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Young people who started using nicotine pouches during puberty were more likely to develop asthma and asthma symptoms, with the highest rates in females and those without smoking history

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To achieve this, there are several calls to action for NHS Trusts (although these go beyond inpatient settings and are relevant for all mental health services): ensure all frontline staff are trained in VBA on stopping smoking as part of NHS mandatory training (in line with NICE guidance) monitor uptake of VBA training amongst community mental health nurses and psychiatrists ensure that mental health professionals know how and where to refer patients to stop smoking support ensure that staff receive education and training about evidence-based interventions, including on e-cigarettes and stop smoking medications offer both combination NRT and varenicline to smokers, with behavioural support work with commissioners to seek adequate funding for the prescribing of stop smoking medicines in community mental health settings Mental health trusts should also consider how best to use e-cigarettes in acute settings to reduce the harm of smoking