What should we do about vaping?

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Hello there and welcome to the Inside Health Podcast. I'm James Gallagher. We're going to be finding out why Veruukas can be so hard to get rid of and what you can do about them in a bit. But first I have a question for you. Can you remember the first time you ever heard of vaping? I can, because it involved the police and bomb disposal. There was armed police surrounding the coach. We were asked to get off one by one slowly.

People were saying there were people with guns in the trees. Everyone was getting pretty scared. That was Jenny Lister speaking to the BBC back in 2012. She'd been on a coach from Preston to London, a passenger had been seen pouring a liquid into a bag, and then a mysterious vapour started to emerge. Other passengers raised the alarm, fearing it could be an explosive device. Armed police swooped in, stopped the coach in the middle of the M six toll road, and it all turned out to be just a vape.

It's hard to imagine the same thing happening now. Vaping has just become so common. I mean it's hard to walk down the street without walking through a vape cloud, you know, one of those sweet smelling ones often taste some strawberries or sweeties. And figures out this week suggest vaping has now reached record levels. More than 5.6 million adults in the UK, that's one in ten of us, now vape.

What to do about it all is a question for governments around the world. Vapes have the potential to help people quit smoking, but also raise concerns about getting a generation of children hooked on nicotine. So we're going to discuss how to get the balance right in a moment. And we're going to meet somebody who's actually used vapes to quit smoking. But first, I went to a youth club in London. I'd say about ten percent people vape in wrestling. And when did it start?

Somewhere three a ten so about fourteen fifteen. And of the friends you have the that vape, why do they say they do it? They said they tried it at first and they liked it and they can't really stop. So it's just something that they do really. I think people kind of choose vaping over smoking because you don't need to light the cigarette and you can like take like two or three pulls and put it in your pocket and the smell disappears quite quickly.

As opposed to tobacco, which is why I think people tend to gravitate to vaping rather than smoking. The people I hang around we don't bate but we see people in school or like outside of school doing it. What's it like in school when some of your friends fape and some don't? It's a bit annoying because they don't really get in trouble for it and they'll miss classes to do vaping but they won't really get a consequence. Do you ever feel like the pressure to join in? Yeah.

What would your mum or dad say if they ever caught you? Not that you would. get me in trouble, lots of trouble. They take my phone, do everything they can. Thank you.

They were so honest down at the youth club, weren't they? We'll be popping in again in a bit, but for now I want you to meet Richard from Somerset because he used vaping to finally quit smoking. I started at the age of ten and I kind of took to it like a duck to water, really. But you started at ten, that is really young. Yeah. I mean it wasn't seen back then as that bad a thing to be doing. People didn't know quite how bad smoking was. And how did it take off from there?

So I ended up smoking around about sixty a day, um unfiltered king size cigarettes and they were the really strong variety. Was it having an impact on your body? By the time I was thirty five I was having trouble walking up more than two flights of stairs and yeah it was just coughing up all sorts of unreal, nasty stuff. It was definitely killing me. So Richard, did you ever try to stop?

I tried absolutely every method. I tried all the sensible ones first. I tried nicotine replacement therapy, the patches, gum At the time inhalators were a new thing, I tried those. None of that worked. I also tried the less sensible things like hypnosis and acupuncture, which those didn't work either. And I'd kind of got to the point of Yeah, but I'd actually given up giving up smoking. I thought it was never ever gonna happen. When did vaping come into all of this for you?

I was really quite early into vaping. The first e-cig I ever bought was about 2007. And It was a teeny tiny small cigarette sized device from China. Um there were no shops or anything where you could buy them in this country at that point. And I tried it and I could see the potential but it didn't do it for me. There wasn't enough nicotine probably and everything was not very pleasant flavor. But things change'cause Vapes became a lot more common and then the flavours came in.

