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** 28 May 2020
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** UK
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** Vape stores among those to re-open for business on 15 June when lockdown eases (#2)
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** Text message tells vulnerable people in UK they are dropped from shielding list (#1)
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** International
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** Opinion: Tobacco smoking and COVID-19 infection (#4)
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** Study: Vaping may increase risk of gum disease (#3)
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** UK
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** Vape shops will be allowed to re-open for business on 15th June 2020 following three months of closure under the UK coronavirus lockdown legislation.

The legislation, which did not class vape shops as “essential retail outlets,” forced shops across the country to close their doors, prompting many to open new online stores.

Source: Convenience Store, 28 May 2020
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Read Article ([link removed])


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** People with cancer, severe asthma or liver disease have been dropped from the UK government’s coronavirus shielding list by text message before their doctors have been able to speak to them.
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** The decision to remove people with various health conditions from the shielding programme has caused upset. The text also informed people they would no longer qualify for government food parcels.

Louisa Fenton, 24, a care assistant, who has had brittle asthma since childhood, said getting the message had caused her extreme distress, as she thought her condition put her at risk of a severe case of coronavirus if she became infected: “Throughout lockdown I’ve been living on my own and I’ve been relying on the food boxes. Now a doctor has decided I’m not on the shielding list. But I think I need to be put back on it. Coronavirus attacks the lungs – how can they tell me not to stay at home?” she said.
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Vanessa Hebditch, from the British Liver Trust, said: “The government has said that individual doctors can use their clinical judgment and take people off the shielding list. I’ve had assurance from the Department of Health and Social Care that nobody should have received a text as the first piece of communication. Their consultant should have written to them or rung them. Some people who have received this message haven’t had those conversations, so clearly this was a blip. Our advice, if you do receive a text, is to continue to shield until you have received direct advice from your own clinician.”

The government confirmed it had asked clinicians to review the records of people to ensure that only those who needed to shield were on the shielded patient list, and said that doctors should have written to explain the decisions that had been made. The text was supposed to confirm that support would end and direct patients to other forms of help.

A government spokesperson said: “Those advised that they no longer need to shield may still access forms of support including the NHS Volunteers network, and will retain their supermarket priority delivery slots.”
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** Source: The Guardian, 27 May 2020
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** International
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** Richard N van Zyl-Smit, University of Cape Town, Guy Richards, University of the Witwatersrand and Frank T Leone, University of Pennsylvania write in The Lancet Respiratory Medicine on the importance of tobacco control beyond the COVID-19 pandemic:

"It is possible that the period of self-isolation and lockdown restrictions during this pandemic could be used by some as an opportunity to quit smoking, but realistically only a minority of people will achieve cessation. For the majority, the increased stress of a potentially fatal disease, possibility of loss of employment, feelings of insecurity, confinement, and boredom, could increase the desire to smoke. During the financial collapse of 2008, tobacco shares were one of the only shares to increase.

"Here, we suggest a few steps to help reduce tobacco use during this pandemic and hopefully long after. First, every smoker should be encouraged to stop, be provided with advice, support, and pharmacotherapy, if available; times of crisis can often provide the impetus to stop smoking. Banning tobacco sales might not be wholly effective if people are still able to access cigarettes and so other measures need to be implemented to discourage tobacco use. In South Africa, before the pandemic, the illegal cigarette trade was thriving and according to news reports, virtually all smokers have ready access to cigarettes, provided they can afford the inflated prices.

"Second, we need more data; many of the H1N1 influenza cohorts did not report on smoking status, which is also the case for many other infectious diseases. To determine the effect smoking might have on infection, it is essential that every person tested for COVID-19, and for other respiratory infectious diseases, should be asked about their smoking history. All outcomes related to screening, testing, admission, ventilation, recovery, and death need to be evaluated relative to smoking status and adjusted for comorbid conditions, such as ischaemic heart disease and COPD.

"Finally, the world should aim to be tobacco free, but given the intricate web of finance, taxes, jobs, lobbying, and payments made to officials, this is unlikely to happen in the near future. However, the battle against tobacco use should continue, by assisting smokers to successfully and permanently quit. Avoiding COVID-19 now, but having lung cancer or COPD later on, is not a desired outcome; therefore, any short-term interventions need to have long-term sustainability."

Source: The Lancet, 25 May 2020
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Read Article ([link removed](20)30239-3/fulltext)


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A study published in Science Advances looking at the mouths of young healthy vapers found evidence of clear changes to the bacterial makeup of the mouth (oral microbiome) which could raise their future risk of gum disease.
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Lead author Purnima Kumar, an oral surgeon and professor of dentistry at Ohio State University, and her team took samples of plaque—the sticky film of bacteria that coats our teeth—from more than 120 young, healthy volunteers. The researchers then sequenced the genetic material found in the plaque. Volunteers fell into five groups (i) smokers, (ii) nonsmokers, (iii) e-cigarette users, (iv) former smokers currently using e-cigarettes, and (v) dual cigarette and e-cigarette users.

“We’re using the microbiome almost like a canary in the coal mine. It responds very quickly to environmental changes in a measurable way long before the human body responds to it. So it almost foretells the future for us,” Kumar said. “What we saw is that e-cigarettes create an incredible amount of stress in the microbiome. And these bacteria respond to the stress by creating a very mucousy, slimy layer.” These slimy changes to the microbiome, according to Kumar, likely antagonize the immune system, making the mouth more likely to become chronically inflamed. Over time, that inflammation could lead to serious gum disease.

“These people have no evidence of gum disease,” Kumar said. “They would get a clean bill of health in my office. But when you compare their microbiome to people who already have established gum disease, it’s so similar. So at a molecular level, these people are already starting to shift away from a healthy mouth. This would take years to manifest, but most oral diseases are chronic diseases. And we don’t even know what kinds of new diseases we might get from these kinds of microbial changes” she added.

More research is needed to confirm the team's results, as well as to better understand how vaping could affect oral health. One limitation of the study was that it only studied people using older-generation modifiable vaping devices, as opposed to the simpler pod based systems such as those popularised by Juul. Kumar’s team is now studying these newer devices.

Source: Gizmodo, 26 May 2020
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** Sciences Advances - Adverse effects of electronic cigarettes on the disease-naive oral microbiome ([link removed])
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** See also: Daily Mail - Vaping for just a few months puts young, healthy people at risk of oral health problems ([link removed])
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.

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