E-CIGARETTESWHAT YOU NEED TO KNOW ABOUT

Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD Pharma6/Jan18

INSIDE: A3 poster to

display in your pharmacy

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

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CANCER INSIGHT

FOR PHARMACY STAFF January 2018

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.

Despite this, there is a rising misconception among the public that e-cigarettes are equally or more harmful than smoking; yet research to date indicates that they are far less harmful as they don’t contain tobacco or involve combustion.

In 2017, a landmark paper funded by Cancer Research UK demonstrated that many key 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). This was only the case for those who switched entirely to e-cigarettes from tobacco.1

In light of the growing evidence, the Royal Pharmaceutical Society (RPS) has acknowledged that e-cigarettes do have a potential role to play in helping smokers reduce and stop smoking. However, it’s not yet possible to know the long-term impact of these products. Their current advice to pharmacists is to use professional judgement when giving advice to customers on e-cigarette use.

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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.

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So far the evidence suggests the safety profile of e-cigarettes is more comparable to that of Nicotine Replacement Therapy (NRT) products than to tobacco. Any potential long-term risks are likely to be far outweighed by the well-established harms of tobacco.

FREQUENTLY ASKED QUESTIONSWhile it’s still crucial to signpost customers interested in quitting to Stop Smoking Services, you will no doubt experience people asking you questions directly about e-cigarettes. The Q&A below aims to help equip you with evidence-based answers…

1. IS IT OK TO USE NRT AND E-CIGARETTES AT THE SAME TIME?

People can safely use an e-cigarette and NRT in conjunction. It’s important that people get enough nicotine to satisfy their cravings, and stay off cigarettes.

2. IS IT OK TO SMOKE AND VAPE AT THE SAME TIME?

Health benefits are only seen when people stop smoking tobacco completely, therefore it’s advisable to encourage customers to strive towards stopping smoking tobacco. But, there’s no evidence that smoking cigarettes and vaping at the same time is any worse than just smoking tobacco.

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 smokers.

4. ARE THE CHEMICALS IN E-CIGARETTES HARMFUL?

Some studies have found chemicals in e-cigarette vapour that are known to cause health problems. But these are generally at far lower levels than in tobacco smoke.

5. IS SECOND-HAND VAPOUR FROM E-CIGARETTES DANGEROUS?

Unlike tobacco smoke, there’s no good evidence to suggest that second-hand e-cigarette vapour is dangerous to others. For further Q&As, visit cruk.org/ecighub

FURTHER RESOURCES:

• 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

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Stop Smoking Services remain the most effective way for smokers to quit, and most 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).

• The RPS are keen to keep an eye on long-term safety findings. They currently acknowledge that e-cigarettes have a potential role to play in helping smokers reduce and stop smoking in the short term, or as a pathway to NRTs.

• The General Pharmaceutical Council has said that pharmacists should consider guidance from bodies such as the RPS and the Medicines and Healthcare products Regulatory Agency (MHRA) when deciding whether to make e-cigarettes available to customers.

• There aren’t currently any e-cigarettes available that are licensed as smoking cessation aids by the MHRA, and it is unlikely that there will be a licensed product in the UK any time soon. However, there are now

regulations governing the manufacture, sale and advertising of e-cigarettes under the Tobacco and Related Products Regulations 2016 and European Union Tobacco Products Directive.

• The Royal College of General Practitioners now recommends that e-cigarettes may be promoted as an option for smoking cessation, where appropriate. The British Medical Association has said that e-cigarettes have significant potential to help reduce tobacco-related harm.

CURRENT GUIDANCE ON E-CIGARETTES

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cancer-insight-pharmacy

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