Tag: CoEHAR

  • CoEHAR: Vapes Most Effective Quitting Tool

    CoEHAR: Vapes Most Effective Quitting Tool

    Image: CoEHAR

    A recent review conducted by the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) at the University of Catania found that e-cigarettes are more effective than other treatments for smoking cessation.

    Published in Drug and Alcohol Dependence, the study represents one of the most comprehensive analyses to date, evaluating 16 systematic reviews and encompassing data from 24 randomized controlled trials (RCTs).

    According to the authors, e-cigarettes outperformed other cessation treatments in eight out of 11 meta-analyses. No evidence was found to suggest that e-cigarettes are less effective than any alternative treatments. And while mixed results emerged when comparing ENDS to traditional nicotine replacement therapy, the overall trend favored ENDS for cessation efficacy.

    “The data from our umbrella review can support the integration of harm reduction strategies into public health policies in many countries,” said Renée O’Leary, lead author of the review, in a statement. “However, the review highlights a critical gap in existing cessation strategies, with long-term success rates for e-cigarettes remaining modest at 10 percent-12 percent and the effect of relapse has not been sufficiently studied. New treatments and approaches are urgently needed”.

    Despite these promising findings, the study also emphasizes the need for greater scientific rigor in the field. According to the authors, the analysis exposes significant reporting biases in many studies.

    “This study provides robust evidence supporting the potential of ENDS as an effective cessation aid, but it also calls for enhanced clinical guidelines and further exploration of long-term outcomes,” stated Riccardo Polosa, co-author and founder of CoEHAR.

  • Study: No Major Respiratory Symptoms Among Vapers

    Study: No Major Respiratory Symptoms Among Vapers

    A groundbreaking international study conducted as part of the Veritas cohort project has provided crucial insights into the respiratory health of exclusive e-cigarette users with no established history of smoking. Published in Scientific Reports, the study assessed respiratory symptoms among adults who had never been habitual smokers but used e-cigarettes, offering a rare glimpse into the health effects of vaping in this specific population.

    Led by researchers from CoEHAR and their global collaborators, the study compared respiratory symptoms between a cohort of e-cigarette users and a control group who had never smoked conventional cigarettes. The results indicate that individuals who have never smoked but exclusively used e-cigarette devices do not exhibit clinically relevant respiratory symptoms. Moreover, the study highlights the importance of distinguishing between statistically and clinically significant results when evaluating the health impacts of e-cigarettes.

    “Veritas lays the groundwork for longitudinal research to further assess the long-term effects of e-cigarettes on respiratory health. These findings are essential for shaping public health policies based on scientific evidence, especially as we work to differentiate the effects of vaping from those of traditional smoking,” said Riccardo Polosa, founder of CoEHAR.

    “What makes the Veritas project unique is not only its reach across six geographically diverse areas,” said Jeffrey Zamora, the study’s lead author, “but also its ability to provide data on the real-world use of e-cigarettes, including the most commonly used device types (refillable, disposable, pod-based) flavor preferences, and variations across different socio-cultural groups.”

  • Catania to Host Conference on Harm Reduction

    Catania to Host Conference on Harm Reduction

    Image: CoEHAR

    The Center of Excellence for the acceleration of Harm Reduction (CoEHAR) will host its national conference on Oct. 30 at the University of Catania, Italy.

    The 2024 edition will host 25 speakers from prestigious research centers and international universities, including the Moffitt Cancer Center, Dartmouth College, George Washington University and the Milken Institute School of Public Health.

    “Scientific research on harm reduction strategies has reached a critical turning point, where information about new frontiers represented by modified-risk devices can no longer be ignored,” said CoEHAR founder Riccardo Polosa in a statement.

    “This year’s gathering with our colleagues from the harm reduction scientific community will allow us to capture the current state of research, providing even more important answers on the health benefits that modified-risk devices can bring to dental health, vision and diabetes management. There will also be a focus on new technologies and the application of artificial intelligence systems in smoking cessation therapies.”

