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RCSI Members Attack UK Approach

Two members of the Royal College of Surgeons in Ireland have attacked the UK’s position on encouraging smokers to switch to vaping by trotting out evidence free myths

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Writing an article for The Conversation, Donal O'Shea and Gerry McElvaney, two members of the Royal College of Surgeons in Ireland (RCSI), have launched an attack on the UK Government’s pledge to improve the promotion of vaping to current adult smokers. They ludicrously claim that switching to e-cigs means smokers are “swapping one health risk with another”.

Recently, the Department of Health announced that it plans to roll out a programme whereby free vape starter kits are going to be offered out to one million adult smokers in an effort to encourage them to quit smoking and reduce their exposure to harm.

The policy builds on the substantial and compelling evidence gained from independent academic research covered in the government’s “Nicotine vaping in England” 2022 evidence update and Cochrane Library’s “Electronic cigarettes for smoking cessation”.

The Irish pair state that there is “mounting evidence shows that vaping is also not without harms and risks” and say the UK should stick with offering traditional nicotine replacement products instead.

The trouble is that the assertion there is “mounting evidence” is fundamentally flawed – there isn’t. This is a position adopted by those who have bought into the Bloomberg narrative hook, line and sinker. So much so, some might wonder if either of them have read the convincing evidence to support switching to vaping.

To begin with, they claim “studies have shown that vaping can induce bronchiolitis”. They fail to link to a single peer reviewed study. What they do is link to a 2020 conference presentation that was not peer reviewed and relies heavily on American work and flawed mouse studies.

In one report people who used nicotine e-cigarettes had increased blood pressure, heart rate and blood vessel constriction immediately after vaping nicotine,” they write.

It is a measure of the straws the pair are clutching for when you consider that the linked study demonstrated vaping produces similar effect to drinking a cup of coffee.

If there was a lingering suspicion that the article is a product of ideological opinion rather than evidenced fact, this is dispelled when they go on to claim that vaping is linked to “Evali (e-cigarette or vaping use-associated lung injury)”.

Although this additive is now banned in both the US and UK, it is an example of the damage that can happen when vape-heated chemicals are inhaled into the lungs,” they say.

Small problem with this: vitamin E acetate is not a ‘vape chemical’.

They even ignore gold standard evidence demonstrating that vaping works for smokers – to rely on a one piece of work saying, “smokers who switched to e-cigarettes may relapse and use cigarettes later on.”

Fortunately, Professor Linda Bauld has responded in a measured fashion: “It might be useful to point out one important correction in relation to the second to last paragraph: ‘Instead of recommending people switch from one risky habit to another, the government should instead recommend the use of medically proven nicotine replacement therapies (such as skin patches, gums and nasal or oral sprays) and personalised counselling to help smokers quit’.

“We already do this and have been not just recommending but also funding and promoting this for more than 20 years. The UK was the first country in the world to introduce free at the point of use smoking cessation services that combine evidence-based behavioural support (counselling) with licensed stop smoking medications including NRT stop smoking services.

“These services still exist (despite funding reductions). The swap to stop scheme in England is intended to be an addition to these services, NOT replace them. It’s adding harm reduction (not harm free, but reduced harm compared to smoking) to existing publicly funded interventions.”


Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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