Yeah. In two thousand and eight I had a look at vaping and found that things had moved on enough. Uh I s gave up smoking in two thousand and nine and it happened completely by accident. The way I noticed, uh I'd actually budgeted money to spend on tobacco and around about March of 2009 I discovered that I hadn't bought any tobacco for at least four weeks.

And I was absolutely blown away by that. I'd never ever thought I would stop smoking and then it happened completely by accident. It was astounding. I was wondering, do you prefer or did you prefer vaping and is that why you accidentally switched? It kind of slowly took over and in the end it's a much nicer experience. Even aside from the health gains, yeah, it doesn't taste like burning plants.

Yeah, I prefer fruit flavours and the original E cigs only came in tobacco flavour, and it's a kind of a a strange approximation of what cigarette is because there is no smoke in vaping, so there's no way it can ever taste of smoke and it's not actually very pleasant. It's a little bit like the you know, those banana flavoured sweets that taste nothing like banana. Uh yes, but worse. Ha ha. I don't know, they're pretty bad.

Richard, a concluding thought, like how's your body doing now? That body that, when smoking, couldn't get up the stairs? I mean, luckily, I had an MRI, and the comment was, Lung's unremarkable, clearly a non-smoker. So having seen that, I actually asked them if there was any sign at all that they could see that I vaped and and I was told no, there was none. And I'm now fitter at fifty-three than I was at thirty-five. So yeah, that is an absolute night and day difference in hell.

Well thank you to Richard for sharing his experiences. But let's turn now to what to do about vaping. So the King's speech outlining the agenda for the Labour government included plans to impose limits on the sale and marketing of vape.

On the other side of the world, Australia is going to make vapes available only from a pharmacist in plain packaging and in just a limited number of flavours, while the World Health Organization says it's concerned about the rise in vaping and how they're targeted at children. So how concerned should we be by rising numbers of people vaping? Well to discuss, I'm joined by Hazel Cheesman, who's the Deputy Chief Executive of the charity Action on Smoking and Health.

and Doctor Sarah Jackson from the Alcohol Tobacco Research Group at University College London. Welcome both of you to the programme. Thank you. So Hazel, can I just start with you? How settled is the science now? Can we say definitively that vaping helps people quit smoking?

Yeah, we can be pretty definitive that vaping helps people to stop smoking. We have really high quality evidence now from lots of really well conducted scientific trials which show that Using a vape improves people's chances of quitting and it improves people's chances of quitting more than the standard medications that we have nicotine replacement therapy.

Rydyn ni'n ymwneud â'r hyn ymwneud â'r hyn ymwneud â'r hyn ymwneud â'r hyn ymwneud â'r hyn ymwneud â'r hyn, mae'r hyn ymwneud â'r hyn ymwneud â'r hyn. So from our data, more than half of people that have quit smoking in the last five years have done so with a vape. So, you know, we're pretty clear that this is an effective way to stop smoking. Sarah, can you just chart for me the emergence of vaping in the UK? When did it start? How many people are doing it now?

Yeah, so vapes started to become popular. Between twenty eleven to twenty thirteen we saw quite a rise in vaping in that period, and then it was fairly level between twenty fourteen and about twenty twenty one. But then since disposable e cigarettes enter the market we've seen a real surge in vaping. So vaping rates have risen quite substantially over the last couple of years. And is that across the board or have we seen a a change kind of like in who's vaping as well?

We have. So we've seen an increase in vaping pretty much across the board, but the increase has been greatest at younger ages. And is that all disposable? It's not all disposables, so the rise in disposable vaping has been most pronounced in the youngest age groups, but we're also seeing the greatest rise in non disposable vaping in these age groups as well. Absolutely, we've seen these increases among young people, but it's also important to remember

that most of the people that are vaping are ex smokers or current smokers. We have got usage in people that have never smoked before and that is a cause of concern and we'd like to see that figure lower. But most of these people are people who would otherwise be smoking or smoking more.

