The National Cancer Institute awarded $15 million to a consortium of 10 academic institutions in four countries to assess the likely impact of current and potential future policies regulating tobacco products, including increasingly popular vaping products.

Warren Bickel, the inaugural Virginia Tech Carilion Behavioral Health Research Professor, will use $2.63 million of the major consortium research grant to examine how a person decides to use a vaporized nicotine product, such as an e-cigarette, over a conventional cigarette.

“The effects of new policies need to be understood to deal with the existing smoking problem and to manage new products,” said Bickel, who also directs the Virginia Tech Carilion Research Institute’s Addiction Recovery Research Center. “However, no current research method can adequately estimate, prior to implementation, the effects of a new regulation of the introduction of a new tobacco product on the patterns of consumption and substitution by current smokers across the various tobacco/nicotine products available in the ever more complex tobacco marketplace.”



To answer this gap in both technique and knowledge of tobacco control, Bickel and his team are introducing a novel methodology called the Experimental Tobacco Marketplace. People who smoke can volunteer to participate in controlled experiments where they can choose conventional cigarettes, vaporized nicotine, or other tobacco products under various conditions.



“By placing the mix of products, prices, and specific policies under experimental control, we can estimate the effects of novel policies under conditions that simulate real-world circumstances,” Bickel said.



Bickel and his team will test four factors influencing a person’s choice between vaporized nicotine products and conventional cigarettes: nicotine dose, extra costs, smoke-free environments, and flavors.



“If a person gets enough nicotine, doesn’t have to pay extra taxes, can use the e-cigarette in places where conventional cigarettes are banned, and has several flavor options, perhaps the person will choose vaping over smoking,” Bickel said. “Maybe it will only take one of those variables to influence a person’s decision, and maybe that’s the first step toward managing a continuously growing public health problem.”



The consortium also includes researchers from the Medical University of South Carolina, Georgetown University, University of Illinois at Chicago, the State University of New York, Susquehanna University, and the Roswell Park Cancer Institute, all in the United States; the Cancer Council Victoria in Australia; the University of Waterloo in Canada; and King’s College London in England, as well as the Virginia Tech Carilion Research Institute team. Some of these scientists will investigate the risks and benefits of vaporized nicotine products.



“There is a hotly contested debate in the medical and public health communities about whether vaporized nicotine products, such as e-cigarettes, will prove to have a net positive or negative impact on population health,” said Anthony J. Alberg, a co-investigator on the grant and the interim director of the Hollings Cancer Center at the Medical University of South Carolina. “The data generated from this project will help guide decision-makers and ultimately governments as to the most prudent course of action under this complex set of circumstances.”

The proposed studies are designed to comprehensively examine how different policies might influence the use of vaporized nicotine products and smoked tobacco products.



“The overarching goal is to develop forecasting models to estimate the population health impact of different product regulatory schemes,” Bickel said, “with the result of decreasing tobacco related mortality and morbidity.”