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Health and safety information on Electronic cigarettes / vapourisers / vape sticks use. Smoking tobacco is a major risk to health with half of all long term users killed by their addiction. Electronic cigarettes (e-cigs) are not cigarettes. They do not contain tobacco and using them is not smoking. They are proving attractive to smokers as are a safer alternative to cigarettes. E-cigarettes are significantly less harmful than tobacco cigarettes but are not harmless. Their long term health impact is unknown. They are not currently licensed for prescription. Once the EU Tobacco Products Directive (TDP) comes into effect in May 2016, e-cigs containing over 20mg/ml of nicotine will have to come under the TDP. Above that level such products will require authorisation by the Medicine and Healthcare Products Agency (MHRA) in the same way as nicotine replacement therapy (NRT). There has been a significant increase in the numbers of smokers and ex-smokers using these products in the last 12 months. WHAT IS AN ELECTRONIC CIGARETTE or VAPE STICK? An e-cigarette consists of three components: a battery, an atomiser and a cartridge or ‘tank’ containing the nicotine liquid called e-liquid or e-juice. The liquid nicotine is suspended in propylene gycol or glycerine and water. The level of nicotine in the cartridges may vary and some also contain flavourings. When a user sucks on the device, a sensor detects air flow and the battery heats the liquid through a small heating element in the cartridge causing it to evaporate. This vapour then delivers the nicotine and flavours to the user. First generation electronic cigarettes (often called “Lookee, Likee’s”) were usually designed to simulate tobacco cigarettes in their use and appearance. Newer second or third generation electronic cigarettes often called mods, PV's (personal vaporizer) or APV's (advanced personal vaporizer) have an increased nicotine-dispersal performance, housing higher capacity batteries, and come in various shapes. These are reported as being more effective nicotine delivery systems and a more pleasant user experience. AGE RESTRICTIONS: These devices are not yet covered by any age restriction legislation, although Trading Standards would recommend as best practice that retailers do not supply these to persons under 18 years of age and manufacturers should voluntarily state on the product label that the items should not be sold to under-18s.There is clear government intention that these products should not be sold to under 18’s. NICOTINE WARNINGS: Tobacco and carbon monoxide kill people, nicotine keeps them smoking as it is addictive. It can, however, be used to help people stop smoking. Nicotine is classed as a poison in its pure form and, if ingested in high enough doses, can kill. It is toxic in contact with the skin in high concentration. It should be supplied in a clearly labelled, child resistant package and stored out of the reach of children and pets. MEDICATIONS and MEDICAL CONDITIONS: Quitting smoking with or without a licenced medical product or an e-cigarette can cause changes affecting a medical condition or in medication levels. These changes are generally very positive for health in the long term, but may need extra monitoring and support initially as the client’s body adjusts to the lack of tobacco and falling nicotine levels. On stopping smoking, some drugs may need their levels increasing initially to ensure therapeutic range, whilst others may need to be reduced. Some drugs may even need to be stopped. Smokers who Are pregnant Have a pre–existing medical condition Are going into hospital or have just come out of hospital Are on any prescribed medication are more vulnerable and are strongly advised to seek advice and support from an NHS Stop Smoking Service Adviser. PLEASE TURN OVER FOR FURTHER HEALTH AND SAFETY INFORMATION Quit4life/ shareddrive/ Ecigs June 2014 /Quit4Life E Cig Health and Safety information June 2014 Health and safety information on Electronic cigarettes / vapourisers / vape sticks use. USE WITH HOME CARE OXYGEN: Recent reports are indicating that there could be a risk of an ignition and fire with an electronic cigarette whilst a patient is undergoing home oxygen therapy, due to the heating element and power source getting saturated with oxygen. Electronic cigarettes should not be used or their batteries charged in the vicinity of a patient on home oxygen. ALLERGIC REACTIONS: Some e-cig users have experienced mild to more severe allergic reactions such as sore throat, itching, diarrhoea and muscle pains. This is possibly due to allergic reaction or sensitivity to the Propylene Glycol (PG) or an ingredient in the flavourings which can be nut based. If there is a known allergy to nuts or sensitivity to cosmetic products; client should look for nut free flavourings and ask their supplier about Vegetable Glycerin (VG) liquids. Stop using the product and see Doctor if symptoms get worse or they are concerned. BATTERIES AND CHARGERS: Faulty batteries and chargers, and those used inappropriately, can and have caused explosions and fires. Users and staff should be aware of the risk of the potential fire hazard when using or recharging. E-cigarettes batteries should not be recharged in NHS premises or vehicles E-cigarettes should not be used in an oxygen rich environment Safety advise should be given to patients using them at home - NEVER leave batteries unattended when charging Discontinue using a battery if it fails to retain a charge or looks damaged in any way Dispose of safely and according to regulations FURTHER INFORMATION: For further information on specific e-cigarettes, enquiries should be directed to the relevant manufacturer or supplier. For further general information on e-cigarettes and smoking see: Southern Health NHS Foundation Trust: Smokefree Policy 2013. SH HR 37 Hampshire County Council Trading Standards Advice: http://www3.hants.gov.uk/tradingstandards/product-safety/electronic-cigarettes.htm ASH Action on Smoking and Health www.ash.org.uk NHS STOP SMOKING SERVICE SUPPORT: Ideally speak to your local Quit4Life NHS Stop Smoking Service Adviser or a medical practitioner before using an e-Cigarette, and if using one to quit tobacco smoking. The additional behavioural change support provided freely by Quit4Life will increase chances of quitting smoking and staying quit safely if clients use an e-cigarette or any other medication. Quit4life/ shareddrive/ Ecigs June 2014 /Quit4Life E Cig Health and Safety information June 2014