RAPIDS 2015 Annual Meeting February 25-28 • Philadelphia, PA 2015 Notes _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ 2 2015 Rapids Papers • Saturday, February 28, 2015 • 8:00 a.m.-9:30 a.m. voluntarily adding a self-designed warning label to its packages of MarkTen brand PA26-1 e-cigarettes. This study assesses awareness of the MarkTen warning label and EVIDENCE FOR A CAUSAL EFFECT OF COFFEE CONSUMPTION whether exposure to the warning label influences beliefs about e-cigarettes. A ON HEAVINESS OF SMOKING AND SMOKING CESSATION: A national convenience sample of 1,201 adult smokers (current use of cigarettes TWO-SAMPLE MENDELIAN RANDOMISATION ANALYSIS only) and dual users (current users of cigarettes and e-cigarettes) was surveyed in November 2014 with respondents being randomized to one of three conditions: Jennifer J. Ware, PhD*, Amy E. Taylor, PhD, Philip Haycock, PhD, Peter J. Rogers, MarkTen pack image with warning label, MarkTen pack image without warning PhD, George Davey Smith, M.D., and Marcus R. Munafò, PhD, University of label, or no pack image. Self-reported awareness of the warning label was high Bristol. in the warning label condition (70.0%) and no warning label condition (50.6%), indicating that consumers may already expect these products to contain warning Coffee consumption is associated with a range of smoking behaviours. Given labels. Logistic regression models compared risk perceptions and beliefs among the widespread use of coffee worldwide, and the substantial health burden those in the two pack image conditions (with and without warning label), controlling posed by smoking, determining the causal impact of coffee consumption on for dual use, awareness of the MarkTen brand, age, gender, race/ethnicity, and smoking behaviour is of clear public health importance. However, traditional income. Respondents in the warning label condition were three times more observational studies do not allow us to confidently determine direction of likely to agree that “MarkTen brand e-cigarettes contain dangerous chemicals” causality between variables, and cannot rule out the possibility of confounding. (aOR=3.29, p<0.001) and twice as likely to agree that “MarkTen brand e-cigarettes Mendelian randomisation (MR) offers a solution to these issues. This approach are dangerous to your health” (aOR=2.39, p<0.001) than those in the no label uses genetic variants which robustly associate with an exposure of interest (e.g., condition. Respondents in the warning label condition were also less likely to coffee consumption) as proxies for said exposure. We performed two-sample agree that they would buy MarkTen brand e-cigarettes “to reduce health risks of MR analyses, using publicly available data, to explore the causal effect of coffee smoking” (aOR=0.75, p=0.048) and that “nicotine in MarkTen brand e-cigarettes consumption on smoking initiation, smoking heaviness, and smoking cessation. provides the help that smokers need to quit” (aOR=0.71, p=0.023) than those in Data from the Coffee and Caffeine Genetics Consortium and the Tobacco and the no label condition. These results suggest that MarkTen’s voluntary warning Genetics consortium were used to estimate gene-exposure and gene-outcome labels on e-cigarettes were noticed by consumers and may influence perceptions associations respectively. Summarised estimates from multiple genetic variants about the dangers of these products, the risks of e-cigarettes relative to cigarettes, were combined using fixed effects meta-analysis. No evidence for a causal effect and e-cigarette use as a cessation aid. of coffee consumption on smoking initiation was observed. However, we observed evidence consistent with a causal effect of coffee consumption on smoking FUNDING: This work was funded under a RTI International contract with the heaviness. Each additional cup of coffee consumed per day corresponded to a Florida Department of Health’s Bureau of Tobacco Free Florida. ~1.5 cigarette per day decrease in daily consumption (beta -1.49, 95% CI -2.88 to JUSTIFICATION: This research provides policymakers with evidence regarding -0.09, p=0.037). This relationship may be mediated by caffeic acid, a polyphenol the influence of a voluntary, manufacturer-designed warning label on e-cigarette present in coffee which inhibits the activity of CYP2A6, a nicotine metabolising packaging on smokers’ and dual users’ perceptions of e-cigarettes. enzyme. We also observed evidence consistent with a causal impact of coffee consumption on smoking cessation. Each additional cup of coffee consumed per CORRESPONDING AUTHOR: Paul Shafer, MA, Research Economist, RTI day corresponded to a 26% reduction in the odds of being a former (relative to International, Public Health Policy Research Program, 3040 East Cornwallis Road, current) smoker (OR 0.74, 95% CI 0.56 to 0.98, p=0.038). This effect may be Research Triangle Park, NC 27701, United States, Phone: 919-316-3550, Email: due to the impact of cigarette smoke on caffeine metabolism, and the resultant [email protected] experience of caffeine toxicity following smoking cessation. These results have the potential for clinical application, and would benefit from follow-up in an experimental setting. FUNDING: JJW is supported by a Post-Doctoral Research Fellowship from the PA26-3 Oak Foundation. JJW, AET and MRM are members of the UK Centre for Tobacco GLOBAL APPROACHES TO E-CIGARETTE REGULATION and Alcohol Studies, a UK Clinical Research Council Public Health Research: Centre of Excellence. Funding from British Heart Foundation, Cancer Research Ryan David Kennedy, PhD*, Ayodeji Awopegba, DMD, MPH, Elaine De Leon, UK, Economic and Social Research Council, Medical Research Council, and MHS, Joanna E. Cohen, PhD, Institute for Global Tobacco Control, Johns Hopkins the National Institute for Health Research, under the auspices of the UK Clinical Bloomberg School of Public Health Research Collaboration, is gratefully acknowledged. Support from the Medical Research Council (MC_UU_12013/6) is also gratefully acknowledged. Background: E-cigarettes and other electronic nicotine delivery systems JUSTIFICATION: We observed evidence that was consistent with a causal impact vaporize liquid that can produce an aerosol. A policy scan was conducted to of coffee consumption on smoking heaviness and smoking cessation: increased identify