Is Vaping Safe?

Reports of a possible link between e-cigarette use and deaths from lung disease predominantly in America have led some medical experts to warn of the dangers of vaping.

In a bid to answer some of the questions vapers may have in the wake of media reports about the situation in America, we contacted the UK government organisation responsible for regulating e-cigarette products in the UK, the Medicines and Healthcare products Regulatory Agency (MHRA).

Is it safe to vape in the UK, given the cases that are being investigated in the US?

E-cigarette products are regulated and must meet safety and quality standards before they can be sold in the UK.

The MHRA is aware of reports in the USA regarding a number of patients falling ill following vaping and are reviewing the available information. The MHRA assess all reports received in association with nicotine-containing e-cigarettes and should any potential safety concerns be identified we will take appropriate action to protect public health.”

What do we know about why people have been falling ill after using an e-cigarette in the US?

According to the U.S. Centers for Disease Control many patients affected by possible cases of lung illness report using e-cigarette products with liquids that contain cannabinoid products, such as tetrahydrocannabinol (THC).

Are vape products containing THC sold in the UK?

THC is a controlled substance in the UK and there are no vaping products containing THC which are approved for sale on the UK market.

Recreational use of THC is illegal and the use of illicit drugs can have potentially dangerous side effects because they have not been subject to the safety and quality standards put in place to protect public health.

What advice would you give to people concerned about using e-cigarettes in Wales?

It is advised that vaping products are not modified or used with homemade or black market cartridges, containing illicit substances, in order to preserve the health of their users.

The MHRA runs the notification scheme in the UK for e-cigarettes devices and nicotine containing e-liquids, which in order to be notified need comply with the Tobacco and Related Product Regulations. We encourage all consumers to ensure that they are buying notified products from reputable retailers. The MHRA also receives reports of potential safety concerns and work with local Trading Standards teams to investigate as needed.

Have there been any reports of people falling ill in the UK after using an e-cigarette?

Between 20/05/2016 – 06/09/2019, the MHRA has received 62 spontaneous UK Yellow Card reports of adverse reactions associated with nicotine-containing e-cigarettes. The MHRA encourages members of the public and healthcare professionals to report any potential side-effects associated with e-cigarettes to the Yellow Card Scheme (https://yellowcard.mhra.gov.uk/).

It is essential to note that a report of an adverse reaction does not necessarily mean that it was caused by the e-cigarette, but a suspicion by the reporter that the e-cigarette may have been the cause. Other factors such as the underlying disease or concomitant medicines may contribute to suspected adverse reactions.

Smokers 30 times more likely to develop mouth cancer if they mix tobacco and alcohol, warns leading academic

Having a drink whilst smoking, dramatically increases a person’s chance of developing mouth cancer

Smokers mix alcohol tobacco
Michael Lewis, Professor of Oral Medicine at Cardiff University’s School of Dentistry

That’s the warning from Michael Lewis, Professor of Oral Medicine at Cardiff University’s School of Dentistry who said smokers are 30 times more likely to develop mouth cancer if they mix alcohol and tobacco.

He said the risk of mouth cancer rises sharply in those who drink alcohol while smoking as it enables chemicals from the tobacco to be drawn more easily into the lining of the mouth:

“Tobacco alone is a factor in 60% of cases of mouth cancer whilst alcohol is a factor in 30% of cases. However, when the two habits are combined, there is a 30-times increase in the likelihood of developing this form of cancer,” said Professor Lewis.

“Tobacco contains a range of harmful chemicals known to cause cancer called carcinogens. When tobacco smoke mixes with alcohol in the mouth, these chemicals are drawn into the soft tissues lining the mouth which subsequently undergoes malignant change,” he added.

Professor Lewis went on to say that he believes smokers are “relatively unaware” of the risk of developing mouth cancer as a result of their habit, compared to the risk of lung cancer.

Mouth cancer is usually painless in its early stages but can produce a variety of changes in the mouth, including an ulcer, red or white patch or swelling. It is treated by radiotherapy or surgery, yet, according to Professor Lewis, more than half of sufferers die within five years of diagnosis. [i]

Suzanne Cass is CEO of the tobacco control campaign group ASH Wales. She said:

“For many smokers a cigarette and a drink go hand in hand. But as we now know, alcohol and tobacco are a lethal combination.

“Smoking is not a normal lifestyle choice, it is a devastating addiction that destroys the lives of thousands of smokers and their families in Wales every year.

“We would urge those in the grip of this addiction to seek help to give up from NHS Wales’ free smoking session service Help Me Quit.”

