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** 23 August 2022
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** UK
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** Dentistry Online evidence base update: Vaping and oral health (#1)
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** More smoke-free spaces could be coming to Greater Manchester (#2)
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** International
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** US Study: Vapes help to quit smoking without increasing nicotine dependence (#22)
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** Melbourne City Council instating vape-free zones and extending smoke-free zones (#4)
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** UK
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** Dentistry Online evidence base update: Vaping and oral health
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Dr Richard Holliday, senior lecturer, honorary consultant in restorative dentistry and specialist in periodontics at Newcastle University, and Professor Elaine McColl, professor of Health Services Research, discuss the impact of vaping on oral health. They disclaim that their brief overview of the evidence is not headline grabbing and, as with many things in healthcare, the reality and professional advice they give is nuanced, risk-based and with caveats.

They say that evidence shows e-cigarettes are an effective cessation aid that can be more effective than nicotine replacement therapy. The use of e-cigarettes in this way is supported by many organisations such as the NHS, NICE, Office for Health Improvement and Disparities, and the Royal College of Physicians.

They make a distinction between this and the very different clinical situation with regards to vaping: an individual who has not previously smoked, but starts regularly using an e-cigarette. The increasing popularity of disposable e-cigarettes particularly among young people and increased promotion on social media platforms has prompted greater discussion on the potential attractiveness of vapes to never-smokers.

For the first situation (smokers/ex-smokers), Holliday and McColl write this is a disease-rich starting position. Any negative oral health impacts from e-cigarette use are likely to be small and of relatively minor consequence to the substantial beneficial oral health changes from stopping smoking. They add that this is supported by clinical studies that see an improvement in oral health and reduction in risk of disease development or progression. They state that longer-term use is a balanced judgement between smoking relapse prevention versus the small risk of any detrimental effects from the e-cigarettes themselves.

In contrast, in the second situation (a young person who is a ‘never-smoker’), they generally have a healthy starting position. Whilst irregular or short-term use are unlikely to lead to any measurable intraoral effects, the addictive properties of nicotine carries a risk that users become addicted and long-term users.

Holliday and McColl describe the three areas of impact that long-term e-cigarette use might have on oral health: periodontal health, caries, and oral cancer. However, they say research is needed given the lower quality of existing evidence.. They note additionally that, unlike tobacco, nicotine is not a carcinogen, and therefore oral cancer isn’t a suspected health impact of vaping.

They conclude that more clinical evidence is needed and underscore the need for messaging given to patients by dental professionals to be tailored to the individual, with advice on e-cigarettes situated in their clinical context.

Source: Dentistry, 22 August 2022
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** More smoke-free spaces could be coming to Greater Manchester
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A new public consultation has been launched for residents, community groups, and local businesses of Greater Manchester to share their views on proposals for the creation of more outdoor smoke-free spaces in the city-region. The city-region joined the Partnership for Healthy Cities, which provided a grant of £79,000 for the plans, in creating several outdoor spaces with a prohibition on smoking in a bid to become healthier and greener while also challenging societal attitudes around smoking. The initiative hopes to protect more people from the harm of tobacco and to prevent younger generations from picking up the habit.

There are no plans to introduce fines for people caught smoking, with an "education-first" approach adopted instead, offering smokers support to quit, the Local Democracy Reporting Service (LDRS) said.

Paul Dennett, chair of Greater Manchester Integrated Care Partnership Board and deputy mayor for Greater Manchester said the region had some of the highest smoking rates in the country and added: "Consultations carried out in 2018 showed us that 8 out of 10 people thought it was a good idea – with areas of most concern including children’s playgrounds, school entrances and outside public libraries and town halls.”

Ariella Rojhani, director of the Partnership for Healthy Cities, added: “We applaud Greater Manchester for creating an opportunity for residents to help ensure the spaces they use every day will be smoke-free. Through this work, Greater Manchester is building a legacy as a city-region that cares deeply about health and wellbeing, not just now but well into the future.”

Following the results of the consultation, the plans will be finalised in autumn with the first new smoke-free space expected by the end of the year. The first phase of the project will be delivered by Manchester City Council and NHS Greater Manchester Integrated Care, on behalf of Greater Manchester Integrated Care Partnership.

Source: Oldham Times, 22 August 2022

See also: BBC Manchester - Manchester Piccadilly Gardens considered for outdoor smoking ban ([link removed])
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** International
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** US Study: Vapes help to quit smoking without increasing nicotine dependence
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E-cigarettes may help people decrease their dependence on combustible cigarettes without increasing their overall nicotine dependence, a new study from researchers at the Centre for Research on Tobacco and Health at the Pennsylvania State University has found. Findings were published in Nicotine and Tobacco Research.

The researchers enrolled 520 participants interested in reducing their cigarette intake but with no plans or interest to quit smoking and instructed them to reduce their cigarette consumption over the six-month study period. Participants randomly received an e-cigarette that delivered 36, 8 or 0 mg/mL of nicotine, or a cigarette substitute that contained no tobacco, as an aid in their efforts to reduce their cigarette consumption.

At six months, all participants in the e-cigarette groups reported significant, decreased cigarette consumption, with those in the 36 mg/mL group smoking the least number of cigarettes per day. The study also found that those in the e-cigarette groups reported significantly lower dependence on the Penn State Cigarette Dependence Index than those in the cigarette substitute group. E-cigarette dependence did not significantly change throughout the study, with the exception of participants in the 36 mg/mL group who saw significant, increased dependence over the course of the study, yet still much lower when compared with cigarette dependence.

Yingst said of the findings: “Our results suggest that using e-cigarettes or a cigarette substitute to reduce cigarette consumption can result in a reduction of self-reported cigarette use and dependence. Importantly, use of the high concentration e-cigarette did not increase overall nicotine dependence, and was associated with a greater reduction in cigarette smoking compared to the cigarette substitute.”

Note: The UK regulations restrict e-liquids to a nicotine strength of no more than 20mg/ml (2.0%).

Source: Asian Trader, 22 August 2022
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** Melbourne City Council instating vape-free zones and extending smoke-free zones
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Melbourne City Council is investigating how to extend smoke-free zones across train station entrances and council-owned buildings. The ban is currently in place across 13 outdoor areas, but could also come into effect at landmarks such as Town Hall, libraries and community sporting centres. Signs across the city's existing smoke-free zones will soon be updated to explicitly ban vaping.

Melbourne City Council has no say over whether bans should be in force at state-owned buildings.

Lord Mayor Sally Capp said: “'We know that smoking is incredibly harmful, not just for smokers themselves but for recipients of second-hand smoke.”

It is estimated 19,000 Australians die from the effects of tobacco each year, but there are no deaths linked to vaping, Quit Victoria states.

Source: Daily Mail Australia, 23 August 2022
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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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