Tobacco Awareness

Tobacco comes in many forms including:

• cigarettes - most common type of tobacco product in Scotland.  They contain two main tobacco leaf varieties, fillers included stems and other waste products, water, flavourings and additives.  The additives are use to make the cigarette more palatable to the user.  There are over 600 different additives currently permitted for use in cigarettes in the UK such as moisturisers to prolong shelf life, sugars to enable the smoke to be more easily inhaled, flavours such as chocolate, vanilla and menthol.  These additives can be toxic when combined with other substances or when burned during smoking. 
• rolling tobacco - many people who smoke roll-ups don't use a filter, so they end up inhaling more tar and nicotine and therefore become highly addicted.  Roll-ups are at least as harmful for you as ordinary cigarettes and can cause the same health risks.  Research suggests that people who smoke roll-ups also have an increased risk of cancer of the mouth, oesophagus, pharynx and larynx compared to smokers of manufactured cigarettes.  
• illicit tobacco - this is tobacco that has been smuggled into Scotland illegally. This can be packaged to look like your regular brand. It can be either rolling tobacco or cigarettes. Whilst it may be cheaper than legal tobacco, it comes at a cost.  The ingredients of illicit tobacco aren't known or regulated. Whilst no tobacco is safe, illicit tobacco could contain higher levels of harmful chemicals.

Breathing in other people's smoke is known as exposure to second-hand smoke or passive smoking. When you smoke, it's not just your health that's put at risk, but the health of anyone around you.

Most second-hand smoke comes from the tip of a burning cigarette. This makes it almost impossible to direct smoke away from those around you. If you only smoke in one area of your home the harmful chemicals will spread rapidly from room to room and can linger for up to 5 hours. If you smoke in a confined space such as a car, you're exposing your fellow passengers to even more harmful chemicals. This is why smoking in cars with children on board has been banned in Scotland since December 2016.

Risks to other people

People exposed to second-hand smoke face the same dangers as smokers themselves. They too inhale the same poisonous gases and thousands of toxic chemicals found in tobacco smoke. Their risk of developing smoking-related diseases will also increase.

Pregnant women exposed to second-hand smoke will pass on harmful chemicals to their babies. Second-hand smoke is also particularly harmful for children, and others with long-term heart and/or breathing conditions.

Short-term effects

Some short-term effects from exposure to second-hand smoke include:

• coughing
• headaches
• eye and nasal irritation
• sore throat

Long-term effects

Long-term effects from exposure to second-hand smoke include increased risk of:

• coronary heart disease (risk increased by 25-30%)
• lung cancer (risk increased by 20-30%) and other cancers
• stroke (risk increased by 20-30%)
• increased risk of chronic obstructive pulmonary disease (COPD) and other breathing problems

Breathing in second-hand smoke makes the blood stickier, meaning there is an increased risk of blood clots forming, even with brief exposure. A blood clot can block an artery and cause heart attacks, strokes, angina and complete heart failure.

In pregnant women exposed to second-hand smoke, there is an increased risk of complications during the pregnancy and after the birth. The most likely risk is that your baby could weigh less than expected.

Risks to children

Children breathe faster than adults, which means they take in more of the harmful chemicals in second-hand smoke. They're even more sensitive to smoke than adults because their bodies are young and still developing.

Research shows that babies and children exposed to a smoky atmosphere are likely to have increased risk of:

• breathing problems, illnesses and infections
• reduced lung function
• wheezing illnesses and asthma
• sudden and unexpected death in infancy (SUDI)
• certain ear, nose and throat problems, in particular middle ear disease

There is also an increased risk of developing bacterial meningitis, bronchitis, pneumonia and acute respiratory illnesses.

Further information on the effects of second hand smoke can be found on Action on Smoking and Health (ASH) (opens new window) website

Take it Right Outside

The campaign gives people who smoke the facts, helping them understand how smoking indoors pollutes the air their family breathes and how they can take simple steps to make their home and car smoke-free.

