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Scotland to launch first safety trial of e-cigarettes and pregnant women

http://www.heraldscotland.com/news/14722004.Scotland_to_launch_first_safety_trial_of_e_cigarettes_and_pregnant_women/

SCOTLAND is to carry out the world’s first study examining the safety of e-cigarettes for pregnant woman and their unborn babies.

The study comes amid growing controversy over e-cigarettes. Last week it was reported that they are as bad for your heart as smoking after research found a similar effect to conventional smoking on the stiffness of the main blood vessel in the body.

Several hundred women will be recruited for a major trial next year which will investigate whether ‘vaping’ can help women who struggle to quit smoking while pregnant, the Sunday Herald can reveal.

Researchers from the UK Centre for Tobacco and Alcohol Studies, a network of 13 universities, will also track the progress of their babies until the age of two to assess if there are any potential harmful effects.

But critics said it was already known arterial stiffness is caused by nicotine – which can also be caused in other ways such as drinking coffee.

In the UK prominent medical bodies – including the Royal College of Physicians (RCP), the British Lung Foundation and Cancer Research UK – say all current evidence suggests e-cigarettes are significantly less harmful than smoking.

A recent report published by the RCP said the risk to health from vaping was unlikely to exceed 5% of the harm from smoking tobacco.

Yet in other countries, including Brazil, Singapore and Austria, the sale of e-cigarettes is completely banned, while many others have restrictions in place.

The use of e-cigarettes before 2010 was rare, but now it is estimated around two million in the UK are ‘vaping’.

Linda Bauld, professor of health policy at the University of Stirling and deputy director of the UK Centre for Tobacco and Alcohol Studies, said perceptions of risk of e-cigarettes had changed in the past five years, with many now believing they were as harmful as smoking. She said this was “not great” for public health experts who believe they could be helpful in trying to tackle the harm caused by tobacco.

“We are primarily interested in adult smokers who struggle to stop – that includes groups like prisoners, people with mental health problems and pregnant women,” she said. “We haven’t made much inroads into reducing smoking rates in these groups, so for these groups e-cigarettes offer real promise.”

Bauld said the first trial in the world to assess the use of e-cigarettes in pregnant women would begin early next year, with one of the sites in Scotland.

She said it was possible as in the UK nicotine replacement therapy (NRT) is routinely given to pregnant women who are struggling to stop smoking, unlike in many countries where it is only prescribed by a doctor.

“We will be recruiting several hundred pregnant smokers and randomising them to use NRT and behavioural support, or an e-cigarette and behavioural support and then we will see how they get on,” she said.

“We will look at ‘does it help them stop smoking, do they like it and is it safe’?”

According to the latest statistics just over 9,900 pregnant women in Scotland are smokers at their first health visit – ranging from nearly 30% from the most deprived areas to just 4.5% from the least deprived.

New guidance for midwives states only NRT products should be recommended, but a woman should not be discouraged from using e-cigarettes if it helps her to quit smoking.

Janet Fyle, policy adviser with the Royal College of Midwives, said any research into the issue would be welcome. “We have to say the jury is still out on e-cigarettes. We do not know what the harm is if any, so we have to be cautious and say to (pregnant) women this is the perfect opportunity to give up smoking, improve your health and stay smoke-free,” she said.

Sheila Duffy, chief executive of anti-tobacco charity ASH Scotland, said all evidence so far suggested that tobacco is much more harmful than e-cigarettes, but cautioned that e-cigarettes were “not harmless”.

She added: “There are still many unknowns, partly because there is such a wide range of different products and liquids, and partly because the research is still ongoing. We are now starting to see some interesting findings, but while we have a really good body of evidence on the vast harmfulness of cigarettes and tobacco, we don’t yet have a complete evidence base on the long-term health effects of using e-cigarettes.”

She raised concerns over multinational tobacco companies buying up e-cigarette brands. “If e-cigarettes can get smokers off tobacco, then I welcome them as harm reduction,” she said. “But if they are used by tobacco companies as a way of reaching out and getting their messages to young people, that could be a real danger.”

Sarah Jakes, of the New Nicotine Alliance UK, a charity set up to promote nicotine products for reducing cigarette smoking, said the debate over vaping safety was a result of a “war of ideologies” between those who favour a ‘quit or die’ approach versus those who took a pragmatic view.

She said: “In my view, the former group constantly manipulate and overblow potential harms in order to undermine the arguments of the harm reduction proponents.”

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