Addiction Audio

In this episode, Harry Tattan-Birch talks about his recent article on the increased popularity of disposable vaping products. He discusses the difference between this new generation of vaping products compared with the original versions.He talks about the data that suggest a rise in vaping alongside a lack of change in use of nicotine products overall. And the three reasons why disposable vapes have become more popular; including the low up-front cost, nicotine delivery/nicotine salts, and the convenience.“You can just walk into a shop, buy a device, open the packet and instantly start using it. you don’t have to know anything about coils… the concentration of e-liquid, you don’t have to charge it.”Harry also talks about how the team were able to publish relatively soon after noticing the trend. He talks about using data from the Smoking Toolkit Study and how this supports efficient and effective publishing, enabling researchers to see what’s happening real-time on the nicotine market. Original article: Rapid growth in disposable e-cigarette vaping among young adults in Great Britain from 2021 to 2022: a repeat cross-sectional survey by Harry Tattan-Birch and colleagues. Published in Addiction (2022)

In this episode of Addiction Audio, Rob Talks to Dr Ashley Gearhardt from the University of Michigan about whether highly processed foods can be considered to be addictive substances.Dr Gearhardt starts by defining highly processed foods before covering the issues that arise from having an addictive substance (such as food) that you can’t ‘opt out’ of. Ashley makes comparisons with other addictive substances noting that highly processed foods can induce cravings and lead to a loss of control. She then talks about which foods have a bigger impact on addictive behaviours highlighting foods that contain refined sugars and added fats such as pizzas and donuts.Rob and Ashley then discuss the limits to research whereby there is little agreement on how to define an addictive substance. This is in stark contrast with a growing consensus on how to identify addictive behaviours. There are, for example, agreed diagnostic criteria for addiction, but there is less agreement on how to define whether a substance is addictive.They also talk about how a substance that isn’t intoxicating can be addictive.“It isn’t necessarily the amount of pleasure or liking you get at the moment you consume them [highly processed foods], but the ability that they have to sensitise motivation systems to want more and more and more”“We argue that we need to treat these highly processed foods, not so much as foods per se but as highly refined substances that have been engineered to be incredibly rewarding.”Original article: Highly processed foods can be considered addictive substances based on established scientific criteria by Ashley Gearhardt and Alexandra DiFeliceantonio. Published in Addiction (2022)

In this episode of Addiction Audio, Rob talks to Ebtesam Saleh a Doctoral student at the Charite university in Berlin. Ebtesam talks about her recent systematic review of qualitative research on substance use among refugees. She talks about talks about the limitations of using survey data to explore this issue and how qualitative research can help contextualise the problems faced by refugees in a culturally sensitive way. Ebtesam discusses the impact that research can have and how researchers can minimise the potential for re-traumatisation through research interviews. She also discusses the cultural differences in how people view substances and substance use. With substances like coca, betul quid and prescription drugs being viewed, legislated and used in different ways in different countries. There are also multiple barriers to treatment that refugees can experience from stigma to a lack of resources and including structural factors such as health insurance requirements in different countries. Ebtesam then talks about the many refugee groups whose experiences are not present in the literature:“For example, Yemen hosts many refugee populations from African conflict countries; while Yemen itself is a country struggling with civil war, so it looks like a refugee crisis within a country of crisis. So, a crisis within the crisis”

In this episode of Addiction Audio, Drs Mignonne Guy and Megan Piper talk about their work on the racial equity taskforce for the Society for Research on Nicotine and Tobacco (SRNT). It was a powerful and wide-ranging discussion about developing anti-racist practice, social constructs of race, research methods, society organisations and research funding structures. Megan and Mignonne began by talking about why the racial equity taskforce was set up, how they determined what to do and the findings of the SRNT policy review. They then discuss wider issues of race and inequality that run throughout academia, describing how health disparity research can be suppressed and discouraged as well as the impact of the tobacco industry’s racist history. The discussion then focuses on how key research concepts – including methods often considered central to public health research – need to change or be replaced in order to eliminate the impact of structural racism on research and on population health. They finally offer advice to organisations about how to undertake their own racial equity reviews. “When we look at our policies and we see that there’s nothing about race, no, that’s not surprising … because that’s how this invisible dominant whiteness takes over everything – by excluding those groups and not explicitly referring to other populations.” - Dr Mignonne Guy  “So, this scientific premise that we have been operating under and training …. so many scientists under that the population can be controlled for doesn’t work. [This] really does elevate the importance of studying specific populations because their experiences are so very different they can’t be controlled for.” - Dr Megan Piper “We’re asking people to divest from their scientific legacy and to try to construct something new and be part of that and pioneering this type of work” - Dr Mignonne Guy

In this episode we talk to Dr Sharon Cox about developing an ontology around nicotine and tobacco products. Sharon also talks about the importance of ontologies and how they are important for research. She talks about how to manage disagreements when developing a system that categorises and defines products, behaviours and properties. “So, as researchers, which we are, we should be pedants and we should think it’s important that the products we write about we write about with accuracy.”  “Because we want to be clear, we want to be really clear with the public. We want to make sure that we’re writing lay outputs, developing ad campaigns advising companies….. we want to make sure that we’re communicating the science of our subject as clearly as we can. And that really starts with our academic work.”  Original article: Toward an ontology of tobacco, nicotine and vaping products by Sharon Cox and colleagues. Published in Addiction (2022)

In this episode, Professor Matt Hickman talks about using population modelling to identify the population implications of Opioid Agonist Treatment (OAT). He covers the impact that OAT has on drug-related deaths and other causes of mortality as well as how models can be used to explore what mortality rates would have been without OAT in New South Wales, Australia.Professor Hickman talks about their findings that, without OAT, the number of overdose deaths would have been 50% higher.“So, what we were trying to do in this study was to model the counter-factual of how many deaths there would be if there hadn’t been any opioid agonist treatment. In theory the ideal model would be a trial in which you have OAT versus no OAT in a population, now clearly that’s unethical and can’t be done.”He also talks about how the research team set up a dynamic model that they used to explore the data, matching incarceration and OAT records. They then used those data alongside findings from systematic reviews to model the hypothetical impact of OAT on a real population.“We’ve done models before, theoretical models which say ‘if we increase the opioid agonist treatment programme and we increase duration at a certain point what impact would that have?’ but that’s rarely based on actual real data. So …there’s modelling and there’s modelling, and this model is based on real empirical data and we think that gives it a bit more credence”. Original paper here: Modeling the population-level impact of opioid agonist treatment on mortality among people accessing treatment between 2001 and 2020 in New South Wales, Australia by Antoine Chaillon and colleagues. Published in Addiction (2022)