    The full program can be downloaded here.

  • Paper Highlights Adaptive Cessation Methods

    Paper Highlights Adaptive Cessation Methods

    Adaptive smoking cessation approaches can help individuals who struggle with traditional methods, according to a new study led by Gal Cohen, head of scientific affairs at Rose Research Center in North Carolina, USA, and conducted in collaboration with researchers from the Center of Excellence for the acceleration of Harm Reduction (CoEHAR) at the University of Catania in Italy.

    Nearly 40 years after the U.S. Food and Drug Administration approved the first smoking-cessation products, the effectiveness of most methods remains low, with smokers requiring an average of 30 attempts for each successful cessation outcome.

    In their paper “Personalized and Adaptive Interventions for Smoking Cessation: Emerging Trends and Determinants of Efficacy,” Cohen and his team analyze the limitations and prospects of the most commonly used smoking cessation methods, and conclude that adaptive smoking cessation approaches can represent a better solution for individuals who struggle with traditional methods.

    The study highlights the complexities of cigarette addiction and innovations in cessation products. By focusing on individual determinants of efficacy—such as sensory preferences and nicotine tolerability—the article offers fresh insights into smoking cessation and advocates for personalized, adaptive treatment plans. It also highlights how emerging approaches, like cytisine and combustion-free nicotine delivery systems, provide new avenues to reduce smoking-related morbidity.

    “Quitting smoking is hard; you are trying to extinguish the complex interplay of nicotine delivery, sensorial experience and use ritual that cigarettes provide to people who smoke” said Cohen in a statement. “However, the emerging array of pharmaceutical cessation therapies and nicotine substitution products offer the opportunity to personalize the off-ramp from smoking.”

    According to CoEHAR founder Riccardo Polosa, nicotine replacement therapies provide neither the bolus nicotine delivery nor the sensory stimuli and behavioral rituals associated with smoking. Conversely, electronic nicotine delivery systems represent the most prevalent nicotine substitution products and were used every day or some days by 11-17 million U.S. adults.

    In a survey of adult vapers in the U.S., U.K. and Canada, 73 percent of respondents said they used e-cigarettes because they wanted quit smoking.

  • Something to Smile About

    Something to Smile About

    The CoEHAR is studying the impact of reduced-risk products on oral health.

    Photo: Andrei

    By Stefanie Rossel

    Polosa and his team anticipate observing better gingival/gum conditions, improved tooth color and reduced dental plaque accumulation in smokers who stop smoking after switching to alternative tar-free nicotine products. | Photo: Chris Frenzi

    In the context of smoking-related issues, oral health has long been neglected. According to Riccardo Polosa, founder of the Center of Excellence for the acceleration of Harm Reduction (CoEHAR) in Italy, this can be explained by several factors. “Smoking is primarily linked to fatal systemic conditions such as cancer, heart disease and respiratory problems, which tend to overshadow its effects on oral health,” he says.

    In addition, until recently, dentists were less aware of the detrimental impact of smoking on oral health, particularly in managing gum disease, tooth loss and dental implant procedures. What’s more, because oral health is influenced by multiple factors, including diet, oral hygiene practices and genetic predispositions, it is difficult to isolate smoking as a culprit.

    “Dentists have historically been hesitant to invest their professional efforts in helping clients quit smoking,” Polosa says. “However, there is now an increasing recognition among dental professionals of the significant benefits of smoking cessation in improving treatment outcomes, and more and more dentists are increasingly promoting smoking cessation strategies and advocating for the use of tar-free nicotine products.”

    To investigate changes in oral health parameters and dental aesthetics in smokers who switch to tar-free nicotine products, the CoEHAR earlier this year launched the SMILE study with funding from the Foundation for a Smoke-Free World (FSFW), which recently rebranded as Global Action to End Smoking. Polosa says the study is the first and only of its kind, as it aims to measure risk reduction, harm reversal and smoking cessation combined, which sets it apart from other trials that focus solely on cessation.

