Addiction Audio


Heated tobacco products and nomenclature with Katie East

Season 2, Ep. 1
In this episode, Dr Katherine East talks about her recent article on heated tobacco product use. When conducting this research, Katie talked to former and current smokers who use IQOS to understand the words they use to describe themselves and what they do in relation to heated tobacco products. Katie and Rob then talk about how the language can reflect identity and how this can influence the risk of people relapsing to smoking or other forms of nicotine use. They discuss the importance of social norms and how language can play a substantial role in shaping those norms. Katie explains why some potential words that might have been used have since been discarded, including “heaters” and “IQOSers”. They also talk about different social circumstances and how heated tobacco use, vaping and smoking identities interact. Link to Katie’s previous podcast“Lots of people refer to it as smoking still…. It also means less having to explain what it is because very few people have heard of IQOS”“The way that people refer to things and they way they think about themselves as product users can influence their behaviour.”“Whilst people referred to IQOS use as smoking they were very resistant to being identified as a smoker”. Original article: ‘It's not what you'd term normal smoking’: a qualitative exploration of language used to describe heated tobacco product use and associated user identity by Katherine East and colleagues. Published in Addiction (2022).

Highly processed foods and addiction with Ashley Gearhardt

Season 1, Ep. 48
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)

Racial equity, research and the SRNT taskforce with Mignonne Guy and Megan Piper

Season 1, Ep. 46
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

Opioid agonist treatment, drug related deaths and dynamic models with Matt Hickman

Ep. 44
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)