Can I just ask this because I think we should ask this straight up and be completely honest about it. Why do we care if people vape? You know, we have varying drug policies across different types of drugs across society. People drink and that causes harm to their bodies. causes harm to the health service, causes harm to the family members of people if they become abusive when they drink. So why do we care about vaping?

Well, I I think we care about vaping for the same reason that we care about people consuming other drugs that could have potential health consequences. So to be really clear, if you are switching from smoking to vaping, you are Yeah. No brainer, absolutely. You're definitely reducing the amount of harm you do to yourself.

But if you've never smoked and you'd never be likely to smoke, there is a chance that over the long term that could do your body some harm. Um and there's also the question that nicotine has an an addictive potential. And if you need not be addictive to something, that's positive for your income, for your well being. Did you want to come in on that, Sarah?

Yeah, I agree with what Hazel's saying. I think we care about it in a different way to the way we care about smoking, which has incredibly harmful effects and we know this. And as Hazel said, there are studies that show very clearly that vaping is less harmful than smoking. So there are studies that have looked at users' blood, their saliva, their urine, and they've measured exposure to different harmful substances. And they see that the levels and numbers of these different harmful substances

in people who vape are so much lower than they are in people who smoke. But some of them are higher in people who vape than people who don't smoke or vape. So there are some risks associated with smoking. See you right. It's not zero risk.

Well Sarah Hazel, take a listen to this. It's the view from the youth club, the teenage world view on vaping. Most of my friends from school. They do they enjoy it? What's the appeal? I got no clue. I know like between classes I look for my friends and I find a ball in the toilet and then the toilet will smell like lemonade and peach. So I go in there and I know that all my friends are in there doing their thing. Have you ever?

a couple of times but like not on like a way where I'm like I need it like every five seconds. But I felt like it was the right thing to do at the time'cause I felt like if I didn't do it then it made me a buzzkill compared to everybody else. So it was like might as well just try it. So we get a bit of a picture there about young people and vaping, don't we, Hazel? So do we actually have the stats? Do we know how many children are vaping?

So our data tracking use among eleven to seventeen year olds, we estimate that there's around just under a million eleven to seventeen year olds who've tried vaping. So it doesn't mean that they're vaping all the time, but they've they've tried vaping. Experimenting. Yeah, they've experimented. In fact the majority of that use is experimental.

But something like two hundred and fifty thousand children are using vapes more regularly. And you know, that is a cause for concern because these young people need not be using these products at all. It's an offence to sell them these products. But yeah, they're not doing anything illegal, it's worth being The young people aren't committing the offence, but the people selling them to them are committing an offence.

And the concern has been that this figure has gone up. So we went from a period where while adult vaping was increasing, use among under eighteens was pretty low. And then around twenty twenty one that figure went up. quite dramatically, and that coincided with the arrival on the market of these really appealing, really available, quite cheap, disposable vapes. And that appears to have driven quite a lot of appeal among the under eighteens and also in young adults.

Just affordability is like Exactly. if you've got pocket money you can afford to buy Pocket money prices for sure. And over the last between twenty four and twenty three, that's kind of stabilised, at least in our data, but nor have we seen that figure go down significantly. So we are gonna need some more government intervention if we're gonna bring that rate of youth vaping back down again.

Have you seen a difference in the coolness of vaping over time?'Cause it very much emerged as a way of quitting smoking. No one was going round saying, Oh, that's the cool thing to do a decade ago. Yeah, and I think we've seen that starting to shift over the last couple of years with disposables. I mean, they're branded really attractively, they come in all sorts of cool flavours.

at adult smokers. I think we've seen vaping become more of a phenomenon on social media. We're seeing a lot of TikTok accounts promoting vaping and making it cool. So it's almost become the new fashion accessory for young people. Well, on that exact topic I asked teenagers at the youth club what's cropping up in their socials.

There's a lot of people promoting it, say, for example, like, TikToks. You'll just see, like, a lot of people just having vapes. But you see, like, even ads on TikTok, and there'll be, like, different flavours, and I think that, like, entices kids, and it'll make them want to get it as well. If they were targeted towards adults, you know, like on the cigarette packet.

