Understanding the Role of Evidence and Management Conflicts of Interest in E-cigarette Regulation and Policy: a Qualitative Interview Study

Smith, M. J. , Skivington, K. , Katikireddi, S. V. and Hilton, S. (2021) Understanding the Role of Evidence and Management Conflicts of Interest in E-cigarette Regulation and Policy: a Qualitative Interview Study. SRNT 27th Annual Meeting, 24-27 Feb 2021.

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Background: Public health guidelines aspire to be evidence-based and follow a transparent process to produce recommendations. Electronic cigarettes (e-cigarettes) are a useful case study to examine this process given the rapidly developing evidence base and range of vested interests in policy recommendations. In this study we conducted interviews with experts involved in developing e-cigarette guidelines to better understand the role of evidence and the management of conflicts of interest in producing recommendations about e-cigarette policy. Methods: We conducted 15 in-depth interviews with guideline methodologists, policymakers and academics from the three selected jurisdictions (UK, Australia and USA). Participants were asked about evidence selection and assessment, the role of evidence and the process for managing conflicts of interest. Thematic codes were developed and refined iteratively to reflect emergent themes. Results: All participants agreed that guidelines should be evidence-based, and the role of evidence is paramount to developing public health guidelines. Participants described barriers to developing e-cigarette guidelines, including the lack of long-term evidence-meaning only limited policy-relevant evidence is available to guide policy. Participants were also in agreement about the importance of declaring conflicts of interest and how these influence the sources of evidence that are drawn upon. Most participants stated evidence with links to the tobacco industry should be discounted, however, one participant acknowledged the quality of the evidence outweighs declarations of interest. Several participants acknowledged the presence of conflicting evidence can influence recommendations detailed in guidelines. Conclusions: We illustrated that public health guidelines need to take clear account of the evidence, but that experts involved in developing e-cigarette public health guidelines perceive there to be substantial challenges in how to handle conflicts of interest. Guideline developers should have a well-defined and robust process to assess the evidence when conflicts exist.

Item Type:Conference or Workshop Item
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal and Skivington, Dr Kathryn and Hilton, Professor Shona and Smith, Dr Marissa
Authors: Smith, M. J., Skivington, K., Katikireddi, S. V., and Hilton, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
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