cancer insight...• smoking in england - smoking toolkit study • ash - use of e-cigarettes in...
TRANSCRIPT
E-CIGARETTESWHAT YOU NEED TO KNOW ABOUT
Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD GP17/Oct17
INSIDE: A3 poster to
display in your practice
LET’S BEAT CANCER SOONER
cruk.org
GARETTES
ARE FAR SAFER THAN SMOKING
Growing evidence shows
e-cigarettes are helping
people to stop smoking5
E-cigarettes contain
nicotine but not cancer
causing tobacco1
Nicotine is addictive, but does
not cause cancer2
Passively breathing
vapour from e-cigarettes
is unlikely to be harmful4
3
Tobacco is the biggest cause of preventable death in the UK
Over 100,000 deaths
per year
= 10,000
Cre
ate
d b
y Fr
ee
pik
CANCER INSIGHT
FOR GPsOctober 2017
ata released by ASH in May 2017 reports that for the first time, there are now more ex-smokers than smokers using e-cigarettes in Great Britain. Since 2012, the number of
people using e-cigarettes has risen from 700,000 to 2.9 million. There is a misconception among the public that e-cigarettes are as harmful as smoking; however, research to date indicates that they are far safer as they don’t contain tobacco or involve combustion.
In 2017, a landmark paper funded by Cancer Research UK demonstrated that many toxicants present in smokers’ urine were significantly lower in long-term e-cigarette users (who had been using their product for at least six months). These included metabolites of the lung carcinogen NNK and a number of volatile organic compounds. This was only the case for those that switched entirely to e-cigarettes from tobacco.1
In light of the growing evidence, the RCGP now recommends that e-cigarettes should be promoted as an option for smoking cessation, when appropriate.
Whilst we don’t yet have definitive proof of the long-term safety of e-cigarettes, the evidence
D
CLEARING THE AIR ON E-CIGARETTES
CURRENT E-CIGARETTE USERS BY SMOKING STATUS, GB 2014 - 2017
1.5 million
people in the UK who used to smoke now
use e-cigarettes instead
For more information, please visit cruk.org/ecighub.
1. S
hah
ab L
, et
al. N
ico
tin
e , C
arci
no
ge
n ,
and
To
xin
Exp
osu
re in
Lo
ng
-Te
rm E
-Cig
are
tte
and
Nic
oti
ne
Re
pla
cem
en
t T
he
rap
y U
sers
A C
ross
-se
cti
on
al S
tud
y. 2
017
.
80%
60%
40%
20%
0
2015 20172014 2016
SMOKERS
EX-SMOKERS
NEVER SMOKED
Source: Opinion research from YouGov on behalf of ASH (May 2017)
45%
63%
35%
2% 3%
52%
suggests the safety profile of e-cigarettes is far more comparable to that of other NRT products than tobacco. Any potential long-term risks are likely to be far outweighed by the well-established harms of cigarettes.
FREQUENTLY ASKED QUESTIONSWhile it’s still crucial to signpost patients interested in quitting to Stop Smoking Services, patients may have specific questions about e-cigarettes. Here are some common FAQs you might find useful.
1. IS IT OKAY TO USE NRT AND E-CIGARETTES TOGETHER?
For people using an e-cigarette who want to use other nicotine-containing products at the same time, it is safe to do so. It’s important that people trying to quit smoking get enough nicotine to satisfy their cravings, and stay off cigarettes.
2. IS IT OK TO SMOKE AND VAPE AT THE SAME TIME?
There’s no evidence that smoking cigarettes and vaping at the same time is any worse than just smoking tobacco. But the greatest health benefits are seen when people stop smoking tobacco completely, so quitting smoking should be the goal.
3. CAN E-CIGARETTES BE A GATEWAY TO SMOKING?
This hasn’t been shown to be the case in the UK. There is still very low use of e-cigarettes among never smokers and very few of these people go on to become long-term users or smokers. A recent study found that the highest rate of regular use of e-cigarettes in young people who had never smoked was just 0.5%.