They make it like really scary and they show you all the scary pictures. On a vape packet it's bright and colourful and they got like these cute names like Pink Lemonade and you know it's is it's targeted towards somebody who would like that stuff. Hazel, those teenagers clearly feeling like these vapes are being aimed at them. Is there anything we can do about that?

This is all stuff that's really ripe for regulation, you know, how they're being promoted in shops and how they're being packaged and promoted to to young people. Once come to regulation in a second, but Sarah, can I ask you the million dollar question first? Does vaping lead to smoking? If young children start vaping, do they become the smokers of tomorrow?

So there's studies that have looked at this where they've followed people over time, and they do see that young people who vape are more likely to go on to start smoking than young people who don't vape. But this doesn't mean that vaping causes the smoking. So we see studies showing that there are sort of common genetic pathways that may make someone more likely to use nicotine. People might just be more likely to take risks.

there isn't good evidence yet that vaping is causing people to smoke. But in fact what we're seeing is the opposite where groups that have had the largest increases in vaping are actually also showing the largest decreases in smoking.

So this suggests that there may be, for some people, a gateway effect where some people start vaping and go on to smoke, but Insofar as that's happening, it's happening much less than a potential diversion effect of vaping, where people who would have otherwise gone on to smoke are taking up vaping instead, and that's stopping them from going on to become a smoker.

Sarah, do you think we need to do something about the numbers of children vaping? Yeah, you know, it's concerning to see so many young people trying vaping and vaping regularly. So we do need tighter regulation.

But all of this is a balancing act, isn't it? Between still retaining something that is definitely helping smokers to quit. We know that smoking is one of the worst things you can do for your health, so on that side they're a good thing, but you don't want to encourage lots of children to do it.

And that plays out all over the place. So one of the ideas in the Tobacco and Vapes bill is around, well, what about restricting the different flavours of vapes? But we heard from Richard right at the beginning of this programme saying flavours is what helped him stop smoking. Hazel. Yeah, I mean th this is the challenge with this policy area is it's got to be calibrated.

And flavours is one of those really interesting areas. So there were a lot of flavours on the market before we saw an increase in youth vaping. It doesn't seem that it's necessarily flavours per se which are driving that appeal among young people. all of the branding that has gone around those flavours and remove all the branding, all the bright colours, all the things which are driving young people to experiment and try these products.

And Sarah, what about disposable vapes, which are much cheaper and and which you in your data kind of like linked the emergence of those to to the surge in the number of people vaping? Do they need to go, do you think?

There is a place for disposables in terms of their ability to help people quit, but there are a lot of people using them who probably don't need to be I think a lot of what we've seen in the last few years has probably been linked to the emergence of disposable vapes, but I don't think a ban is necessarily going to solve that problem.

I think, you know, proceeding with the ban on disposable vapes is the right thing to do, but we need to think about the other regulations which go around these products. Then you know, we'll be in a much better position in a couple of years' time, I hope, where we've seen youth vaping come back down, but we've maintained this really valuable tool to help reduce smoke. Uh Hazel, Sarah, thank you so much for coming into the studio. Key. Thanks.

Hej, du får jag berätta en sak. Ja. Min kusin buse behövde nätverkskablar, fassadfärg och. Vet du vad han köpte det? På tre olika stöll. Han kun ju handla allt här på biltiman. Men det berättar jag inte för honom om. Alltid brett sortiment. Snälla, snälla, sluta! Jag kommer inte köpa utåt er! Det är dum i huvudet. What man? Det blir i alla fall inte värre än så här. Ibland är det nej, det finaste du kan ge. 한글자막 by 한효정

Well after all of that I think I need a nice long relaxing bath. Well, bath time's over, but now to the business of getting rid of this incredibly stubborn Veruca from my left heel. It's about two millimeters across. But I know I had this before the pandemic started. So that's probably five years old and I've been throwing everything imaginable at it. Um no matter what I do, it starts with filing it down.