    Geographically Diverse Approach

    The international, randomized controlled trial involves 474 participants in four countries—153 in Catania (Italy), 45 in Warsaw (Poland), 168 in Chisinau (Moldova) and 108 in Bandung (Indonesia). The decision to focus on these countries was based on strategic and practical considerations, Polosa explains. “Mandated by the FSFW’s mission, the selection of low[-income] and middle-income countries was crucial to facilitate the dissemination of high-quality tobacco harm reduction [THR] science through collaborative partnerships and knowledge exchange,” he says. “Additionally, factors such as low operational costs and strong interest in participating in the study were significant in their inclusion. Italy was specifically chosen to take a leadership role in training and coordination within the study.”

    All four countries have high smoking rates, providing a substantial pool of participants for studying smoking cessation and switching behaviors. “The selection of these countries enables the SMILE study to capture a broad spectrum of socioeconomic, healthcare and cultural factors that influence smoking behavior and the adoption of THR,” says Polosa. Each country represents a distinct healthcare system, ranging from well-established systems in Italy and Poland to less developed systems in Moldova and Indonesia. This diversity enhances the study’s relevance and generalizability on a global scale.”

    Indonesia presents a unique case due to its widespread use of clove cigarettes, which account for nearly 90 percent of the Indonesian cigarette market. “Studying THR in a context where very popular traditional tobacco products dominate can offer valuable insights into cultural attitudes toward smoking cessation and alternative nicotine-delivery systems,” says Polosa. “Smoke from clove cigarettes contains high particulate matter and toxicants, making them as harmful as conventional tobacco cigarettes. Therefore, THR is strongly needed in Indonesia, with advocacy and education being key to successful implementation.”

    Dentists increasingly recognize the significant benefits of smoking cessation in improving treatment outcomes. | Photo: RomanR

    State-of-the-Art Technologies

    For their study, the SMILE researchers recruited cigarette smokers interested in switching to alternative products. The participants were randomly allocated to receive either standard care, including cessation counseling (i.e., “very brief advice”), or the nicotine product of their choice plus very brief advice. The trial also includes a reference group of individuals who had never smoked. The researchers then recorded participants’ cigarette consumption and tar-free nicotine product at every visit. Additionally, participants were asked to return all empty, partly used and unused consumables. Throughout the study, the researchers monitored smoking and tar-free nicotine product use via a tracker app.

    “The SMILE tracker app is an integral component of the SMILE study, designed to monitor participants’ behaviors and lifestyle choices. Through daily prompts, the app assists in tracking cigarette consumption, the use of nicotine products, and regular oral hygiene practices such as brushing, flossing and mouthwash use. Although personal oral hygiene practices were carefully tracked, there was no emphasis on oral hygiene education or management of dietary patterns,” says Polosa.

    “A standardized approach was implemented to mitigate the effect of these potential confounders on both primary and secondary study endpoints,” he continues. “Participants were explicitly advised to continue their established oral hygiene practices for the entire duration of the study. Furthermore, adherence to specific restriction criteria before each scheduled study visit was emphasized to prevent any confounding of the collected data.”

    To prevent confounding factors, oral hygienists removed plaque, calculus and stain from the study participants’ teeth 14 days prior to baseline measurements. “This critical element is absent in most clinical trials,” says Polosa.

    Chronic periodontal disease is common in smokers that is unlikely to improve with cessation alone, according to Polosa. “Therefore, participants with periodontitis have been excluded, and only participants with mild to moderate gingivitis have been recruited, as they are more likely to maximize the impact of the intervention.”

    The researchers use state-of-the-art technologies, such as spectrophotometers and quantitative light-induced fluorescence scanners, to quantify tooth discoloration and the amount of dental plaque.

