Sharon Cox

University College London | UCL · Department of Epidemiology and Public Health

Objectives: The last five years have seen substantial changes in England's social and economic landscape as a result of Brexit, the Covid-19 pandemic, and cost-of-living crisis. We aimed to examine changes in cross-border and illicit tobacco purchasing, and associations with quitting activity, over this period. Design: Nationally-representative mon...

Introduction Pod Vaping Devices (PVD) such as JUUL have become extremely popular in the US although their uptake and use in the UK remains lower. A key difference between the US and the UK is the nicotine strength legally permitted, typically 59mg/mL in the US but capped at 20mg/mL in the UK and EU. This may limit the ability of EU vaping devices t...

BACKGROUND: Tobacco smoking cessation is associated with improvements in mental health. This study assessed psychological distress, using the K6 non-specific screening tool ((items cover feelings of nervousness, hopelessness, restlessness, depression, ‘everything an effort’ and worthlessness), by smoking status, time since quit, and use of a non-co...

Background and aims: We aimed to create a basic set of definitions and relationships for identity-related constructs, as part of the Addiction Ontology and E-Cigarette Ontology projects, that could be used by researchers with diverse theoretical positions and so facilitate evidence synthesis and interoperability. Methods: We reviewed the use of...

Objective To understand the burden of chronic obstructive pulmonary disease among people who use illicit opioids such as heroin, and evaluate inequalities in treatment. Design Cohort study. Setting Patients registered at primary care practices in England. Participants 106 789 patients in the Clinical Practice Research Datalink with illicit opioi...

Background: We looked at changes in the prevalence of increasing and higher risk drinkers reporting a reduction attempt motivated by temporary abstinence and changes in prevalence of use of the official app accompanying Dry January between 2020 vs 2021, following the onset of the COVID-19 pandemic. We also explored potential shifts in the sociodem...

Aim: To examine the association of self-reported COVID-19 disease status with cutting down, past-month and past-year quit attempts and motivation to stop smoking. Design and setting: Repeat cross-sectional survey, representative of the adult population in England. Participants: Past-year smokers, n = 3338 (aged ≥ 18 years) responding between M...

Background and aims: Ontologies are ways of representing information that improve clarity and the ability to connect different data sources. This paper proposes an initial version of an ontology of tobacco, nicotine and vaping products with the aim of reducing ambiguity and confusion in the field. Methods: Terms related to tobacco, nicotine and...

Background Novel nicotine delivery devices (NNDDs) are a safer alternative to combustible tobacco smoking. Understanding what factors can facilitate people who smoke to use NNDDs can inform intervention design and public health messaging. This study aims to explore the facilitators and barriers to NNDD use from the perspective of smokers without pr...

Narratives around alcohol are important in determining how people decide who or what qualifies as problematic alcohol use. Narratives draw on common representations that are subject to influences including historical and normative influences. We argue that there are two dominant narratives that relate to how alcohol use disorder (AUD) is identified...

Measures of social cognition have now become central in neuropsychology, being essential for early and differential diagnoses, follow-up, and rehabilitation in a wide range of conditions. With the scientific world becoming increasingly interconnected, international neuropsychological and medical collaborations are burgeoning to tackle the global ch...

Background: There is a strong shared association between smoking tobacco and drinking alcohol. This study aimed to compare smoking prevalence and smoking characteristics in drinkers who were versus were not at risk of alcohol dependence in England. Methods: We used cross-sectional data from a monthly, nationally representative survey of adults i...

Measures of social cognition have now become central in neuropsychology, being essential for early and differential diagnoses, follow-up and rehabilitation in a wide range of conditions. With the scientific world becoming increasingly interconnected, international neuropsychological and medical collaborations are burgeoning to tackle the global cha...

Smoking prevalence in several high-income countries is steadily declining but remains persistently high in ‘lower’ socioeconomic position (SEP) groups, contributing to inequities in morbidity and mortality. Smoking to relieve stress is a commonly endorsed motive for continued smoking; however, it remains unclear whether smoking to relieve stress ha...

