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

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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

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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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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

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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

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