New Evidence for Health Professionals

When it comes to the education for health professionals about vaping, there is no greater source than the National Centre for Smoking Cessation and Training (NCSCT). It provides training resources, clinical tools and access to the very best of research findings. The NCSCT has now released a new version of its vapes and vaping guide for health and social care professionals and believes it will have a substantial impact on the quality of advice being given.

The team behind the guide
The team is led by Andy McEwen, the Director of the NCSCT, Programme Director of the UK National Smoking Cessation Conference, and a Senior Editor of the journal Addiction. Andy is ably assisted by Professor Hayden McRobbie, Dr Kirstie Soar, and the New Nicotine Alliance’s Louise Ross.

Seventeen other independent academic and advocacy experts also fed into the process that produced the finished document meaning that it carries a guarantee of accuracy and quality.

The current environment
The general public, including smokers and non-smokers, are labouring under growing levels of misunderstanding, according to the latest findings from anti-smoking charity Action on Smoking and Health.
The charity found: “Four in ten smokers (39%) in Great Britain now believe vaping is as or more risky compared with smoking.”
Action on Smoking and Health called on journalists (and anyone else reporting on vaping) to contact the ASH press office prior to publishing articles in future as part of its campaign to stop misinformation about vaping.
Health professionals are not exempt from this worrying growth in a lack of understanding. For example, a recent survey confirmed that 77% of doctors think nicotine causes lung cancer – which is not the case.

With busy lives, the work of the NCSCT is key to transforming incorrect beliefs and opinions within the health service.

The Parliamentary Under-Secretary of State for Primary Care and Public Health said in the forward of the guide: “To give smokers the best chance of quitting – and to make informed choices about when to stop vaping – we depend on well-trained, well-informed professionals.”
This is the aim of the NCSCT.

The problem
Medical professionals are exceptionally busy people and struggle to keep up with developments in the field of vapes and vaping.
The guide states: “In the last few years there has been a significant increase in research on e-cigarettes and evidence reviews have been, and continue to be, regularly published.”
It explains the need for the document: “This briefing is specifically written to summarise information and address issues relevant to health and social care professionals and to stop smoking practitioners in particular.”

Don’t say electronic cigarette or e-cigarette
The NCSCT wants medical and health care staff to change the way they talk about vapes. While the very first devices were made to look as much like a cigarette as possible the same can’t be said for the most popular devices today.
The team says: “From now on in this briefing we will refer to vapes or vaping devices, to the use of these devices as vaping and occasionally to people who use these devices as people who vape.”
The booklet quotes New Nicotine Alliance trustee Sarah Jakes saying: “Unfortunately, because the term contains the word cigarette it now seems to carry negative connotations to many of those who are engaged in the battle against smoking and may explain some of the reluctance to accept that vaping is very different to smoking.”

People new to vaping can be confused by the huge number of different terms associated with vaping, it’s almost like learning a new language. The document seeks to help guide professionals through this minefield by providing a comprehensive definition list of other terms for vapes such as ‘pods’, ‘mods’, ‘juice’, ‘MTL’ and ‘DTL’.

But it’s correcting misunderstanding where the briefing comes into its own.

Eliquid flavours
Relying on research evidence, they say:

·The most popular flavour category is fruit
·A variety of flavours are “one of the reasons why vaping is such an attractive alternative to smoking”
·Sweet flavours are derived from sweeteners, and “do not pose a threat to oral health or people with diabetes”
·Flavours are one of the advantages of vaping because people can experiment and try new ones

They add: “There is emerging preliminary research evidence that flavour switching occurs and that fruit and other sweet- flavoured e-liquids are positively related to people who smoke transitioning away from cigarettes.”
The authors recommend that health and social care professionals visit vape shops to talk to the staff about devices and their range of juices.

The environmental impact of vaping
While acknowledging the impact that discarded vapes – especially disposables – can have on the environment, the authors add: “However, in comparison with smoking they are more favourable because most users do not vape long-term and because of the huge environmental impact of smoking.”

Who vapes and why
Using the Government’s data, the briefing points out the fact that almost everyone who vapes used to be or still is a smoker.
The team also highlight how successful vapes are at helping smokers to quit tobacco use compared to traditional nicotine replacement products:

·Vapes are more effective than combination NRT; 18% vs 8%.
·Participants who had quit smoking in the vape group were more likely to still be using their product at one year than those in the NRT group
·Vape users experienced fewer urges to smoke and less withdrawal discomfort
·Among smokers who did not manage to stop smoking, those in the vape group reduced
·their cigarette consumption by ≥50%, significantly more than those in the NRT arm
·People who quit smoking using vapes had a greater reduction in coughs and phlegm production than those who quit with NRT

Pointing to the Hajek study, they added: “Vapes were more effective and less costly than NRT, they were also more cost-effective.”

Other vape issues
McEwen, McRobbie, Soar, and Ross also address topics such as the benefits of switching to vapes during pregnancy, underage use, the non-existence of a gateway effect (leading non-smokers into smoking), and how secondhand vapour doesn’t pose a risk – especially when compared to cigarette smoke.
Finally, they round off by covering the physical health advantages of switching to vaping and comprehensive suggestions for best practice in health and social care settings, before addressing the multitude of common myths and misunderstandings.

It is hoped that this briefing document will help to drive an increase in understanding and the development of more vape friendly smoking cessation services, playing a key role in helping to eliminate tobacco related harm.