“The debate is far from over and questions remain about their benefits and harms,” said Professor Martin McKee last year. “A fundamental principle of public health is that policies should be based on evidence of effectiveness. So does the available evidence show clearly that e-cigarettes are as effective as established quitting aids? Unfortunately not.”
Irrespective of whether the champion of ignorance and misrepresentation considers the debate done, the NCSCT briefing makes for compelling evidence that, for the NHS, it is. The document begins from the premise that the Public Health England report (criticised by McKee) was comprehensive and provided the foundation for the advice now being given to frontline staff.
What this document does in accomplished fashion is to shoot down the myths, lies and baseless fears propagated by those who do a disservice to their positions. Whether you are new to vaping or a seasoned vaper, the points they make are a joy to read:
- “Nicotine does not cause smoking related disease, such as cancers and heart disease. These are caused by other chemicals found in tobacco smoke. Nicotine in e-cigarettes poses little danger to adult users. In order to prevent accidental poisoning of children, e-cigarettes and liquids should be stored away safely (just as you would with household cleaning products and medicines, including NRT products).
On the use of vaping equipment
- “Public Health England recommends that stop smoking services should offer support to people who are using e-cigarettes in a quit attempt.”
- “E-cigarettes can support people to quit smoking.”
- “Clients of stop smoking services who combined e-cigarettes with behavioural support had the highest quit-rates in 2014 –15”
On advice for service providers
The document makes four simple points, stunning in the level of common sense given to create an e-cigarette friendly service:
- “Don’t be anxious about not being an expert.”
- “Familiarise yourself with e-cigarettes. Talk to experienced vapers, visit a reputable retailer and read posts on forums.”
- “Be positive when speaking about e-cigarettes.”
- “Don’t push people to come off their e-cigarette.”
- “Don’t be alarmed about recreational nicotine.”
- “Look forward to hearing people celebrate their success, and telling you that using an e-cigarette and receiving support was a revelation.”
At this point it is worth noting that the only comment Martin McKee has made on the subject of vaping since this publication was released was to retweet a Simon Chapman tweet proving that neither of them understand statistics.
- “One service in the City of London provided free e-cigarette starter packs in addition to standard stop-smoking medications as part of a research project. Their experience suggests that such a provision can increase the attractiveness and efficacy of the service. Despite the extra cost of the e-cigarettes, this practice generated savings because e-cigarettes are typically cheaper than licensed stop smoking medicines and a proportion of clients found that they did not need any other medication.”
On other applications
- “E-cigarettes could also have a significant role to play in managing temporary abstinence, and as part of a quit attempt, for those smokers entering institutions that are smokefree (e.g. in secondary care, mental health services and prisons).”
The NCSCT emphasise the comparative safety of vaping, something Chapman and McKee refuse to accept despite all the evidence supporting the position. They go on to confirm the absence of a gateway effect by stating that virtually all vapers are ex-smokers or current smokers who are looking to quit or a convenient alternative. The report confirms the progress made by technology and that newer products are more effective at delivering nicotine. When combined with the stance that vaping is more successful than alternative nicotine replacement therapies it doesn’t so much knock a hole in McKee’s anti-ecig boat – but torpedoes it then scuba dives down to the wreckage and blows the rest to smithereens.
- “Short-term exposure to e-cigarettes appears to pose few if any risks.”
- “There are no high quality safety data from long-term e-cigarette use, but there is no good reason to expect that their use would be anywhere near as risky as smoking.”
- “Low levels of toxicants and carcinogens have been detected in e-cigarette liquid and vapour, but these are much lower than those found in cigarette smoke.”
McKee and Stanton Glantz have claimed such a thing as second-hand and third-hand vape is genuine. No:
- “The concentration of toxins in exhaled vapour is much lower than that in side-stream and exhaled cigarette smoke, and is expected to pose no measurable health risk to bystanders.”
And Simon Chapman’s statistically-challenged tweet intimated that dual users don’t cut down, not so according to the NCSCT:
- “Dual use of cigarettes and e-cigarettes has been associated with increased motivation to quit, and to a reduction in the number of cigarettes smoked.”
The briefing continues with a brief coverage of the research to date before continuing to explain to quit staff why many smokers experience dissatisfaction when trying vaping for the first time. It amplifies that most move on to the cigalike products, which are notorious for providing a lower level of nicotine and pleasure.
Example questions lead to standard answers for want-to-vape service users. Topics include the strength of liquid, types of flavour and what brands of equipment to purchase – they even deal with the topic of exploding li-ion cells. In summary, it is an outstanding document that deserves to be read by vapers and those looking to make the switch.