Vaping, with Kay Burley on Sky News

Kay Burley paraphrased, from 0:00

Health officials in England had said that day that hospitals should sell e-cigarettes and let patients vape in private rooms; Public Health England’s estimate, as she put it, was that the devices might be helping some 20,000 people a year give up smoking, and the body wanted GPs able to prescribe them. She introduced me, joining from Lincoln as an A&E doctor, and asked whether hospitals should really open their doors to vaping.

Dr Kishan Rees from the recording, 0:32

I think it’s early days in terms of looking at the evidence that’s come out. The landmark study, that’s saying long-term vaping is far safer than smoking, looked at a hundred and eighty-one participants, and one thing that the media hasn’t actually picked up on is that the authors themselves in this study do say that there’s some limitations. So we certainly need more research and more evidence to look into it. Because let’s remember, when smoking was coming out in the 30s and 40s, it was actually encouraged, that it was very healthy, and look how wrong we were with that. So bearing in mind these devices have only been regulated since 2015, 2016, both in the States and over here, we definitely need to look into it, and there needs to be more research. But it does suggest that in a select group of patients, who are struggling to quit smoking and have tried other things, this may be a benefit to them.

Kay Burley paraphrased, from 1:29

There were other issues to look at though, she said, not least what is described as popcorn lung, which she had never heard of before that day.

Dr Kishan Rees from the recording, 1:37

I was going to say! Yeah, I’m so glad you brought that up. Because in 2016 the American Lung Association came out with this: they found, the decade earlier, that workers that were working in a popcorn factory were basically breathing in diacetyl, which is incredibly toxic to the lungs, and it causes a condition called bronchiolitis obliterans. Now that’s a bit of a mouthful, so you can see why popcorn lung has caught on, but it’s a really serious condition. It causes thickening and scarring of the alveoli, which are the air sacs in your lungs, and it can basically get patients presenting with coughing and wheezing and being short of breath, very similar to COPD. So while these e-cigarettes may help patients trying to quit smoking, and reduce the risk of cancer, which is obviously associated with cigarettes, we need to be very careful that it’s not causing other lung conditions which equally cause suffering and problems for patients. So I would be reluctant to let people start kind of vaping in areas, because we honestly don’t know; there is some evidence to suggest out there that some of the chemicals in these e-cigarettes are dangerous and, as you said, cause popcorn lung.

Kay Burley paraphrased, from 2:53

And how did I feel about the marketing, she asked: sweet flavours, bubblegum and mint among them, clever marketing in her view, drawing people to consider the devices again.

Dr Kishan Rees from the recording, 3:08

I think that’s a really important point. We’ve got to be careful that this isn’t seen as like some kind of lifestyle choice, and it’s marketed to kids and to younger people. In 2015 Public Health England put out a report suggesting actually the numbers of people that are young, and haven’t smoked, trying e-cigarettes and vaping, is minuscule. But we’ve got to bear in mind that there’s a powerful tobacco lobby, and people are smoking less, and some of the tobacco manufacturers are making e-cigarettes and vapes, so you know, there may be a vested interest in there, in terms of monetising and promoting this. So yeah, absolutely we need to be really careful, and it ties into education with kids: just like telling them smoking is bad for them, telling them the potential risks of vaping. And while it might be useful, as we said, for helping people to get off cigarettes, it’s probably not in the best interests of swathes of the population to rush out and start vaping. I certainly wouldn’t recommend that at all.