So this thing is seriously stubborn. I've tried everything I can think of. So I've had cryotherapy at the GP, I've had those over-the-counter treatments. So this one here is a salicylic acid high strength. And I've even reached the point of reading blogs going, have you thought about using duct tape? So what I really want to know is why can varukkas be so hard to get rid of?

Well to try to find the answer, we're joined by podiatrist, Dr. Ivan Bristow and Linda, who's had a massive veruca of her own. So hello to you both. Hello. First of all, Linda, what were yours like? It's probably the size of my thumb pad. It's stuck out of my foot. It's not a vruka anymore. It's a big gross. It was big and white and lumpy and had little tentacles sticking out of

And what was it like when'cause a lot of the advice around verruokas is just uh just wait for your body to get rid of it, it'll go eventually. Most people's verukkas go in a couple of years. How did you feel when you were told that? Well, I was devastated. She did a biopsy just to check that it wasn't cancer. But while she was stitching up the hole, she said to me, Oh, I know it's a Vruka, but let's get this on your record. And told me to seek private help.

Well, Linda, you're making me feel really bad now for complaining about my tiny little Verucca. But Ivan, why do Verukkas, both of ours, tend to be so stubborn? I mean it's a virus that's causing them, isn't it? They're caused by a virus which uh specifically infects the outermost layer of the the skin, the epidermis called the human papillomavirus. Um the younger you are, the quicker you get rid of them, but if you have a verruca as an adult

for whatever reason the walk will persist and you'll have it maybe for five to ten years on average, which is a obviously a very long time if you've got something which is painful on the sole of your foot. But As far as we can understand, the wart virus is very good at hiding from the immune system. So it's located in the outer layers of the skin where there isn't much immunity.

and it encases itself in a lot of hard skin and so it's able to evade most of the body's normal tactics to destroy it. You know, it's the the ultimate sort of hiding infection, if you like. Shall we just have a quick whiz through, Ivan, uh of the treatments that people are recommended to try? So over the counter like little creams that you can put on, the the ones that contain is it salicylic acid?

Yep, there's various ones. Salicidic acid is one lactic acid in another. Um, essentially what they'll do, they'll soften the hard skin over the water. which effectively makes it more vulnerable, but they can take a very long time. You could be doing that for months. Yeah. Cryotherapy has been around for hundreds of years in various forms.

Um as far as it goes, it's the formation of ice which damages the cells, which is alleged to have immune effects. But we don't have good evidence that it's acting on the immune system. It's probably more destructive. Okay, I did try duct tape and I'll be honest, um I I wasn't convinced it was gonna work before I tried it. And then when it was falling off basically after it been on ten minutes anyway, I w I was one hundred percent convinced it wasn't gonna work. But what's the idea there?

uh it wasn't a good idea it was Ha ha ha. Yeah. Sorry. It was it was all based on a piece of research in two thousand and two which uh looked at duct tape in treating hand and foot warts on children. One of the problems with the research is sometimes there can be a bias and in this particular study the bias was they had a quite a young population, so they naturally got rid of their warts very quickly, and the researchers ultimately assumed it was down to the duct tape, not down to nature.

And of course it's very, very newsworthy. Duct tape, something you can buy from a DIY store, stick it to your foot, treat your water. Of course it became an instant overnight hit. Since they've repeated the study two or three times, they've never been able to replicate the results of the initial study. So uh A bit like your duct tape. It it stuck for a while and then it just got bored and fell off I think.

Okay, I'm gonna put my duct tape back in the toolbox where it belongs. Um what is the best advice for what we should be doing to tackle Verukkas then? The best advice and give is persistence and often it's about just being consistent with the treatment that you're doing, but be patient. If it's not hurting, if it's not spreading, if it's not giving you any problem, probably the best advice is to leave it and it will go anyway.

