I’ll say it again: E-cigarettes are still far safer than smoking

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Despite evidence suggesting e-cigarettes are far less harmful than smoking, more people than ever believe them to be just as harmful. Professor Linda Bauld discusses the evidence

January is a time for New Year’s resolutions and if you’re one of the world’s one billion smokers, your resolution may be to stop smoking. For some people, this year’s quit attempt might involve an electronic cigarette, and a recent study in England, published in the BMJ, suggested that these devices helped at least 18,000 smokers to stop in 2015 who would not otherwise have done so. That’s very good news, but will there be as many quit attempts in 2017 as there have been in the past with e-cigarettes? I’m not so sure.

Since I last wrote about e-cigarettes in this column one year ago, headlines about the dangers of these devices have continued to appear and show no sign of abating. The result is clear. More people believe today, compared with a year ago, that e-cigarettes are as harmful as smoking. In fact these incorrect perceptions have risen year on year, from fewer than one in ten adults in Great Britain in 2013 to one in four this past summer. Surveys of smokers show similar patterns, with an increasing proportion believing that e-cigarettes are more or equally harmful than tobacco.

Related: Why can’t scientists agree on e-cigarettes?

Related: Does a tobacco-free world need to be nicotine free?

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I’ll say it again: E-cigarettes are still far safer than smoking

My cancer diary: ‘That was a hell of a wake – I hope I’ll remember it for years’

Tuesday 15 November

After four days of in-patient treatment – intensive rehydration, intravenous antibiotics and two units of blood, not to mention so many blood tests that “find the vein” became an almost full-time staff pastime – I’m feeling much better. So now back at the Royal Marsden [specialist cancer treatment hospital] for blood tests ahead of what I hope will be more chemotherapy treatment on Thursday.

And good news! Blood pressure’s up and stable; platelets and white blood cells all well within safe range – so all clear for treatment. This is quite a relief, and I’m sure I’m not the only cancer patient – or physician, for that matter – who feels this, but having to miss treatments is frustrating and a bit of a worry. The fear being that as treatments are skipped, the cancer and its offshoots will regain ground, thus making them harder to treat further down the line. Anyhow, none of that this week!

Thursday 17 November

Having missed a week of treatment, whereas this should’ve been a double drug week – paclitaxel on the NHS, and ramucirumab up in the private patients’ “suite” – in fact, as we’re in what is in effect now week two in the cycle, it’s NHS paclitaxel only.

Infusion goes well – once they’d found a vein for the cannula (the rather clever device through which infusions are delivered into veins). With the cold cap applied I still live in hope that I won’t lose my hair. And what a relief to have actually got another round of treatment!

Friday 18 November

In Manchester today for an appearance on BBC Breakfast’s sofa at an outside broadcast they’re doing to mark the end of a series of reports on cancer – one of which, as I think I mentioned before, featured me and a conversation with my old friend Nick Robinson about how to discuss cancer with family, friends and the world beyond. The programme came from the Maggie’s centre at the Christie hospital. Maggie’s centres are there for people with cancer – and others affected by it: carers, family, friends etc – to drop in for help, advice or just a chat.

It was heartening to meet other people living with cancer – and a great coming-together moment when the presenter tried to tell three of us we had “terminal” cancer, which was met with a good humoured but unanimous raspberry. The only certainties in life are, as they say, death and taxes, and so it is when you’ve got cancer. I might have weeks, months, years or even a full lifespan ahead of me. I know I’ve got advanced cancer and well recognise that changes the odds considerably – but I’m not out yet and neither were any of my fellow contributors.

I was asked one question, though, which really made me think. Why had I decided to be so public about my cancer? Which as I sat in the Maggie’s centre did make me think about how privileged my position is compared with so many others with cancer diagnoses.

First, I’m a journalist and so have a way of approaching my own disease which interests and engages me as a story in its own right and – as any journalist will attest – once you’ve got a story, the urge to tell it is almost irresistible. Second, I have access to ways of telling it both on the radio and in print. And third, I’m not 35 and still building a career or in the dating game or running my own business where I’m the key business winner. Who would want to tell a prospective boss or date or client about a diagnosis like mine? Nor am I facing a relationship breakdown by revealing all – you don’t exactly make yourself an investment by telling people you’ve got cancer.

For me, by contrast, there is virtually no downside. I suppose what I’ve realised is that for many people, that’s just not the case. So there is a long way to go in terms of society in general coming to terms with the realities of cancer – after all, Cancer Research statistics suggest that one in two of us will get it at some point in our lives.

Tuesday 22 November

Back to the Marsden today for blood tests ahead of treatment on Thursday – I hope! I’ve been feeling generally OK, although pesky kidney stones have been back. Unfortunately, the tests show that my platelet count has dropped again and so has the level of the white blood cells – critically important to fighting infections.

