Month: April 2023

Just 41 per cent of smokers are aware of less harmful alternatives to cigarettes.

A lack of clear information around less harmful cigarette alternatives is preventing more smokers from quitting, new research shows.

In a recent survey commissioned by British American Tobacco (BAT) and carried out by market analysts Kantar, 41 per cent of adult nicotine users in the UAE and Saudi Arabia were aware of how to reduce the harm imposed by smoking.

Data also showed 85 per cent of adult UAE smokers were open to switching to nicotine products such as vapes, compared with 35 per cent of smokers in Saudi Arabia.

However, a recent study by the US National Heart, Lung, and Blood Institute found long-term use of e-cigarettes can significantly increase the risk of cardiovascular disease.

“We continue to be clear that smoking causes serious health risks, and the only way to avoid these risks is not to start or to quit,” said BAT Middle East’s general manager, Alexandre Ghanem.

“For those who would otherwise continue to smoke, we encourage them to switch completely to alternative nicotine products with reduced risk potential compared to smoking, backed by robust science.

“This is in part driven by growing acceptance of the credible body of scientific evidence that confirms nicotine alternatives to smoking emit fewer and lower levels of toxicants compared to conventional cigarettes.

“With vaping in particular, the harm reduction potential is a fraction of the risk of smoking.”

Nicotine, which is found in both tobacco and e-cigarettes, has proven to be as addictive as cocaine and heroin.

Doctors said caution should be applied to e-cigarette use, due to their nicotine content.

“Vaping can be a good alternative to cigarettes provided the nicotine content in e-cigarettes is reduced,” said Dr Amal Louis, a consultant interventional cardiologist at Canadian Specialist Hospital, Dubai.

“Some vapes contain more nicotine than cigarettes and can be more harmful to the heart as it is the nicotine that has deleterious effect on the heart rather than smoke from burning.

Dr Louis emphasised that while nothing is burnt in vaping, the harmful effects of vapes on the lungs are yet to be known.

“The main concern is more and more teenagers and schoolchildren getting into vaping as vapes seem to be more attractive and a ‘cool’ option for teenagers compared to conventional cigarettes.

“Vaping can be part of a smoking cessation strategy if adopted cautiously with reducing dosage of nicotine in e-cigarettes.”

Developing alternatives

The global tobacco industry is aiming to reduce the health impact of its business, with several tobacco harm reduction strategies in place.

Methods include technology to develop healthier alternatives, such as e-cigarettes and heat-not-burn products that produce fewer harmful emissions, although they still contain highly addictive nicotine liquid.

BAT aims to encourage 50 million smokers to switch to non-combustible products by 2030, with 22.5 million consumers already making the transition, the company said.

“While the scientific consensus recognises that nicotine is not the primary cause of smoking-related diseases, misperceptions on nicotine still persist that perpetuate the idea that the nicotine alternative products such as vaping products are equally harmful or even more so than cigarettes,” said Mr Ghanem.

“We believe this is the result of a disconnect between science and public perception, which is one of the key challenges facing the acceptance of Tobacco Harm Reduction.”

Surge in use of smoking alternatives

A 2017 UAE Ministry of Health and Prevention Cancer Incidence report showed lung cancer was the third most common cause of cancer deaths.

There has been a huge spike in e-cigarette and vaping usage in recent years, with some countries adopting the products for their stop-smoking strategies.

Pregnant women in the UK will be offered £400 (Dh1800) in shopping vouchers as an incentive to quit smoking, while free vaping kits will be handed out to a million smokers to help wean them off cigarettes.

Meanwhile, in New Zealand, health officials have backed the potential of vaping products to help improve public health by offering a route out of cigarette use for the country’s 550,000 daily smokers.

According to market researchers Euromonitor International, e-cigarette users have increased globally from 7 million in 2011 to around 80 million in 2021. Mordor Intelligence’s Middle East & Africa E-Cigarettes Market report the region’s vaping market is forecasted to grow at a rate of 9.74 per cent from now until 2027.

However, these figures do not include youth vaping or illicit vapes sold illegally.

Despite its popularity, there are concerns over the uptake of vaping among young non-smokers, particularly teenagers in schools, which has been described as an ‘epidemic’ in the UK. Some schools have installed cameras and strict penalties for those vaping on school grounds.

“While vaping is a preferable alternative to smoking for adults, we are concerned about the rise in youth vaping, particularly the increasing use of disposable vaping products,” said UK health minister Neil O’Brien in a recent government release.

Industry regulations

The vaping industry is under pressure to self-regulate to keep devices out of the hands of children. It comes after watermelon-flavoured Elf Bars were found to contain at least 50 per cent more nicotine liquid than the recommended amount, which led to a temporary ban in the UK.

Relx International is another vape manufacturer that sells e-cigarettes across Europe, the UK and the Middle East.

Robert Naouss, Relx external affairs director for Mena and Europe, said the industry had a responsibility to ensure vapes are not used by children.

“We do not approach non-smokers, former smokers or underage consumers and we ensure people are of legal age in the countries in which we operate,” he said.