With 85% of second-hand smoke being invisible and odourless, many are unaware that smoking indoors, even at an open window or standing at the back door, isn't enough to protect children, as the harmful chemicals linger and easily drift around the home.

Visit the Take it Right Outside campaign (opens new window) for quizzes, hints and tips on second-hand smoke.

Stopping smoking increases your chances of living a longer and healthier life. You'll feel the benefits from the day you quit. Not only will you to start to save money but you'll experience a reduced risk of:

• heart disease, stroke, vascular disease and respiratory disease
• a whole range of cancers

Your life expectancy will be greater, and you'll notice an improvement in the symptoms of smoking related diseases such as Chronic Obstructive Pulmonary Disease (COPD).

Stopping smoking can help you live life to the full. You'll feel fitter and more able to take part in physical activity. This in turn can benefit your mental health and wellbeing.

For more information on the benefits of stopping smoking, look on NHS Inform's stop smoking (opens new window) website.

E-cigarettes have been available for purchase for just over a decade in Scotland. They have become increasingly popular. Based on current evidence, vaping e-cigarettes is definitely less harmful than smoking tobacco.

There is still a lot we do not know about e-cigarettes. Although they contain nicotine, which is addictive, vaping carries less risk than smoking tobacco. It would therefore be a good thing if smokers used e-cigarettes instead of tobacco cigarettes, only as a potential route towards stopping smoking. Further research is required to understand the risks of e-cigarettes.

Will an e-cigarette help me stop smoking?

Many thousands of people in the UK have already stopped smoking with the help of an e-cigarette. There's growing evidence that they can be effective.

Using an e-cigarette can help you manage your nicotine cravings. To get the best out of it, make sure you're using it as much as you need to and with the right strength of nicotine in your e-liquid.

A major UK clinical trial published in 2019 found that, when combined with expert face-to-face support, people who used e-cigarettes to quit smoking were twice as likely to succeed as people who used other nicotine replacement products, such as patches or gum.

You will not get the full benefit from vaping unless you stop smoking cigarettes completely. You can get advice from a specialist vape shop or your local stop smoking service.

How safe are e-cigarettes?

In the UK, e-cigarettes are tightly regulated for safety and quality.  They're not completely risk free, but they carry a small fraction of the risk of cigarettes. E-cigarettes do not produce tar or carbon monoxide, two of the most harmful elements in tobacco smoke. The liquid and vapour contain some potentially harmful chemicals also found in cigarette smoke, but at much lower levels.

Are e-cigarettes safe to use in pregnancy?

Little research has been conducted into the safety of e-cigarettes in pregnancy, but they're likely to be much less harmful to a pregnant woman and her baby than cigarettes. If you're pregnant, licensed NRT products such as patches and gum are the recommended option to help you stop smoking.

But if you find using an e-cigarette helpful for quitting and staying smokefree, it's much safer for you and your baby than continuing to smoke.

Is e-cigarette vapour harmful to others?

There's no evidence so far that vaping causes harm to other people around you.

This is in contrast to secondhand smoke from smoking, which is known to be very harmful to health.

If you want to stop smoking, you can make small changes to your lifestyle that may help you resist the temptation to light up.

Think positive: You might have tried to quit smoking before and not managed it, but don't let that put you off.   Look back at the things your experience has taught you and think about how you're really going to do it this time.

Make a plan to quit smoking:  Make a promise, set a date and stick to it. Sticking to the "not a drag" rule can really help.  Whenever you find yourself in difficulty, say to yourself, "I won't even have a single drag", and stick with this until the cravings pass. Think ahead to times where it might be difficult (a party, for instance), and plan your actions and escape routes in advance.

Consider your diet:  Is your after-dinner cigarette your favourite? A US study revealed that some foods, including meat, make cigarettes more satisfying. Others, including cheese, fruit and vegetables, make cigarettes taste terrible. So swap your usual steak or burger for a veggie pizza instead.   You may also want to change your routine at or after mealtimes. Getting up and doing the dishes straight away or settling down in a room where you don't smoke may help.