If it is painful, then start off with, as you mentioned, the over the counter treatment. I have to be honest, I find that if I just leave mine alone, that's when it causes me no problems at all. It's almost as though the treatment itself is the thing that is th th the most painful. Do you find that, Linda, that not only can your Varuca be painful, but actually when you try to do something about it it becomes painful?

Yes, yes, yes. I I actually um try cutting off the little tentacles with some scissors. I had terrible pains all through the night, pain shooting up my leg'cause it was a touch to my nerve or my my foot. Ivan, would you recommend cutting at your Wartz and Vrookers?

Definitely not. One of the key things is that you will spread the infection. One of the things we always tell patients is not to pick because if you dig at the virus, for example, with your fingernail, you can carry the infection under your fingernail and the next thing is you've got warts growing from underneath your fingernails.

and anywhere else that it's spread to. My best advice would be if it is painful and you really need to do something to it is to Soak your foot in some warm water and use uh something like a disposable emery board or a pumice stone that's exclusive to your warts, not to be shared with the family, of course.

and to just gently rub to remove the hard skin. But as Linda says, if you rub it too hard, it it's very it's very vascular, has lots of blood vessels in it and lots of tiny nerve endings. So if you go too hard it will bleed.

How do you balance when doing that, that risk between filing it down and making it worse by well potentially spreading it further? Because You know, y you're damaging the rest of your skin and you're flaking off little bits of dried skin everywhere and y you know, you don't know if somebody else is gonna walk anywhere near where some of that has gone, or if you could be rubbing some of those viruses into another bit of your foot which could become a bit like a wound and

end up having multiple Farukas. That is a potential risk. The main thing is just to localize what you're filing, just to file the wart, not to reuse the Emery board anywhere else on the body. One Fruka, recover. Are you good for life? It's a bit like chicken box. Once you've had chicken box, that's another slightly different type of virus.

you don't get chicken box again, but there will always be one or two people who say, Well, I've had it twice and those people in very small numbers. But generally speaking, once immunity occurs, you're you're very unlikely to succumb to the warp virus infection again on the skin. It's okay if you get there in the end, though, Linda. I don't know how you feel about it, but sometimes I feel a little bit embarrassed by my Varuker. I mean they are a bit embarrassing, aren't they? Yes.

Very embarrassing. And I would recommend anybody to reach out to their local churopodist and get some help. Why? Because it was big and horrific and had tentacles. Ha ha ha. Linda makes a very interesting point there because um one of the things about skin problems is they're very visible and if you have a wart or varuka on your feet, your hand research has shown how incredibly embarrassing it is. And I think uh Linda's right that, you know, we should come out of the dermatological closet and uh

Well Ivan, thank you for coming on. Thank you. And to you too, Linda, and I hope your Verruca experiences are all firmly in the past now. Well that would be lovely. I look forward to wearing my pretty little sandals. Well it's summer I think that's the perfect excuse, isn't it? Now um we did discuss there a little bit about embarrassment that came with both mine and Linda's Veruokas.

And embarrassment is something we're going to tackle in a future episode of Inside Health, so I need a little bit of your help actually. So if there are any medical conditions that you think are just too embarrassing that we don't talk about in public and we need to, then let me know. Or if embarrassment has got in the way of you seeking medical help, then again get in touch.

Insidehealth at bbc.co.uk is the way to get in touch. But you've been listening to the Inside Health Podcast with me, James Gallagher, the producer was Hannah Fisher, and the assistant producer was Katie Thompson. Technical production by Emma Harth, and this show was the BBC Wales and West production for Radio 4. BBC Sounds, music, radio, podcasts. 英語 Det är en bensinstation sväng in, tanka! Alltid till ett hårt pris.

Under miljontals år har djur utvecklat sofistikerade parningsritualer. Fåglar, dansar, vargar gular och åskar går in på Amazon. En Date Night Lasag. På Amazon hittar han levande ljus, lyxiga vinglas till fing pris och en extra tandborstad. デートナイトフォローヘンだ!