about this research please contact the Alcohol and Tobacco Team at VicHealth on (03) 9667 1333.