My consultant, Dr Starling, appears even more fed up and disappointed than me, especially because there are some very early signs – no symptoms from the main tumour at all, improved liver function and other markers showing positive – that might suggest the new regime is working on the cancer. Trouble is, it might also be rendering me unable to safely receive it. Consultant wondering – but really hoping not – whether I might be in the 2% of people (yes, 2%) to whom the drug paclitaxel appears to do this. Naturally I am with her on this!

So treatment on Thursday now looking unlikely. More self-injections to promote white blood cell production prescribed, and more blood tests (we really are running out of veins) booked for early Thursday morning …

Wednesday 23 November

Up at 6.15 to prepare for The Media Show. But, to be honest, the kidney stones are killing me, the medication can make one a bit dopey, and I’m feeling pretty fatigued. So 7am speak to producer, who takes the news brilliantly well and sets out to find a stand-in presenter. I always feel bad doing this but BBC Radio has been really brilliant about it, and I guess if I did present a programme and made a hash of it I’d feel quite a lot worse.

Thursday 24 November

Back at the Marsden. Blood results not great so definitely no treatment today. Another date missed and more of the frustration and underlying issues to worry about. But a platelet infusion later and it’s onwards and upwards!

Friday 25 November

Months ago I agreed to a request from the Media Society – and the London Press Club and the Royal Television Society – to consider participating in an evening looking at my career. Flattering and hard to turn down in many ways but weirdly like an invitation to my own wake. With the help of BBC Radio they managed to get the historic Radio Theatre at Broadcasting House, home to so many BBC comedies and performances. And the event is tonight!

It is framed as an interview between me and Roger Bolton, presenter of Radio 4’s Feedback but a TV executive of many, many years’ experience who once upon a time as editor of Nationwide gave me my first proper job in telly. Well, 300 guests and a packed Radio Theatre beckoned – and, I should say, with every likelihood of a £2,000-plus donation to the Marsden charity. But what had I let myself in for?

Back at the Marsden again, the platelet count had improved but there was no significant movement on the white blood cells and the amazing Dr Starling was actively worrying about whether I should even do the Radio Theatre event. Ultimately she relents, and with a very strict set of instructions – get a cab there and back, stay away from anybody with a cough or cold, and if you get a temperature or even feel just really off, call the emergency helpline immediately – gives me her blessing.

Audience reaction was truly amazing and utterly humbling. As wakes go, it’ll be one to remember – which I trust I will for many years to come!

To donate to Maggie’s centres, visit maggiescentres.org

My cancer diary: ‘That was a hell of a wake – I hope I’ll remember it for years’

I"m 43 and schizophrenic. According to the statistics, I"ll be dead in 17 years | Joshua Gliddon

You’ve got a choice. You can either buy cigarettes, or get food to see you through the week. For most people it’s a no-brainer. Of course you’d buy food. But if you’re suffering from schizophrenia, living on the disability support pension and facing other psycho-social challenges, then the choice isn’t so clear.

“Some of my patients will choose cigarettes over food,” my clinical specialist nurse told me. “They also drink huge amounts of coffee. I’ve even seen people eating dried coffee from the tin.”

So what’s going on here? I’m schizophrenic, and aside from dealing with the symptoms of the illness, there’s another statistic which I’m struggling to come to grips with. People with schizophrenia tend to live between 14 and 20 years less than the general community.

Every year, 9,000 Australians with a serious mental illness will die prematurely. We face higher incidence of diabetes and cardiovascular disease, very high levels of unemployment, and many of us are in temporary housing. It’s not a good mix.

I’m also 43. The average life expectancy for a non-indigenous Australian male is around 80 years, a bit longer for women. I smoke, and weigh more than I should. According to the statistics, I’ve got about another 17 years left in me. That’s quite sobering.

Professor Amanda Baker, a senior researcher at the National Health and Medical Research Council (NHMRC) specialising in schizophrenia, told me there are a number of reasons why people with schizophrenia have reduced life expectancies. The big ones are poor lifestyle, unemployment and social isolation. She said that around 85% of people with schizophrenia smoke, compared with approximately 20% of the general population.

One of the main reasons people smoke, she said, is that the medications used to treat the illness are often sedative and dulling, and so people use tobacco and caffeine heavily because they’re stimulants.

The medications also have other side effects. For reasons that aren’t entirely clear, the anti-psychotics used to treat schizophrenia have a negative effect on metabolism. When I was first put on Olanzapine, a potent anti-psychotic, I put on about 25 kilos in a matter of months. I’ve moved onto a different medication since then, but it’s also weight unfriendly, and despite doing moderate exercise, I’ve never been able to shake the weight I gained.

