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Bedford lost £14m last year due to smoking breaks

Figures released this week show smoking costs Bedford borough’s economy almost £34million a year.

But the biggest cost to the economy is not early deaths (£8.79million), smoking-related disease (£4.25million) or lost productivity because of sick days (£2.48million), says Action on Smoking and Health (ASH).

Instead the big cost is from people taking smoking breaks – reckoned to have cost Bedford firms nearly £14million last year because of lost productivity.

Councillor Louise Jackson, portfolio holder for public health, said: “Both councils and the NHS are experiencing severe funding pressures so these costs are not sustainable.

“Smoking remains the single largest cause of preventable death and illness in Bedford Borough, and the council provides free advice and support to help smokers to stop.

“People who use the stop smoking service are up to four times more likely to quit and last year we helped more than 700 people to successfully stop.

“For advice and support call 0800 013 0553.”

Deborah Arnott, chief executive of ASH, said: “We know that most local authorities remain committed to reducing smoking but key services are under threat from public health funding cuts.”

http://www.bedfordtoday.co.uk/news/bedford-lost-14m-last-year-due-to-smoking-breaks-1-7801719

Hong Kong Department of Health Tobacco Control Zero Efforts

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Not much proof that e-cigarettes can help people stop smoking

http://www.nst.com.my/news/2017/01/203391/not-much-proof-e-cigarettes-can-help-people-stop-smoking

As people become more aware of the dangers of smoking, many have taken steps to reduce the number of cigarettes smoked or to stop the bad habit. Public and private health centres and pharmacies provide smoking- cessation services, which include evidence-based treatment. These studies were based on large-scale population with medication that has been proven to be safe and effective. Nicotine replacement therapy (Nicorette) and Varenicline (Champix) have been used by those who wanted to quit smoking, and they have done so.

Interestingly, there is not much evidence supporting e-cigarette use as an alternative method for smoking cessation.

Recently, the Institute of Public Health, Health Ministry, conducted a survey on the use of e-cigarettes among adolescents and adults in Malaysia (The Tobacco and E-cigarette Survey among Malaysia Adolescents and The National E-Cigarette Survey 2016).

The results were disturbing. The majority of those who use e-cigarette are dual users. This means that they smoke cigarettes and e-cigarette. This is hazardous as it may result in nicotine overdose, which can lead to death. This can strengthen their addiction to nicotine, which hooked them to cigarettes in the first place.

Almost 70 per cent of the dual users stopped e-cigarette but continued smoking conventional cigarettes.

Most school children and adolescents started using e-cigarettes out of curiosity.

The main pull factors were the flavours and smell of e-liquids.

Many other dangerous substances can be introduced by drug pushers and dealers by just lacing the liquids.

Nearly 75 per cent of the study population felt that e-cigarettes were not useful to stop smoking and more than half wanted these to be banned.

DR RASHIDI MOHAMED PAKRI MOHAMED Nicotine Addiction Research Group, Universiti Malaya

The effect of pack warning labels on quitting

The effect of pack warning labels on quitting and related thoughts and behaviours in a national cohort of Aboriginal and Torres Strait Islander smokers

Anna Nicholson, GDipPH, BPhty(Hons) PhD Ron Borland, PhD Pele Bennet, BHSc Maureen Davey, MB BS FAFPHM Jasmine Sarin, BHSci(Indig Hlth) Anke Van der Sterren, MPH MA BA Matthew Stevens, PhD David Thomas, MB BS PhD FAFPHM

https://academic.oup.com/ntr/article-abstract/doi/10.1093/ntr/ntw396/2871245/The-effect-of-pack-warning-labels-on-quitting-and

Abstract

Introduction:

The high prevalence of smoking among Aboriginal and Torres Strait Islander people in Australia (39%) contributes substantially to health inequalities. This study assesses the impact of warning labels on quitting and related thoughts and behaviours for Aboriginal and Torres Strait Islander smokers.

Methods:

Participants were recruited from communities served by 34 Aboriginal Community Controlled Health Services and communities in the Torres Strait, Australia, using quota sampling. A cohort of 642 daily/weekly smokers completed relevant questions at baseline (April 2012-October 2013) and follow up (August 2013-August 2014).

