Electronic cigarettes could have a huge effect on public health | Marcus Munafo, University of Bristol

June 20, 2016 2.17pm BST – Marcus Munafo – The Conversation

Tobacco still kills 6m people around the world every year. Despite huge public health efforts to help people quit and prevent young people starting, smoking remains the single greatest cause of ill health and premature death. And even with restrictions on tobacco advertising and smoking in public places, many young people continue to take up smoking. The situation is even worse in poorer countries, where support to stop smoking is limited, and tobacco control policies weaker.

So in light of this, how should we view the increasing popularity of electronic cigarettes?

image-20160620-8853-1qda1qwThe gadgets deliver a nicotine hit by heating a nicotine-containing propylene glycol (e-liquid) to create an aerosol (usually called “vapour”), which is inhaled. Put simply, they deliver nicotine almost as effectively as a conventional cigarette, but without the vast majority of other chemicals present in tobacco smoke (either from the tobacco itself, or as a result of the burning process).

A whole culture is emerging around “vaping”. Many devices offer a range of power settings, and a vast array of e-liquids is on offer, with varying nicotine contents and flavours. Enthusiasts often apply modifications to their devices, and engage in “cloud chasing” – competing to produce the largest and most interesting clouds of vapour. And yes, young people are experimenting with e-cigarettes (in the same way that they have always experimented with pretty much everything), although at the moment there is no strong evidence this is leading to subsequent cigarette use, or even long-term e-cigarette use.

The rapid growth in use of e-cigarettes, especially among smokers trying to cut down or quit, has taken the public health community and the tobacco industry by surprise. Both are struggling to catch up. Health professionals are hurrying to carry out research to develop evidence-based guidelines and policies. Meanwhile, the tobacco industry is buying up e-cigarette companies and introducing its own products onto the market.

So how concerned should we be about this emerging and disruptive technology?

Should we encourage existing smokers to use e-cigarettes to help them stop smoking, even if this means they continue using nicotine long-term? In the United Kingdom there is some consensus that smokers should be encouraged to use e-cigarettes if they feel they might help, and the National Centre for Smoking Cessation and Training is supportive of their use. Part of the reason many vapers feel so passionately about the subject (and react strongly when they feel that vaping is being unfairly attacked) is that for the first time, through the use of e-cigarettes, they have felt able to take control of their nicotine habit, stop smoking, and reassert some control over their health, without being medicalised in the process.

But a problem remains in the lack of information on the possible harm of e-cigarettes. This is unlikely to change any time soon, since the health effects of tobacco use can take several decades to emerge, and it’s probable the same will be true for e-cigarettes. Nothing is entirely risk-free, but the vastly reduced number of chemicals present in e-cigarette vapour compared to tobacco smoke means we can be confident that vaping will be much, much less harmful than smoking.

Heartening evidence

As part of the investigation into the effects of e-cigarettes, we investigated how the cells found in the arteries of the heart, known as human coronary artery endothelial cells, responded when they were exposed to both e-cigarette vapour and conventional cigarette smoke. We found the cells showed a clear stress response from the cigarette smoke, but not from the electronic cigarette. This suggests tobacco smokers may be able to reduce immediate tobacco-related harm by switching from conventional cigarettes to e-cigarettes.

Many people find it difficult to function without their first caffeine hit of the day. But no one is seriously calling for coffee shops to be dismantled or regulated. Nicotine is addictive, but much less so on its own than in tobacco, where other chemicals enhance its effect. At the doses consumed by vapers the harm is likely to be very low (although we need to continue to research this), and many vapers actually gradually move to zero nicotine content e-liquids, even while continuing to vape.

Of course, we may end up with a large population of long-term nicotine users who use e-cigarettes to deliver nicotine rather than cigarettes, but all of the evidence at the moment suggests that this population will almost entirely comprise ex-smokers. This would produce a vast public health gain.

We must be careful not to restrict smokers’ access to e-cigarettes, or over-state the potential harm of their use, if this will put people off making the transition from smoking to vaping. To do so would deny us one of the greatest public health improving opportunities of the last 50 years.

Original post – The Conversation | More on E-cigarettes from UKCTAS

“Nicotine, perhaps the most unlikely wonder drug” Dan Hurley

If dozens of human and animal studies published over the past six years are borne out by large clinical trials, nicotine — freed at last of its noxious host, tobacco, and delivered instead by chewing gum or transdermal patch — may prove to be a weirdly, improbably effective drug for relieving or preventing a variety of neurological disorders, including Parkinson’s disease, mild cognitive impairment (MCI), Tourette’s and schizophrenia. It might even improve attention and focus enough to qualify as a cognitive enhancer. And, oh yeah, it’s long been associated with weight loss, with few known safety risks. nicotine-fix

Nicotine, the Wonder Drug? | DiscoverMagazine.com.

