Centre of Excellence for the Acceleration of Harm Reduction (CoEHAR)

The Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), an interdepartmental Research Centre, was founded in March 2018 by Riccardo Polosa at the University of Catania, Italy.¹² CoEHAR is one of the multiple “Centres of Excellence” set up with Foundation funding as hubs for research on tobacco harm reduction.

For more information on the Foundation, see our pages on the Foundation for a Smoke-Free World and its Centres of Excellence.

Relationship with the tobacco industry

Both CoEHAR and its founder Polosa have significant links to the tobacco industry. Polosa has disclosed that he has worked as a consultant to British American Tobacco. He has also previously received funding from Philip Morris International, Philip Morris USA, JUUL Labs Inc. and collaborated with tobacco industry scientists. More information can be found on our page on Riccardo Polosa.

CoEHAR funded by Foundation for a Smoke-Free World

In 2018, CoeHAR was established with a grant from the Foundation for a Smoke-Free World (FSFW, now Global Action to End Smoking), an ostensibly independent scientific organisation aimed at “accelerating the end of smoking”, which is solely funded by Philip Morris International (PMI).³ The official grantee named in FSFW’s 2018 tax return was ECLAT SRL, “a spin off of the University of Catania”.⁴ ECLAT SRL received two grants in 2018. The first grant, awarded on 30 May 2018 to the value of US$130,559, was to establish the Centre of Excellence for the Acceleration of Harm Reduction (COEHAR).³ The second grant, awarded on 28 September 2018 and worth US$75,246, was to “accelerate and improve smoking precision and detection rate of monitoring the smoking episodes by using the smokebeat technology”.³

In 2019, CoEHAR received an additional US$8,036,493 from FSFW to:⁵

“act as a hub for the global coordination of scientific research projects for advancing the science of tobacco cessation and harm reduction.”

In 2020 CoEHAR received US$88,551 from FSFW.⁶ In 2021, its grant value was increased to US$1,083,565,⁶ and in 2022 increased again to US$2,822,437.⁷

CoEHAR was granted US$4,047,066 in 2023, around US$1 million of which was for a new study investigating dual users of “combustible tobacco cigarettes and electronic nicotine delivery systems to assess the effect of different dual use patterns on toxin exposure and risk”.⁸ Between 2018 and 2023 CoEHAR, via ECLAT SRL, received a total of US$16,283,917 from FSFW (now GAES).⁹

As of July 2024, the University of Catania and CoeHAR have not disclosed the centre’s FSFW/GAES funding on their respective websites.²¹⁰ Find out more about the Foundation’s Centres of Excellence.

Partnerships

CoEHAR describes itself as a consortium with partners including Eclat (the organisation through which CoEHAR receives its grant funds from FSFW)¹¹¹², the ‘Center for Tobacco Prevention and Treatment’ (CPCT) and the Italian Anti-Smoking League (LIAF).¹³

CoEHAR also lists seventeen ‘international partners’ which include other FSFW grantees such as COREISS and the NOSMOKE Institute at Patras Science Park, and universities in Iran, Morocco, Serbia, Romania, Bangladesh, USA, Oman, Poland, Russia, India, Brazil, Indonesia and the UK.¹³

People

CoEHAR employs a group of researchers and administration staff from the University of Catania. The staff at CoEHAR work in a variety of departments at the university such as Clinical and Experimental Medicine, Legal Sciences, Biomedical and Biotechnological Sciences and the Centre for Tobacco Prevention and Treatment.¹⁴ Riccardo Polosa is the founder of CoEHAR.¹⁴ Polosa was also the Director of CoEHAR up until January 2020 when he was replaced by Giovanni Li Volti.¹⁵¹⁴ Giovanni Li Volti is also a professor at the University of Catania in the Department of Biomedical and Biotechnological Sciences.¹⁶

Outputs

Projects

The following are some of the projects launched by CoEHAR, with funding from FSFW:¹⁷

• Catania Conversation – a project which aims to connect journalists, scientists and opinion leaders to work together and fill the “communication gaps” around tobacco harm reduction.¹⁸
• REPLICA – an initiative looking to replicate studies on e-cigarettes and heated tobacco products (HTPs) to validate industry results.¹⁹²⁰ According to the REPLICA website, the study aims to “replicate and validate high-profile studies on the cytotoxicity and inflammation induced by cigarette smoke and aerosol from electronic nicotine delivery systems (ENDS)”.²¹ In February 2020, Serbian national television broadcast a tour of CoEHAR’s research laboratory at the University of Kragujevac with Giovanni Li Volti. Serbia is one of the six partner countries participating in the Replica project In addition to Italy and Serbia, the other counties participating are the US, Russia, Oman and Indonesia.²²
• SMILE project – a research project lead by CoEHAR “that aims to assess the impact of cigarette smoking and of reduced-risk products on oral health, in four different countries, Italy, Poland, Moldova and Indonesia.”²³
• The International Summer School on Project Management (ISPM) – project that aims to support project management skills of young professionals and students.²⁴ Riccardo Polosa and Francesco Purrello, the Director of the Department of Clinical and Experimental Medicine at the University of Catania, are on the ISPM Committee board.²⁵
• Veritas Cohort – a study looking at the long-term effects of e-cigarette use on non-smokers and low-level smokers.²⁶
• Diasmoke – “A Randomized Controlled Multicentre Study evaluating changes in Cardiovascular Risk Factors in Smokers with type 2 Diabetes Mellitus after switching from Tobacco Cigarettes to Combustion-Free Nicotine Delivery Systems: DIASMOKE 2.0 Study”.²⁷
• In Silico Science – a training programme for researchers looking to applying “living systematic reviews and umbrella reviews” to harm reduction research.²⁸
• FoodRec – a project developing digital monitoring software to track the dietary habits of people quitting smoking.²⁹For a full list of CoEHAR projects visit its website.