Results:

We considered three baseline predictor variables: noticing warning labels, forgoing cigarettes due to warning labels (‘forgoing’) and perceiving labels to be effective.

Forgoing increased significantly between surveys only for those first surveyed prior to the introduction of plain packs (19% vs. 34%), however there were no significant interactions between forgoing cigarettes and the introduction of new and enlarged graphic warning labels on plain packaging in any model. Forgoing cigarettes predicted attempting to quit (AOR: 1.45, 95% CI: 1.02-2.06) and, among those who did not want to quit at baseline, wanting to quit at follow-up (AOR: 3.19, 95% CI: 1.06-9.63).

Among those less worried about future health effects, all three variables predicted being very worried at follow-up. Often noticing warning labels predicted correct responses to questions about health effects that had featured on warning labels (AOR: 1.84, 95% CI: 1.20-2.82) but not for those not featured.

Conclusions:

Graphic warning labels appear to have a positive impact on the understanding, concerns and motivations of Aboriginal and Torres Strait Islander smokers and, through these, their quit attempts.

IMPLICATIONS

Graphic warning labels are likely to be effective for Aboriginal and Torres Strait Islander smokers as they are for the broader Australian population.

The Surgeon General’s Report on E-Cigarettes: Quitters & Starters

By Dr. Sudip Bose, MD

http://www.huffingtonpost.com/dr-sudip-bose/the-surgeon-generals-repo_b_14046964.html

Jan. 7, 2016 — A report on e-cigarettes released at the end of last year by the US Surgeon General’s office shows a number of risks related to the popular product — particularly regarding young people — that should make them a lot less popular, but likely won’t. The act of “vaping” is often thought of as a safer alternative to smoking, but that’s not necessarily the case. Here are the dangers and potential dangers people should be paying attention to related to e-cigarettes:

The Debate

E-cigs are at the center of one of the most contentious debates in public health. The availability and appeal of using e-cigs as an alternative to smoking cigarettes has been growing quickly over the years for both those who are new to smoking, as an introductory product, and to those who are trying to quit smoking, who see it as a more “healthful” way of trying to kick the smoking habit.

However, e-cigs don’t solve the nicotine problem at all. Yes, e-cigs eliminate tar, and yes, e-cigs eliminate the tobacco — both dangerous elements to one’s health. And that’s definitely good. But what they do not eliminate is the critical element of nicotine. Nicotine is one of the most highly addictive substances on earth. It’s presented in a liquid and then vaporized form in an e-cig; you inhale through the e-cig, and as you inhale, the nicotine and other substances in the liquid are atomized and absorbed into your lungs. The nicotine in an e-cig is a lot more concentrated and potent.

New Users

For those who have never smoked and who are interested in the experience, e-cigs are an entry-level product that have been promoted and marketed as being safe. They’re not. They may be “safer” than cigarettes, but that’s only by degree.

While a new “vaper” isn’t exposed to the other substances of tar and tobacco such as are found in a normal cigarette, he or she is getting concentrated and more potent doses of nicotine. That’s not good. And we’re seeing younger and younger people trying these. Also not good. The e-cig “e-liquid,” which is what produces the vapor that users inhale and exhale, are marketed in an array of flavors that appeal to younger users — junior high and high school age kids — they’re available for order online, and you’re getting addicted right away to the habit of using nicotine. The flavors available boggle the imagination: bubble gum, banana, “Mother’s MIlk,” blueberry-lemon, banana cinnamon nutbread, pomegranate, strawberry — it goes on endlessly. These teenagers — and even younger children — are getting addicted early, which could lead to smoking, and e-cigs can easily become a gateway to trying and developing an addiction to more serious drugs. Addiction correlates to crime. People need to feed their habit, they break into homes to steal things to resell, they commit robberies on the streets, all to get money to feed their addiction. Ultimately they make some very poor choices and place themselves in very dangerous situations.

