ASH Daily News for 4 November 2019



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UK

  • Are vaping scare stories just as dangerous as tobacco?
  • More than £1 million a week spent on the consequences of smoking in Barnsley

International

  • Study: E-cigarettes aren’t a ‘gateway’ to teen smoking

Parliamentary Activity

  • Parliamentary questions

UK

Are vaping scare stories just as dangerous as tobacco?

Jo Macfarlane writes in the Daily Mail about the health concerns relating to e-cigarettes in light of US reports of vaping-related lung injury and death:

“Terry Miller, 57, from Gateshead, was a lifelong smoker but switched to vaping – only to die from an apparently similar illness to that affecting the US. His widow Glynis has since called for a fresh inquest into his death and remains convinced that if it wasn’t for vaping, he’d still be alive. Does the untimely death of Terry Miller prove that vaping kills? The short answer is no.

“The best current evidence on vaping suggests there is no reason to stop. The consensus view of a body of experts is that there is every reason to continue. They speak in frustration over what they describe as ‘highly misleading’ information circulating through the media. There is no doubt the US is facing a significant problem with the lung condition. But the truth is that it is ‘entirely localised’ and thought to be because of the specific way US victims are vaping. There is no evidence the same issues are happening here. Nor is there proof that vaping caused either Mr Miller’s death or led to the latest heart attack fatality.

“[…] There is concern among scientists that, amid the misleading reports, vapers are returning to cigarettes in the mistaken belief that they are safer. Evidence from University College London shows a recent dip in the numbers using vapes to quit. Instead, they go ‘cold turkey’, dramatically increasing the risk of relapse – or may stick to smoking.

“[…] So what’s the truth? It’s firstly worth noting that vapes do expose people to some cancer-causing toxins. But only a minuscule amount – and nowhere near as much as much as in cigarette smoke. Why, then, are there so many problems in the US? Firstly, vaping products are more tightly regulated in the UK. Size and nicotine strength are limited and ‘stimulating’ additives, such as caffeine and taurine, are banned. What’s more, the majority of US lung injuries appear to be associated with inhaling THC, the psychoactive ingredient in cannabis. The most recent announcement by the US Centers for Disease Control and Prevention revealed 86 per cent of victims reported vaping unregulated THC. Unlike in the UK, cannabis is legal in some US states.

“But how does that explain the further 14 per cent who apparently weren’t using cannabis products? Prof Britton explained: ‘Urine tests show some were using cannabis oil but didn’t admit it when asked. It will be cannabis oil that is depositing in the lungs and provoking an inflammatory action.’ Those who died in the US were diagnosed with lung injuries which closely resemble lipoid pneumonia. The rare disease results from inhaling an oily substance which lodges in the lungs, causing inflammation and damage. When THC is vaped, it is contained in oil. And Vitamin E acetate – which experts have also expressed concern about – is used to thin the oil for vaping. But in the UK, cannabis-related products do not contain THC. They are limited to ‘CBD oil’, used to combat anxiety and chronic pain. It is vaped as a liquid, not an oil.

“[…] ASH’s Deborah Arnott said: ‘Lives will be lost if deaths like these scare people back to smoking.’ Mr Miller remains the only death from lipoid pneumonia associated with vaping in the MHRA’s data. One other case did not prove fatal. Prof Britton said: ‘If e-cigarettes were causing scores of lipoid pneumonia deaths in the UK, we would have more than one recorded. ‘So what’s happening in the US is not happening here or in other countries where vaping is popular.’”

Source: Daily Mail, 2 November 2019

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More than £1 million a week spent on the consequences of smoking in Barnsley

Figures for the financial impact of smoking have been compiled in Barnsley with the cost to the town put at more than £62m a year – despite recent reductions in the number of people smoking. A breakdown of those figures show that in one community, Wombwell, the cost to society through smoking is £3.2m a year, with £362,000 going on social care costs for smokers who find themselves in poor health as a result of their addiction.

Personal costs are also high, with the average smoking resident spending £2,000 a year to support their addiction – or £40 a week. The impact of smoking is also shown to have more wide reaching impacts, with a tonne of smoking related litter dumped on the streets of the town each year, needing to be cleaned up at Barnsley Council’s expense.

Barnsley Council has launched a campaign to make smoking invisible to the emerging generation, which means voluntary smoking bans at locations including Elsecar Park, outside Barnsley Town Hall and around school gates. Those initiatives have been well supported and the hope is that by removing smoking as ‘normal’ behaviour witnessed by growing children, they will be prevented from smoking in the future.

Source: The Star, 4 November 2019

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International

Study: E-cigarettes aren’t a ‘gateway’ to teen smoking

Vaping makes teens more likely to try cigarettes, but doesn’t increase the odds that they’ll become smokers, according to a new study that looked at more than 12,000 middle school and high school students in the US. The study calls into question earlier research that has linked e-cigarettes to smoking in the US.

The new research, published in Nicotine and Tobacco Research, suggests any relationship between teenage vaping and smoking can be attributed to shared risk factors for tobacco use – for example, whether an adolescent drinks alcohol or is surrounded by smokers.

Earlier research, such as a 2018 study from the University of California, San Francisco, linked vaping to “established cigarette smoking” in adolescents. But the new study has a simple explanation for that apparent link: People who tend to vape may just be more similar to those who tend to smoke.

Researchers accounted for preexisting differences among teens, looking at demographic information such as race and sex, and also behavioural information, such as how often a teen reported being disciplined or how often they took risks. Before controlling for those characteristics, trying an e-cigarette increased the odds of being a “current smoker” nearly 36-fold. But that effect went away when researchers accounted for more than a dozen “shared risk factors.” Vaping still made teens more likely to have ever tried a cigarette, though, even if they didn’t end up becoming regular smokers.

Arielle Selya, the study’s lead author and an assistant scientist at Sanford Health in South Dakota, said her research undermines the “gateway hypothesis” that vaping leads to smoking. Over-regulating e-cigarettes, she said, could actually push teenagers back to smoking. “We have to ask what the effect of regulating e-cigarettes would be,” Selya said, adding that “at a minimum, existing policies should be continuously re-evaluated as more research comes out.”

Source: CNN, 4 November 2019

Nicotine & Tobacco Research: The relationship between electronic cigarette use and conventional cigarette smoking is largely attributable to shared risk factors

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Parliamentary Activity

Parliamentary questions

E-cigarettes: Pneumonia

Asked by Mr Ranil Jayawardena, North East Hampshire
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of trends in the prevalence of lipoid pneumonia since the introduction of vaping.

Answered by Jo Churchill, The Parliamentary Under-Secretary for Health and Social Care
It is not possible to assess the trends in the prevalence of lipoid pneumonia since the introduction of vaping. This is because there is insufficient data to identify this trend.

Source: Hansard, 1 November 2019

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