An Interview with Karen House – Leicester City Stop Smoking Service
Listening to Louise Ross from the Leicester City Stop Smoking Service last year I was astonished by some of the reasons smokers are continuing to smoke.
For example, some people are still smoking because they fear popcorn lung (very rare, and zero established cases from vaping) more than lung cancer (1.6 million deaths per year, with an estimated 80% coming from smoking.)
The Leicester Stop Smoking service deal with objections to vaping all the time.
Together we put a list of common objections smokers have to vaping and role-played it out with Leicester stop smoking expert Karen House.
Why would I try vaping – I’ve heard that it’s bad for you?
A lot of research has now been done on e-cigarettes and experts agree that they are at least 95% less harmful than smoking.
The two main ingredients in tobacco which cause health problems and premature death are tar and carbon monoxide – neither of these things are in electronic cigarettes.
But I’ve read in the newspapers, in the Sun and whatnot, that vaping is worse for you than smoking?
Unfortunately the media often gets it wrong and there have been some studies that have been very misleading.
E-cigarettes are definitely much safer than smoking. If you would like accurate information on electronic cigarettes it’s best to look at the Public Health England website.
Some of the studies present headlines in the media and then when you look deeper into them it turns out that’s not the case at all. So going to a reputable website is the best thing.
So why are papers publishing this?
I think there’s a very firm grip on people’s imaginations that anything associated with smoking is going to be bad for you.
Because vapes are seen as a replacement product, there is a firmly held belief already before any evidence comes out that these are likely to lead to similar problems.
It’s about a preconceived idea and an expectation that something you smoke and inhale into your lungs is bound to be bad for you. People often think it’s the nicotine in tobacco that’s the problem when we know it’s not nicotine – it’s the tar and carbon monoxide.
But we don’t know what’s in e-cigarettes!
Actually we do, and there are very few ingredients compared to tobacco cigarettes.
All of the ingredients have been around for a long time, so there is nothing new or unknown in e-cigarettes. They are regulated by consumer protection legislation, but are not yet licensed as a medicine.
What about the formaldehyde in e-cigarettes?
This news report was based on a study where the liquid in the e-cigarette was heated to such a high temperature that it actually damaged the liquid.
No user would be able to use it this way, it would taste burnt and disgusting! Since then that study has been completely discredited. Unfortunately, a lot of people have read that piece and probably gone back to smoking, which will do far more damage to their health.
That’s not the only thing I’ve heard about e-cigs, though. I’ve also heard that vaping can cause popcorn lung?
Yes, that’s another media piece that has misrepresented the truth. Diacetyl is a flavouring that is used in the food industry for things like popcorn, to give a buttery flavour.
A study showed that Popcorn lung (bronchiolitis obliterans) was found in 8 popcorn plant workers exposed to very high doses of diacetyl. This led to headlines on vaping risks to the lungs.
It has been found in some e-liquid flavours. But levels of diacetyl in EC vapour are 100 times lower than in cigarette smoke and yet smoking has never been linked to popcorn lung. (Source: Paul Aveyard- Professor of Behavioural Medicine, Oxford University, UK Centre for Tobacco and Alcohol Studies).
Efforts have been made to exclude diacetyl from e-liquids but there may be a few still hanging around, so it’s always best to buy liquids from reputable retailers.
There’s more! I also saw some research that says they are bad for your heart. You’re not saying that’s rubbish too, are you?
The study reported well known temporary effects of nicotine on blood pressure and stiffness of the aorta – the main artery into the heart.
Coffee has this effect to a larger extent and lasts much longer. Other things that cause this are watching football and exercise! It’s something we would all expect to happen to us over the day.
Basically the media story that came out of that took the story completely out of context. Because vaping delivers less nicotine than smoking, participants had to vape for 30 minutes to match 5 minutes of smoking.
Smoking, on the other hand, has been to shown to dramatically increase your heart rate and lead to a massively increased risk of heart disease. Your heart is far off better with an e-cig!
The findings of the study do not support the media claims and do not call into question the strong evidence that vaping is much less harmful to cardiovascular health than smoking
The thing is, if I switched to vaping I’d still be addicted, and I’d still be smoking.
