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January 1st, 2017:

Quitting smokers ‘should not vape’

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

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

Another reason not to smoke while pregnant

Kids whose mothers smoked while pregnant were 24 percent more likely to show signs of kidney damage in their urine tests by age three.

Women who smoke during pregnancy may be more likely to have children with kidney damage than mothers who steer clear of cigarettes, a study suggests.

Smoking during pregnancy has long been linked to preterm and underweight babies and a wide range of birth defects. The current study offers fresh evidence that the kidneys are among the organs at risk for damage, said lead author Dr. Maki Shinzawa, a public health researcher at Kyoto University in Japan.

“Cigarette smoking releases nicotine and other harmful or potentially harmful substances, such as nitrogen oxide, polycarbonate, and carbon monoxide, some of which cross the placenta,” Shinzawa said by email. “Some of these trans-placental substances may affect fetal programming of the kidney during pregnancy.”

Shinzawa and colleagues examined data from urine tests from 44,595 children to look for elevated levels of protein in the urine, which can indicate impaired kidney function.

Data on maternal smoking was collected during women’s prenatal checkups, and researchers also had records from their children’s health checkups at four, nine, 18 and 36 months of age.

Overall, 79 percent of women said they never smoked and another 4 percent said they stopped smoking during pregnancy. About 17 percent of the mothers said they continued to smoke while they were pregnant.

The absolute risk of kidney damage among the children was low. But compared with children born to nonsmoking mothers, kids whose mothers smoked while pregnant were 24 percent more likely to show signs of kidney damage in their urine tests by age three.

Urine tests showed elevated protein levels in 1.7 percent of children born to smokers, 1.6 percent of kids whose mothers were former smokers and 1.3 percent of children born to women who never smoked. Children exposed to second-hand smoke at home also appeared to have a higher risk of kidney damage than kids who didn’t live with smokers, but the difference wasn’t big enough to rule out the possibility that it was due to chance.

One limitation of the study is its reliance on women to accurately report and recall how much they smoked before or during pregnancy, and a lack of lab tests to confirm smoke exposure, the authors note in the Clinical Journal of the American Society of Nephrology.

Still, the findings add to evidence linking smoking to kidney damage, a connection that some previous research has established for adult smokers and for children who inhale second-hand smoke, said Dr. Paul Fowler, director of the Institute of Medical Sciences at the University of Aberdeen in the UK.

“Maternal smoking has been observed to lead to reduced kidney size in offspring, which is of concern since it is known that retarded kidney development contributes to (high blood pressure) and renal injury in adults,” Fowler, who wasn’t involved in the study, added by email.

“This study highlights one more reason why women should not smoke during pregnancy and why children should be raised in cigarette-free households,” Fowler said. “It is not, in itself, an overwhelming reason, but rather one more nail in the coffin.”

Tobacco and its environmental impact: an overview

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Worldwide Cigarette Price per pack (Marlboro ) 2016

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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.


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.

Monitoring tobacco use and prevention policies

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