AIBU to be surprised doctors ask about smoking but not vaping?

[CassandraWebb]

I've had a hospital stay and a few appointments recently because of breathing issues. We are pretty sure they are caused by my rare condition but understandably doctors want to check for other contributing factors.

One thing that has struck me is that they ask whether I smoke /have smoked but they don't ask about vaping. I don't do either but I had understood vaping can cause breathing issues and it's so prevalent now that I feel surprised they don't ask

I would imagine someone who vapes would answer yes to the question "are you a smoker?". I might be ignorant as I don't do either but I consider both smoking.

I would assume they are classed as one and the same for the purposes of a health questionnaire or doctors query.

You'd have to be incredibly pedantic or evasive to answer "No" because you don't buy Benson & Hedges, knowing fine well you puff away all day on your candyfloss vape.

Smoking covers vaping, most people would say they vape if asked about smoking, especially in a respiratory appointment. If you don't its your own stupid fault if you don't get the correct treatment

Totally with you OP. I suspect a young vaper who had never smoked would answer No to that question. DH is pretty senior in NHS - I’m going to ask what they ask in his hospital.

I don't think medics are as concerned about vaping as they are about cigarette smoke. I know some of my relatives definitely don't think they "smoke" but they do vape. It's not the same at all they say. Medics rarely ask if you smoke weed do they?

I used to complete health questionnaires with patients.

I used to say something along the lies of 'Have you ever smoked including cigarettes, vapes, marijuana or any other tobacco products?'. For vapes, I'd clarify if it was with nicotine or not. I agree with others though, it should be clear what is being asked, because some people see vaping as smoking, whereas others wouldn't.

Might be practice-specific? It doesn't matter what reason I go in to see my GP or practice nurse, the first thing they ask is am I still not smoking or vaping, and what is my weight. Every single time.

I agree with you OP. I was asked if I smoked I'd say no. I used to smoke, I now vape, and the experience of both is very different. With smoking you can feel irritation, a cough etc. with vaping you feel the same whether you've recently vaped, vape less or more recently etc. I'm not saying vaping isn't harmful but it doesn't feel harmful so lots of people see the two things very differently. I would probably volunteer that I vape but i wouldn't answer yes to smoking.

I have vaped and never smoked. I would still answer no to ever having smoked. I have never used nicotine. If its important to someone that they know I have vaped, they would need to ask me specifically as I think of them as different things entirely.

My relative (a proper cynic!) says he never tells medics he smoked when younger or that he vapes occasionally now. His theory is that no matter what the heck is wrong with you, the medics immediately blame the cigs/vapes and often don't consider much else! Well of course they do, but that's his theory anyway, and all his chest x rays, bloods etc. are clear these days at 70 yrs old.

He's not giving up the vapes at this stage he said. And honestly.... I don't blame him either.

I had an app the other day and the nurse asked if I smoked of vaped.

Most patients who vape tell me they do so when I ask about smoking. I've never thought to ask separately about vaping because I consider it under the same umbrella as smoking, as do friends who vape.
It's an interesting point; might consider asking separately in future.

You know, they have a script, just like telephone pests, they have a script. OSCE exams at med school - they train them to ask all the relevant questions in a short amount of time and this is all learnt by rote, no room for brain work, they use a script, one for COPD, one for arrhythmia, etc., etc. Everything is scripted. They are timed as well! Like a Japanese factory in the early 1980s (I saw documentaries). So one day they will send them a new script, only this time for adults, not students - NICE guidelines and they will start asking about vaping.

I know plenty of people who have given up smoking and taken up vaping. To the question "do you smoke" they would answer "no, I've given up."

Yes I know people who say they don't smoke but they have a vape needing surgical removal at their mouths the whole time. I think vaping is disgusting but surprised the op did not get asked also as it is very harmful too.

True, but there are far more disgusting things going on to get riled up about these days IMO.

Not you.... but there are some permanently offended people out there!

When I was vaping after quitting smoking every time I filled in a healthy questionnaire and was asked about smoking I said I don't smoke but I do vape and the HCP would always tell me to tick "No" then. It was the same in maternity services when I was pregnant, they said they don't class vaping as smoking.

Mine does. I have chronic asthma and during my reviews, I’m always asked if I smoke and/or vape. (I don’t and never have.)

I’ve been told that I’d be surprised of the number of people who deny smoking, but vape heavily. Hence, why my medical practice tend to specify both smoking and vaping.

I guess its partly because doctors have to follow data in their recommendations: there’s a huge body of clinical evidence establishing that smoking tobacco is bad for pretty much every aspect of human health.

With vapes its logical to assume they are harmful and there is some data linking them with health issues but its fairly preliminary and we don’t have enough long term data to confirm this. (Also if history is a guide the companies making vapes and ecigarettes will be doing their damndest to stop this making its way into the public domain.

It takes a while to build that evidence base and the NHS moves at the pace of a constipated dinosaur so it probably hasn’t made its way into the pathways yet.

I might be wrong and I would be interested to hear what medics say.

"they don't class vaping as smoking"
As an ex smoker now vaper this has been my experience too, with GPs, hospital Drs, in fact all clinical staff, vaping not classed as smoking.

That’s pretty shocking. You would think they could build in a bit of awareness of the nuances here.

Hotel rooms say no smoking or vaping - so they differentiate!

The app we use in the hospital I work in asks if patient’s smoke, it doesn’t ask about vaping and there is no where to add it. 🤷🏻‍♀️

I reckon they haven't distinguished it yet because vaping is steam + flavour and often nicotine. As a drug nicotine is not dangerous, but addictive. I suppose there will be a pile on now to say how bloody awful they are. That's not the point, the steam/vapour might be annoying to the point of madness, but the effect of vapes in the user is not seen as dangerous YET!

I'm on the fence, as I would much prefer to see my relative vaping for example than crawling the walls in withdrawal from fags and eventually taking up cigarettes again.

It's an ongoing debate. I personally don't mind them, there are worse things people can do around me and until they are banned I live and let live.

I wouldn't assume smoking included vaping if not explicitly stated.

I'd also assume it was because vaping isn't recognised as a health risk in the same way as smoking tobacco is and so data isn't being collected on that.