    “These study endpoints measure important patient factors that may drive behavior change,” says Polosa. “This is particularly persuasive for young adults, for whom a cardiovascular-cancer-respiratory risk-based narrative is either ineffective or counterproductive and for whom concern about bad breath and poor dental aesthetics due to enamel discoloration and ‘tar’ stains may be a much more significant reason to stop smoking.”

    The Importance of Aesthetics

    The SMILE study allows volunteers to choose their own type of tar-free nicotine product, says Polosa. “This personalized choice is likely to enhance adherence, retention, and optimize compliance, thus maximizing cessation of tobacco cigarettes,” he explains. “This unique approach also generates results that are not product-specific and therefore more generalizable and realistic for implementing such a strategy in the real world.”

    According to Polosa, the researchers enroll only those who would not otherwise commit to a smoking cessation counseling program but are prepared to choose from smoking alternatives such as e-cigarettes and tobacco-heating products. The study has been designed to allow participants to tailor their own “nicotine experience” by selecting the tar-free nicotine product that aligns most with their preferences, thereby maximizing the transition away from tobacco smoking and reducing the likelihood of relapse.

    The study is not designed to coerce participants to avoid tobacco smoking completely, he says. Dual use is not prevented; therefore, the sample size has been oversampled to ensure that enough exclusive users of tar-free nicotine products by the end of the study are included.

    “The SMILE study also provides a unique opportunity to evaluate the impact on oral health and dental aesthetics among individuals who simultaneously smoke conventional cigarettes and use tar-free nicotine products,” says Polosa. “Different dual-use patterns exist—e.g., strong switchers versus light switchers—and are likely to have varying impacts on overall oral health. We expect to observe progressive changes with different patterns of dual use.”

    Perhaps the most interesting aspect of the SMILE study is its inclusion of aesthetics. Polosa says that stained teeth and tobacco odors are a growing concern, especially among young smokers, who demand not only healthy mouths but good-looking smiles.

    “Everyone wants to have a perfect dentition, as it helps in interpersonal contacts and raises value in the job market,” he says. “In our social media-driven age, vanity plays a significant role in influencing behavior. The desire for an attractive appearance, including a bright smile, is often a powerful motivator, especially among younger demographics who are highly engaged with social media platforms.”

    Evidence from literature demonstrates that using images of damaged and tar-riddled lungs does not act as an effective deterrent to smoking, he says. “This is partly because people do not respond well to negative messaging and because they do not identify such images with their own bodies. The focus on aesthetics—rather than vanity—is important because we are conveying a positive outcome message for smoking cessation, leveraging the explosion in social media posts of happy, healthy people with bright smiles.”

    Appealing to individuals’ desire to present themselves well and feel confident not only acknowledges the importance of aesthetics but also offers practical solutions for oral healthcare practitioners, such as aesthetic-enhancing alternative nicotine products for those who may struggle to quit smoking, according to Polosa. “The goal here is to harness today’s emphasis on appearance to encourage healthier behavior,” he says. “I predict that the argument for better aesthetics and oral health will become a more prominent and effective tool in smoking cessation efforts.”

    The study’s results are expected in 2025. Polosa and his team anticipate observing better gingival/gum conditions, improved tooth color and reduced dental plaque accumulation in smokers who stop smoking after switching to alternative tar-free nicotine products.

    Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.
  • Li Volti Reconfirmed Director of CoEHAR

    Li Volti Reconfirmed Director of CoEHAR

    Photo: CoEHAR

    The Center of Excellence for the acceleration of Harm Reduction (CoEHAR) has reappointed Giovanni Li Volti as its director for the next four years.

    “Following the path already undertaken by Riccardo Polosa, founder of CoEHAR, our center is today considered the most influential and productive in the world in the field of research applied to the harm reduction,” Li Volti said in a statement acknowledging the reappointment.

    “A recognition that has led our university to be celebrated and rewarded several times for the productivity of its members, for innovation in the scientific field and for the large and important internationalization actions that have brought to Catania, in just five years, more of 150 researchers and stakeholders from all over the globe, interested in our activity.