Background Smoking is extremely common amongst adults experiencing homelessness. To date, there is no nationally representative data on how tobacco dependence is treated and if and how smoking cessation is supported across the homeless sector. The aim of this study was to document smoking and e-cigarette policies of UK homeless services and identif...

Aim: To measure whether the prevalence of use and real-world effectiveness of different smoking cessation aids has changed in England since the Covid-19 pandemic. Design: Representative monthly cross-sectional surveys, January 2015-June 2021. Setting: England. Participants: 7,300 adults (≥18y) who had smoked within the previous 12 months and...

London Network of Nurses and Midwives Homeless Group

Measures of social cognition have now become central in neuropsychology, being essential for early and differential diagnoses, follow-up and rehabilitation in a wide range of conditions. With the scientific world becoming increasingly interconnected, international neuropsychological and medical collaborations are burgeoning to tackle the global cha...

Background: To explore the level of participation in Dry January during the COVID-19 pandemic between 2020 and 2021, and potential shifts in the sociodemographic and drinking characteristics of those taking part. Methods: We analysed data from: i) 1863 increasing and higher risk drinkers responding to a nationally representative survey of adults in...

Background and aims: Smoking is extremely common among adults experiencing homelessness but there is lack of evidence for treatment efficacy. E-cigarettes are an effective quit aid, but they have not been widely tested in smokers with complex health and social needs. Here we build on our cluster feasibility trial and evaluate the offer of an e-cig...

This report summarises the presentations and discussions that took place during the first Ontologies for Research in the Behavioural and Social Sciences (OntoBess) workshop, held in Bozen-Bolzano and virtually on the 18th September 2021. The workshop highlighted the relevance of ontologies to address overarching challenges in the behavioural and so...

Background and aims Cigarette smoking takes place within a cultural and social context. Political views and practices are an important part of that context. To gain a better understanding of smoking, it may be helpful to understand its association with voting patterns as an expression of the political views and practices of the population who smoke...

The 1988 U.S. Surgeon General’s Report titled ‘Nicotine Addiction’ was a comprehensive treatise setting out the evidence that tobacco is addictive and showing that nicotine lies at the heart of this addiction. It likened tobacco to drugs such as cocaine and heroin, and provided a powerful rationale for combining public health and clinical approache...

Introduction Up-to-date monitoring of non-combustible nicotine products (e.g. e-cigarettes, nicotine replacement therapies (NRT), heated tobacco products (HTP); NNP) is important to assess their impact. To date, there is little evidence on the association between ever regular use (defined here as 1 year or more) of NNP and current smoking status....

Background and aims: There is concern that young people may be attracted to e-liquid flavours, prompting long-term vaping in naive users and potentially subsequent tobacco smoking. We aimed to review use of e-liquid flavours by young people and describe associations with uptake or cessation of both regular vaping and tobacco smoking, adverse effec...

Introduction: Smoking among those who live with children is an important influence on smoking initiation among children. This study assessed socioeconomic inequalities in smoking and quitting-related outcomes among all adults with and without children in the household. Methods: Monthly repeat cross-sectional household survey of adults (16+) from...

Background Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to (1) develop and test a selection of relative risk messages for e-cigarette products;...

Background The COVID-19 pandemic in England led to major changes in the delivery of support via stop smoking services (SSS) and to the widespread temporary closure of bricks and mortar e-cigarette retailers (vape shops herein). The impact of disruptions across the smoking cessation support landscape has not been fully documented. The purpose of thi...

Background and aims: Cigarette smoking takes place within a cultural and social context. Political views and practices are an important part of that context. To gain a better understanding of smoking, it may be helpful to understand its association with voting patterns as an expression of the political views and practices of the population who smok...

Background Smoking prevalence is extremely high in adults experiencing homelessness, and there is little evidence regarding which cessation interventions work best. This study explored the feasibility of providing free electronic cigarette starter kits to smokers accessing homeless centres in the UK. Objectives Seven key objectives were examined t...

