Smokers attending A&E will be handed vaping 'starter packs'

Smokers attending A&E will be handed vaping ‘starter packs’ in Government-funded trial to see if it helps them kick the habit

• Initiative at five NHS hospitals will see smokers at A&E units offered e-cigarettes 
• Research shows e-cigarettes can be a useful tool to help people quit tobacco 
• Devices are controversial as people can become addicting to vaping 

Hospital patients will be handed vaping ‘starter packs’ in a bid to help them stop smoking tobacco under a new Government-funded trial.

The initiative at five NHS hospitals will see smokers who attend A&E units offered e-cigarettes when they are discharged.

Research has shown that nicotine e-cigarettes can be a useful tool to help people quit tobacco.

However, the devices are controversial as people can become addicting to vaping and research has suggested they can lead to heart and lung damage.

Experts at the University of East Anglia (UEA) are today launching a trial which, if successful, could see the NHS routinely provide e-cigarettes as part of its stop smoking programmes.

The research team aim to recruit around 1,000 smokers who have attended emergency departments for any medical reason.

Smokers who agree to take part in the trial will be randomly assigned to receive either a pack of e-cigarettes and referral to local stop smoking services, or just written information about locally available stop smoking services.

Both groups of patients will be asked if they are still smoking one, three and six months after they attended hospital.

Hospital patients will be handed vaping ‘starter packs’ in a bid to help them stop smoking tobacco under a new Government-funded trial

Professor Caitlin Notley, from UEA’s Norwich Medical School, said: ‘Many people who smoke want to quit, but find it difficult to succeed in the long term.

VAPING CHEMICALS ‘MIX TO FORM NEW TOXIC COMBINATIONS’

The chemicals produced by e-cigarettes combine inside people’s lungs to make entirely new combinations that are toxic to living cells, scientists have found.

Chemicals that produce flavours such as vanilla, berry and cinnamon can mix up with other solvents in the gadgets and become a danger to health.

‘We consistently observed that the new chemicals formed from the flavours and e-liquid solvents were more toxic than either of their parent compounds,’ said Professor Sven-Eric Jordt, a pharmacologist at Duke University in North Carolina.

He and colleagues at Yale University isolated chemicals used in e-cigarettes and put them onto human lung cells in a lab.

The cells were those that occur in the lining of the bronchi, which are the main airways that connect the windpipe to the insides of the lungs.

Chemicals they looked at included the flavourings vanillin, ethyl-vanillin, benzaldehyde, cinnamaldehyde, and the solvents propylene glycol and vegetable glycerine.

The team said that e-cigarette manufacturers often claim that their devices are safe because they contain chemicals considered to be stable.

But when they mix inside the devices, Professor Jordt and colleague found, they form unstable compounds which could then go on to damage healthy cells.

They appeared to irritate receptors in nerve endings linked to the heart and blood vessels, and also to actually be able to kill cells in the lungs.  

Damaging effects could be seen even when the vapour was breathed in in low quantities. 

The scientists said they were surprised by what they saw in the lab because they did not expect the chemicals to become more unstable and dangerous as they mixed. 

‘Activation of sensory irritant receptors can increase the heart rate and, in predisposed people, can lead to an irregular heartbeat and higher blood pressure,’ said Professor Jordt.

‘It can also increase secretions in the nasal passages and throughout the lungs and airways, leading to coughing and breathing difficulties.’  

‘Electronic cigarettes mimic the experience of cigarette smoking because they are hand-held and generate a smoke-like vapour when used. They can be an attractive option for helping people switch from smoking, even if they have tried and failed in the past.

‘We know that they are much less harmful than smoking tobacco, and that they have been shown to help smokers quit.

She added: ‘We’ll be looking at the number of people who successfully quit smoking across both groups, to see which intervention works best.

‘We’ll also work out how much it would cost to roll the scheme out nationally.’ Trial co-lead Dr Ian Pope said: ‘Emergency Departments in England see over 24 million people each year of whom around a quarter are current smokers.

‘Attending the Emergency Department offers a valuable opportunity for people to be supported to quit smoking, which will improve their chances of recovery from whatever has brought them to hospital, and also prevent future illness.’ The new trial is funded by the National Institute for Health Research (NIHR), which is funded by the Department of Health.

It will run at five hospitals in England and Scotland – the Norfolk and Norwich University Hospital, the Royal London Hospital and Homerton University Hospital in London, Leicester Royal Infirmary and the Royal Infirmary of Edinburgh.

The initiative has been launched as a new major study by the University of Oxford suggested e-cigarettes containing nicotine are an effective way of helping people quit tobacco.

The Cochrane review found that e-cigarettes could increase the number of people who stop smoking compared to other forms of nicotine replacement therapy – such as chewing gum and patches – and compared to electronic cigarettes that do not contain nicotine.

Public Health England have repeatedly endorsed e-cigarettes since they became available around a decade ago. Health officials believe tens of thousands of people stop smoking every year after switching to vaping.

Latest PHE estimates show that around 2.7 million adults in England vape, compared to nearly seven million who smoke tobacco.

Although e-cigarettes are better for people than tobacco, there are still concerns they pose a risk to health.

Last year a major Government-backed review of their safety found that e-cigarettes can worsen heart disease and lung disorders while the risks posed by inhaling ingredients used to flavour them are still ‘unknown’.

The research said e-cigarettes should only be used as an aid to quit smoking. Scientists have also warned that smokers who switch to e-cigarettes often remain addicted to nicotine and fail to quit altogether.

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