National alcohol charity Alcohol Change UK is holding its annual Wales conference on 18th September at Glyndŵr University which will focus on the links between alcohol and other issues, including smoking, gambling and mental health problems.

Andrew Misell, Director for Wales at Alcohol Change UK , said:

“Alcohol problems rarely occur in a vacuum. There are many reasons that people drink to excess: and many other issues that go hand in hand with drinking, including tobacco use. Many of these other issues, including smoking, exacerbate the issues caused by heavy drinking.

“Because people with alcohol problems have such diverse and complex needs, support services need to be ready to deal with that and provide support for people who don’t fit neatly into one treatment category. That’s what we’ll be focussing on at our conference, and we hope to see a wide range of professionals there who are keen to take a whole-person approach to their work.”

Research from the National Institute on Drug Abuse found that cigarette smoking increases the likelihood of relapse among people recovering from substance misuse disorder and has suggested that helping people to quit smoking improves their chances of recovery from use of other drugs such as alcohol.

People with substance misuse disorders are two to four times more likely to smoke than the general population and research has shown there is a higher smoking prevalence amongst those misusing other substances.

If you are a smoker who would like to find out more about support to quit, contact Help Me Quit on 0800 085 2219 or visit the ASH Wales website.

If you are worried that you are drinking too much you can use Alcohol Change UK’s drinking quiz to see how risky your drinking is. Support to cut down is available if you need it; you can visit your GP or local alcohol service to get the right help for you.

[1] Lewis M A O. Mouth cancer: Presentation, detection and referral in primary dental care.  Br Dent J 2018; 225: 833-840.

What are the best ways to give up smoking?

When quitting smoking it is important to do your research to find the best method that works for you. Quitting is a personal thing and there isn’t always a one size fits all answer.

There are however some quit methods that may give you a better chance of success…..

1) NHS Help and Support

From nicotine replacement therapy (NRT) products to e-cigarettes, there are plenty of options available to help you quit for good. Using these products in combination with support from local stop smoking services means you have an even greater chance of success. Smokers who give up using free NHS support are said to be 3x more likely to quit for good.

Help Me Quit is run by NHS Wales and will help you to find the quit smoking support that suits you best – whether that’s weekly group sessions in your local area or one to one meetings with a smoking cessation advisor. The service is tailored to meet your needs and you will be supported along the way with access to NRT and behavioural support.

2) E-cigarettes

The growth in the popularity of e-cigarettes has seen them become one of the UK’s most popular quit tools. They allow smokers to inhale nicotine in a vapour and do not burn like tobacco-cigarettes. Experts estimate that e-cigarettes are at least 95% less harmful than cigarettes.

They are popular with smokers trying to quit as you still get the nicotine, the hand to mouth gesture and the visual effect of the exhaled smoke without the other harmful chemicals contained in tobacco cigarettes.

E-cigarettes come in different models, with plenty of options, however it is important to make sure you’re buying your e-cigarette from a credited business that meets regulations.

Read our interview with some of Wales’ vape shop owners 

3) Understanding your habits

Smokers often struggle when trying to quit as the nicotine hit is gone but the daily habits and rituals are still there. As well as treating the physical addiction, in order to quit successfully you also need to address your patterns of behaviour and psychological addiction.

If you’re trying to quit – try changing your routine or finding alternative activities that don’t trigger the urge to light up a cigarette.

Read our article on smoking and the unconscious brain

Like we said at the start, there is no one size fits all method to quitting smoking and you might need to try a few different approaches until you find the option that works best for you.

Seeking support from a local NHS service however is proven to be effective, with smokers 3x more likely to quit successfully than if they go it alone!

Is smoking bad for your brain?

The brain controls every aspect of our lives and the impact of it being damaged in any way can be devastating.  We all take steps to protect our brains, such as wearing a cycling helmet or avoiding knocks to the head. But did you know that giving up smoking is also a great way to prevent damaging our precious grey matter?  Here’s why smoking is bad for your brain: 

The cycle of addiction

Nicotine addiction is so powerful that it causes changes in your brain that will affect your moods, leading to anxiety and irritability. The brain develops extra nicotine receptors to deal with the large doses of nicotine you inhale. As soon as the brain stops being fed with the nicotine, withdrawal symptoms kick in, leading to mood changes.  Smokers will then smoke to relieve these symptoms, flooding their brains with nicotine once again. And so the cycle continues…

Long term damage

Researchers have found that smoking does long term damage to the structure of the brain. A study carried out in 2015 and published in the Molecular Psychiatry journal, looked at the brain scans of 500 smokers, non-smokers and former smokers. It found that current and former smokers actually have a thinner cortex, the part of the brain that deals with memory, language and cortex, than non-smokers. The cortex does thin naturally with age, but the researchers found that smoking accelerates that process, leading to mental decline. On a more positive note, however the researchers did find that stopping smoking leads to some restoration of the cortex – albeit a slow one.