Introduction: Up-to-date monitoring of non-combustible nicotine products (NNP) is important to assess their impact. To date, there is little evidence on the association between long-term regular use (defined here as one-year or more) of NNP and current smoking status. Aims/methods: The purpose of this study was to examine the prevalence, and sociod...

Background: The early 2020 Covid-19 outbreak in England led to major changes in delivery of support via stop smoking services (SSS) and to the widespread temporary closure of bricks and mortar e-cigarette retailers, indicating serious disruption to the overall level of support available for smokers trying to quit. At the same time, there was a publ...

Introduction In a secondary analysis of our published data demonstrating compensatory vaping behaviour (increased puff number, puff duration and device power) with e-cigarettes refilled with low vs. high nicotine concentration e-liquid, here we examine 5-day time course over which compensatory behaviour occurs under fixed and adjustable power setti...

E-cigarettes are now the most popular quit aid chosen by smokers in England. Mobile phone text messages have been shown to be a useful tool in facilitating smoking cessation attempts by providing behaviour change support. To date, no published examples of text messages exist specifically aimed at smokers attempting to quit with e-cigarettes (vaping...

Background: Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to i) develop and test a selection of relative risk messages for e-cigarette products;...

Background: Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to i) develop and test a selection of relative risk messages for e-cigarette products;...

Ontologies are being used in many areas of science to improve clarity and communication of research methods, findings and theories. Many of these ontologies use an upper level ontology called Basic Formal Ontology (BFO) as their frame of reference. This article summarises Basic Formal Ontology and shows how it can provide a basis for development of...

Ontologies are being used in many areas of science to improve clarity and communication of research methods, findings and theories. Many of these ontologies use an upper level ontology called Basic Formal Ontology (BFO) as their frame of reference. This article summarises Basic Formal Ontology and shows how it can provide a basis for development of...

Decades of researches aiming to unveil truths about human neuropsychology may have instead unveil facts appropriate to only a fraction of the world’s population: those living in western educated rich democratic nations (Muthukrishna et al., 2020 Psych Sci). So far, most studies were conducted as if education and cultural assumptions on which neurop...

Smoking rates in the UK are at an all-time low but this masks considerable inequalities; prevalence amongst adults who are homeless remains four times higher than the national average. The objective of this trial was to assess the feasibility of supplying free e-cigarette starter kits to smokers accessing homeless centres and to estimate parameters...

Humans have developed specific abilities to interact efficiently with their conspecifics (social cognition). Despite abundant behavioral and neuroscientific research, the influence of cultural factors on these skills remains poorly understood. This issue is of particular importance as most cognitive tasks are developed in highly specific contexts,...

Smoking rates in the UK are at an all-time low but this masks considerable inequalities; prevalence amongst adults who are homeless remains four times higher than the national average. The objective of this trial was to assess the feasibility of supplying free e-cigarette starter kits to smokers accessing homeless centres and to estimate parameters...

Recent evidence suggests that e-cigarette users tend to change their puffing behaviors when using e-liquids with reduced nicotine concentrations by taking longer and more frequent puffs. Using puffing regimens modelled on puffing topography data from 19 experienced e-cigarette users who switched between 18 and 6 mg/mL e-liquids with and without pow...

Background: There is increasing evidence that e-cigarettes (EC) are an effective smoking cessation aid when combined with behavioural support. There is further evidence for digital tailored interventions as cost effective approaches that can increase smoking cessation rates. Experimental work also suggests the addition of a ‘nicotine fact sheet’ ca...

Response to the UK Government Consultation: Advancing our health: prevention in the 2020s. Supporting Smokers to Quit using the COM-B model.

Background To date, there has been no review of the research evidence examining smoking cessation among homeless adults. The current review aimed to: (i) estimate smoking prevalence in homeless populations; (ii) explore the efficacy of smoking cessation and smoking reduction interventions for homeless individuals; and (iii) describe the barriers an...

