Contextual influences on the role evidence in e-cigarette recommendations: a multi-method analysis of international and nation recommendations

Smith, M. J. , Katikireddi, S. V. , Skivington, K. and Hilton, S. (2023) Contextual influences on the role evidence in e-cigarette recommendations: a multi-method analysis of international and nation recommendations. Evidence and Policy: A Journal of Research, Debate and Practice, 19(3), pp. 400-422. (doi: 10.1332/174426421X16711062023280) (PMID:37529415) (PMCID:PMC7614860)

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Abstract

Background: E-cigarette policy has varied across jurisdictions, contrasting with the previous coordinated approach of international tobacco control communities. Aims and objectives: A multi-method case study approach was used to understand the role of evidence and external and internal contextual factors in the development of public health recommendations across four purposively selected jurisdictions (WHO, UK, Australia and USA). Methods: Informed by Dobrow et al’s (2004) conceptual framework for context-based evidence-based decision making, four data sources were drawn upon: 1) 15 public health bodies’ e-cigarette recommendation documents; 2) seven development documents produced by the public health bodies; 3) sources of evidence cited in the public health bodies’ recommendation documents; and 4) 15 qualitative interviews with experts. Thematic analysis and citation analysis were conducted to aid triangulation of evidence. Findings: We found a complex interplay between internal and external factors which influence the role and use of evidence in the development of e-cigarette recommendations. For example, recommendation documents’ remit (internal factor) was influenced by various external factors such as epidemiology and policy history, with decisions made over time having reshaped the external context. Considering the findings with respect to evidence utilisation, we propose a modified version of Dobrow et al’s (2004) framework, highlighting the important interplay between internal and external contextual factors. Discussion and conclusion: This research suggest internal and external contextual factors mutually interact and influence how evidence is incorporated into recommendations. This dynamic interplay of contextual factors may help explain why different policy approaches are pursued concerning public health topics, particularly e-cigarettes.

Item Type:Articles
Additional Information:MS is a self-funded PhD Student and acknowledges funding from Cancer Research UK grant PPRCTAGPJT\100003. SVK acknowledges funding from an NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council grant MC_UU_00022/2 and the Chief Scientist Office of the Scottish Office of the Scottish Government Health Directorates grant SPHSU17. KS is funded by the Medical Research Council grant MC_UU_00022/3, the Chief Scientist Office of the Scottish Government Health Directorates grant SPHSU18, and is also supported by a Medical Research Council Strategic Award (MC_PC_13027). SH is funded by the Medical Research Council grant MC_UU_00022/1, the Chief Scientist Office of the Scottish Government Health Directorates grant SPHSU17, and Cancer Research UK grant PPRCTAGPJT\100003.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Skivington, Dr Kathryn and Katikireddi, Professor Vittal and Hilton, Professor Shona and Smith, Dr Marissa
Authors: Smith, M. J., Katikireddi, S. V., Skivington, K., and Hilton, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Evidence and Policy: A Journal of Research, Debate and Practice
Publisher:Policy Press
ISSN:1744-2648
ISSN (Online):1744-2656
Published Online:20 January 2023
Copyright Holders:Copyright © 2023 Policy Press
First Published:First published in Evidence and Policy: A Journal of Research, Debate and Practice 19(3): 400-422
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
309944Young people's engagement with e-cigarettes and their marketing: a mixed methods, engaged project to co-produce recommendations for policyShona HiltonCancer Research UK (CRUK)PPRCTAGPJT\100003SHW - MRC/CSO Social & Public Health Sciences Unit
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiOffice of the Chief Scientific Adviser (CSO)SCAF/15/02SHW - Public Health
3048230021Inequalities in healthAlastair LeylandMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
3048230071Inequalities in healthAlastair LeylandOffice of the Chief Scientific Adviser (CSO)SPHSU17HW - MRC/CSO Social and Public Health Sciences Unit
3048230031Relationships and healthKirstin MitchellMedical Research Council (MRC)MC_UU_00022/3HW - MRC/CSO Social and Public Health Sciences Unit
3048230081Relationships and healthKirstin MitchellOffice of the Chief Scientific Adviser (CSO)SPHSU18HW - MRC/CSO Social and Public Health Sciences Unit
168560MRC SPHSU/GU Transfer FellowshipsLaurence MooreMedical Research Council (MRC)MC_PC_13027SHW - MRC/CSO Social & Public Health Sciences Unit
3048230011Complexity in healthSharon SimpsonMedical Research Council (MRC)MC_UU_00022/1HW - MRC/CSO Social and Public Health Sciences Unit