Let’s look at those two things separately.
Firstly, yes, you would still be addicted to nicotine to start with, just as you would be if you used nicotine patches or another nicotine medication like gum to give up. But vaping is not as addictive as smoking, so most people find it easier to give up if they want to.
Some people decide that they want to carry on using e-cigarettes for the longer term, which is fine, as they are a lot safer than smoking.
Secondly, by using an e-cigarette you definitely would not still be smoking. Although e-cigarettes look and feel quite like smoking, the important thing is what’s in them. People get ill and often die from disease caused by the tar and carbon monoxide in tobacco, not the nicotine. Vapes have the nicotine but not the dangerous stuff.
But wouldn’t I look like a bit of an idiot?
I’m sure some people thought smoking looked ridiculous when it was first introduced to this country by Sir Walter Raleigh in 1586, but times change and nowadays there are nearly 3 million people using e-cigarettes in all shapes and sizes.
Have a look around next time you are in town, vaping is everywhere, and nobody is bothered, it’s become quite normal. Once you get used to it, it won’t cross your mind that it’s strange. It’s becoming the new normal.
So you say that vaping is better than smoking. But isn’t it true that we don’t know enough about them yet?
Actually we know a lot about them. We know there are very few ingredients compared to tobacco cigarettes. All of these ingredients have been around for a long time, so there is nothing new or unknown in them.
Okay, it’s great that’s there some evidence, but surely we don’t know what’s likely to happen in the long term. After all, it took hundreds of years for us to find out that smoking tobacco is bad for you.
In a sense that’s true, we can’t know the long term effect of combining these ingredients in this particular way, but because we know a lot about the ingredients, and they are not new, the experts feel very confident that the risk of unexpected problems developing in the future, is very low.
Science is also far more advanced these days and we are able to know a lot more, and we can find out things a lot quicker, than when people first started smoking tobacco.
The experts in the field of smoking cessation and tobacco related harm are naturally reluctant to come out and say something if they are not very certain there is evidence to support it. They have their professional reputations to consider.
These experts are saying that they are very confident that these products are at least 95% safer and we are not expecting any long term problems. That’s a real stamp of approval from our point of view and is why we feel confident to work with these products.
Vaping isn’t the only alternative to smoking, is it? Would I be better off using vaporised tobacco product such as the IQOS?
This is a newish product and we’re waiting to hear how safe they are.
There is not sufficient reliable evidence yet as to the potential harms from IQOS products. It is thought that they are likely to be less harmful than smoking tobacco, but not as safe as e-cigarettes which contain no tobacco at all. Experts agree that vaping is at least 95% less harmful than smoking.
So at the moment we are not happy to recommend IQOS, but that may change.
I did actually have a go on my friend’s vape and it really made me cough, so I haven’t bothered again.
Yes, and people often cough when they first try smoking too. I don’t know if you remember your first cigarette?
It’s because it’s slightly different from what you’re used to. It’s not exactly the same as cigarette smoke.
I usually advise people to start slowly and experiment with different ways of inhaling. They usually get used to it over a couple of days. The important thing is to stick with it for a while. Most people who do that get on fine with vaping as long as they they give it a chance.
I have to tell you that my friend is puffing more on his e-cig than he used to smoke, so what’s the point?
Well, e-cigarettes are not yet as good at getting the nicotine to your brain as tobacco cigarettes, so to start with most people find they have to puff a bit more to get the same effect. It’s nothing to worry about and its likely to settle down when you’ve been vaping a while.
It’s worth trying different strength liquids to find the one which is right for you. Your local vape shop should be able to advise you on this.
Most people find that when they’ve been vaping a while, they don’t need as much nicotine anyway and are able to reduce the strength of the liquid they use. Some even end up on nicotine free liquid, or choose to stop vaping altogether, with very little problem.
A huge thanks to Leicester Stop Smoking Service for their help with this blog post. Switching to vaping is much easier if you have professional support, so if you’re a smoker in Leicester do give them a call on 0116 4544000 and see how they can help you!