Everything They Needed To Know

Posted 12th August 2019 by Dave Cross
Tees, Esk and Wear Valleys NHS Foundation Trust experts have produced a document for mental health practitioners to help them understand vaping better. The excellent document lays out facts in an accessible manner and encourages colleagues to encourage patients to give up smoking by switching to vaping.

Suzy Ker, Consultant in working-age adult psychiatry, Emily Peckham, Research fellow in the Mental Health and Addiction, Simon Gilbody, Professor of Psychological Medicine, and Susan Bonner, Research nurse, produced the paper published online by Cambridge University Press.

The publication seeks to improve understanding of e-cigarette usage, the risks and benefits, the current position on use of e-cigarettes in mental health settings, and tips on how to take an e-cigarette/vaping history and how to offer advice about use.

For the benefit of those who are not experts in vaping, the team explain how electronic cigarettes have developed, from Herbert Gilbert’s initial design in 1963 through to the vast range now in existence. They lay out a simplified version of the legislation and cover some other interesting background: “Speed of nicotine delivery to the brain is slower than from inhaled tobacco smoke, which means users do not receive the virtually instant ‘hit’ of nicotine that is experienced when smoking a cigarette.”

Some information is slightly dated: “Of the thousands of flavour choices on the market, the most popular are menthol and tobacco, followed by fruit, sweets, alcohol and other drink flavours (Zhu 2014). More unusual examples include crab legs, beer and hot dog (authors’ online search, 5 October 2018). The inclusion of a flavour in e-cigarette liquid may be important for the acceptability of e-cigarettes to smokers who are trying to quit.”

Unlike much of the nonsense being published across the Atlantic, the quartet stick resolutely to facts: “Nicotine is the substance that causes addiction to tobacco-smoking, but it is not one of the components that can kill. Unlike standard cigarettes, e-cigarettes and their vapour do not contain tobacco, tar, carbon monoxide or the thousands of toxins that are in tobacco smoke; in fact, as burning is not involved, they do not produce smoke.”

  • Vaping among children in the UK is thought to be low
  • 76% of 11- to 18-year-olds say they have never tried e-cigarettes
  • Only 2% vape at least once a week
  • 99.8% of children who vape regularly have a history of cigarette use

“The main purported benefit of vaping is that it can act as an aid to smoking cessation or to help people reduce the number of cigarettes they smoke,” they write. “The latest Public Health England guidance on what clinicians should discuss with patients regarding options for stopping smoking (Public Health England 2018) makes reference to vaping as a viable option for self-managed quitting. It states that using an e-cigarette has similar or better results than an attempt to quit using nicotine replacement therapy (NRT).”

They state: “In amalgamating the current evidence, what is clear is that, although vaping is not 100% safe, it remains a much safer alternative to smoking and should be promoted as such.”

With this paper, the UK continues to lead the world in tobacco-related harm reduction common sense.

Resources:

  • “Everything you wanted to know about e-cigarettes and vaping but were afraid to ask: a guide for mental health clinicians” by Ker, Peckham, Gilbody and Bonner – [link]
  • Answers 1e - 2d - 3e - 4b - 5a


 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker