Taking prescription opioids for too long can be harmful. Here’s how to cut back and stop

Source: The Conversation – Global Perspectives – By Aili Langford, Pharmacist, Lecturer, NHMRC Emerging Leadership Fellow, Sydney Pharmacy School, The University of Sydney, University of Sydney

Maskot/Getty Images

Opioids, such as oxycodone, morphine, codeine, tramadol and fentanyl, are commonly prescribed to manage pain. You might be given a prescription when experiencing pain, or after surgery or an injury.

But while opioids may relieve pain in the short term, they provide little to no lasting improvement in pain or function beyond a few weeks for people whose pain isn’t caused by cancer.

Opioids can also cause side effects such as nausea, constipation and drowsiness, as well as serious risks such as dependence and overdose.

Over the past decade, Australia has introduced initiatives to reduce opioid use and related harm. This includes new guidelines that recommend reducing the dose or stopping opioids when the risks of continuing outweigh the benefits.

Many people can reduce or stop opioids without their pain worsening. Some people even experience less pain. However, for some people, reducing or stopping opioids can result in worse pain, mental health crises and even suicide.

Our new research, published today in the New England Journal of Medicine, explains how to safely reduce and stop taking prescription opioids.

How do you know when it’s time to stop? Then what?

Determining whether it is appropriate to reduce or stop opioids depends on several factors unique to each person. These include:

  • why opioids were prescribed
  • how long they’ve been used
  • what other treatments you’ve tried
  • how the medication affects your pain, function and quality of life
  • your life circumstances.

If it’s appropriate to trial reducing or stopping opioids, guidelines from Australia, the United Kingdom and the United States emphasise the following principles:

1) Shared decision-making

Shared decision-making is where health-care professionals and patients work together to set goals, weigh risks and benefits, and make informed choices.

This means collaboratively designing an opioid reduction plan that reflects the person’s needs, preferences and circumstances, rather than imposing a one-size-fits-all approach.

Research shows shared decision-making may lead to better outcomes, and patients value this process.

2) Reduce gradually

Stopping opioids suddenly can cause withdrawal symptoms such as anxiety, insomnia, and stomach upset. Rapid dose reductions can also increase the risk of overdose, mental distress and suicide.

To avoid these risks, opioids should be reduced gradually over weeks, months or even longer. The process should be flexible, allowing for pauses or adjustments to the reduction plan if needed.

When someone takes lower doses of opioids over time, their body’s tolerance decreases. If they return to a higher dose, there is a risk of overdose. For this reason, health-care professionals may recommend having naloxone available. This is a medication that can reverse an opioid overdose.




Read more:
Naloxone can reverse opioid overdose. Here’s why you might need some at home or in your bag


3) Set up other supports

Supportive strategies should be used before, during and after reducing opioids. These can include:

  • physical therapies such as physiotherapy
  • psychological approaches such as mindfulness
  • non-opioid medications
  • mental health support from health-care professionals, friends and family
  • education about pain self-management.

The evidence supporting specific interventions is often limited or uncertain. Choosing a strategy will depend on your individual preferences and access. The best approach is likely a combination of several different supports.

4) See your health-care provider for ongoing monitoring

Regular monitoring from a health-care professional is recommended during and after opioid reduction to assess pain, function, withdrawal symptoms and wellbeing.

This can help to ensure that any issues are identified early and are addressed.

If someone experiences a clear decline in their quality of life, for example, it may be necessary to pause or stop the taper and revisit it later, provide extra supports or implement strategies to manage withdrawal symptoms.

We need a health system that supports this process

Making opioid reduction safer and more effective requires putting these principles into practice. But many patients and health-care professionals still face challenges when doing so.

It’s best practice to access a team-based pain management program with support from a doctor, physiotherapist and psychologist, among other providers, to manage pain and reduce the use of opioids. But access to these services remains limited in many parts of Australia.

Physio works with patient in a clinic
Not everyone has access to team-based pain management.
Hispanolistic/Getty Images

Consumer organisations and professional bodies have called for greater access to team-based pain services so more people, especially those living in rural and under-served areas, can access support.

Australian health-care professionals have also requested more education and training in pain management, prescribing and opioid reduction, as well as stronger evidence about what works, for whom and why. This is so they’re better able to tailor their care to each person’s needs.

Other strategies such as reducing the amount of opioids prescribed – including after surgery – have also been proposed to help prevent long-term opioid use and the need for reduction plans later on.

The Conversation

Aili Langford receives funding from the Australian National Health and Medical Research Council through an Investigator Grant Fellowship. She sits on the Executive Committee of the Australian Deprescribing Network (ADeN). This is an unpaid volunteer role.

Christine Lin receives funding from the National Health and Medical Council and the Medical Research Future Fund. She is a member of the Australian Physiotherapy Association and Fellow of the Australian College of Physiotherapy.

ref. Taking prescription opioids for too long can be harmful. Here’s how to cut back and stop – https://theconversation.com/taking-prescription-opioids-for-too-long-can-be-harmful-heres-how-to-cut-back-and-stop-265874

Do you speak cat? Take this quiz to find out

Source: The Conversation – Global Perspectives – By Julia Henning, PhD Candidate in Feline Behaviour, School of Animal and Veterinary Science, University of Adelaide

Katelyn G/Unsplash

While often miscast as mysterious or hard to understand, cats are actually excellent communicators. In fact, in free-ranging cat colonies, physical fights are kept to a minimum through clever use of body posturing, scent exchange and vocalisations.

Cats have also adapted their communication for humans. For instance, adult cats don’t usually meow at each other. But when around people, cats meow a lot, suggesting they have adapted this vocalisation for communicating with humans.

And it’s not just the meow. Cats have a wide vocal repertoire for conveying different meanings, even for specific people. Bonded cats and humans often develop their own communication repertoires, similar to having a unique dialect.

Cats can understand human communication too. Studies show cats know their own names and the names of their companions, and can recognise human emotions, even changing their own behaviour in response.

Despite all this, humans still routinely misunderstand cats. Our new study, published in Frontiers in Ethology, shows just how little people understand the cues cats give. Try the quiz below to see how well you speak cat.

What we did

We asked 368 Australian participants to watch videos of human–cat play interactions. But not all the videos were “play” for the cat. Only half of the cats were playing, while the other half were actually showing signs they didn’t want to play, or were feeling stressed by the interaction.

After each video, participants were asked if they thought the interaction was overall positive or negative for the cat, based only on the cat’s behaviour. They were then asked how they would interact with the cat in the video they had just seen.

How well do you speak cat?

Watch the short videos below and decide: is the cat feeling positive or negative about the interaction? Remember to base your answers only on the cat’s behaviour.

What did our study find?

Results showed that participants struggled to recognise negative cues indicating discomfort or stress in cats.

For videos of cats who weren’t playing and were showing subtle negative cues (such as sudden tension in the body or avoiding touch), participants only recognised the negative cues about as well as chance (48.7%).

Even when participants watched videos of cats showing overt negative cues like hissing, biting or trying to escape, they still incorrectly categorised these as positive 25% of the time.

Recognising when a cat is stressed is only the first step. We also need to know how to respond to these cues.

Even when participants did successfully recognise negative cues, they often chose to engage with the cat in ways that would cause more stress and increase the risk of human injury, such as stroking, belly rubbing and playing with hands.

A man in a summer outfit on a street pats a friendly cat who is wearing a collar.
Cats are excellent communicators – you just need to know the signs.
Micky White/Unsplash

Stress is unhealthy

Stress can have serious consequences. Cats who experience regular or prolonged stress (including from unwanted interactions like those in the negative videos) are at higher risk of heath issues such as bladder inflamation.

They’re also more likely to develop behaviours people find problematic, such as increased aggression or urinating outside of the litter tray. In turn, these behaviours increase risk of the cat being euthanised or rehomed.

Cat stress is bad for humans, too. If a person doesn’t heed early warning signs, the cat may bite or scratch, depositing bacteria and microorganisms deep into the skin. Rapid infection follows 30%–50% of cat bites. If not treated promptly, it can lead to serious complications including sepsis, chronic health issues and even death. Cat bites and scratches can also transmit zoonotic diseases such as cat scratch disease.

A calico cat getting hugs and pats.
Cats are less stressed when they’re not having to deal with unwanted interactions.
Fuzzy Rescue/Unsplash

How to play safely with cats

Watch for early warning signs a cat isn’t enjoying themselves and stop if you notice any. By the time cues are obvious, cats are already experiencing distress.

Early warnings include turning away, dodging or blocking attempts to touch, flinching, body tension, ears back or to the side, lip/nose licking and tail thrashing, slapping or tucking.

Touch

Avoid sensitive areas such as the belly, paws or the base of the tail. Cats prefer to be touched on the head and neck.

Avoid using hands to play. It teaches cats that hands are toys, and increases the risk of accidental injury. Instead, use toys that keep your face and hands away, such as a wand toy with a long handle.

Tail

Tail movements aren’t always a negative sign – they just mean the cat is emotionally stimulated and that could be from stress or excitement. Cats also use their tails for balance. So it’s best to consider the tail in combination with the whole body and the context.

Changes in tail movements can also give important clues to the cat’s mood. Generally, the bigger the movement, the more intense the feeling. So, if the movements start to get bigger or faster during play, or if a tail goes from relaxed to swishing when you touch, that might be a sign to back off.

Ears

Cats’ ears are like antennas that swivel and adjust to pinpoint sound, but they can also give us a clue to how they are feeling. If the ears move for a moment and then return to a relaxed position, that usually means they’re listening to the world around them. If the ears remain flattened and back, that’s a sign of distress.

Vocalisations

Trilling and chirruping both suggest a playful cat, while hissing, growling and yowling all indicate stress. Purring might seem positive but may indicate a cat is stressed and trying to self soothe.

Let them be

When early warnings don’t work, cats may show overt signs such as hissing, growling, trembling, hiding and, ultimately, biting or scratching.

If you notice warning signs, give the cat plenty of space. When stressed, cats don’t like being touched or having people too close. If the cat comes back and re-initiates contact, that’s a good sign they’re comfortable, but keep watch for warning signs returning.

If you pay attention to your cat’s behaviour and give them space when they need it, with a bit of practice you might just become fluent in cat.

The Conversation

Julia Henning does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Do you speak cat? Take this quiz to find out – https://theconversation.com/do-you-speak-cat-take-this-quiz-to-find-out-268217

Comment les enfants du baby-boom vivront-ils la fin de vie au Québec ?

Source: The Conversation – in French – By Jean-Ignace Olazabal, Responsable de programmes, Université de Montréal

Les personnes âgées de 65 ans et plus (environ 2 250 000 personnes en 2033) représenteront 25 % de la population de la province de Québec au début des années 2030, les enfants du baby-boom composant dès lors la presque totalité de la population aînée.

Le taux de mortalité augmentera cela dit progressivement à partir de 2036, avec plus de 100 000 décès par année, et dépassera de loin le nombre de naissances, maintenant le Québec dans un contexte de post-transition démographique qui pourrait provoquer un déclin de la population globale.

Quoi qu’il en soit, l’augmentation de la longévité prévue fera que ces nouveaux vieux, les enfants du baby-boom, seront plus nombreux à devenir octogénaires et nonagénaires que ceux des générations précédentes. En effet, les 80+ pourraient représenter près de 8 % de la population en 2033, alors que l’espérance de vie prévue par Statistique Canada sera de 82 ans pour les hommes et de 86 ans pour les femmes.

Il est clair que la balise 65+ n’est plus la même qu’il y a 50 ans, et que la vieillesse est désormais un cycle de vie long, avec les enjeux et défis que cela comporte. Or, paradoxe remarquable, alors que le Québec figure au palmarès des sociétés où l’espérance de vie est la plus haute, elle est également celle où la demande d’aide médicale à mourir est la plus importante.

Anthropologue de la vieillesse et du vieillissement, je suis responsable de la formation en vieillissement à la Faculté de l’apprentissage continu (FAC) de l’Université de Montréal et je m’intéresse aux aspects sociaux du vieillissement des enfants du baby-boom au Québec.


Cet article fait partie de notre série La Révolution grise. La Conversation vous propose d’analyser sous toutes ses facettes l’impact du vieillissement de l’imposante cohorte des boomers sur notre société, qu’ils transforment depuis leur venue au monde. Manières de se loger, de travailler, de consommer la culture, de s’alimenter, de voyager, de se soigner, de vivre… découvrez avec nous les bouleversements en cours, et à venir.


Des vieux nouveaux genres ?

Si le baby-boom est un phénomène démographique englobant les personnes nées entre la fin de la Seconde Guerre mondiale et le milieu des années 1960, il est convenu, ici comme en France ou aux États-Unis, de réserver le nom baby-boomers aux personnes nées entre 1946 (1943 au Québec) et 1958.

Dans son livre intitulé Le fossé des générations, publié en 1971, l’anthropologue Margaret Mead disait des baby-boomers états-uniens qu’ils constituaient une génération préfigurative, en ce sens qu’ils ont inversé les termes de la transmission intergénérationnelle, les jeunes instruisant leurs aînés et, du coup, leurs pairs, plutôt que l’inverse, défiant ainsi la tradition.

Cette inscription en faux contre les valeurs parentales et ancestrales aura permis l’essor de la contreculture dans les années 1960-1970, comme l’expliquent les sociologues Jean-François Sirinelli dans le cas de la France et Doug Owram dans celui du Canada, à travers des valeurs jeunes (la musique pop, la consommation de drogues récréatives ou l’amour libre par exemple). Elle aura également permis de rompre avec la traditionnelle transmission des rôles et des statuts au sein de la famille, comme le souligne le sociologue québécois Daniel Fournier.

Un effet de génération

On parle ici d’un effet de génération au sens sociologique du terme. Au Québec, les baby-boomers seraient, selon le sociologue québécois Jacques Hamel, ceux qui constituent cette fraction des enfants du baby-boom ayant souscrit au slogan « qui s’instruit, s’enrichit » et qui détiennent ces « diplômes universitaires, expression par excellence de cette modernisation » que connut le Québec dans les années 1960.

Ces derniers auront fomenté, sous l’égide des aînés ayant réfléchi la Révolution tranquille (soit les René Lévesque, Paul Gérin-Lajoie et autres révolutionnaires tranquilles), des transformations majeures au sein d’institutions sociales et d’idéaux aussi fondamentaux que la famille (en la réinventant), la nation (en la rêvant) ou la religion catholique (en la reniant de façon massive).

Le sociologue américain Leonard Steinhorn reconnaît dans cette génération des personnes aux valeurs progressistes ayant tendance à une plus grande reconnaissance de la diversité culturelle, des nouvelles mœurs (comme la légalisation du mariage homosexuel, de l’aide médicale à mourir, ou du cannabis récréatif), ou de l’égalité entre les hommes et les femmes, par rapport aux générations précédentes.


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Mais ce qui distingue surtout ces baby-boomers vieillissants des générations de personnes âgées d’antan, c’est la persévérance dans la conviction de la primauté du sujet, par delà les conventions sociales, même dans la dépendance et la fin de vie.

L’effet de génération, bien qu’il diffère chez chacun des membres d’un même ensemble générationnel, est un produit de l’histoire et des conditionnements sociohistoriques auxquels le sujet aura été exposé au cours des premières décennies de sa vie. Les premières générations du baby-boom ont dès leur jeune âge adulte participé activement à la laïcité de l’État et de l’espace public et privé, et souscrit à l’État technobureaucratique promu par la Révolution tranquille, libérant le sujet des attaches communautaristes pour le rendre autonome.

Les enfants du baby-boom et la fin de vie

L’affranchissement des contraintes religieuses chez les Québécois d’origine canadienne-française, le difficile accès aux soins palliatifs pour les personnes âgées et, surtout, la volonté de contrôler sa propre destinée, sont autant de facteurs qui risquent d’influer sur la fin de vie et la mort des enfants du baby-boom au Québec.

En 2023, 7 % des personnes décédées au Québec – majoritairement des personnes âgées – ont choisi la mort médicalement assistée, dans un contexte d’acceptation sociale presque unanime. En effet, 90 % de la population québécoise appuie la loi sur l’aide médicale à mourir, selon un sondage Ipsos, soit le plus haut taux au Canada.

La détresse existentielle face à la fin de vie et le refus de la souffrance et de l’agonie pourraient expliquer l’engouement des enfants du baby-boom pour ce qu’ils considèrent une mort digne.

Or le grand volume de personnes qui constituent l’ensemble des cohortes du baby-boom, soit les personnes nées entre 1943 et 1965, invite à réfléchir au sort qui sera réservé à beaucoup d’entre eux et elles quant à la qualité et à la quantité des soins et des services publics qui leur seront alloués. Étant donné le contexte plutôt critique du Réseau québécois de la santé et des services sociaux, se pose la question des conditions dans lesquelles se dérouleront ces nombreux décès, estimés à plus de 100 000 par année dès 2036.

Pas tous égaux devant la vieillesse

Certes, une bonne proportion de personnes parmi ce grand ensemble populationnel seront effectivement à l’aise financièrement et jouiront d’un bon état de santé grâce à leur niveau d’éducation, à de généreuses pensions et autres fonds de retraite, à de saines habitudes de vie, et à la biomédecine. Cela étant dit, une proportion non négligeable vieillira appauvrie et malade. Les inégalités sociales de santé demeureront importantes au sein de ces nouvelles générations de personnes âgées.

Les hommes bénéficieront globalement d’un avantage sur les femmes en termes de conditions de retraite et de qualité de vie, tout comme les natifs par rapport aux immigrants, soulignent les démographes Patrik Marier, Yves Carrière et Jonathan Purenne dans un chapitre de l’ouvrage Les vieillissements sous la loupe. Entre mythes et réalités. Cela aura une incidence sur les conditions d’habitation et de résidence, sur les coûts privés en santé et sur la qualité du vieillissement en général.

Ces inégalités sociales de santé feront que les dernières années de vie de plusieurs, des femmes surtout, risquent de l’être en mauvaise santé, appauvries et sans forcément un entourage de qualité. Mais vivre plus longtemps à n’importe quel prix n’est pas le souhait de beaucoup parmi les enfants du baby-boom, et ce indépendamment de leur statut socioéconomique.

L’aide médicale à mourir deviendra-t-elle, dès lors, un acte médical ordinaire, alors que le système public de santé et de services sociaux connaîtra une pression accrue ? Quoi qu’il en soit, ce geste médical ultime devrait toujours jouir d’une popularité incontestable parmi les nouveaux vieux Québécois, du moins ceux d’origine canadienne-française qui ont rompu avec le catholicisme, ce qui pourrait contribuer à freiner l’augmentation de l’espérance de vie au Québec.

Mais encore faut-il que la fin de vie se déroule également dans la dignité.

La Conversation Canada

Jean-Ignace Olazabal a reçu des financements du CRSHC, IRSC.

ref. Comment les enfants du baby-boom vivront-ils la fin de vie au Québec ? – https://theconversation.com/comment-les-enfants-du-baby-boom-vivront-ils-la-fin-de-vie-au-quebec-252148

Lack of progress on joining EU caps another bad month for Ukraine

Source: The Conversation – UK – By Stefan Wolff, Professor of International Security, University of Birmingham

Ukraine is having a tougher-than-usual time at the moment. On the frontlines, the battle of Pokrovsk is raging, and it does not look like Ukraine is winning it.

Nor do things look good for the country’s energy resilience after months of an intensive Russian air campaign targeting key infrastructure. According to the UN, this could trigger another major humanitarian crisis in the already war-ravaged country.

The geopolitical picture looks equally grim. The delivery of long-range Tomahawk missiles, sought by Kyiv for months now, has again been ruled out by the US president, Donald Trump. What’s more, after his meeting with the Chinese president, Xi Jinping, in South Korea on October 30, Trump said that the US and China would work together to end the war in Ukraine.

The possibility of a productive collaboration between Trump and Xi on peace in Ukraine, let alone its successful conclusion, is remote. And even if there was a Washington-Beijing sponsored deal, it would not be in Ukraine’s favour as became clear a few days later.

During a high-profile, two-day visit of the Russian prime minister, Mikhail Mishustin, to China on November 3 and 4, Beijing showed no signs of backing out of its partnership with Russia, which is key to sustaining the Kremlin’s war machine.

Nor does the continuing delay in approving an EU loan to Ukraine worth €60 billion (£53 billion) and backed by frozen Russian assets bode well for Kyiv.

Given all this bad news, it was therefore no surprise that Ukraine’s president, Volodymyr Zelensky, leapt at what looked, on the surface, like good news in the European commission’s latest assessment of Kyiv’s progress towards EU membership. The European commission notes in its report that Ukraine has made progress in all of the 33 different chapters of the accession negotiations. This is as remarkable as it is commendable given that the country has done so in the shadow of Russia’s aggression since February 2022.

Yet, in many areas, progress is modest at best. A more careful analysis of the 2025 commission report suggests that positive news, if any, is in the presentation, not the underlying facts.

ISW map showing the state of the conflict in Pokrovsk, Ukraine, NOvember 4 2025.
This map of the region around the townof Pokrovsk, in Ukarine’s east, shows the extent of Russian advances.
Institute for the Study of War

For example, in relation to the fight against corruption the commission reports that recent developments “cast doubts on Ukraine’s commitment to its anti-corruption agenda”. This is primarily a reference to attempts by Zelensky’s government to limit the independence of the country’s anti-corruption institutions. The issue triggered massive public protests in the summer and forced a partial government climb-down.

Worryingly, the commission also notes “political pressure on anti-corruption activists” and “harassment and intimidation of journalists”. This includes “cases of strategic lawsuits against public participation (SLAPPs) related to journalistic investigations”.

Meanwhile, in the fight against serious and organised crime, the commission report states: “The freezing and confiscation of criminal assets remain very limited.” Other shortcomings concern limited progress on decentralisation, lack of transparency in recruitment to civil service positions, the independence and impartiality of the judiciary, and the persistence of torture and ill treatment in the prison and detention system.

On the one hand, it is not surprising that these shortcomings exist. Ukraine has been fighting an existential war for almost four years. The country has only been a candidate country for EU membership since June 2022, four months after Russia launched its full-scale invasion. Accession negotiations didn’t start until December 2023.

Yet it is the persistence of these highly visible, easily exploitable problems related to fundamental values of the EU that are causing concern. Almost identical issues were raised in the European commission’s opinion on Ukraine’s membership application in 2022. It was raised again in the 2023 report and again in last year’s progress report on accession negotiations.

It may be an exaggeration to claim that Ukraine is experiencing a turn towards a more autocratic style of presidential government under Zelensky. But there clearly are signs that war-time politics in Kyiv has a darker side that does little to bolster the country’s credentials for EU membership.

Discord within

This provides easy ammunition for Ukraine’s detractors inside the EU. Chief among them is Hungary’s prime minister, Viktor Orbán, whose obstruction tactics have frustrated European commission efforts on Ukraine’s accession.

Poland and Slovakia have joined Hungary in defying the EU’s effforts to complete an updated trade deal with Ukraine. Opposition to Ukraine from within the EU has now been further strengthened by the formation of a eurosceptic, hard-right populist government coalition in the Czech republic.

The EU’s foreign affairs chief, Kaja Kallas, continues to insist that membership for Ukraine by 2030 “is a realistic goal”.

But the EU’s enlargement commissioner, Marta Kos, is more guarded. She has noted that “future accession treaties will need to contain stronger safeguards” to “reassure our citizens in the Member States that the integrity of our Union and democratic values are ensured, also after the accession”.

In an interview with the Financial Times, she said that she did not “want to go down as the commissioner bringing in the Trojan horses”.

Given the detail in Ukraine’s 2025 progress report on areas where Kyiv clearly needs to make urgent improvements, this suggests that the tough times for Ukraine are likely to continue, and not just in its war with Russia.

Though the future of the EU and Ukraine have become ever more closely entwined since February 2022, there remains a bigger question for the EU. Its dilemma is how to balance holding the line on its membership standards and enabling Ukraine to hold the line against Russia.

The Conversation

Stefan Wolff is a past recipient of grant funding from the Natural Environment Research Council of the UK, the United States Institute of Peace, the Economic and Social Research Council of the UK, the British Academy, the NATO Science for Peace Programme, the EU Framework Programmes 6 and 7 and Horizon 2020, as well as the EU’s Jean Monnet Programme. He is a Trustee and Honorary Treasurer of the Political Studies Association of the UK and a Senior Research Fellow at the Foreign Policy Centre in London.

Tetyana Malyarenko receives funding from Elliott School of International Affairs, The George Washington University.

ref. Lack of progress on joining EU caps another bad month for Ukraine – https://theconversation.com/lack-of-progress-on-joining-eu-caps-another-bad-month-for-ukraine-268921

How Zohran Mamdani’s ‘talent for listening’ spurred him to victory in the New York mayoral election

Source: The Conversation – UK – By Daniel Hutton Ferris, Lecturer in Political Theory and Philosophy, Newcastle University

Zohran Mamdani, a 34-year-old democratic socialist, has been elected as New York City’s mayor. He became the first New York mayoral candidate to win more than 1 million votes since 1969, and looks set to secure over 50% of the total vote.

With almost all of the votes counted, independent candidate Andrew Cuomo seems to have been backed by 41.6% of voters. Republican Curtis Sliwa has secured just 7%.

Mamdani, who has become New York City’s first Muslim mayor, swept to victory on what was characterised as a radical left-wing platform. He has promised to tax millionaires more in order to fund free buses and childcare for all.

He has also vowed to honour an International Criminal Court arrest warrant for the Israeli prime minister, Benjamin Netanyahu, over alleged war crimes in Gaza if he visits New York. The Israeli foreign ministry has previously called Mamdani a “mouthpiece for Hamas propaganda”.

How did a figure on the far left of American politics, who is also a staunch critic of Israel, win in a city that is full of millionaires and home to a sizeable Jewish population?

The corruption and sexual harassment scandals affecting his main rival certainly helped, as did the focus of his campaign on making life more affordable for New Yorkers. Mamdani’s presence on social media raised his profile and attracted voters, too.

He posted slick videos on TikTok and Instagram throughout his campaign, including one where he criticised the rent increases seen under outgoing mayor Eric Adams while running the New York City marathon.

But journalists and commentators have noticed something else that has helped boost Mamdani’s appeal among New Yorkers. He has what the New York Times called in July “a rare talent for listening”.

Mamdani is unusually reflective in interviews, often thinking silently for more than 20 seconds before responding to questions. And after his successful primary earlier in 2025, Mamdani contacted every business and cultural leader in the city he could get hold of to hear about why they opposed him.

The viral campaign videos that made his name also see him walking the streets of New York, asking voters questions and listening to their answers at length without interruption. Mamdani may be a radical, but he really listens.

Talking to voters

Democratic theorists are likely to celebrate Mamdani’s approach. Many philosophers embrace what is known as the “deliberative theory of democracy”, which argues that talking – as opposed to voting – is the central democratic institution.

These people suggest that politicians should talk to a diverse range of voters respectfully about their decisions. Listening to diverse perspectives improves policy because it requires leaders to consider a range of ideas and arguments, relying less on their own gut intuitions.

As a respectful and inclusive political style, it can also help citizens feel heard and challenge the idea that politicians are interested only in power and will say whatever it takes to win. A more deliberative kind of responsiveness to voters can therefore increase political legitimacy and trust.

Political scientists are likely to point out that Mamdani has an important strategic reason for his deliberative political style. New York City uses a system of ranked choice voting, or “the alternative vote”, which asks voters to rank candidates in order of their preference rather than choosing just one.

This encourages politicians to find policy proposals that are supported by large majorities, such as taxing millionaires to pay for free childcare, and to communicate respectfully with people of all political persuasions in the hope they might win their second-preference votes.

Larry Diamond, a leading American democracy expert, has called ranked choice voting the “Archimedean lever of change” for solving the deep polarisation currently affecting US politics. This is because it penalises candidates who rely on divisive rhetoric to appeal to a passionate base of supporters.

They are unlikely to win second-preference votes from people whose first preference is for one of their rivals. Conversely, ranked choice voting rewards politicians who try to bridge political divides with respectful and inclusive campaigning.

Depolarising US politics

There are many lessons that the political left in the US and beyond can learn from Mamdani’s victory. Most obviously, it shows that a socialist and pro-Palestine candidate can win in a major US electoral contest by combining a lively digital campaign with a strong focus on the cost of living.

It also suggests that candidates perceived as being radical are more likely to succeed in elections when they are visibly willing to listen to and deliberate with voters from all sorts of backgrounds.

Mamdani’s rise should also encourage a wider embrace of ranked choice voting. The system has been used to elect members of Australia’s House of Representatives for more than a century and it is now used in the US states of Maine and Alaska, as well as in the San Francisco Bay Area.

It should be adopted elsewhere too, as an antidote to political polarisation. The UK held a referendum on changing the electoral system to the alternative vote in 2011. However, UK voters unfortunately rejected the proposal.

Finally, Mamdani’s victory shows that radicalism and reflectiveness can come together, especially when the electoral system promotes it. Ranked choice voting is so good at encouraging a politics of respect and listening that it is sometimes accused of creating boring centrist candidates.

But Mamdani has reminded us that this does not have to be the case. Reforming US election systems could encourage deliberative responsiveness and depolarise American politics, without taking radical options off the menu.

The Conversation

Daniel Hutton Ferris does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. How Zohran Mamdani’s ‘talent for listening’ spurred him to victory in the New York mayoral election – https://theconversation.com/how-zohran-mamdanis-talent-for-listening-spurred-him-to-victory-in-the-new-york-mayoral-election-268950

US election results suggest Trump’s coalition of voters is collapsing

Source: The Conversation – UK – By Andrew Gawthorpe, Lecturer in History and International Studies, Leiden University

Americans voted in elections on November 4 in the first major test of whether Republicans can hold together the coalition of voters that propelled Donald Trump to the White House in November 2024. The result was a Democratic party triumph.

Trump was not directly on the ballot in any of these elections, the most high-profile of which were to decide who would become the mayor of New York City and the governors of Virginia and New Jersey. But each race has been seen to varying degrees as a referendum on the president and the direction he has taken his party.

American politics is highly nationalised. This means that results in local and state elections are often heavily influenced by how voters feel about the national political situation. This is often frustrating to local politicians.

In New Jersey, for example, the Republican candidate Jack Ciattarelli frequently complained that his Democratic opponent Mikie Sherrill was trying to make their recent race a referendum on the president rather than basing the campaign on the relative merits of their own proposals.

“If you get a flat tire on the way home tonight, she’s going to blame it on President Trump”, Ciattarelli said to voters at numerous campaign rallies. In the end, Sherrill won by 13%.

Republicans’ fraying coalition

None of the major races decided on November 4 were in the states usually regarded as the “swing states” – the ones that could reasonably be won either by the Democrats or Republicans and usually decide the outcome of presidential elections. But this doesn’t mean we cannot learn anything from them.

The nationalisation of US politics means that voters with similar demographic characteristics – for instance, what race they identify as or whether they live in the suburbs or rural areas – tend to vote in similar ways across state lines. If a party is improving its performance in the suburbs of New Jersey, the same is likely to be the case in the swing state of Pennsylvania.

In this respect, democratic socialist Zohran Mamdani’s victory in New York City was the least surprising news of the night. For New York to have its first Muslim mayor is a historic milestone, and Mamdani’s achievement has electrified many. But Democrats usually dominate in urban areas, and he was no exception.

Republicans will be much more worried about what happened elsewhere. In both Virginia and New Jersey, Democrats won by double-digit margins – and they did so by winning back the groups that deserted them in the 2024 presidential election.

In 2024, Republicans were thrilled to make big inroads with Hispanic voters. Many saw it as proof that their party was extending its appeal beyond the white voters who make up its core supporter base. But in the recent elections, those inroads seemed to vanish.

Sherrill, a moderate Democrat who hasn’t generated nearly as much excitement as Mamdani, made her biggest gains in Passaic and Hudson counties, two of New Jersey’s most heavily Hispanic areas. Abigail Spanberger made the same inroads in Virginia.

Suburban voters, who often prove crucial to winning presidential elections, also deserted the Republicans in large numbers. Spanberger won Virginia’s Henrico County, a swathe of the suburbs of Richmond, by 40%. This was the Democrats’ biggest margin of victory in the county ever.

Some caveats

These results are great news for Democrats, and they exceeded the expectations of most observers before election night. Taken together, they seem to suggest that the coalition that won victory for the Republicans in 2024 is collapsing.

But it’s also not time for possible 2028 Democratic presidential candidates to start measuring the White House drapes quite yet. These results reflect a recent trend in US politics in which Republicans have struggled to win so-called off year elections – ones in which the presidency is not on the ballot.

In his ten years on the political scene, Trump has transformed the Republican party by expanding its appeal among less-educated white voters, younger voters and, to some extent, voters of colour.

But these are also groups that are less likely to vote than the average American. As a result, getting them to turn out when Trump is not on the ballot is a goal that Republicans have found elusive. So, we have to be careful about the conclusions we draw from these results.

At a minimum, we can safely say that the results of the recent elections suggest Democrats can expect to perform well in the midterms in 2026. That gives them the opportunity to win back one or two houses of Congress and act as a check on Trump’s agenda.

For their part, Republicans have some soul-searching to do. Trump is constitutionally barred from seeking a third term in 2028. Unless some other Republican can reproduce Trump’s appeal to infrequent voters, the signs are that his party will struggle even in presidential election years.

Much also depends on Trump’s policies in the years to come. Voters are clearly fed up with the lack of progress on reducing the cost of living, the brutality of immigration raids, and the corruption and chaos that many perceive to exist under this administration.

Voter sentiment on these issues is unlikely to change unless Trump changes course. The question, given his political style and his personality, is whether he can – or whether he even wants to.

The Conversation

Andrew Gawthorpe does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. US election results suggest Trump’s coalition of voters is collapsing – https://theconversation.com/us-election-results-suggest-trumps-coalition-of-voters-is-collapsing-268967

England’s plans to get more young people working or studying don’t go far enough – employment expert

Source: The Conversation – UK – By Peter Urwin, Director, Centre for Employment Research, University of Westminster

PeopleImages/Shutterstock

The number of 16 to 24-year-olds in England who are not in education, employment or training (Neet) currently stands at nearly one million.

In a recent document of proposed policy, the government has set out a range of initiatives to help them. These include new qualifications designed for young people who achieve grade two or below in maths and English GCSEs, and guaranteed access to education, training or work. But will these initiatives be successful?

There are a multitude of contributing factors that lead to young people becoming Neet. These include if they have caring responsibilities, special educational needs or disabilities, and mental health challenges. Essentially, though, there are two cross-cutting challenges that must be addressed.

First, too many young people in England reach age 16 with poor qualifications, having become disillusioned with education. England’s further education system faces an enormous challenge to help them achieve results that will enhance their employment prospects.

Second, this leaves them unprepared for employment in a labour market with diminishing opportunities for young, low skilled workers.

Each August, when GCSE results are released, statistics set out what proportion of 16-year-olds achieved a “pass” – a grade four or above – in their exams. Far less attention is paid to the approximately 30,000 young people who do not achieve a grade 1, the lowest grade, in GCSE English and maths.

Most of these young people have complex special educational needs and disabilities or are severely absent from school. Many are not entered for GCSEs at all.

More generally, in research with colleagues, we estimate that there are up to 80,000 lower attaining young people each year aged 16, who for instance, achieve grade two or below in maths and English. Despite a raising of the compulsory age for education and training to 18, many students still do not engage with post-16 learning after their GCSE year.

A key new initiative from the government to address this – detailed further in the recently published independent review into curriculum and assessment – is a reconsideration of the post-16 policy that requires GCSE resits in English and maths for those who do not achieve at least grade four.

For the lowest attaining young people, the pass rate for these resists is currently very low. The proposed introduction of new post-16 qualifications in these subjects at level one, one level below GCSE (level two), for the lowest attaining is therefore encouraging.

Students in exam hall
Currently, students who do not pass maths and English GCSE are required to resit.
KOTOIMAGES/Shutterstock

More generally, there is a refreshing recognition that not all young people will achieve level three – A-levels, T-levels or equivalent qualifications – by the age of 19 and get a job at this level. This includes a suggestion that good quality vocational education pathways will now “prepare students to progress directly into level two occupations” – jobs that require skill levels equivalent to GCSE.

Unfortunately, the new 16 to 19 level one maths and English qualifications that these students will need to take, are envisaged to support them “progressing onto GCSE” in these subjects. Acceptance that many low attainers struggle to achieve this does not seem to fit with a continued drive for them to get GCSE maths and English. Many level two occupations, such as bricklaying and plastering, do not require level two maths and English, so this seems unnecessary.

The job market

The “supply” of approximately 80,000 low skilled young people to the labour market each year is a long-standing problem in the UK as they are much more likely to be Neet.

Many of the government’s proposed policies are relevant to this challenge. The main approach is to provide “guarantees”.

The “youth guarantee” promises young people “access to education, training and/or help to get into work”, including a guaranteed job for those unemployed for over 18 months. The proposed “pathways to work guarantee” will “provide training, work experience and a guaranteed job interview”. There will also be a “guaranteed college place in reserve for all 16-year olds”.

However, the government’s proposals contain little practical consideration of the capacity needed to meet these commitments. Much of the focus on job guarantees (for instance, “payments of up to £3,000 per apprentice” for employers) will simply offset recent national minimum wage and national insurance contribution increases that likely reduce young people’s job opportunities. Local authorities already have similar duties regarding post-16 education guarantees.

The government has set out an ambitious plan for change. However, the lack of practical detail on challenges such as capacity, as well as limitations to any new spending, may constrain the achievement of this ambition.

The government’s commitment to a data-driven approach that joins up skills and employment is very encouraging. Working with colleagues, I am trying to inform this data-driven approach. I would suggest that reversing unintended consequences of previous policies, can be achieved at low cost.

Reintroducing partnership approaches between schools and further education providers, for occupational programmes that spanned the ages of 14 to 18, would better engage those who have become disillusioned with education and provide education and training that prepares them for a variety of level two occupations. Sectors such as construction, health and social care, for instance, are struggling to fill roles.

Any concern over the narrowing of a young person’s learning early in their school career can be mitigated by the government’s commitments to lifelong learning, and the recent national curriculum recommendations that these learners can still progress to level three “if that is the right option”.

