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Examining the sources of evidence in e-cigarette policy recommendations: a citation network analysis of international public health recommendations
- Source :
- PLoS ONE, Vol 16, Iss 8 (2021), PLoS ONE, Vol 16, Iss 8, p e0255604 (2021), PLoS ONE
- Publication Year :
- 2021
- Publisher :
- Public Library of Science, 2021.
-
Abstract
- BackgroundPublic health policies and recommendations aim to be informed by the best available evidence. Evidence underpinning e-cigarettes policy recommendations has been necessarily limited due to the novelty of the technology and the lack of long-term epidemiological studies and trials. Some public health bodies have actively encouraged e-cigarette use whilst others have raised concerns over introducing new health risks and renormalising tobacco smoking. Using citation network analysis we investigated the author conflicts of interest and study funding statements within sources of evidence used by public health bodies when making recommendations about e-cigarette policy.MethodsWe conducted citation network analysis of public health recommendation documents across four purposively selected diverse jurisdictions: WHO, UK, Australia, and USA. We extracted all citations from 15 public health recommendation documents, with more detailed data collected for influential citations (used in 3+ recommendation documents). We analysed the relationships between the sources of evidence used across jurisdictions using block modelling to determine if similar groups of documents were used across different jurisdictions. We assessed the frequency and nature of conflicts of interest.Results1700 unique citations were included across the 15 public health recommendation documents, with zero to 923 citations per document (median = 63, IQR = 7.5–132). The evidence base underpinning public health recommendations did not systematically differ across jurisdictions. Of the 1700 citations included, the majority were journal articles (n = 1179). Across 1081 journal articles published between 1998–2018, 200 declared a conflict of interest, 288 contained no mention of conflicts of interest, and 593 declared none. Conflicts of interest were reported with tobacco (3%; n = 37 journal articles of 1081), e-cigarette (7%; n = 72), and pharmaceutical companies (12%; n = 127), with such conflicts present even in the most recent years. There were 53 influential citations, the most common study type was basic science research without human subjects (e.g. examination of aerosols and e-liquids) (n = 18) followed by systematic review (n = 10); with randomised control trial being least common (n = 4). Network analysis identified clusters of highly-cited articles with a higher prevalence of conflicts of interest.ConclusionPublic health bodies across different jurisdictions drew upon similar sources of evidence, despite articulating different policy approaches to e-cigarettes. The evidence drawn upon, including the most influential evidence, contained substantial conflicts of interest (including relationships with e-cigarette and tobacco industries). Processes to explicitly manage conflicts of interest arising from the underlying evidence base may be required when developing public health recommendations.
- Subjects :
- Conflicts of Interest
Electronic Cigarettes
Social Sciences
Electronic Nicotine Delivery Systems
Geographical Locations
Habits
0302 clinical medicine
Citation analysis
Epidemiology
Medicine and Health Sciences
Smoking Habits
Psychology
Public and Occupational Health
030212 general & internal medicine
Research Integrity
Multidisciplinary
030503 health policy & services
Health Policy
Novelty
Public relations
Research Assessment
Nicotine Addiction
Citation Analysis
Medicine
Public Health
0305 other medical science
Network Analysis
Research Article
medicine.medical_specialty
Computer and Information Sciences
Science Policy
Substance-Related Disorders
Political Science
Science
Control (management)
Oceania
Public policy
Addiction
Public Policy
Tobacco Industry
Research and Analysis Methods
World Health Organization
03 medical and health sciences
Political science
Mental Health and Psychiatry
medicine
Humans
Behavior
Health Care Policy
business.industry
Conflict of Interest
Public health
Conflict of interest
Australia
International health
Biology and Life Sciences
United Kingdom
United States
Health Care
People and Places
business
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- PLoS ONE, Vol 16, Iss 8 (2021), PLoS ONE, Vol 16, Iss 8, p e0255604 (2021), PLoS ONE
- Accession number :
- edsair.doi.dedup.....35522e747bcd5bca5feccc7cbfc7d4ce