Change your drink: The same US study as above also looked at drinks. Fizzy drinks, alcohol, cola, tea and coffee all make cigarettes taste better. So when you're out, drink more water and juice. Some people find simply changing their drink (for example, switching from wine to a vodka and tomato juice) affects their need to reach for a cigarette.

Identify when you crave cigarettes:  A craving can last 5 minutes. Before you give up, make a list of 5-minute strategies. For example, you could leave the party for a minute, dance or go to the bar. And think about this: the combination of smoking and drinking raises your risk of mouth cancer by 38 times.

Get some stop smoking support:  If friends or family members want to give up, too, suggest to them that you give up together.  Did you know that you're up to 4 times more likely to quit successfully with their expert help and advice?  You can also call the NHS Smokefree helpline on 0300 123 1044, open Monday to Friday, 9am to 8pm and Saturday to Sunday, 11am to 4pm.

Get moving:  A review of scientific studies has proved exercise, even a 5-minute walk or stretch, cuts cravings and may help your brain produce anti-craving chemicals.

Make non-smoking friends:  When you're at a party, stick with the non-smokers. 

Keep your hands and mouth busy: Nicotine replacement therapy (NRT) can double your chances of success.  As well as patches, there are tablets, lozenges, gum and a nasal spray. And if you like holding a cigarette, there are handheld products like the inhalator or e-cigarettes.  When you're out, try putting your drink in the hand that usually holds a cigarette, or drink from a straw to keep your mouth busy.

Make a list of reasons to quit: Keep reminding yourself why you made the decision to give up. Make a list of the reasons and read it when you need support.

If you want to stop smoking, several different treatments are available from shops, pharmacies and on prescription to help you beat your addiction and reduce withdrawal symptoms.

The best treatment for you will depend on your personal preference, your age, whether you're pregnant or breastfeeding and any medical conditions you have. Speak to your GP or an NHS stop smoking adviser for advice.

Research has shown that all these methods can be effective. Importantly, evidence shows that they are most effective if used alongside support from local stop smoking service (opens new window).

Nicotine replacement therapy (NRT)

NRT is a medication that provides you with a low level of nicotine, without the tar, carbon monoxide and other poisonous chemicals present in tobacco smoke. It can help reduce unpleasant withdrawal effects, such as bad moods and cravings, which may occur when you stop smoking.

NRT can be bought from pharmacies and some shops. It's also available on prescription from a doctor or NHS stop smoking service.  

There's no evidence that any single type of NRT is more effective than another. But there is good evidence to show that using a combination of NRT is more effective than using a single product.  Treatment with NRT usually lasts 8-12 weeks, before you gradually reduce the dose and eventually stop.

Adults, children over 12 years of age  (although children under 18 should not use the lozenges without getting medical advice first), pregnant women and breastfeeding women (although doctors will advise how to do this safely) can all use NRT treatments.  Always read the packet or leaflet before using NRT to check whether it's suitable for you.  

Sometimes it may be advisable to get medical advice first, for example if you have kidney or liver problems, or you've recently had a heart attack or stroke.

Possible side effects

Side effects of NRT can include:

• skin irritation when using patches
• irritation of nose, throat or eyes when using a nasal spray
• difficulty sleeping (insomnia), sometimes with vivid dreams
• an upset stomach
• dizziness
• headaches

Any side effects are usually mild. But if they're particularly troublesome, contact your GP as the dose or type of NRT may need to be changed.

Varenicline (Champix)

Varenicline is a medicine that works by reducing cravings for nicotine like NRT,  and blocking the rewarding and reinforcing effects of smoking.  Evidence suggests it's the most effective medicine for helping people stop smoking.

Varenicline is only available on prescription, so you'll usually need to see your GP or contact an NHS stop smoking service to get it.  It's taken as 1 to 2 tablets a day. You should start taking it a week or 2 before you try to quit.  A course of treatment usually lasts around 12 weeks, but it can be continued for longer if necessary.

Varenicline is safe for most people to take, except for children under 18 years of age, women who are pregnant or breastfeeding and people with severe kidney problems.