Stroke

According to the Stroke Association, smokers are twice as likely to die if they have a stroke.  Smoking greatly increases your risk of having a stroke with those who smoke 20 a day, six times more likely to have a stroke than a non-smoker. There are different reasons for this. One is due to the 7,000 toxic chemicals contained in tobacco smoke which enter your blood stream from your lungs, damaging cells all around your body.  Cigarette smoke also affects cholesterol levels, which can increase your risk of a stroke.

When you inhale cigarette smoke, you inhale carbon monoxide which reduces the oxygen in your blood and nicotine which makes your heart beat faster and raises your blood pressure. This raises your risk of a stroke.

Smoking also increases the chance of a blot clot forming in your brain, because the chemicals in smoke make the platelet cells in your blood more likely to stick together.  A blood clot can block the blood supply leading to your brain.

The good news is that stopping smoking will reduce your risk of a stroke and those who have already had a stroke can reduce their risk of having another one by quitting.

Dementia

The two most common forms of dementia, Alzheimer’s disease and vascular dementia, are both linked to problems with the vascular system – the heart and blood vessels. As a result smoking, which affects the vascular system by restricting the amount of oxygen in the bloodstream, increases the risk of developing dementia.

Meanwhile the toxic chemicals present in tobacco smoke can also increase inflammation in the brain which can also lead to the developing of Alzheimer’s Disease.

Some researchers estimate that 14% of dementia cases worldwide are attributable to smoking.   According to Bob Woods, Emeritus Professor of Clinical Psychology of Older People at Bangor University, 10% of cases of dementia in the UK may be linked to smoking .   He said however, that giving up smoking decreases the risk of developing dementia, in some cases to the same level as a non-smokers.

If you are a smoker who would like to quit, then click here  to find out how who can help you.

Trailblazing project that helps pregnant smokers to quit is hailed a success

Pregnant women across North Wales are giving up smoking thanks to a ground-breaking specialist service which is delivered in their own homes.

As part of the NHS Help Me Quit for Baby project, run by the Betsi Cadwaladr University Health Board, a dedicated team of smoking cessation advisors, who work solely with pregnant smokers, see women in their own homes for as many appointments as takes for them to quit. They also offer support to family members or partners who want to quit.

Across Wales, around 16% of mums-to-be smoke throughout their pregnancy and 11,864 unborn babies are exposed to harm from tobacco each year.

The Betsi Cadwaladr University Health Board area where 5,800 babies were born between 2017-18, has one of the highest rates of pregnant smokers in Wales. Thanks to the project 238 pregnant women were given help to quit between April 2018 and March 2019, according to the Welsh Government’s latest figures on smoking cessation services.

One in five sudden infant deaths is linked to smoking, as well as long term problems in children such as learning difficulties, hyperactivity, ear, nose and throat problems, obesity and diabetes. Research has shown that children with parents that smoke are three times more likely to take up the habit in later life.

Women in North Wales are referred to the Help Me Quit for Baby service by their midwife at any time during their pregnancy, after taking a CO monitor test to measure the amount of carbon monoxide in their bodies. If a woman agrees to take part in the programme, she is offered weekly specialist support and free nicotine replacement therapy (NRT).

The team believes being able to see women in the comfort of their own home, is key to their success. Home visits also mean the team can also speak with other members of the family who smoke and offer them cessation support. As well as protecting the health of the unborn baby, the team hopes that by helping women and their families to quit smoking, they can enable the baby to live in a smoke-free home once it is born.

“A woman’s family has a huge influence on whether she continues to smoke,” said Kellie Salmon, one of the support workers.

“If a partner is adamant that they want to carry on smoking then that’s a really big barrier to the woman giving up and means you have to work even harder to get them to quit. But if the partner is on board then there’s good chance they will quit together.

 “The fact that we see women in their own homes is a unique selling point of the scheme.  It’s great from a practical point of view because a lot of them live in rural areas and some can’t drive. But it also makes it easier to establish a rapport with them because often they are more relaxed and comfortable in their own home environment.”