We may see less cancer as a result of e-cig use, because the tobacco and tar are gone. But we won’t be able to tell that for years or decades to come. Remember there are other chemicals mixed in with the nicotine in the solution that also could cause cancer down the road. The liquid that becomes vaporized in e-cigs, which you inhale and exhale in a cloud of vapor, contains not only nicotine but an array of other substances, such as propylene glycol, glycerine, flavorings and sometimes components like diacetyl, acetyl propionyl, benzaldehyde and the less-threatening sounding vanillin. We know that when inhaled, diacetyl causes a type of bronchitis known as “popcorn lung” — a scarring of the tiny air sacs in the lungs resulting in the thickening and narrowing of the airways. It may sound benign to a degree, but according to the American Lung Association, “it’s a serious disease that causes wheezing and shortness of breath, similar to the symptoms of chronic obstructive pulmonary disease (COPD).”

Quitting Smoking

If you’re trying to quit smoking, remember the key drug, nicotine, is still very much available through an e-cig and at much higher, concentrated doses. So while you will be eliminating the tar and tobacco of a cigarette, you’re amping up the accessibility of nicotine. That’s not exactly a great way to wean yourself from something harmful — to add more of it to your system.

We’re seeing a lot more nicotine toxicity. For example, little babies we see in the emergency room — sometimes they get a hold of a cigarette and they chew on it, which is usually not that harmful. But if they get a hold of an e-cigarette and ingest some of that liquid nicotine, which again is so concentrated in an e-cig form, we see nausea, vomiting seizures, paralysis — bad things.

Being that the nicotine is one of the most addictive substances, it’s not really helping you quit your addiction, it’s not the path to accomplishing that. And we’re seeing younger and younger people getting into it.

An Alternative to Smoking

There is a rising “connoisseur-ship” that’s evolved in the world of vaping in which vapers discuss vaping in the same way that wine aficionados discuss the nuances of whatever wine they are drinking. That’s great, but that doesn’t lessen the dangers outlined above.

Are vapers listening? Not really. In 2013, e-cigarette-related sales were $1.7 billion, which was double what they were in 2012. In 2015, those sales had risen to $2.9 billion. Many tobacco manufacturers also are in the e-cigarette game. More than 250 e-cig brands are on the market.

Perhaps this Surgeon General’s report will help refocus attention on the dangers of e-cigarettes and give people enough of a reason to take a pass at the growing trend of vaping.

For more about Dr. Sudip Bose, MD, please go to SudipBose.com and visit his nonprofit TheBattleContinues.org where 100% of donations go directly to injured veterans

Follow Dr. Sudip Bose on Twitter: www.twitter.com/docbose

Kingston University academics play key part in project to devise smartphone app that uses games technology to help smokers kick the habit

http://www.kingston.ac.uk/news/article/1765/04-jan-2017-kingston-university-academics-play-key-part-in-project-to-devise-smartphone-app-that-uses-games/

A smartphone app that could help smokers stick to New Year’s resolutions to quit by playing games to combat cravings has been developed by academics at Kingston University and Queen Mary University of London (QMUL). Cigbreak Free was the brainchild of games creation processes lecturer Hope Caton, from Kingston University’s School of Computer Science and Mathematics, and Robert Walton, Professor of Primary Medical Care at QMUL.

Ms Caton – who has extensive experience in video games, having worked on global hit TombRaider IV: The Last Revelation – teamed up with Professor Walton to see if they could combine a fun gaming experience with educational health messages to help smokers fight the urge to light up.

The result of the collaboration between the two universities was an app that works like a regular smartphone game, with players having to complete tasks to progress through levels, gaining rewards and gold stars along the way. However, it also incorporates a combination of some 37 behavioural change techniques – theory-based methods for changing behaviour – selected by QMUL health psychologists to help smokers quit, Ms Caton explained. “People think games are frivolous but we learn a lot through play,” she said. “The good thing about a smartphone gaming app is that you can play it anywhere.

“Craving is a short-term thing, so if you get a craving at 11am, you can play the game in the warm until it passes, rather than going out into the cold for a cigarette. You’ve also got something to do with your hands other than smoke.”

In the game, players have to swipe a certain number of cigarettes to break them within a time limit. As well as progressing through levels, the app includes a quit journal where users can calculate how much money they are saving. There are also mini-games where players have to clear smoke from a room to reveal a health message.