Possible side effects

Side effects of varenicline can include:

• feeling and being sick
• difficulty sleeping (insomnia), sometimes with vivid dreams
• dry mouth
• constipation or diarrhoea
• headaches
• drowsiness
• dizziness

Bupropion (Zyban)

Bupropion is a medicine originally used to treat depression, but it has since been found to help people quit smoking.  It's not clear exactly how it works, but it's thought to have an effect on the parts of the brain involved in addictive behaviour.

Bupropion is only available on prescription, so you'll usually need to see your GP or contact an NHS stop smoking service to get it.  It's taken as 1 to 2 tablets a day. You should start taking it a week or 2 before you try to quit. A course of treatment usually lasts around 7 to 9 weeks.

Bupropion is safe for most people to take, except for children under 18 years of age, women who are pregnant or breastfeeding, people with epilepsy, bipolar disorder or eating disorders

Possible side effects 

Side effects of bupropion can include:

• dry mouth 
• difficulty sleeping (insomnia)
• headaches
• feeling and being sick
• constipation
• difficulty concentrating
• dizziness

E-cigarettes

An e-cigarette is an electronic device that delivers nicotine in a vapour. This allows you to inhale nicotine without most of the harmful effects of smoking, as the vapour contains no tar or carbon monoxide.

Research has found that e-cigarettes can help you give up smoking, so you may want to try them rather than the medications listed above. As with other approaches, they're most effective if used with support from an NHS stop smoking service.

On average giving up smoking saves each quitter around £1500 per year.

Cashtray is an innovative health-promoting project launched by ASH Scotland which provides significant cash benefits for credit union clients and aims to:

• ensure that individuals enjoy the financial savings as well as the health benefits from stopping smoking
• boost promotion and marketing of credit unions and stop smoking services

How does it work?

• a cashtray account is an ordinary credit union account marketed jointly by a credit union and a local health board as a way for quitters to save money not spent on tobacco, after making the decision to stop smoking
• individual smokers, couples or families can all sign up for the account  
• account savers complete a savings plan setting out how often and how much of the money saved by not smoking they will deposit into their account and set a savings goal (e.g. holiday, Christmas gifts, new furniture or appliances)
• credit unions refer anyone interested in stopping smoking and setting up a Cashtray account to the local free stop smoking service for additional support.

Further information on a cashtray account is available on West Lothian Credit Union (opens new window) website, or by calling them on 01506 436666 or by drop into their premises at Unit 57a, The Centre, Livingston EH54 6NB - opposite Primark.

Always make sure to keep yourself safe whilst online. 

There are now more and more apps out there that can help with anything from managing your general wellbeing to those for more specific health concerns. Listed below are some apps to get you started. Whilst these apps can be useful, they are not a replacement for seeking medical advice, if you have concerns about any symptoms you are experiencing you should consult with your GP in the first instance.  

Please check the suitability of each App, and if there are any cost implications or compatibility issues. Whilst most of the apps listed below are free to download, please be aware of potential in-app purchases.

• Quit your way (opens new window): Scotland's free and friendly local stop smoking services can hugely increase your chances of having a successful quit attempt and staying stopped for good. The NHS provides pharmacy and local specialist stop smoking services.
• MYQuit Coach (opens new window) - a physician-approved app that gives you a personalised plan to help you finally stop smoking.  Available on iOS and android, free
• Quit Now (opens new window) - makes quitting easier by helping you focus your energy into four sections, your new ex-smoker status, a strong ex-smoker community, and your newfound health improvements. Browse frequently asked questions or ask the QuitNow! bot questions of your own.  Available on iOS and android, free
• Cloud9WLDAS (opens new window) - want to find out how much you have saved since you quit? Need some tips to help keep you going? Or just want to find out the facts on what smoking does to your health? This app will help with these.  Available on iOS and android, free

Disclaimer

The app developer is solely responsible for their app's advertisement, compliance and fitness for purpose. Unless stated otherwise, apps are not supplied by West Lothian Council, and West Lothian Council is not liable for their use.