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Vaping probably isn’t a gateway to smoking

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Trends in cigarette and e-cigarette use among 16 to 24-year-olds in England suggest that vaping doesn’t encourage more young people to start smoking



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10 March 2022

A man vaping

Anna Berdnik/Alamy

Young people who try vaping are more likely to later start smoking – but a new analysis of trends in nicotine use in England suggests that the so-called gateway theory of vaping isn’t the explanation.

The real reason for the link could be that teens who start vaping are the same ones who are likely to try smoking, regardless of whether they ever have an e-cigarette.

Vaping is much less harmful for people’s health than smoking, causing about 95 per cent less damage, according to an estimate by Public Health England. UK smokers are advised to switch to e-cigarettes to help them quit, but health bodies in some other countries, such as the US and Australia, take a dimmer view of vaping.

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A key argument against making it easy to buy e-cigarettes is that young people who start vaping will get addicted to nicotine, and so will end up switching to traditional cigarettes for the faster nicotine hit. Several studies have shown that teenagers who try vaping are more likely to end up smoking.

But these studies merely observe smoking rates in individuals who have vaped and those who haven’t. Such observational research can’t show that the first factor causes the second, only that the two things correlate.

“It could be the case that there’s a common vulnerability that explains this association. That could be, for instance, because there’s some genetic predisposition to try different things or there’s environmental pressures to try things,” says Lion Shahab at University College London.

Instead of looking at whether individuals were likely to start smoking, Shahab’s team looked at how the rate of smoking among 16 to 24-year-olds in England has changed over the past 11 years, as vaping caught on.

If there really was a gateway effect, then, as vaping rates changed, those for smoking also should have in a related pattern. In fact, while vaping in this age group jumped to about 5 per cent in 2013 and has hovered around there since, rates of regular smoking have fallen from about 30 per cent in 2013 to 25 per cent in 2018, the last year of the study.

The analysis can’t rule out, however, that vaping has a very small gateway effect, says Shahab.

The findings may not convince all critics of e-cigarettes. “I don’t see this study as refuting the extensive evidence that already exists for a gateway effect,” says Martin McKee at the London School of Hygiene & Tropical Medicine. “Following up individuals is the most appropriate way to answer this question.”

Journal reference: Addiction, DOI: 10.1111/add.15838

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Solar storms may cause up to 5500 heart-related deaths in a given year

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In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart



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17 June 2022

A solar storm

Jurik Peter/Shutterstock

Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus

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Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer

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Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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