4 Recommendations for research
The Programme Development Group (PDG) recommends that the following research questions should be addressed. It notes that 'effectiveness' in this context relates not only to the size of the effect, but also to cost effectiveness and duration of effect. It also takes into account any harmful/negative side effects.
All the studies below should report on (and across) different subgroups including, for example: black and minority ethnic groups, lesbian, gay and bisexual and transgender groups, people with mental health problems, prisoners and those who are disadvantaged.
4.1 How effective are licensed nicotine-containing products when used for more than one year? What is the impact of different doses and duration of use? What is the effect on health of long-term use? What are smokers' and practitioners' views on long-term use?
4.2 What impact does stopping smoking but continued use of licensed nicotine-containing products for over a year have on the onset and progression of smoking-related health conditions?
4.3 How effective are interventions to help people reduce the amount they smoke (without the intention of stopping)? How great are the health benefits of smoking reduction (by substituting some cigarettes with licensed nicotine-containing products) compared to stopping smoking? What proportion of people who reduce the amount they smoke go on to stop smoking? How soon after starting to reduce the amount they smoke do they stop completely?
4.4 How effective are different behavioural strategies in helping people to cut down, either in order to stop smoking or to reduce the amount they smoke? This should include an evaluation of behavioural support used on its own and evaluations of specific components of such support (such as scheduling). It should also include evaluations of different types of behavioural support and follow-up, delivered within a clearly defined harm-reduction intervention.
4.5 What impact do different marketing strategies, including mass-media campaigns, have on the number of people who adopt a harm-reduction approach? For example, compare the prices, placements and promotions for different types of licensed nicotine-containing product.
4.6 Which harm-reduction approaches are smokers using and how do these correlate with smoking rates at the population level and among particular groups? For example, how do young people respond to the wider adoption of harm-reduction approaches? Do these approaches contribute to a continued reduction in smoking prevalence among young people, or does it make stopping smoking appear less important?
4.7 What are the most effective methods of monitoring smoking status at the population level? This includes the development of biomarkers that can distinguish between nicotine use and smoking in order to validate these measures.
More detail identified during development of this guidance is provided in Gaps in the evidence.