AZoRobotics speaks with Dr. Emma Ward from UEA and Yazan Sboul from Vaipio about the development of the new smoking cessation device, LEVEL-X. A study (TRAJECT), carried out by the UEA has been funded by Cancer Research UK, this study looks at the smoking habits of 'dual-use' smokers and aims at helping them quit for good.
Can you give our readers a summary of your recent research? What are the main aims of TRAJECT?
Emma: Smoking is still the biggest preventable cause of death worldwide. Regarding COVID-19, we know that smokers who catch the virus are more likely to suffer for longer with more severe symptoms. The best action a smoker can take to improve their health is to quit smoking.
E-cigarettes are a disruptive technology that can provide a harm reduction approach to quitting smoking by using nicotine in a less harmful way. They also replicate many of the behavioral, social and identity aspects of smoking, whilst also providing unique pleasures such as flavors.
Unfortunately, around a third of vapers in the UK also continue to use tobacco, this is known as 'dual use'. Dual use is problematic as vaping's health benefits can only be maximized by switching entirely from tobacco to less harmful vaping.
The TRAJECT study (Tracking via Repeated Assessment of Joint E-Cigarette and Tobacco use) is funded by Cancer Research UK. It aims to find out more about how dual use varies over time, and what factors help or hinder smokers in switching away from smoking tobacco to using e-cigarettes or stopping both. We're using a powerful scientific method, called Ecological Momentary Assessment (EMA), to enable us to build a picture of each participant's smoking and vaping behavior. This gives us a rare view into how these behaviors fluctuate over time and what psychological, social and environmental factors influence this for each person.
Using the EMA method over 90 days, we ask participants to complete a short daily online survey that assesses their mood, environmental factors, and vaping and smoking patterns. Participants will also use a small monitoring device called LEVEL-X, which screws onto tank-based e-cigarettes.
The device will measure the number and duration of puffs, the time between puffs, and the power used per puff to build a personalized profile of the user's vaping patterns. It is the first time that the technology has been used in research and the results will be used to help develop AI to help inform people about their vaping behavior.
What are the predicted outcomes of TRAJECT?
Emma: Our findings will help identify factors that help dual users reduce harm by stopping smoking and inform policy-decisions on how e-cigarettes can be promoted effectively to help people quit smoking forever.
In this study, the LEVEL-X device is used passively to provide in-depth vaping data to identify how e-cigarette use is associated with smoking behavior and other factors, such as mood and social support, which can influence dual use. In the future, it is likely that the information that the technology provides will be used to help smokers quit smoking.
Could you explain to the readers how the LEVEL system was developed?
Yazan: The LEVEL-X devices are developed by Vaipio, a MedTech startup, as part of their smoking cessation solution. Level is a smart smoking cessation device, which monitors users' vaping to determine the level of nicotine intake, using real-time data to guide the user through a painless gradual quitting process (dynamic dose reduction).
LEVEL-X is Vaipio's academic research tool (based on their platform), applying the system and level devices for passive data collection. You can think of it as a smart puff counter that records a range of puff metrics, including duration and power consumption. Our research platform also includes cloud services for remote project management data streaming.
Can you explain how AI will be used to help smokers quit tobacco?
Yazan: Vaipio’s smoking cessation solution uses algorithms that learn user behavior and adapt to build a dynamic quitting program. AI is a broad term, in one sense the Level devices use elements of AI to help people quit smoking by applying self-learning algorithms that build the personal dose reduction pathways. However, in the future, we intend to apply a deeper level of AI to large data sets of smoking cessation behavior, which will feedback from the group behavior and wider environmental factors to benefit individual users.
What benefits can the LEVEL system have over other methods used to quit smoking?
Emma: In the UK, e-cigarettes are the most popular and effective assisted method of quitting smoking. Given the proportion of dual users however, there is clearly a need to make vaping more effective for some quitters. LEVEL-X is an onboard computer for your e-cigarette. It learns how you vape and then uses that data to predict when you'll crave a nicotine hit.
LEVEL-X is designed to help you understand your vaping behavior by precisely monitoring use. This might help people who want to control cravings to smoke or reduce the amount of nicotine they use in their e-cigarette. It can also be used to maintain your current level of nicotine consumption and is very user-friendly, discreet and flexible. It aims to put you in control.
What's next for TRAJECT following the trial?
Emma: The LEVEL-X device will be used to better understand dual use behavior on an individual level. Data from TRAJECT could help inform future work not only relating to smoking cessation but also vaping cessation. This would be incredibly helpful because some smokers are put off using e-cigarettes because they are concerned about continuing nicotine addiction. These smokers may be more open to switching to less harmful vaping if there is an evidence-based approach to eventually quitting nicotine altogether.
Where can readers find more information?
For further information about the research study: www.traject.uea.ac.uk. For further information about the Level device: www.getlevel.io.
About Dr. Emma Ward
Dr. Emma Ward is a Research Fellow in the Addiction Research Group in Norwich Medical School, University of East Anglia (UEA). Dr. Ward graduated with a social science PhD from UEA in 2009 and has a background in researching vulnerable and disadvantaged populations.
Dr. Ward has become particularly interested in how technology can promote healthier behaviors and greater well-being in recent years. Her research mainly investigates real-world uses of e-cigarettes for smoking cessation and relapse prevention. Dr. Ward has also explored how new mothers can utilize technology to promote cancer, preventing health behaviors, including breastfeeding, exercising, and not smoking.
About Yazan Sboul
Yazan Sboul is the founder of Vaipio. Vaipio, the MedTech start-up, has developed the LEVEL-X device as part of their smoking cessation solution. Level is a smart smoking cessation solution, which monitors user vaping to determine the level of nicotine intake, using real-time data to guide the user through a painless gradual quitting process (dynamic dose reduction). The team at Vaipio includes engineers from Imperial College London.
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