Background The Capital Card, developed by WDP, is a digital innovation which acts as a form of contingency management, and aims to significantly improve service user outcomes. WDP is a substance misuse treatment provider commissioned by local authorities across the UK to support service users and their families affected by addiction. The Capital Ca...

Introduction: This study investigated the effects of the European Union Tobacco Products Directive [EU-TPD] Article 20 E-cigarette (EC) health warnings ("This product contains nicotine which is a highly addictive substance. [It is not recommended for non-smokers.]") and a comparative harm message ("Use of this product is much less harmful than smo...

Authorship credit should be given to those who have made a significant contribution to the research project or the resulting article. Those who have not contributed should not be authors; those who have contributed should not be left out. Towards that end, Addiction endorses the use of CRediT (Contributor Roles Taxonomy).

Response to the UK Government Consultation: Advancing our health: prevention in the 2020s. Supporting Smokers to Quit using the COM-B model.

Effects of ECs versus nicotine replacement therapy on short-term smoking abstinence when delivered at a community pharmacy Background: Pressure on UK healthcare budgets has led to restrictions on the range of nicotine replacements therapies (NRT) that can be offered by some pharmacies. E-cigarettes (EC) are now the most popular quit aid in England...

Aims: Drinking alcohol in outdoor public places (e.g. streets and parks) and outside of formally organised events is perceived and reported as antisocial behaviour and may be indicative of a problematic relationship with alcohol, and other clinical needs. This paper aims to address a lack of qualitative research on street drinking in the United Ki...

E-cigarettes (EC) are now the most popular quit aid in England but their effectiveness for cessation if offered at a pharmacy has not been tested. Here we test the effectiveness of offering an e-cigarette with and without nicotine replacement therapy (NRT) on 4-6-week quit rates in adult smokers seeking support from a community pharmacy. A between...

Objectives This study explored the potential for e-cigarette advertisements to (1) enhance attitudes towards cigarettes and/or (2) reduce barriers to e-cigarettes uptake. The study tested whether exposure to an online electronic cigarette advertisement changed attitudes towards cigarettes and e-cigarettes in smokers, non-smokers, e-cigarette users...

Background: Smoking is a key contributor to health and social inequalities and homeless smoking prevalence rates are 4 times higher than the general population. Research on homelessness and smoking to date has been concentrated predominantly in the US and Australia. This study aimed to describe smoking and quitting behaviour in homeless adult smok...

Commentary response to Campbell et al., (2018). Health risk perceptions and reasons for use of tobacco products among clients in addictions treatment

Background: E-liquids are commercially available and manufactured, however some users of e-cigarettes prefer to prepare them at home (Do-it-Yourself; DIY) using individual ingredients. To date there is a paucity of research on how and why users make their own e-liquids. Methods: Forty-one European and US based exclusive users of e-cigarettes (ex...

Background Article 20 of the EU Tobacco Products Directive [TPD] stipulates that e-cigarette packets and refill products must carry a nicotine addiction health warning. Although previous studies conducted in North America have found that perceived harm, addictiveness and intention to use declined following exposure to e-cigarette health warnings, p...

Aims: This paper aims to address a lack of qualitative research on street drinking in the United Kingdom. Drinking alcohol in outdoor public places (e.g. streets and parks) and outside of formally organised events can be associated with reports of antisocial behaviour and/or indicate chronic alcohol consumption and other problematic behaviours (Man...

Table S1 Individual puffing patterns and group averages for each condition.

Introduction Many countries have now mandated warning labels on e-cigarette products. One example, the EU TPD health warning states, “This product contains nicotine which is a highly addictive substance. [It is not recommended for use by non-smokers]”. The impact of the EU TPD warning message on intentions to use, has not been explored within an EU...

Mutual aid fellowships are the most accessible and widely used treatments for different addictive behaviors including problem gambling, yet how and why such treatments may be effective remains underexplored. The present research investigated the relationships between recovery group identification, social support received and provided to the recover...

After publication of the original article [1], the authors noticed an error in the Competing interests section.