The Conversation

Peter Urwin has received funding from UKRI, ESRC, Acas and the Nuffield Foundation,

ref. England’s plans to get more young people working or studying don’t go far enough – employment expert – https://theconversation.com/englands-plans-to-get-more-young-people-working-or-studying-dont-go-far-enough-employment-expert-268606

What if the path to ending fossil fuels looked like the fight to end slavery?

Source: The Conversation – UK – By Rob Lawlor, Lecturer in Applied Ethics, University of Leeds

When Britain abolished slavery in its empire in 1833, it paid the equivalent of hundreds of billions today in compensation – not to the enslaved, but to the slave owners. It was an imperfect, morally uneasy compromise, but it helped achieve a historic transition that had seemed impossible.

Today, as the world struggles to phase out fossil fuels, many doubt
such a transformation is still possible. Emissions keep rising, the Paris agreement isn’t properly enforced and powerful corporations continue to mislead the public and lobby against meaningful change.

Yet slavery was once seen as immovable. It was an institution that was accepted for thousands of years – far longer than fossil fuel-powered capitalism. Slavery was a significant source of wealth for many, and the rich and powerful opposed abolition. Yet it was abolished.

As a thought experiment, let us imagine a future where effective climate action unfolds the way slavery abolition once did. What might that look like?

Leadership and ‘persuasion’

Future historians might not point to a single moment of global unity, with all nations coming together to act as one. Rather, they’ll point to one nation – or a coalition – that took the lead. These early leaders might combine diplomacy, bribery and perhaps even the threat of military force or economic sanctions to “persuade” other countries to follow suit.

That’s how Britain pushed for the end of the slave trade: with a mix of idealism and hard power, with naval patrols and trade sanctions. A global fossil fuel phase out may unfold in a similarly non-ideal way.

Bottom-up pressure, top-down resistance

In this thought experiment, change will not start with governments. Rather, the demand for action will come from the bottom up. Activists will demand change and there will be huge public support but, at the same time, the rich and the powerful will continue to defend the status quo, lobbying against the introduction of stricter legislation.

The slavery abolition movement followed that pattern, with broad public support yet fierce opposition from those with most to lose. In Britain, slave owners were even compensated with £20 million (equivalent to “40% of state expenditure in 1834”) to secure their agreement to the loss of “their” property.

Something similar could happen in the climate fight. Perhaps fossil fuel companies will one day receive financial compensation to ease the transition away from fossil fuels – not because it is deserved, but rather as a pragmatic compromise.

The law as a tool for change

Legal action would also play a pivotal role. Governments and corporations will be (and, indeed, are already being) taken to court.

Abolitionists used the law in much the same way. A good example is a famous case in which enslaved Africans revolted and seized control of the ship La Amistad. The Africans were ultimately freed after reformers highlighted the contradiction between the idea of natural rights for all humankind in the US Declaration of Independence, and laws that allowed people to be private property.

As the historian David Brion Davis noted: “It was this contradiction that helped the reformers to pass laws for very gradual slave emancipation.” The Paris agreement, often dismissed as toothless, could gain real power through litigation in a similar way.

Why this thought experiment matters

Of course, this is not a real prediction. It is a thought experiment. Imagining that climate action will mirror the history of the abolition of slavery doesn’t guarantee that this is what will happen. But the comparison is valuable for several reasons.

It shows that historical precedent matters. Looking at what worked in the past can help us imagine what might work now. Massive moral change really has happened before, even despite entrenched interests working against it. As such, the example of the abolition of slavery offers hope.

It’s also realistic. Global cooperation would be ideal, but history suggests that change will be messier, potentially with some unpalatable compromise or confrontation.

The comparison poses some hard ethical questions. Is it ever justifiable to compensate fossil fuel companies? What forms of international pressure are morally acceptable?

The thought experiment can also sharpen our strategy. If this imagined future is unpalatable – if we’re ultimately not willing to send hundreds of billions to BP, Exxon and co – then it may motivate people to work for better solutions.

Perhaps most importantly, comparing slavery with climate change shows us that individual action still matters. You may feel powerless and want to know what you can do now. The history we have looked at suggests two things: support climate action publicly and, if you can afford it, provide financial support to groups like environmental law charity ClientEarth.

Abolishing slavery was messy and the strategy taken left many uneasy. Perhaps, when the time comes, significant action to mitigate climate change will involve similar controversies. But flawed solutions may be better than none.


The Conversation

Rob Lawlor received funding from the Arts and Humanities Research Council. This funded a project and a number of events that allowed me to collaborate with researchers from other disciplines, including historians.

ref. What if the path to ending fossil fuels looked like the fight to end slavery? – https://theconversation.com/what-if-the-path-to-ending-fossil-fuels-looked-like-the-fight-to-end-slavery-268162

Why even pro-climate action organisations may pull in different directions

Source: The Conversation – UK – By Paul Tobin, Senior Lecturer in Politics, University of Manchester

saepul_bahri/Shutterstock

This year’s UN climate summit (Cop30) in Belém, Brazil, begins with a familiar dilemma: how can we tackle a highly political, long-term problem that involves every country of the world?

Governments, experts and activists have been trying to address climate change since the early 1990s, yet global greenhouse gas emissions remain at record levels.

Emissions growth may be slowing, but even pro-climate action strategies seem to be pulling in different – or even, antagonistic – directions. Our new book presents these antagonisms as a choice between “stability” and “politicisation” in climate governance.

According to those favouring stability, governments should lock in steady, long-term policies that place us on a predictable and gradual track to much lower emissions. Creating policies that commit us to a certain path should help businesses to invest in ways that meet this predictable trajectory.

However, if it is weakened and made inadequate by pro-fossil fuel lobbyists and governments, then the stable path can still meander into climate catastrophe. This is the course we are presently on.

On the other hand, for those pursuing the politicisation of climate action, it is better to encourage political conflict and protests that constantly create pressure for more significant and rapid policy change.

Such strategies can disrupt pro-fossil fuel lobbyists’ grip and expose strategies used by some political figures to dismantle the hard-fought climate goals already in place. But by encouraging increased politicisation of these issues, we may open the door to anti-net zero populists and others seeking to slow or stop climate policy action altogether.

Both schools of thought – stability or politicisation – have their supporters and detractors. Both have benefits and downsides. However, these have rarely been discussed in conversation with one another, until now.

At Cop30, these distinct strategies will be under the spotlight.




Read more:
Why countries struggle to quit fossil fuels, despite higher costs and 30 years of climate talks and treaties


The stability or politicisation dilemma helps to explain why building a strategy that works over years and decades creates difficult questions, not only about policy design but approaches for different organisations and states. These challenges change according to which level of government, which country, and which economic sector is in play.