The app has now been commissioned for use by five London boroughs – Kingston, Kensington and Chelsea, Hammersmith and Fulham, Tower Hamlets and the City of Westminster – as part of their public health smoking cessation services. Residents can download it, enter their postcode and use the app for free, with several hundred people having downloaded Cigbreak Free so far.

Ms Caton and Professor Walton were authors of a recent research study published in the British Medical Journal, which analysed the use of behaviour change techniques and game-like elements in health apps currently on the market. They found that very few of the health apps they looked at were using games to help people make positive health changes.

The development of the app was inspired by a desire to exploit the latest trends in gaming to help improve people’s health, according to Professor Walton, from QMUL.

“Some of the health messages and behaviour change techniques we have used in the game are based on our previous research and include showing players the health consequences of a behaviour, gaining points for grabbing healthy items, or providing virtual financial incentives.

“We’re essentially trying to ‘gamify’ these messages and techniques as a way of embedding them in a person’s mind, in the hope that they will then be able to quit smoking.”

Rewards in the game were a way of giving smokers instant positive feedback, Ms Caton added. “When you’re trying to quit smoking you don’t get much instant feedback except desire. Your health is better but somehow it doesn’t have the same effect as being told you’re winning or getting a gold star,” she explained.

“We had to find subtle ways to include health messages so they don’t turn people off from playing, so the medical team ran 10 focus groups with 120 people to find out what worked and what didn’t.”

The team’s research is now being incorporated within teaching at Kingston University, as part of digital smoking cessation intervention work led by associate professor Dr Darrel Greenhill. Students on the University’s postgraduate game development courses are helping build the next upgrade for the app, using analytics gathered from users to inform improvements to gameplay – with the aim of providing more personalised support to help smokers quit.

“It’s really good experience for our Masters students to be able to work together on projects such as this as part of their digital studio practice module,” said Dr Greenhill, course director for the University’s game development programmes. “Our courses have been developed in consultation with representatives from the likes of Sony Interactive Entertainment Europe and Telefonica Europe. This insight, along with the opportunity to work with clients on real-world game development, helps provide them with the vital skills needed when seeking employment in the digital media industry.”

In January – a key time for smokers to make the resolution to quit – the team will begin a three-month pilot study with app users to evaluate its effectiveness. “The next step for us is to prove quit rates,” Ms Caton said. “We’ve had people smoking 25 cigarettes a day quit, some who’ve gone from 25 to four. It shows it can be effective but we need to get the analytics into the app to get more data and that’s something we’re working on now.”

I’ll say it again: E-cigarettes are still far safer than smoking

Despite evidence suggesting e-cigarettes are far less harmful than smoking, more people than ever believe them to be just as harmful. Professor Linda Bauld discusses the evidence

https://www.theguardian.com/science/sifting-the-evidence/2017/jan/02/ill-say-it-again-e-cigarettes-are-still-far-safer-than-smoking

January is a time for New Year’s resolutions and if you’re one of the world’s one billion smokers, your resolution may be to stop smoking. For some people, this year’s quit attempt might involve an electronic cigarette, and a recent study in England, published in the BMJ, suggested that these devices helped at least 18,000 smokers to stop in 2015 who would not otherwise have done so. That’s very good news, but will there be as many quit attempts in 2017 as there have been in the past with e-cigarettes? I’m not so sure.

Since I last wrote about e-cigarettes in this column one year ago, headlines about the dangers of these devices have continued to appear and show no sign of abating. The result is clear. More people believe today, compared with a year ago, that e-cigarettes are as harmful as smoking. In fact these incorrect perceptions have risen year on year, from fewer than one in ten adults in Great Britain in 2013 to one in four this past summer. Surveys of smokers show similar patterns, with an increasing proportion believing that e-cigarettes are more or equally harmful than tobacco.