Research

Researchers at CoEHAR have published on a wide range of topics relating to smoking, harm reduction and newer nicotine and tobacco products, mainly e-cigarettes. For example:

• A 2024 article published in Frontiers Public Health calls for new methods and definitions to measure youth use of e-cigarettes, arguing that current methods are insufficient.³⁰ This paper was co-authored by Polosa and Arielle Selya, a scientist and consultant at Pinney Associates, an organisation which has worked with JUUL Labs since 2019 and previously with BAT/Reynolds.³¹
• CoEHAR researchers and Selya also published a 2022 article arguing that much e-cigarette epidemiological research is flawed methodologically. They particularly criticise the hypothesis that e-cigarettes could be a “gateway” to cigarette use.³²³³
• A 2020 article titled Smoking and SARS-CoV-2 Disease (COVID-19): Dangerous Liaisons or Confusing Relationships? critiques a study conducted by Brake and colleagues concerning the relationship between smoking and COVID-19. ³⁴ The authors suggest that smokers could be protected against COVID-19. At the height of covid, this was one of several pieces written suggesting that smoking could offer a protective effect against the virus. Researchers at the University of Bath have noted these findings are inconsistent with the broader literature.³⁵
• A 2020 article critiqued a study conducted by Reynales-Shigematsu and colleagues concerning the public health impact in Mexico of combustion-free electronic nicotine delivery systems (ENDS). CoEHAR researchers argue that the original study does not recognise the utility of e-cigarettes as a harm reduction alternative for improving smoking cessation.³⁶³⁷
• A study published in 2019 evaluated different smoking cessation treatments to estimate their efficacy. Its findings include that different strategies, such as using e-cigarettes, improves the success of smoking cessation.³⁸

An investigation in to the publishing practices of CoEHAR researchers found they are “often failing to adequately disclose their links to the tobacco industry”.³⁹

In July 2024, CoEHAR announced a call for papers for a special issue of the Springer journal, Discover Global Society. A CoEHAR researcher was named as Guest Editor of the special issue, titled: “The Tobacco Endgame in Low- and Middle-Income Countries and Indigenous Communities: Evidence Syntheses and Systematic Reviews.”⁴⁰

Events

• In July 2024 Professor Polosa visited the Faculty of Dentistry at Padjadjaran University (UNPAD) in Indonesia, one of CoEHAR’s partners in the both the SMILE project and REPLICA project.⁴¹ Part of the visit was to discuss “the joint agreement to establish CoEHAR at UNPAD as a leading center for harm reduction in Asia[…]”.⁴¹
• The Replica 2.0 project hosts an annual international meeting at the University of Catania for partners involved in the project, last held (at time of writing) in March 2024.⁴²
• The CoEHAR Catania Conversation initiative hosted an online masterclass webinar on 29 May 2020, which is World No Tobacco Day.¹⁸
• On 3 March 2020, CoEHAR partnered with the Italian Anti-Smoking League (LIAF) to participate in a seminar during ‘Scientific Culture Week’ at the University of Catania.⁴³ After many years as President of LIAF, Polosa now serves as LIAF’s Chief Scientific Advisor.⁴⁴
• In September 2019, the winners of the Conrad Challenge, which has received funding from FSFW, travelled to CoEHAR as part of their grand prize. The group of students from the US were guests at CoEHAR for three days and followed a structured visitor programme learning about innovation, technology and excellence at the centre.⁴⁵

Lobbying

• In April 2024, Polosa wrote to Australian Senators on the vaping reform bill, lobbying for a permissive regulatory approach to newer tobacco and nicotine  products.⁴⁶
• In July 2022 CoEHAR members signed a letter in opposition to the Government of Bangladesh’s amendment to the Smoking and Using of Tobacco Products (Control) Act.⁴⁷ The amendment would prohibit smoking in public places, ban tobacco company Corporate Social Responsibility and prohibit sale of e-cigarettes.⁴⁸ The letter urged the government “not to prohibit smoke free nicotine-based alternatives to combustible cigarettes” and to “encourage the migration from high-risk to low-risk products”.⁴⁷
• In August 2022 CoEHAR members, including Riccardo Polosa , sent a similar letter to the government of Malaysia, also urging them “not to prohibit smoke free nicotine-based alternatives to combustible cigarettes”.⁴⁹ The Malaysian Tobacco and Smoking Products Control Bill proposes prohibiting the sale and possession of tobacco or nicotine products to anyone born after 1 January 2007.⁵⁰
• Riccardo Polosa successfully lobbied for e-cigarette retailers to remain open in Italy during the COVID-19 lockdown.⁵¹
• In September 2019, Riccardo Polosa coordinated the first CEN European Standards Committee round table meeting in Catania. Polosa lobbied for tight quality and safety standards for additions to e-cigarette liquids and their design to ensure the safety of the European Vaping Products Market.⁵²
• In August 2019, Riccardo Polosa travelled to New Delhi to urge the Indian Ministry of Health to reconsider the recommendation of a ban on e-cigarettes in all states. A team of scientists, led by Polosa, explained that the government should instead integrate the promotion of “reduced harm” products alongside tobacco control measures and withdraw their recommendation to ban e-cigarettes.⁵³

Relevant links

• CoEHAR website

TT resources

• Global Action to End Smoking
• Foundation for a Smoke-Free World
• Foundation for a Smoke-Free World Grantees
• Foundation for a Smoke-Free World Centres of Excellence
• Harm Reduction
• Newer Nicotine and Tobacco Products
• Heated Tobacco Products
• E-cigarettes
• Riccardo Polosa