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Cutting down smoking = harm reduction

October 27, 2012

Interesting report in today’s Lancet, showing that the risks of dying young are significantly reduced if people give up smoking before 40 and almost eliminated if you quit before age 30.  The research, based on a longitudinal study of over a million women, has been published today to mark the centenary of the birth of Sir Richard Doll the scientist who first proved the link between smoking and lung cancer.

I chaired a seminar this week on the benefits of smoking harm reduction policies.  As chair of the cross party committee on smoking and health I convene many meetings in Parliament to promote good evidence based public health policy.  At this meeting we heard from experts at NICE, the health body that approves products and treatments for prescription by the NHS and the MHRA, the body that licenses health products for use in the UK.

We discussed the benefit of giving smokers the nicotine hit that they crave but separating it from the harmful cocktail of carcinogens and other chemicals that are present in tobacco smoke. Nicotine itself is relatively harmless.  But inhaling it as a by product of burnt tobacco can be lethal.  People will be familiar with nicotine patches and these have been successful in weaning some people off smoking.  Some people find that the patches enable them to quit their habit, others use them as a help to cutting down the number of cigarettes smoked a day.

The best thing for smokers to do to improve their quality of health and lengthen their life expectancy is to give up in one step.  But for many people this is just too hard and can lead to depressing successive failures to kick the habit.  So nicotine replacement therapies (NRT) have a useful role to play in helping people to at least cut down.

Many NRTs are already licensed by the MHRA and can be bought in shops. Some will be used by local GPs and other NHS smoking cessation programmes.  But others are unlicensed, consumer products that cannot claim health benefit. Most prominent among these are electronic cigarettes.  When I first saw an advert for these “e-cigarettes” I was sceptical.  But one of my friends, once a heavy smoker, has now managed to quit tobacco completely by using an e-cigarette.  These e-cigarettes are the same size and shape as the real thing.   But they are plastic and metal, not paper and tobacco.  They deliver a nicotine hit but without the other harmful gases and chemicals in burnt tobacco.  And I guess they help with the habitual side of smoking, something to hold between the fingers or lips.  They even glow on the end…though I think it would be better to have a blue or green colour so people nearby aren’t alarmed into thinking they are real cigarettes!

So we may find that smokers who are finding it hard to quit are given more help by the NHS to break their habit.  I support a range of measures that drive down the rate of smoking. This normally leads to me being caricatured a politician in favour of draconian bans and a nanny state politician who likes telling people what to do.  But I have always known that quitting smoking is really hard for some people.  They are addicted to nicotine and many actually like smoking.  So I hope that once NICE has finished its review, the NHS will be able to give practical help to people who know that smoking is harmful but find it too hard to summon up the will power to quit.

 

You can read the Lancet report here http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61720-6/fulltext

The NICE draft guidance is here http://guidance.nice.org.uk/phg/52/consultation/latest

11 Comments leave one →
  1. John S permalink
    October 27, 2012 11:27 am

    This is a bit of a U-turn – helping smokers rather than demonising them! And a good word for e-cigarettes, even though they are not made by Anti-Tobacco’s paymasters, Big Pharma.

    Have you cleared all this with your masters at ASH?

    • Martin permalink
      April 15, 2013 3:53 pm

      I’m not sure that your conspiracy theories are warranted. ASH aren’t opposed to e-cigarettes:

      ” ASH supports regulation to ensure the safety and reliability of e-cigarettes but, in the absence of harm to bystanders, does not consider it appropriate to include e-cigarettes under smokefree regulations.”

      http://ash.org.uk/files/documents/ASH_715.pdf

      • Chris permalink
        April 16, 2013 9:22 am

        I tried one last month. i have been smoking since 10yrs of age. I was smoking straights….ready made…..until 27 yrs. by then I was smoking averaging 50 ciggies a day. that is 50 gms of baccy. I switched to roll ups at that age and have been reducing my usage all the time. Now I buy a 50gm pouch and can use it for nearly 20 days, ie 2.5gms a day. That took me 20yrs to reduce.

        I bought an e ciggerette and experimented it with regular roll ups. Last e ciggie lasted about 15 days and the pouch 18 days. The problem I had was, there is no taste in the e ciggie, just the hit of nicotine. i tried another pouch without the e ciggie and that lasted 20 days. These stats are not complete. i am buying another e ciggie today and opened a pouch. I will let you know, and bore you with the details. That is if some one comments on this post, mind.