Yet we know that these harm perceptions are wrong. There is now very strong evidence, from a range of studies, that vaping – inhaling nicotine without the combustion involved in smoking – is far less risky than smoking cigarettes. Just a few months ago this body of evidence was brought together by the Royal College of Physicians who published an authoritative report analysing dozens of studies and concluded that the hazard to health arising from long term vapour inhalation from e-cigarettes is unlikely to exceed 5% of the harm from smoking tobacco. The RCP, and since then other UK doctor’s organisations such as the Royal College of General Practitioners, have made clear that it is important to promote the use of e-cigarettes, along with other non-tobacco nicotine products (like Nicotine Replacement Therapy such as gum or inhalators) to smokers who are trying to quit. The work of these organisations is underpinned by a consensus statement endorsed by many of the main health charities and public health bodies in the UK. They agree that vaping is safer than smoking, and while these products are not risk free and should not be promoted to children or never smokers, they have a legitimate and positive role to play in tobacco control.

But this consensus is not shared around the world. The regular stream of media scare stories driving harm perceptions often originates in other countries where there is no such view about relative risks. Some media headlines are driven by poor science but others originate from reports by credible organisations who focus on the absolute risk of any e-cigarette use without comparing it to smoking (which is uniquely deadly and kills one in two regular users). 2016 saw at least two major reports of this kind.

In September the World Health Organisation published a report that set out a series of steps on e-cigarette regulation for countries signed up to the Framework Convention on Tobacco Control, a global public health treaty. These options were primarily about banning or severely restricting the sale, distribution and marketing of e-cigarettes. The WHO report was comprehensively critiqued by the UK Centre for Tobacco and Alcohol Studies, but its findings mean that e-cigarettes will continue to be unavailable to millions of smokers in many countries who have banned these devices or are considering doing so.

December 2016 saw the publication of a review authored by the US Surgeon General, which focused on e-cigarette use in young people. This described e-cigarette use as a public health concern, arguing that e-cigarettes are now the most commonly used tobacco product amongst US youth and that nicotine use in any form is unsafe for young people and also pregnant women. While some of the science in the report is accurate, the conclusions endorsing heavy regulation of e-cigarettes were not. The report did not compare the risks of smoking and vaping, failed to make clear that e-cigarettes are not tobacco products, and drew conclusions about nicotine that would also apply to Nicotine Replacement Therapy – which is safe and licensed for use in pregnancy and by young smokers. It also endorsed policies which could deter current smokers from switching to e-cigarettes. American scientists have critiqued data from the USA that provided the basis for the Surgeon General’s report, but it is likely that this publication will contribute to public perceptions that e-cigarettes are dangerous.

These two reports largely ignore the fact that there are already measures in place in many countries (including all of the EU) to protect the public from any risks from e-cigarettes. These include policies like age of sale, limits on advertising and child- and tamper-proof packaging – all important to protect children while still allowing sales to adult smokers and ex-smokers. Concerns about exploding batteries and nicotine poisoning can also be dealt with by following simple safety rules, such as those set out by the Royal Society for the Prevention of Accidents.

I believe that e-cigarettes have huge potential to save lives by providing an alternative to smoking. Yet this can only be realised if we address negative harm perceptions and communicate honestly with the public. Ongoing research can help with this, and 2016 has seen the start of important studies, many commissioned by Cancer Research UK, which will tell us more in the future. We also need to keep our eye on new technology, such as heat not burn tobacco products, which are emerging and about which we know little. Only time will tell whether the UK’s positive approach towards e-cigarettes strikes the right balance between risks and benefits. For now, however, we must do all we can to encourage smokers to try to stop at New Year or any other time. For those trying with e-cigarettes, this is a positive choice that should be supported.

Linda Bauld is Professor of Health Policy at the University of Stirling, Deputy Director of the UK Centre for Tobacco and Alcohol Studies and holds the CRUK/BUPA Chair in Behavioural Research for Cancer Prevention at Cancer Research UK. She is a former scientific adviser on tobacco control to the UK government and chaired the NICE guidance group on tobacco harm reduction.

This is what happens to your body in the days, weeks, months and years after you quit smoking

Many people will be giving up smoking as a New Year’s resolution, and here’s the motivation to help you see it through

http://www.mirror.co.uk/news/uk-news/what-happens-your-body-days-9547831

As the reality of all the New Year’s resolutions people have adopted sinks in, there is one habit that you’ll never want to go back to.