    “The trust expressed by all of you honors me and motivates me even more to dedicate my energies, and what I have learned so far, to guarantee the success of scientific research in the sector of reducing smoking harm, and to follow the immense work carried out from the entire CoEHAR team and its founder and mentor.

    “The international successes of CoEHAR are the victories of a team and of the great excellence of Catania research. I look to the future with optimism and hope to work in close collaboration with everyone to achieve new shared and far-sighted goals.”

    Tobacco Reporter profiled CoEHAR in its January 2024 print edition and online (see, “Reviewing their Peers”).

  • Researchers to Study Impact of Dual Use

    Researchers to Study Impact of Dual Use

    Photo: tcsaba

    A new project sponsored by the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) will investigate the consequences of the combined use of conventional cigarettes and electronic cigarettes on human health.

    Titled, “MAGnitude of cigarette substitutioN after Initiation oF e-cigarettes and its Impact on biomArkers of exposure and potenTial harm in dual users” (“Magnificat”), the study will involve more than 300 dual users.

    Using specific biomarkers, clinical endpoints and behavioral correlations, researchers will be monitoring participants’ health to quantify the impact of transitioning to combustion-free products.

    Participants will be asked to reduce the consumption of conventional cigarettes and switch to electronic cigarettes for a controlled period. According to CoEHAR, the results of the study will be of great interest in addressing questions related to smoking harm reduction in both clinical and behavioral contexts.

    Tobacco Reporter profiled the work of CoEHAR in its January 2024 issue (see “Reviewing their Peers.”)

  • ECLAT Study Celebrates 10-Year Anniversary

    ECLAT Study Celebrates 10-Year Anniversary

    Photo: Wlodzimierz

    The Center of Excellence for the acceleration of Harm Reduction (CoEHAR) is celebrating the 10th anniversary of the ECLAT study, which according to the organization marked a significant shift in the science of harm reduction.

    Riccardo Polosa

    The project began in 2011 when a research group led by Riccardo Polosa of the University of Catania in Italy decided to evaluate the use of e-cigarettes on a sample of smokers who wanted to quit.

    After two years of recruitment and follow-ups, the first randomized controlled trial on electronic cigarettes came to light. The ECLAT study provided evidence for the first time that the e-cigarette could help people—even those who had no desire to give up smoking—quit combustible cigarettes.

    The ECLAT study subsequently became a source of inspiration for researchers worldwide. Even then, despite the technical limitations of vaping products at that time, the study showed that at the 52nd week, 8.7 percent of smokers using e-cigarettes quit smoking, while 10.3 percent reduced the consumption of traditional cigarettes by at least 50 percent. Moreover, 73.1 percent of those who had quit did not use the e-cigarette at the end of the study.

    Although these data may appear modest today, the ECLAT study paved the way for a line of research that now engages thousands of researchers worldwide. The most recent Cochrane literature review—which also incorporates the ECLAT study—confirms what was revealed in Catania 10 years ago: e-cigarettes are effective tools in the fight against smoking.

    Reflecting on the ELCAT research, Polosa called for continued innovation and evaluation. “If we want to definitively erase the history of smoking, we must continue with research, encouraging continuous innovation and evaluation studies,” he said in a statement. “Harm reduction can and is already saving millions of lives. The path is the right one and must be followed to the end.‘”

  • Reviewing Their Peers

    Reviewing Their Peers

    Photos courtesy of CoEHAR

    CoEHAR’s REPLICA Project evaluates nicotine-related science to ensure that policymakers and the public receive correct and reliable information.

    By Stefanie Rossel

    Riccardo Polosa

    Nicotine products, stakeholders agree, should be regulated based on scientific evidence. Unfortunately, an increasing volume of research underpinning policy appears to be based on questionable science, where researchers are unable to replicate the results. This “reproducibility crisis” occurs across various disciplines, including psychology, medicine and natural sciences. The phrase was coined in the early 2010s, and efforts to remedy the problem have led to the creation of a new scientific discipline, meta science.

