By Sarah Renouf and Natalie Bisal, Research Health Psychologists, Health and Lifestyle Research Unit, Queen Mary University of London
Undoubtedly, smoking is one of the biggest causes of death and illness where every year around 100,000 people in the UK die from smoking, with many more living with debilitating smoking-related illnesses. Health psychologist like us focus on providing behavioural support through one to one and group work as well as using aids to support quitting, such as Nicotine Replacement Therapy (NRT) or Champix, a tablet which dulls cravings and decreases the pleasurable effect of smoking. Our clinic regularly provides a combination of support which is effective in increasing the chance of successfully quitting. But a new kid of the block has appeared which has challenged our thinking of smoking cessation; the e-cigarette.
Although the use of e-cigarette has risen dramatically over the past 10 years and is now the most popular smoking cessation aid in the UK, our knowledge and the research has not kept up with this development. Many people report that e-cigarettes can help address the habitual side to smoking that other medications can’t, such as the throat hit and hand-to-mouth action. However, there have been a spate of conflicting opinions of the harms of e-cigarettes from various media reports as well as from major health organisations such as NICE - which makes it difficult for the public to understand whether or not e-cigarettes are a useful way to quit smoking or a harmful alternative. Health psychology research has perhaps been surprisingly slow to react to this proliferation of e-cigarette use considering our focus on behavioural habits. Recent research is now emerging which highlights the potential positive impact of e-cigarettes where they are 95% less harmful than regular cigarettes and are associated with increased success rates of quit attempts. Despite these developments, the profession in general has been decidedly slow to adapt to developments, experts such as Professor Peter Hajek and Professor Robert West (who have been vocal supporters of the e-cig option) are the exception rather than the norm. More research is needed into the long-term effects of e-cigarettes and their potential in certain populations, such as pregnant women or those with mental health problems, where the greatest impact on their health might be seen. Health psychologists need to adapt to this ‘new kid on the block’ and are uniquely placed to explore the potential of e-cigarettes and investigate contexts in which they may not be helpful as well as explore barriers including some individuals discomfort with the idea of replacing one habit for another.
Within our clinic, we try to take an active role in adapting to these new developments where we seek to understand the concerns of e-cigarettes where our role can be one of educator to highlight the evidence which is emerging of the good safety record and benefits of e-cigarettes. We are also looking at using the proliferation of e-cigarette use to draw more people into our clinic, for example, we are currently partnering with local e-cigarette shops to make our service more attractive to quitters. We are also involved in research, including an ongoing trial comparing the effectiveness of e-cigarettes to NRT to increase our knowledge in this area. However, services like ours increasingly suffer threats to government funding which severely undermines our ability to continue this work and the long-term aim to reduce deaths and illness from smoking-related diseases – however something has to change if we are to continue to help address this health concern.