Dr Sarah Gentry

Academic Foundation Doctor

Dr Sarah Gentry is an Academic Clinical Fellow in Public Health at Norwich Medical School, University of East Anglia (UEA) and Norfolk County Council. She trained at Peninsula Medical School (Universities of Exeter and Plymouth) and has an MPhil in Public Health from the University of Cambridge and an intercalated BSc from Imperial College London.

Her research interests are primarily around health improvement and health services, particularly smoking cessation interventions for vulnerable groups and the role of e-cigarettes.

She has considerable previous experience in quantitative, qualitative and mixed-methods evidence synthesis, on subjects including smoking cessation for vulnerable groups, school gardening interventions, research impact and eHealth interventions for the prevention, diagnosis and management of HIV infection.

Sarah is also interested in medical education, having completed a PGCert in Medical Education at Cardiff University and recently led a systematic review on Serious Gaming and Gamification interventions for health professional education.

Aim: E-cigarettes are a popular aid to quitting smoking and are estimated to be 95% safer than tobacco smoking. There are a wide variety of devices and patterns of use. This research examined associations between e-cigarette use, smoking relapse and long term abstinence from smoking.

Design: Cross-sectional study.

Setting: Online survey.

Participants: 371 participants with experience of vaping and sustained tobacco cessation or relapse.

Measurements: Factors associated with smoking relapse were examined, including device type, e-liquid used and smoking history.

Findings and Conclusions: Most participants were long-term abstinent smokers intending to continue vaping. Most initiated e-cigarette use with a vape pen (45.8%) or cig-a-like (38.7%) before moving onto a tank device (89% reported their most recently used device was a tank device).

Those using a tank or vape pen were less likely to relapse than those using a cig-a-like (tank vs. cig-a-like OR=0.06, 95% 0.01 to 0.64, p=0.019).

There was an inverse association between starting strength and relapse, interacting with device type (OR=0.79, 95% CI 0.63 to 0.99, p=0.047), suggesting risk of relapse was greater if starting with a low nicotine strength and/or less sophisticated device.

Those initiating vaping with a less sophisticated device and lower nicotine strength e-liquid appear to be at higher risk of relapse to tobacco smoking. Self-report patterns of device use suggest changing patterns over time, with many users moving from less sophisticated, tobacco flavoured cig-a-like devices, to more sophisticated tank devices with food and sweet flavours.

Co-Authors

Emma Ward, Senior Research Associate, Norwich Medical School, University of East Anglia, Norwich, UK Richard Holland, Head of Leicester Medical School and Professor of Public Health Medicine, Leicester Medical School, University of Leicester, Leicester, UK Lynne Dawkins, Associate Professor of Psychology, Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK Caitlin Notley, Senior Lecturer in Mental Health, Norwich Medical School, University of East Anglia, Norwich, UK