    To tackle the reproducibility crisis in the nicotine sector, the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) in November 2019 launched the REPLICA Project, an initiative to independently validate the results of e-cigarettes and heated-tobacco products (HTP) studies.

    “Annually, billions of dollars are poured into biomedical research, yet more than half of these studies cannot be replicated due to flawed experimental designs, inadequate methodologies and faulty statistical analyses,” explains Riccardo Polosa, the founder of the CoEHAR, who also is a full professor of internal medicine in the Department of Clinical and Experimental Medicine of the University of Catania in Italy. “Bad science holds back medical progress,” he says. “The challenge of replicability is widespread, spanning numerous scientific domains, including the field of THR.”

    According to Polosa, the problem is amplified due to the contentious nature of tobacco and nicotine. “Often, the focus seems more centered on perpetuating controversy rather than prioritizing public health concerns,” he says. “The unfortunate reality is that there appears to be minimal interest in resolving the replicability crisis within the field of THR science, as it may conflict with the mainstream anti-THR narrative.”

    Unique Approach

    The REPLICA Project replicates published in vitro toxicity studies with the help of seven research laboratories spread over various countries, including the U.S., Indonesia and Serbia. According to Polosa, this approach is unique. “Its success hinges on complete harmonization between these research labs, necessitating ongoing international training, adherence to standard operating procedures and uniformity in lab equipment/material,” he says.

    “We uphold the highest tobacco research standards, employing ISO-regulated setups for smoking/vaping laboratories and approved standardized smoking/vaping machines in our replication studies. While you cannot directly compare the REPLICA’s approach with the individual studies we replicate, many of the studies we aim to reproduce lack adherence to the best tobacco research standards. They often overlook smoking/vaping laboratory standards regulated by ISO guidelines and resort to unregulated homemade smoke/vape machines. Our methodology aligns with the open science principle—in contrast to the works we assess, which frequently present methodological ambiguities and sometimes obscure interpretations of data.”

    According to Polosa, the advantage of REPLICA’s cooperation model lies in the consensus reached when results from one laboratory align with those from others. This, he says, ensures a more reliable basis for new knowledge. Replication, Polosa adds, bolsters confidence in scientists’ findings.

    “Furthermore, this networking model of multiple research labs united in pursuing a common objective fosters unique opportunities for knowledge sharing and building capacity, thereby ensuring elevated standards in THR research,” says Polosa. “In line with [the] CoEHAR vision and mission, nascent labs in low-[income] and middle-income countries can connect with the REPLICA consortium, providing them with the chance to thrive. Specifically, young researchers from Serbia and Indonesia have been offered CoEHAR mobility training programs at the University of Catania under the guidance of REPLICA researchers.”

    Promoting Understanding

    In the first phase of the REPLICA Project, which ran until 2022, researchers replicated seven studies. The project initially focused on independently verifying science published by the tobacco industry. As it gained expertise, the project also began evaluating papers published by academia in scientific journals.

    “Each decision to replicate a study revolves around identifying topics vital for better understanding of the THR paradigm and for improved protection of human health,” explains Polosa. “In addition, feasibility considerations for all partners within the study’s framework become paramount. Although consideration about studies that appear to be flawed are secondary, we occasionally opt for studies that are partially well-executed, recalibrating inadequately set parameters. This meticulous approach aims to inform the scientific community, regulatory bodies and lay public with credible and comparable data that mirrors the normal condition of use of combustion-free nicotine products.”

    In several studies, the REPLICA Project researchers were able to replicate outcomes. “Specifically, our investigations revealed consistent evidence indicating the reduced capacity of e-cigarettes and HTPs to induce cytotoxicity, inflammation, endothelial damage, genotoxicity and mutagenesis in human lung epithelial and endothelial cells,” says Polosa.