During the appointments the team get to know the women they work with and find out more about why they smoke, admitting they can often become ‘a shoulder to cry on’. A big part of the quit process is encouraging behavioural change and getting them to adjust their daily routine, according to Help Me Quit for Baby team member Jackie Buckley. She said:

“Many women say the only way they can cope with their lives is by smoking.  They see it as the only way they can have five minutes to themselves. So, we encourage them to find other ways to de-stress such as playing a game on their phone instead.

“Often they go round to see their families and everybody gathers together to have a smoke. It’s a ritual and they still want to be a part of that. It’s really important to get them to come up with their own ideas of how to deal with those sorts of situations.”

Smoking in pregnancy carries serious health risk. The carbon monoxide in tobacco smoke reduces the amount of oxygen to the placenta which can lead to

  • Premature delivery
  • Increased risk of miscarriage
  • Still birth
  • Sudden infant death.

There is, says Jackie, a big taboo around the subject of smoking in pregnancy, and many women feel ashamed of their habit – a feeling that stops some admitting they smoke and seeking help to quit.

The team aims to adopt a totally non-judgemental approach to the women they work with and are keen to empathise that they are not there to criticise or lecture their clients: “We take a very non-judgemental approach,” said Jackie.

 “We tell women that we’re not there to judge them but to get the best support for them to quit smoking. If it becomes too clinical then that becomes a barrier so we try to speak to them as we would with a friend and we encourage them to be honest, for instance, if there is a blip and they start smoking again. It also helps to share stories of other women we have worked with who have managed to stop smoking.”

Although women are primarily referred to Help Me Quit for Baby by their midwives, as news of the project’s success spreads, the team are increasingly being contacted by women who have heard about their work via word of mouth.

The greatest reward for the team however, is when a woman successfully quits smoking, giving her new born baby, a better chance in life: “When people do quit it’s just so rewarding and we really feel we’re doing a job that makes a difference to people’s lives,” said Kellie.

Suzanne Cass is CEO of the tobacco control campaign group ASH Wales. She congratulated the team on the success of the scheme and said she hoped it would one day be available across Wales: “Smoking is not a lifestyle choice for pregnant women, it is an addiction that poses a serious health risk to them and their babies.

“It is crucially important that tailored, non-judgmental support is available to help these women to quit in an environment that they feel comfortable in.

“The success of this project shows what can be achieved by thinking outside the box and providing flexible, innovative and targeted support that is designed to meet the needs of pregnant smokers and their families.”

 

Editor’s Notes

According to experimental statistics on maternity statistics in Wales 2017-18 published on November 1 2018, the percentage of women who smoked in pregnancy in the Betsi Cadwaladr ULHB was 20.5%.

Enquiries: Diana Milne | PR Officer] | diana@ashwales.org.uk | 02920 490621| 0781 851 8567|

Or Beth Mahoney | Marketing and Communications Manager | Beth@ashwales.org.uk | 02920 490621|

Is smoking bad for your skin?

The simple answer is yes.  You only have to look at a heavy smoker to see the damage it causes to their skin.

Smoking prematurely ages your skin by between 10 and 20 years. You’re three times more likely to develop facial wrinkles if you’re a smoker, particularly around your eyes and mouth and many smokers have a sallow yellow-grey complexion.

But why?

This is because when you smoke it reduces the amount of oxygen in your bloodstream. This means there is less oxygen reaching your skin, meaning it ages more quickly and has a dull, grey appearance.

It also reduces the levels of collagen in your skin, a protein that keeps skin elastic. Without adequate supplies of collagen, wrinkles start to develop.

The toxins in the cigarette smoke also cause cellulite, regardless or your diet or fitness regime.

Dry skin is another side effect of smoking. No matter how much expensive moisturiser you slap on, smoking more than 10 times a day will continue to reduce the moisture levels in your skin, leaving it parched and more prone to irritation.

Will it cause spots or breakouts?

You may find yourself suffering from adult acne as a result of smoking. A study published in the Dermato Endocrinology journal looked at 1,050 women and found that smokers were more likely to have adult acne than non-smokers.  The scientists behind the study believe that cigarette fumes affect oil production in your skin leading to the possibility of acne.

How can we stop this?

So, it’s pretty clear that smoking is bad for your skin. But, on the bright side, if you stop smoking, you’ll prevent further deterioration.  And within just two weeks of quitting your circulation will start to improve, bringing more oxygen to your skin and a better, brighter complexion.

For information on how to quit contact NHS Wales’ Help Me Quit service on 0808 085 2219

or by visiting www.helpmequit.wales.