“We do not want to be targeting children, it is bad for business and unethical. I want to sleep at night.”

Relx is involved in the vaping sector’s first clinical research project.

Reviewed by the China Clinical Trials Registry and the World Health Organisation’s International Clinical Trials Registry Platform, the three-month study investigated the metabolic kinetics of nicotine in humans and the effects on human biomarkers, following the replacement of conventional cigarettes with Relx devices.

Meanwhile, the company’s Guardian Programme aims to market products to smokers over the age of 18 by using neutral packaging and conducting spot-checks on retailers.

“The e-cigarette industry in this region is still young, but many countries around the world have accepted that regulated vaping products are a better alternative to cigarettes,” said Mr Naouss.

“They do not burn anything, but they are not risk-free.”

Dr Gopal Chawla, a pulmonologist at NMC Speciality Hospital in Dubai said standardised vaping products would improve product safety.

“It is important to market vaping as an alternative to smoking and not as the beginning of something new,” he said.

“Various flavours are being used indiscriminately without the actual knowledge of their byproducts, which can be hazardous.

“There is a need for standardisation of vaping products because all that is available to us in the market is not entirely safe.”

Technology can help to plan complex operations and keep patients out of hospital.

From holographic surgical planning for complex procedures to predictive tools to keep patients out of hospital, artificial intelligence is playing a growing role in health care.

Robots may never replicate the human touch or the bedside manner required in the care profession, but the technology is helping medics become more efficient with their time.

AI algorithms can analyse data to identify population health patterns and offer insights to improve patient care and outcomes.

Experts say that as Al and data analytics play a bigger role than ever, digitalisation has the potential to transform care.

“Digitalisation has changed the face of the healthcare industry,” said Naser Al Riyami, chief operating officer at Burjeel Medical City in Abu Dhabi.

“It has improved access to care, enhanced patient engagement, enabled personalised medicine, and driven overall efficiency in healthcare delivery.

“Al and data analytics play a bigger role than ever in health care today.”

Meanwhile, mobile apps ease the appointment process, allowing patients to access reports, and help healthcare providers manage their conditions.

Holographic surgery

Since 2021, Burjeel Medical City has used holographic technology to improve surgical planning.

Holographic surgery is an FDA-approved system used to create replicated 3D images of a patient’s organs.

It gives surgeons greater insight into a patient before surgery, allowing them a new opportunity to familiarise themselves with the patient’s anatomy before surgery.

As part of its radiation oncology programme, the hospital also uses the ExacTrac dynamic patient positioning and monitoring system by German tech firm Brainlab, which combines surface, thermal and X-ray tracking technology to achieve pinpoint accuracy during treatment.

“AI algorithms can help us identify patients at risk of developing certain conditions, allowing for earlier intervention and treatment,” said Mr Al Riyami.

“In personalised medicine, AI algorithms can also identify patterns that can help healthcare providers customise treatments.”

Despite progressive steps, limitations have been found in some areas of health care.

In radiology, researchers at Hospital Cochin in Paris found the OpenAI ChatGPT interface gave incomplete or inaccurate answers to questions posed by interventional radiologists.

When asked for the treatment for bleeding after a Whipple procedure — a major surgery to remove part of the pancreas in cancer patients — the same procedure was reported three times, but with three different descriptions by the AI software.

Researchers concluded ChaptGPT and similar chatbot models were capable of generating coherent, grammatically correct text, but were unable to respond accurately to more specific, technical questions.

The findings were published in the Canadian Association of Radiologists Journal.

Elsewhere in the UAE, Prime Hospital is one centre to adopt AI to help manage patient flow.

It uses an AI global healthcare technology platform called Heaps to track deviations in a patient’s care to ensure the right interventions are made.

The system allows health professionals to monitor patients with chronic conditions and predict what could go wrong with their future care, so a more proactive approach is taken to keep them out of hospital.

“The primary objective is to reduce the rate of avoidable hospitalisation and repeat hospitalisation,” said Mohammed Hamid, regional head for Heaps.ai in the GCC and Mena.

“Traditional care co-ordination models are labour intensive and often build on manual processes.

“AI models provide a low-cost high effectiveness solution which allows organisations to expand their services and coverage elsewhere.”

While AI is efficient at analysing vast data sets of data, faster and more accurately than humans, it still lacks a humane qualities that are pivotal in healthcare.

Dr Mrudul Ramachandran, a specialist of internal medicine, at Aster Clinic in Arabian Ranches, Dubai, said incoming AI would make doctors stronger, more capable and efficient in terms of treating people, but the role of medical professional was far from obsolete.

“AI can be a smart assistant to a doctor, it cannot replace a human doctor,” he said.

“Compassion and empathy are two inevitable qualities a doctor must possess.

“Treating a patient involves being compassionate and empathetic to their emotional and physiological needs, AI as a technology cannot help in this case.

“It is not fool-proof. AI analyses data and interprets it based on the data sets on which the AI models have been validated.

“If the data set is biased or lacks quality – it might generate false results so AI cannot make a final judgement on the diagnosis.

“A doctor has to use his skills to confirm the diagnosis. AI can only support the process.”