    Other studies revealed irregularities, however. “We’ve pinpointed noteworthy methodological flaws in at least three recently replicated studies,” says Polosa. “For instance, one study encountered issues due to an inadequately supplemented culture medium, resulting into abnormal cytotoxicity in cells. In another instance, researchers used incorrect fluorochromes, hindering the clear distinction of adhesion events of inflammatory cells to the vascular bed. Lastly, flavors were vaporized at excessively high temperatures using a furnace instead of the intended vaping machine under standard conditions of use. These identified flaws are either in the process of being addressed or have been thoroughly examined and will be disclosed in forthcoming peer-reviewed publications.”

    According to Polosa, the reported shortcomings relate not only to scientists’ mistakes but also the editors and reviewers who approved the publication of low-quality research.

    Providing Accurate Information

    Polosa says that CoEHAR’s researchers actively seek out the original authors to discuss methodological shortcomings and to request additional information with the goal of establishing productive collaboration and enhance the replication protocol. “Unfortunately, this is not as straightforward as it should be,” he says. “Previously, we encountered situations where authors offered only partial responses to our concerns, leading to increased confusion regarding their ‘irregular’ approaches in their scientific work.

    “Regrettably, this lack of comprehensive information resulted in the abandonment of replication attempts in most cases. Often, eminent scholars in this field, despite their expertise, unintentionally make errors in their study approaches. However, some may hesitate to acknowledge or fail to grasp these errors. Through focused scientific engagement, our aim is to educate researchers, especially those new to the THR paradigm, facilitating a deeper comprehension of these intricacies.”

    While the CoEHAR team hasn’t encountered many studies that warrant retraction, there have been instances that would justify such a course of action, like the most recent one investigated, which has not been published yet. “We’re considering this course of action pending discussions with the original author,” says Polosa. “It’s important to note that while some studies may not be inherently flawed, they might be inadequately aligned with the subject matter. For example, certain studies might provide valuable insights in other areas but fall short in their relevance to evaluating the effects of vaping. When the study setting is drastically different from the context of vaping, its conclusions can’t be responsibly applied to this specific practice. It’s akin to studying the impact of a bicycle accident at 350 km/h and then advocating to ban bicycles due to their perceived risk, a distortion of reality that fails to accurately address the intended subject.”

    The project’s foremost objective, Polosa insists, is to provide accurate information to the public rather than preserving the reputation of the scientists behind the original studies. “While retractions aren’t taken lightly and involve careful consideration, our obligation remains toward ensuring the public and policymakers receive correct and reliable information.”

    Phase Two

    CoEHAR is funded by the Foundation for a Smoke-Free World (FSFW), which was financed exclusively by Philip Morris International until Oct. 20, 2023, when the organization announced it would no longer accept tobacco funding in an effort to address concerns about is independence.  Polosa emphasizes that credibility of his team’s work is not an issue if REPLICA studies debunk original science. “Although we’re relatively new, our credibility is steadily building,” he says. “The strength of CoEHAR’s REPLICA project rests in its robust, high-quality research, consistently published in reputable scientific journals. Despite funding ties with FSFW, our project has swiftly garnered a positive reputation worldwide. This funding association doesn’t diminish our research’s significance. REPLICA’s growing scientific output unequivocally proves this point.”

    Increased funding should be directed toward replication studies of THR products, notes Polosa. “Stakeholders need to commit additional resources to this vital research area,” he says. “We are grateful to the FSFW that has recognized the importance of replicability in science and has generously provided cutting-edge equipment and other resources, supporting our mission to reinvigorate replication science in THR.”

    Engaging with media outlets to communicate findings from replication studies is an essential aspect of the project. “However, a significant challenge arises when the original study’s results were sensationalized, as there might be little motivation to rectify misinformation if the correction lacks the same attention-grabbing quality,” says Polosa.

