ASH Daily News for 4 January 2019


  • E-cigarettes remain a burning issue amongst health experts
  • Study: Misperceptions about vaping common among UK smokers
  • Study: Shisha smoking as harmful as cigarettes and positively associated with obesity
  • South West: NHS sites across Bath and North East Somerset to go smokefree in 2019


  • Number of smokers in Denmark increases for first time in 20 years

Link of the week

  • Public Health England: Health Harms campaign



E-cigarettes remain a burning issue amongst health experts

Prof Linda Bauld, professor of public health at University of Edinburgh and deputy director of the UK Centre for Tobacco and Alcohol Studies, and Dr Suzi Gage, lecturer in psychology and epidemiology at the University of Liverpool, write in the Guardian on the divergence in international opinion on e-cigarettes: “A number of factors appear to be fuelling this, but in 2018 one more than any other seemed to be driving the debate…are e-cigarettes creating a new generation of nicotine users, and will these vapers become the smokers of the future?

“Scientists and regulators on both sides of the Atlantic pondered the evidence on these questions in 2018 and came to different conclusions…This transatlantic debate has wider implications because reports of study findings are played out in the global media, causing confusion in countries that have not yet decided how to regulate e-cigarettes.

“Evidence from the US and UK combined indicates that efforts to deter teenagers from trying vaping may discourage adult smokers from using e-cigarettes to quit smoking. Fortunately, in both countries smoking rates continue to decline for both adults and young people, a fact often forgotten amid the furore about e-cigarettes. If e-cigarettes were a gateway to tobacco, these trends would stall or be reversed…We should not be forced to choose between protecting children and supporting the one in two adult smokers who will suffer and die prematurely from a smoking-related disease if they continue to smoke. The challenge in 2019 and beyond will be to ensure the right balance is struck.”

Source: The Guardian, 4 January 2019

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Study: Misperceptions about vaping common among UK smokers

Research from King’s College London finds smokers and ex-smokers in the UK overestimate the harm from vaping, with fewer than 6 out of 10 accurately believing that e-cigarettes are less harmful than tobacco cigarettes. Misperceptions appear to be on the increase and are particularly strong among smokers and those who have never tried vaping.

According to the study, when asked about the relative harms of e-cigarettes and tobacco cigarettes only 57.3% of participants correctly said vaping was less harmful than smoking, while 21.8% said equally harmful, 3.3% said more harmful and 17.6% didn’t know. For NRT, 63.4% said it was less harmful than smoking. Previous research from the same team suggests the proportion of people with accurate knowledge is dropping: in 2012, 66.6% said vaping was less dangerous than smoking, this fell 60.4% in 2014. At the same time, the proportion of people who think smoking and vaping are equally harmful is rising, from 9% in 2012 to 16.9% in 2014.

Lead researcher Dr. Leonie Brose said: “It is possible that smokers may not try e-cigarettes or NRT due to inaccurate beliefs about nicotine and vaping. A lot of public discussion and media reporting focuses on harms from vaping, but we rarely see any reports on how deadly smoking is—1500 people die from smoking-related illness every week in England alone. Correcting misperceptions around nicotine may help smokers move towards less harmful nicotine delivery methods.”

Source: Medical Xpress, 3 January 2019

Addiction – Harm perceptions of e‐cigarettes and other nicotine products in a UK sample

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Study: Shisha smoking as harmful as cigarettes and positively associated with obesity

Smoking shisha can be as harmful as smoking cigarettes, new research has found. The study, conducted by researchers from Brighton and Sussex Medical School, also found that smoking shisha was associated with a person’s risk of diabetes and obesity, however researchers said the cause of the association was not clear. The participants, from Iran, took a questionnaire which investigated their smoking history, cardiovascular risk factors and anxiety and depression. This was then measured against their biochemical results, analysed by taking blood tests.

Professor Gordon Ferns, Head of the Department of Medical Education Brighton and Sussex Medical School, said: “From a health policy perspective, it would be important for the public to recognise the risks of hookah smoking. The use of flavoured tobaccos may be particularly attractive to young people. Hookah smoking should be treated no differently from cigarette smoking.”

The results are supported by the British Heart Foundation (BHF) which stated: “Traditionally shisha tobacco contains cigarette tobacco, so like cigarettes it contains nicotine, tar, carbon monoxide and heavy metals, such as arsenic and lead. As a result, shisha smokers are at risk of the same kinds of diseases as cigarette smokers, such as heart disease, cancer, respiratory disease and problems during pregnancy.”

Source: The Telegraph, 2 January 2019

Diabetology & Metabolic Syndrome – Hookah smoking is strongly associated with diabetes mellitus, metabolic syndrome and obesity: a population-based study

See also: ASH – Waterpipes (shisha) fact sheet

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South West: NHS sites across Bath and North East Somerset to go smokefree in 2019

From the 1st January 2019 NHS sites across Bath & North East Somerset (B&NES) will be introducing new policies making all sites smokefree. The move to smokefree status will see a total ban on smoking anywhere on NHS sites, including grounds, gardens and in vehicles in car parks for all patients, visitors and NHS staff.

NHS providers across the region have been offering support to staff and patients to either stop smoking or to manage their nicotine dependency while at work or during their stay in hospital through a range of initiatives, including the provision of nicotine patches and vaping devices.

Cherry Jones, Director of Public Health at Swindon Council, said: “We are starting the new year by taking some real steps to help people comply with our policy, so we have taken down smoking shelters and are supporting those who are looking to give up smoking and switch from tobacco by allowing vaping and the use of e-cigarettes in outdoor areas on Trust properties.”

Source: The Midsomer Norton, Radstock & District Journal, 3 January 2019

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Number of smokers in Denmark increases for first time in 20 years

Figures published by the National Board of Health in Denmark reveal that there has been a significant increase in smoking prevalence for the first time in two decades. The figures, which come from an annual survey of smoking amongst 5,017 people, evidence an increase from 21.1% smoking prevalence in 2016 to 23.1% according to the latest figures. This represents a 9.5% increase since 2016.

Niels Them Kjær, Project Manager for Tobacco Prevention at the Danish Cancer Society, calls the figures “a disaster”. “We have not had landmark political decisions on smoking for years. Not enough resources are spent on it. It’s as if we’ve accepted that smoking costs the lives they cost,” he said.

Source: The Local, 3 January 2019

See also: Politiken – First time in 20 years: More Danes smoke

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Link of the week

Public Health England: Health Harms campaign

Public Health England (PHE) has released a new film showing the devastating harms that come from smoking, and how this can be avoided by switching to an e-cigarette.

The film has been released as part of PHE’s Health Harms campaign, which encourages smokers to attempt to quit this January, by demonstrating the personal harm to health from every single cigarette.

The film features Dr Lion Shahab, Associate Professor in Health Psychology at Univeristy College London, and Dr Rosemary Leonard, Medical Journalist and practising GP, visually demonstrating the high levels of cancer-causing chemicals and tar inhaled by an average smoker over a month, compared to an e-cigarette or fresh air.

See also: PHE – Health Harms campaign resources

See Link