Dr Katie East started an SSA fellowship in October 2021. The SSA’s Rob Calder caught up with Dr East to find out more about her research and her tips for getting a post-doctoral fellowship.

We are going to use large international datasets to look across different countries that have different e-cigarette regulations and identify different ways that governments communicate the harms of vaping.

SSA: Congratulations on your fellowship, what do you plan to study over the next 3 years?

Dr East: “The fellowship looks at factors that influence vaping harm perceptions among young adults and how they can be modified. So, we know that vaping is less harmful than smoking, but an increasing proportion of the British population inaccurately perceive vaping to be more harmful or equally harmful than smoking. We also know that these misperceptions are increasing, but we don’t really know why or how we can correct them.” 

Do you have any indications about why some people might think that vaping is more harmful than smoking?

“Well, I guess don’t want to give any spoilers, but some of the hypothesized mechanisms are things like regulations. So, some countries restrict e-cigarettes, sometimes to a similar extent as cigarettes by putting like warning labels on them or by adding nicotine limits and other regulations that might make the public perceive them to be harmful.”

“Another factor is the impact of media and news stories, particularly around things like the EVALI outbreak – the outbreak of lung injuries in the US. There was lots of media coverage of that, and data suggest that in lots of different countries that reporting has exacerbated misperceptions of harm from vaping. So yeah, the media, and regulations are the main things that I will look at.”

How do you plan to look this? Your history is in using big datasets. Are you going to do that again?

“Yes, this will build on the work I’m already doing. We are going to use large international datasets to look across different countries that have different e-cigarette regulations and identify different ways that governments communicate the harms of vaping. So, for example. We have datasets that use the same methods across the US, England, Australia and Canada.”

“In the US, a lot of emphasis is placed on the potential of e-cigarettes to harm kids. Some of the messaging from leading health organisations in the US is that e-cigarettes pose a risk to health and, in particular that they shouldn’t be used by young people. In the UK, the messaging tends to be more nuanced and focused on the potential of e-cigarettes to help adult smokers to quit smoking.”

“You can then use datasets across different countries to exploit differences in the policies and messaging to look at the impact on vaping perceptions. It’s also possible to look at over time to when different policies have been introduced and when messaging differs in different countries and how that might impact perceptions.”

“For example, warning labels were implemented in England and the EU a few years ago, but more recently in Canada and the US. Also, with the EVALI outbreak there was a lot of media communication in the US and there was some, but not as much in England. So, all of these different patterns of policies and communications allow us to look at the impact of messaging on behaviors and harm perceptions.”

Are you planning any qualitative research in this area?

“Yes, but not as a main focus of the fellowship. I have recently led a qualitative paper that looks at harm perceptions of IQOS, which is a novel heated tobacco product, and why people perceive it as less harmful than smoking and the reasons for that. And now we’re also looking at the language that people use to describe IQOS use in the context of changing landscapes of nicotine and tobacco products.”

Yes, you hear people say that don’t you? ‘Smoking is banned on the platform and that includes vaping’. I always think ‘but smoking doesn’t include vaping’. You’ve got smoking and vaping and both are banned on the platform.

“Yes! And then what about other things like IQOS and new products that are coming out? My research will help to understand how they are perceived, but the main focus of the SSA Fellowship is on vaping perceptions.

You said that this builds on work you’ve done before, so what’s your background?

“My PhD looked at how social norms towards smoking – so things like whether your friends smoke, whether you perceive society approves of smoking – were associated with policies and behaviors across countries. And it turns out that smoking norms didn’t really seem to matter as much as theories suggest. The behavior of people closest to you is a strong predictor of your own behavior, but less so the behaviour of society or whether you think other people approve smoking. So, if you have friends who smoke, you are also more likely to smoke. When you’re looking to change things like public attitudes, however, social norms don’t seem to really predict behavior. So that line of research for me kind of came to an end. We then started looking more harm perceptions, because evidence suggests that harm perceptions are strong predictors of behavior.”

Be strategic about the people that you want to work with, based on where you want to be, what methods you want to use and what datasets you want to use.

How did you get into research on tobacco and tobacco policy?

“I did my undergrad in psychology at the University of Bristol and I looked at motivations for alcohol use among undergrads. So, that was my first experience doing research. Not very well done, but it had a great title ‘Cocktail of drinking motives at university’.”

“I then did my masters at UCL with Dr Tom Freeman and Dr Will Lawn who have also received SSA funding! That was looking at tobacco dependence and craving using an experimental paradigm and that’s how I got into tobacco research. Then after I finished my masters, I got a Research Assistant position at King’s where I did my PhD with Professor Ann McNeill and Dr Sara Hitchman, who lead the England arm of the International Tobacco Control project and do huge amounts of work on tobacco control and e-cigarette policies.”

How has the past 18 months been? Were your studies interrupted by COVID?

“I was very lucky to get a postdoc position working with Professor Dave Hammond at the University of Waterloo in Canada which I started in April 2020, at around the time that the pandemic was kicking off. So, I was meant to move to Canada to do that, but I ended up doing all of it remotely because of the pandemic. I did move to Canada for a few months, but there were still a lot of restrictions, which precluded me going into the office. So, I then moved back to the UK. It meant I never actually met the team in person, and everything was done over Teams. But then I guess that’s been same for everyone else. Luckily the work I do is all online!”

What advice would you give to postdoctoral researchers who are looking to apply for fellowships?

“Get feedback early and start thinking about it early. If you identify a scheme, I recommend starting to prepare at least 6 months, ideally a year, before it’s due. Also be strategic about the people that you want to work with, based on where you want to be, what methods you want to use and what datasets you want to use. Approach people and ask them if they would be willing to be co-applicants, because that will help you build networks and get access to resources and data.”

“Oh yes, and if you if you don’t get one fellowship, then apply again. This was the fourth one I applied for. Not because the SSA was a low priority, just because of the timings. And I also never thought I’d get the SSA fellowship…  so that’s another piece of advice: aim high!”

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