For instance, it is easier to push for politicisation and conflict when you’re not a member of a marginalised or racialised community already facing myriad hurdles to political participation.

Conversely, it is hard to avoid having to engage in politicisation and conflict in areas where there are deep historical power structures that need to be challenged. For example, in the UK, land ownership concentration blocks peat restoration – both because landowners want to keep peat moors dry to maximise their grouse shooting revenue, and because the land concentration means they are very powerful within the British state.

graphic on blue earth, man in suit standing on top looking through telescope
It is hard to avoid having to engage in politicisation and conflict in areas where there are deep historical power structures.
AndryDj/Shutterstock

Tension between timeframes

Our book traces these dynamics across a range of cases, from the fossil fuel industry in the US to strategies used by the insurance sector and central banks; from China’s industrial policy to environmental justice social movements in Germany; and from arguments about Norwegian oil extraction to Brazilian and South African renewable energy generation.

International relations expert Jennifer Allan explains that previous UN climate summits have been shaped by this clash in strategies, right back to the Kyoto protocol, the 1997 agreement that set emissions targets for economically developed countries.

Whereas the EU was previously the driving force behind depoliticisation of negotiations, more recently, countries such as India and China are also pursuing such strategies. As Allan warns, this may delay the implementation of climate policies as more states debate how best to progress.




Read more:
To address the environmental polycrisis, the first step is to demand more honesty


In Belém at Cop30, similar dynamics will be at play. Efforts are ongoing to implement the 2015 Paris climate agreement agenda and process. Core issues remain on how to ensure regular reporting of emissions, alongside questions around who pays for the consequences of climate change.

At the same time, there will be a continued politicising push by certain countries and social movements. States such as the US, Saudi Arabia and their allies will be trying to politicise the negotiations to stymy progress. Meanwhile, social movements will be protesting to keep the pressure on negotiators and promote climate justice for those who are hardest hit by climate change.


Don’t have time to read about climate change as much as you’d like?

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The Conversation

Paul Tobin has received funding from the Economic and Social Research Council.

Matthew Paterson receives funding from the Economic and Social Research Council (UK). He is a member of the Green Party of England and Wales.

Stacy D VanDeveer as received funding from Independent Research Fund Denmark, MISTRA (Sweden), Research Council of Norway, Uppsala University (Sweden), German Marshall Fund of the United States, US National Science Foundation

ref. Why even pro-climate action organisations may pull in different directions – https://theconversation.com/why-even-pro-climate-action-organisations-may-pull-in-different-directions-261047

Vaping might seem safer than smoking but your heart could tell a different story

Source: The Conversation – UK – By Preeti Mahato, Lecturer in Global Health, Royal Holloway, University of London

StockLab/Shutterstock

You may have heard that vaping is the “safer” choice than smoking. But what if the very thing designed to protect your health also puts your heart at risk?

Vaping does not exist in isolation. It is part of a wider story about smoking, inequality and the growing burden of heart disease in the UK. Even after years of public health campaigns, smoking remains common in England’s most deprived areas.

The reasons are complex. People living with financial strain, insecure jobs and chronic stress are more likely to smoke. Targeted marketing and limited access to stop-smoking services make it even harder to quit. At the same time, one in two UK adults have high cholesterol, and many do not know it.

Reports show that people in the poorest communities have the highest rates of smoking and other risk factors for cardiovascular disease, including raised cholesterol.

As vaping becomes more common in these same communities, a new form of nicotine use could be replacing one heart risk with another. Many people now switch from cigarettes to vapes to reduce harm, but growing evidence suggests the benefits may not be as clear-cut as once thought.




Read more:
Popcorn lung: how vaping could scar your lungs for life


Research shows that vaping can help some people quit smoking more effectively than other methods, but newer findings challenge the belief that e-cigarettes are a harmless substitute.

Several studies have now linked vaping to arterial damage in both the brain and heart, even among people who have never smoked traditional cigarettes. The cells that line our blood vessels, known as the endothelium, keep arteries supple, regulate blood pressure and stop fatty deposits from sticking to the walls. When these cells are damaged, arteries lose elasticity and blood flow becomes less efficient, raising the risk of cardiovascular problems.

One study found that regular vapers had impaired blood vessel function. Their arteries could no longer expand and contract properly. Other research on humans and animals exposed to vapour showed less flexible arteries, higher blood pressure and damaged endothelium in both the brain and heart. This arterial stiffening increases the likelihood of heart attack, stroke and dementia.




Read more:
How vaping primes the lungs for COVID damage


So what is behind this damage? When someone vapes, the vapour carries nicotine, chemicals and microscopic particles into the bloodstream. These trigger inflammation and oxidative stress, meaning the body’s defences go into overdrive and start attacking healthy tissue. Vaping also reduces nitric oxide, a molecule that helps vessels relax, while increasing harmful free radicals. Together, these effects make arteries less able to do their job and more prone to disease, increasing the risk of heart problems.

Vaping can also raise blood pressure and heart rate, even after a single session. Over time, this mix of irritation, inflammation and stress wears down the arteries, even in people who have never smoked before.

The UK’s NHS Health Check programme mainly screens people aged forty and over for heart-disease risks. Yet vaping is most common among people under 40, and routine screening is not designed to detect early vessel injury in this age group. Young vapers may therefore carry silent artery damage for years before any problem appears on standard tests. Evidence suggests that vaping can cause early artery changes similar to those caused by smoking, increasing the risk of cardiovascular disease (CVD) later in life.

That is why education and prevention are so important. Schools and public health campaigns play a vital role in showing young people that vaping carries long-term risks, including damage to the heart. Programmes that combine classroom learning with interactive activities have been shown to make a real difference. Initiatives such as Catch Your Breath and Essex’s Break the Vape aim to stop young people from vaping before they start, and to support those who want to quit, reducing their future risk of heart disease.

The wide differences in heart disease deaths across England show that prevention efforts are still not reaching everyone equally. A whole-system approach to CVD prevention is essential. Schools, councils, NHS services and local communities need to work together to tackle shared risk factors such as smoking and vaping.

Screening cannot yet detect early artery damage in younger adults, but education remains our best defence. Helping young people understand how vaping affects the heart can protect the next generation from the hidden dangers of nicotine addiction and cardiovascular harm.

The Conversation

Anusha Seneviratne previously received research funding from the British Heart Foundation.

Preeti Mahato does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Vaping might seem safer than smoking but your heart could tell a different story – https://theconversation.com/vaping-might-seem-safer-than-smoking-but-your-heart-could-tell-a-different-story-268612