Smoking – a condition that causes smokers to die younger, smell terribly and all at a huge cost to your wallet.

But taking a look at what happens to a smoker’s body when they give up is enough to keep you off the fags and sticking to your New Year’s resolution for good.

Quitting smoking is the best thing any smoker can do for their health.

It’s a fact that around half of long-term smokers will die from the deadly addiction, The Newcastle Chronicle reports.

We know that “we all die eventually”, but smokers die on average 10 years earlier, and tragically from much more painful and debilitating illnesses, such as lung cancer, heart attacks and strokes.

The sooner smoking is given the boot, the sooner the body can begin to repair itself.

Any amount of time smoke-free gives the body – especially the lungs and bloodstream – time to “breathe” again and take in the clean air needed to recuperate.

Some damage caused by smoking which will never go away, but if you say goodbye to smoking you’ll live a much healthier, longer, richer life.

One of the scariest aspects of quitting smoking can be the unknown of what will happen and this often puts people off trying to be smoke-free in the first place.

What happens to the body

The human body is an amazing thing. Just 20 minutes after that last cigarette, it begins to recover.

Nicotine, the addictive chemical in smoking, acts as a stimulant and gives that all-important ‘kick’.

Not long after the last puff of smoke, heart rate and blood pressure return to normal following this high.

Eight hours

This is the testing time when most smokers reach for another cigarette.

The effects of withdrawal are strong as nicotine leaves the bloodstream and cravings start to happen.

One day

Anxiety and ‘stress’ levels peak. The feeling of stress associated with quitting smoking isn’t usually stress – it’s a sign of withdrawal.

That’s why it’s untrue that smoking de-stresses, it’s just feeding a craving.

In fact, research shows non- and ex-smokers feel less stressed than smokers.

Two to three days

If you decide to go ‘cold turkey’ there’s no nicotine left in the body but it’ll take a while to adjust to this new feeling. Using nicotine replacement therapy (NRT) such as gum, patches or e-cigarettes supplies the body with nicotine and allows smokers to wean themselves off smoking gently, making it easier to quit cigarettes.

Taste and smell receptors are given the chance to heal, meaning food will never have tasted so good!

One week

Making it one week smoke-free means quitters are over the worst of it.

It’s perfectly normal to think about smoking regularly – it’s now a case of mind over matter as the body no longer physically craves tobacco.

Many quitters experience a nasty cough, but this is perfectly normal – it’s the lungs’ way of clearing themselves as much as they can.

Two weeks

Blood circulation, especially to the gums and teeth, returns to normal levels, the same as a non-smoker.

Now that the mouth isn’t being bombarded with smoke, tissue damaged by gum disease can recover.

One month

Withdrawals can range from anger, anxiety, insomnia and mild depression, but by month one these feelings should have subsided. If not, a trip to the GP is recommended.

Quitters who make it to four weeks smoke-free are five times more likely to stay smoke-free for good.

Two months

The risk of heart attack risk has started to drop. With lung function improving too, climbing the stairs gets that little bit easier each day.

Three months

Walking long distances is a lot easier now. Any bad coughs should have disappeared, but if not, being seen by a doctor is imperative as it can be a sign of something more sinister.

Six months

Any tiredness and shortness of breath will be a thing of the past.

Cilia, air sacs in the lungs, have re-grown and healed some of the damage caused by smoking, but the lungs will never be 100% healthy.

One year

Ex-smokers are 50% less likely to have a heart attack, heart disease or a stroke within just one year of quitting.

Five years

Diabetes is an illness long-term smokers can develop. Make it five years smoke-free and the risks of it occurring are the same a non-smoker.

Five to 10 years

Amazing! The risk of having a stroke is now the same as that of a non-smoker. Smoke makes blood sticky and hard to move around the body and that’s why smokers are much more likely to have a stroke.

10 years

Lung cancer is the biggest risk to a smoker’s life. Within 10 years of quitting, the chance of death from lung cancer is half that of a smoker. The risk from other cancers such as mouth and pancreatic have reduced significantly.