FOR FURTHER INFORMATION, SEARCH:
• NCSCT - Electronic cigarettes: A briefing for stop smoking services
• PHE – E-cigarettes: an evidence update
• RCP – Nicotine without smoke
• Smoking in England - Smoking Toolkit Study
• ASH - Use of e-cigarettes in Great Britain
*So
urc
e: B
row
n J
, Be
ard
E, K
otz
D, M
ich
ie S
, We
st R
. Re
al-w
orl
d e
ffe
cti
ven
ess
of e
-cig
are
tte
s w
he
n u
sed
to
aid
sm
oki
ng
ce
ssat
ion
: a c
ross
-se
cti
on
al p
op
ula
tio
n s
tud
y. 2
014
.
Stop Smoking Services remain the most effective way for smokers to quit, and many are supportive of e-cigarettes. Though more likely to be successful with behavioural support, e-cigarettes offer smokers a low-effort quit aide to breaking their habit. This could make them suitable for some, especially those who have tried and failed to quit using licensed medicines.
Visit nhs.uk/
smokefree
WHAT’S THE MOST SUCCESSFUL WAY TO STOP SMOKING?
225%More successful thangoing cold turkey
+
60%More successful thangoing cold turkey
No more successful than cold turkey – probably because people don’t use enough
COLD TURKEYQuitting with no support
E-CIGARETTESUsing electronic cigarettes without professional support
NRTUsing Nicotine Replacement Therapy without professional support from a Stop Smoking Service
SUPPORT AND MEDICATIONCombined specialist support and prescription medication*
LET’S BEAT CANCER SOONERCancer Research UK is a registered charity in England and Wales (1089464), Scotland (SC041666) and the Isle of Man (1103).
Primary care clinicians should provide advice to smoking patients on the relative risks of smoking
Patients should be advised that behavioural support and prescription medication from local Stop Smoking Services (SSS) is the most effective quit method. Primary care clinicians should provide referral to SSS where these services exist and the patient wishes to access this support
Using their clinical judgement on an individual patient basis, primary care clinicians may wish to promote e-cigarette use as a means to stopping. Patients choosing to use an e-cigarette in a quit attempt should be advised that seeking behavioural support alongside e-cigarette use increases the chances of quit success further. Most SSS are e-cigarette friendly and patients can be advised to bring one to their appointment if they would like to quit using their device
THE RCGP POSITION STATEMENT ON E-CIGARETTES The RCGP recently updated its position statement on e-cigarettes. Here are three of the new recommendations for GPs:
Read the full statement at
www.rcgp.org.uk/cancer
1
2
3
IGN UP TO RECEIVE CANCER INSIGHT BY EMAILWe know time can be a barrier when trying to stay up to date with the latest cancer research and advice.
Get Cancer Insight, your expert guide to relevant cancer information, sent straight to your inbox.
Access practical tools and resources, including:
• The evidence
• Case studies
• Training modules
• Free patient resources
YOU CAN BE SMOKE FREESIGN UP
NOWAt cruk.org/
cancerinsight GP
LET’S B
EAT
CA
NC
ER SO
ON
ERcru
k.org
GA
RE
TT
ESA
RE FA
R SA
FER T
HA
N SM
OK
ING
Gro
win
g evid
ence sh
ow
s e-cig
arettes are help
ing
p
eop
le to sto
p sm
okin
g5
E-cigarettes co
ntain
n
icotin
e bu
t no
t cancer
causin
g to
bacco
1N
icotin
e is ad
dictive, b
ut d
oes
no
t cause can
cer2
Passively b
reathin
g
vapo
ur fro
m e-cig
arettes is u
nlikely to
be h
armfu
l4 3
Tob
acco is th
e big
gest cau
se of p
reventab
le death
in th
e UK
Over 10
0,0
00
death
s
per year
= 10
,00
0