Scoping of Policy Impacts for Regulating E-cigarettes (SPIRE): a data and decision-analytic model mapping project

Background

E-cigarettes (EC) deliver nicotine efficiently without combustion, and thus are less harmful than standard cigarettes while aiding smoking cessation. Yet, EC are not risk-free, particularly for people who have never smoked, and their use has been rising, especially among young people. Decision modelling can be used to synthesise data and understand and predict the impact of EC policies on consumption and health outcomes.

To date limited modelling of EC use and policy effects has been undertaken in the UK and little is known about the data needed to do so. Aims and objectives

We aim to identify a) data sources that can inform modelling of priority policies and b) gaps in data that are required to undertake appropriate modelling by:

1. Engaging with stakeholders to identify priority EC policy options, mechanisms of action, unintended consequences, key subgroups and outcomes of interest;

2. Providing recommendations for the types of modelling that could be constructed to assess the impact of key EC policies; 3. Establishing which categories of data would be most valuable and at what level of detail;

4. Identifying data currently available and describing any potential issues including data accessibility and access costs;

5. Suggesting new types of data that would need to be collected to allow accurate modelling of EC policies and how future research efforts could be coordinated. Methods

We will use an established conceptual modelling framework for developing the structure of public health models. We will hold stakeholder workshops to identify key EC policy options, mechanisms of action, potential unintended consequences, priority subgroups and outcomes of interest. Participants will include key national/local policy makers, non-governmental EC policy experts, lay members, experts in public health and behavioural science, commercial determinants of health, data collection/analysis and modelling methods.

A behavioural systems map will be developed to set out hypothesised causal relationships between potential interventions, sociodemographics, psychological variables, EC and smoking behaviours and their interactions, macro-level drivers (e.g., norms, business interests), and health outcomes. We will use existing guidance for complex systems models and a new toolbox of methods for modelling the influences on behaviour to provide recommendations for the types of modelling that could be undertaken to assess key EC policies.

Existing data to parameterise such a model will be identified via input from collaborators, stakeholders and targeted literature reviews. We will describe any potential data issues, including missingness, data accessibility and costs. Areas with data missing will be identified and possible ways of collecting or calibrating data will be described.

We will hold a second stakeholder workshop to discuss and resolve any key issues arising from a review of the draft report. Public views will be given a strong emphasis by including lay members in the workshops and as advisors to the project team. Anticipated impact and dissemination

The project will enable commissioners to fund appropriate research for data collection and modelling to assess potential EC policy options. This future research could help improve societal health, reduce inequalities and costs to the health service. We will disseminate findings via the NIHR Journals Library, stakeholder events, conferences, journal articles and webinars.