    He cites the example of the 2019 EVALI crisis in the United States, when an initially mysterious outbreak of lung injuries was at first erroneously attributed to nicotine vaping but later turned out to have been caused by adulterated (and illegal) THC products. Once the original, sensationalized narrative had spread, it became difficult to correct.

    “Similarly, in the realm of in vitro toxicological studies investigated by the REPLICA researchers, algorithms often prioritize popularity over accuracy, complicating efforts to disseminate corrected information effectively,” say Polosa. “Despite these hurdles, our commitment remains steadfast in sharing our findings extensively with the public, academia and relevant stakeholders.

    “While our replication efforts are starting to gain traction in shaping public opinion and influencing regulatory bodies, the primary goal of our studies is to assess ongoing and future research and prevent recurring errors within THR science. Ultimately, our aim through this correction process is to dispel substantial misconceptions about the health risks associated with combustion-free nicotine products. As we progress, we anticipate a reduction in sensationalized and inaccurate reporting by the media, leading to a more informed and balanced understanding among the public and policymakers.”

    In 2023, the REPLICA Project entered its second phase, which among other things aims to align the project’s studies with academic research while elevating the complexity level. “Our focus is on replicating and expanding studies conducted in collaboration with partners,” says Polosa.

    “Specifically, we’ll conduct thorough screenings for cytotoxicity and mutagenicity, examining increasing concentrations of most common vaping flavors. These results aim to ascertain the safety of these flavors and their concentrations for inhalation. Within our REPLICA 2.0 project, we aim to shed light on the potential impact of nicotine on cancer development. Employing a comprehensive approach, we’ll utilize various assays to screen for carcinogenicity. Regulatory bodies like the U.S. Environmental Protection Agency and the International Agency for Research on Cancer heavily rely on these models’ data to classify substances and make informed regulatory decisions.”

    Stefanie Rossel is Tobacco Reporter’s editorial contributor. An experienced trade journalist, she combines sharp reporting skills with in-depth knowledge of the tobacco and vapor industries. Prior to joining Tobacco Reporter, Stefanie was editor-in-chief at Tobacco Journal International, where she worked for a decade. Fluent in English, German and French, Stefanie covers tobacco news around the world. She is based in Germany.
  • CoEHAR Scientists Among the Most Cited

    CoEHAR Scientists Among the Most Cited

    Image: COEHAR

    The 2023 update of the ranking compiled by Plos Biology and Elsevier, conducted by researchers from Stanford University, honors 20 scientists of the Center of Excellence for the acceleration of Harm Reduction (CoEHAR) at the University of Catania among the most cited scientists globally.

    The latest update of the database “Updated science-wide author databases of standardized citation indicators” was released in October 2023.

    The annually updated database recognizes excellence in the field of scientific research, selected from a sample of 100,000 researchers and divided into 22 different scientific areas and 176 additional sub-fields.

    CoEHAR founder Riccardo Polosa remains one of the most cited scientists in his field, recognized for the quality of contributions in the field of research applied to smoking harm reduction.

    However, this year, in addition to Polosa, 19 additional CoEHAR researchers are honored for their work and included in the database, the organization announced on its website.

    They are: Sebastiano Battiato, Antonino Belfiore, Aldo Calogero, Filippo Caraci, Rosita A. Condorelli, Filippo Drago, Margherita Ferrante, Antonio Gagliano, Fabio Galvano, Giuseppe Grasso, Antonino Gulino, Gaetano Isola, Rosalia Maria Leonardi, Sandro La Vignera, Giovanni Li Volti, Venerando Rapisarda, Martino Ruggieri.

    Among the recognized CoEHAR scientists, there are also Council members from different universities: Emmanuele Jannini from the University of Rome Tor Vergata and Maria Luisa Brandi from the University of Florence

    The Plos Biology database uses six citation parameters, including the total number of publications and the number of times an article related to a scientific study in which the scientist in question is a single or first author is cited.