New Job Opportunity!

Research Worker – King’s College London

Reference: THW/15/059639/575
Salary Details: £27,057 to £31,342 per annum
Allowances: Plus £2,323 London Weighing
Contract Type: Temporary/Fixed term
Contract Term: Full time
An exciting opportunity has arisen for a research worker to work on a new 10-month project: “Development of Tools to Measure Norms Towards Ordinary Cigarettes and Nicotine Use”. The post-holder will join an established team of tobacco researchers within one of Europe’s leading addiction research centres. The work is being led by Professor Ann McNeill, and Dr Sara Hitchman, with researchers from the Univeristy of Stirling, and NatCen, and is funded by the Public Health Research Consortium.

The research will involve a literature review of current measures, consultations with experts in the field, cognitive testing of new measures, a soft launch of the tool, and inclusion in national surveys. A project in parallel will also examine existing data on norms towards tobacco use in the UK and other countries over the last 10 years.

Although this position is advertised for full-time, candidates who are interested in part-time work will also be considered. Please be sure to indicate your availability on your application.

Closing date: 17 June 2015

Read more and apply here!

E-cigarettes generate high levels of aldehydes only in “dry puff” conditions. (GET THE FACTS!)

“You have certainly seen the reports, accompanied by huge media campaigns, stating that e-cigarettes generate many times higher levels of carcinogenic aldehydes compared to tobacco cigarettes. We have always responded that such findings were the result of severe overheating of the device, which the vapers identify and avoid. We have repeatedly referred to the dry puff phenomenon as an explanation of these findings and why they were unrelated to realistic use. The authors of those studies and reports should have known the existence of the dry puff phenomenon since I have presented it in detail in a publication back in 2013! However, it is hard to explain this to someone who has limited background on e-cigarette function. So, it was time to present true evidence which, as always, have the strongest impact.” Dr Farsalinos


These findings emphasise the importance of making clear the conditions in which tests of this kind are undertaken and avoiding sweeping assertions that can mislead the public. Vapers are not exposed to dangerous levels of aldehydes. My reading of the evidence is that e-cigarettes are at least 95% safer than smoking. Smokers should be encouraged to switch to vaping.

Professor Peter Hajek

Read more

‘Is nicotine all bad?’ By Kate Kelland

Psychologists and tobacco-addiction specialists, including some in world-leading laboratories in Britain, think it’s now time to distinguish clearly between nicotine and smoking. The evidence shows smoking is the killer, not nicotine, they say.

“We need to de-demonize nicotine,” said Ann McNeill, a professor of tobacco addiction and the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, who has spent her career researching ways to help people quit smoking.

Exp_8_NicotineV2

Smoking kills half of all those who do it – plus 600,000 people a year who don’t, via second-hand smoke – making it the world’s biggest preventable killer, with a predicted death toll of a billion by the end of the century, according to the World Health Organization.

Few doubt that nicotine is addictive. How quickly it hooks people is closely linked to the speed at which it is delivered to the brain, says McNeill. The patch is very slow; gum is slightly quicker. But there is no evidence as yet that significant numbers of people are addicted to either. Daniel, who works long hours in London’s financial district, says he chews less on weekends when he’s relaxing, doing sport and hanging out with his kids.

One reason smoking is so addictive is that it’s a highly efficient nicotine delivery system, McNeill says. “Smoking a tobacco cigarette is one of the best ways of getting nicotine to the brain – it’s faster even than intravenous injection.” Also, tobacco companies used various chemicals to make the nicotine in cigarettes even more potent.

Pure nicotine can be lethal in sufficient quantities. There is some evidence it may lead to changes in adolescent brain development, especially to the part responsible for intelligence, language and memory.

Stanton Glantz, a professor of tobacco at the University of California, San Francisco, says the younger kids are when they start using nicotine, the more heavily addicted they get. “This is likely because their brains are still developing,” he said.

Countering that, others say studies have focused on animals and that in any case, nicotine should not be available to under-18s. Michael Siegel, a tobacco control expert and professor at Boston University, says that in the few studies so far, such effects have been seen only in smokers, not smoke-free nicotine users.

Elsewhere, studies have looked at nicotine’s potential to prevent Alzheimer’s disease, and to delay the onset of Parkinson’s.

A study in the journal Brain and Cognition in 2000 found that “nicotinic stimulation may have promise for improving both cognitive and motor aspects of Parkinson’s disease.” Another, in Behavioral Brain Research, suggested “there is considerable potential for therapeutic applications in the near future.” Other work has looked at the stimulant’s potential for easing symptoms of attention deficit hyperactivity disorder (ADHD).

See the whole article here.