  2. October 27, 2012 11:33 am

    Not a U turn at all John! As I say in last para – I am in favour of a range of measures to reduce prevalence of smoking. You dwell on the sticks. Well this is a carrot! Enjoy the moment…

  3. buryzee permalink
    October 27, 2012 11:44 am

    This is good information thank you. I know how hard it is to quit. I have been smoking since I ran away from my parents’, at the age of 11 yrs. Now I am 46. I gave it up once when I had hepatitis and I did not drink for 6 months and that helped me. About 10 years ago I realised the harm smoking is doing to me and I started reducing. I was smoking about 60 straights a day. Then I was treated for nice holiday at our majesty’s pleasure and I started roll ups.

    I realised that I needed a smoke before I do the washing up and after. It was the same for every deed I did at that time. This self realisation helped me to reduce smoking. Lots of time, it is the taste in my mouth, more than the nicotine hit. The best nicotine hit I get is from the first drag of the day. Now I smoke 2 to 3 grams of roll up tobacco a day. That is 2 to 3 straights a day. I tried patches, chewing gum etc, except the e-ciggie and I did not like them, as they did not seems to work. I hope this will help someone who wants to quit it or reduce it.

    • October 27, 2012 6:28 pm

      Thanks, keep trying to cut down and I hope you find a therapy that helps you to quit one day!

  4. October 27, 2012 2:59 pm

    Thank you for this post Stephen. As you know I’m a smoker and do actually enjoy it but I also realise it’s extremely harmful… However, I have have survived an incredible number of life threatening illnesses over the last three years including a case of medical negligence. I’m left severely disabled with multiple physical and psychological conditions and find that smoking is one of only a few pleasures left in my life. I do admire your work on this issue and hope that it helps many people and that, one day, I too might be inspired to give it up :) Hope you are well…xxx

  5. RTS permalink
    October 28, 2012 8:38 am

    The common mistake made by non-snokers (and I see you’ve made it as well) is to think its the nicotine that keeps smokers smoking. Certainly it’s a factor, especially for the first few days after you quit, but it’s only a small part of the equation. The craving for nicotine actually passes fairly quickly; maybe a week or two. People who’ve quit returning to smoking, weeks or months after the addiction has passed do so because they miss the experience of smoking This is why typical NRT replacement therapy has a 92% fairly rate; all it offers is nicotine, it doesn’t replace the experience of smoking.
    E-Cigs, on the other hand imho have become so popular so quickly because they’re the whole package. They’re safer (at least that’s the perception – I have no special knowledge here), they satisfy the nictoine craving, but most importantly; it feels like you’re smoking.

    However, thatnks to anti-smoking hysteria surrounding E-Cigs we’re already getting to the situation where the use of E-Cigs are being banned indoors (not at governmental level obviously). My company did just this last week, claiming that because there was glycol in them they were too dangerous to tolerate; this is a company where gas powered forklifts and deisel trucks are driven within the factory – but the emissions from an E-Cig are too dangerous?!? There are other, more public incidents of the use of E-Cigs being banned, usually with the flimsiest possible reasoning.

    The point being being, if people have to go outside to use their E-Cig, how many will see it as pointless and have a real one instead.

    I find is strange that they is it safe / isn’t it safe thing has rumbled on for so long. I would image it would be a relatively simple job for any competent lab to measure the smission froms an E-Cig, compare the results next to the established toxicity levels for all the compounds it finds and publish the results; thus settling the issue.

  6. Despina Bortz permalink
    January 9, 2013 4:40 am

    e-cigarettes are nice since they do not contain so many harmful chemicals that cause cancer.,

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  7. Shawn Bocklund permalink
    February 12, 2013 12:09 pm

    Since the public became aware about the dangers of smoking a couple of decades back, many individuals have found stopping the tobacco practice hard. Brands have actually been innovating and manufacturing smoking cessation products for many years now. From nicotine patches to gum, nicotine abusers have actually been utilizing them to quit their practice.Electronic cigarettes (additionally known as e-cigarettes and electric cigarettes) are the newest product on the marketplace. They are made to look and feel like real cigarettes, even to giving off synthetic smoke nonetheless they do not actually include any tobacco. Users inhale nicotine vapor which looks like smoke without any of the carcinogens found in tobacco smoke which are unsafe to the smoker and others around him.`

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  8. Edwin Carpenter permalink
    July 8, 2014 6:21 am

    Smoking kills and every time you smoke. Even thou there are no people around you there is still someone somewhere that can inhaled that. No wonder a lot of people died from second hand smoking, and those people who inhaled the smoke that came from the cigar that you left.

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