Post-10 years

When smoking, the heart works harder to pump smoke-ridden blood and this leads to increased risk of heart attacks and disease. After 10 years smoke-free, the risk of heart disease is the same as a non-smoker

Quitting smokers ‘should not vape’

Anti-tobacco group says to use ‘safe’ nicotine gum and patches

http://www.independent.ie/irish-news/health/quitting-smokers-should-not-vape-35332992.html

Smokers considering giving up tobacco as a New Year’s resolution are being advised not to switch to electronic cigarettes for their nicotine hit due to safety worries about the long-term use of the devices.

The anti-tobacco advocacy group ASH Ireland has advised quitters to instead use nicotine patches or gum.

Vaping has been endorsed by governments in the UK and other countries but ASH chairman Dr Pat Doorley said he was concerned about the risk it poses to long-term health.

“Some people say they do help them but we don’t think the evidence is strong enough for us to support them and there are concerns about their long-term safety,” he said.

“Only a limited body of work has been carried out in the area of e-cigarettes and more research would have to be carried out here before we could endorse their use.”

The Health Information and Quality Authority is due to release a report on its study into smoking stimulation and smoking interventions.

While Dr Doorley said he would welcome any findings in the report, he advised that people looking to give up cigarettes should stick to “very useful” gums and patches.

He added: “Nicotine replacements will not give you the same hit but they can get you through cravings, especially for people who are highly addicted, for example those people who need a cigarette first thing in the morning.

“We would recommend those rather than e-cigarettes because they are proven to be effective and have proven to be safe. There is no such thing as a medicine or a pill with zero risk but they’re very safe.”

Despite a huge reduction ion in the number of smokers in recent decades, more than 5,900 people died from the effects of smoking in 2016.

Dr Doorley warned that the majority of people who kick the habit only do so after making numerous attempts and advised that people seek out support to quit.

“Having a plan is key and anyone who does have one will benefit,” he said. “This should involve having a date they want to quit by but there is no one-size-fits-all approach.”

People who manage to give up smoking will not just experience health benefits but will also make financial savings. Dr Doorley said: “A 20-a-day smoker will spend just over €4,000 on cigarettes annually. The overall cost of smoking in society is also significant, costing the State well over €1.6bn annually, with €506m spent on direct healthcare costs.

“Quitting is all positive – there are no downsides.”

Sunday Independent

E-CIGARETTE NICOTINE DELIVERY: DATA AND LEARNINGS FROM PHARMACOKINETIC STUDIES

By Ian M. Fearon, PhD; Alison Eldridge; Nathan Gale; Christopher J. Shepperd; Mike McEwan, PhD; Oscar M. Camacho; Mitch Nides, PhD; Kevin McAdam, PhD; Christopher J. Proctor, PhD

Study suggests e-cigarettes can provide effective delivery of nicotine for persons trying to quit smoking.

https://www.heartland.org/publications-resources/publications/e-cigarette-nicotine-delivery-data-and-learnings-from-pharmacokinetic-studies

Abstract

Objectives: E-cigarettes could potentially play a major role in tobacco harm reduction by delivering nicotine in a vapor containing significantly fewer toxicants than cigarette smoke and may aid smoking behavior changes such as reduction or cessation.

Methods: We examined blood nicotine levels in smokers who were non-accustomed to e-cigarette use (Study 1) and accustomed e-cigarette users (Study 2). We compared nicotine levels when participants used a closed modular system e-cigarette to those when participants smoked a cigarette.

Results: In Study 1, Cmax (geometric mean (CV)) during a 5-minute puffing period (10 puffs, 30 seconds apart) was 13.4 (51.4) ng/ ml for a regular cigarette. The e-cigarette Cmax was significantly lower (p .05) at 2.5 (67.8) ng/ml. In Study 2, during a 5-minute ad libitum puffing period, cigarette Cmax was 7.2 (130.8) ng/mL, and it was 7.8 (108.2) ng/mL for the e-cigarette.

Conclusions: Our data demonstrate heterogeneity of nicotine deliveries both between products and also with the same products used by different cohorts, eg, accustomed users versus smokers. Such differences must be taken into account when determining the likely behavioral impact, on smoking reduction and cessation, of nicotine delivery data and when planning e-cigarette nicotine pharmacokinetic studies.