According to Baker, until recently there wasn’t a lot of attention paid to the physical health aspects of serious mental illness. Clinicians didn’t discourage patients from smoking because there was a pervasive attitude that you “don’t upset the schizophrenics.”

Not so long ago it was also OK to smoke in psychiatric institutions. Public facilities have clamped down on that, but smoking is still common in private hospitals.

Is there anything that can be done?

“People with schizophrenia are generally more dependent, and have less coping skills than the general population, and that makes it very hard for them to give up or make lifestyle changes,” Baker said.

So the initiative needs to come from both patients and their care team. While psychiatrists in the past were only focused on medication and the mind, these days, said Baker, they are being encouraged to have a wider view of their patient’s health, both physical and mental.

What needs to happen is a greater focus by clinicians on the overall wellbeing of their patients. Baker said this is finally occurring.

“Psychiatrists are being encouraged to look after the physical, as well as mental health of their patients, and that means addressing smoking, as well as diet and exercise,” she said.

That’s a good start, but for the meantime, people with serious mental illnesses like schizophrenia will continue to die young. And that is a major downside of being sick.

I"m 43 and schizophrenic. According to the statistics, I"ll be dead in 17 years | Joshua Gliddon

The Positive aspects of Wholesome Smoothies: I’ll Drink to That

If you want to keep hydrated, assist your digestion and load up on nutrients, the reply is basic: drink a smoothie. Whether you sip a fruit or vegetable smoothie, or a blend of the two, you’ll be offering your physique a fantastic enhance no matter what time of day. Whilst fruit smoothies may sound a lot more attractive, it is crucial to consider that they’re chock total of sugar if they’re enjoyed alone. You will get a lot more well being positive aspects if you add some veggies to the blender, since all veggies are rich in antioxidants.

In truth, green vegetable smoothies — with a handful of fruits mixed in for good measure — are becoming more and more well-liked, and not just with athletes. That’s largely simply because they are high in the two nutritional vitamins and minerals. Plus, because the veggies are raw when they’re pureed, much of the healthful fiber is still intact, which is good for all facets of your digestion.

How to Make a Healthy Smoothie

All vegetables offer you distinct health advantages, so commence by considering what vitamins or minerals may be ideal for you. Spinach is usually a excellent base, as its flavor isn’t overpowering. Then start off including veggies you like. Soon after all, there’s no sense in incorporating greens you do not take pleasure in consuming when cooked, because probabilities are you won’t get pleasure from them in a raw smoothie either.

Parsley, cucumbers and kale all work well in a smoothie, as do edible wild plants and other seasonal veggies. To mix up the color — which will assist you consume a lot more nutrients — fluctuate the colours of your veggies maybe add carrots and beets, each of which are packed with substantial-value nutrients. An additional consideration when creating your smoothie is to use really little, or avoid, greens that have powerful taste profiles, this kind of as celery these veggies tend to overpower the taste of your drink. Rather, emphasis on a couple of important veggies so the taste is not as well far out in left discipline.

Although smoothies are largely healthy, just as any meals, as well a lot of a single point can be detrimental. To keep away from any abdomen upset, switch up the kinds of veggies you use one way to do this is to use seasonal vegetables in your smoothies. In addition, speak to your care supplier. If you have had kidney stones, you will want to reasonable the amount of swiss chard and raw spinach you eat, whether or not in smoothies or not, due to the fact of the oxalates located in the raw versions of these vegetables.

Even so, really do not allow individuals information deter you from getting creative with your smoothie. Whilst vegetable smoothies may well not sound all that interesting, they can be, specially if you tinker with the taste combinations. Adding protein powders — slowly, to stay away from a frothy smoothie — can thicken the drink. Greek yogurt can also make the smoothie creamier and far more drinkable.

Placing fruits in your green smoothies can also make them far more satisfying. Plus, you can heighten the volume of nutritional rewards in your drink by combining each veggies and fruits. That is due to the fact while a lot of veggies are packed with insoluble fiber that support with constipation, only a handful of fruits, like apples and citruses, have insoluble fiber. Rather numerous fruits, in addition to peas, lentils and seaweed, contain soluable fiber that assists you really feel total. Some fruits high in this variety of fiber incorporate mangos, blueberries, bananas, peaches, strawberries, melons, and pears. Not only do they amp up the overall health advantages, but they can make your drink creamier as properly.

By incorporating these fruits to your smoothie, not only will you be more likely to finish your drink, but you will also be much less inclined to consume much more, whether it’s for breakfast, lunch or just a snack. In that way, healthier smoothies can be wonderful as meal substitutes — as lengthy as they include the proper variety of fiber.

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The Positive aspects of Wholesome Smoothies: I’ll Drink to That