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How to tell if you DO have a temperature

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Fever is one of the major tell-tale signs of infection with coronavirus — when we come down with an infection, our temperature can rise as part of our immune response to kill it off.

The rise is triggered by chemical messengers released by immune cells travelling to the hypothalamus, the part of the brain that controls temperature, telling it to increase the heat within your body — known as the core temperature.

Most of our lives our body temperature hovers around 37c (between 36.5c and 37.5c). It’s classed as a fever if it goes over 37.8c.

‘Viruses are more likely to die off when temperature goes above 38c,’ says Dr William Bird, a GP in Reading, Berks.

Not only does a high temperature directly kill the virus, it also triggers a cascade of responses in the body that fire up immunity. For example, a temperature above 37c can speed up the activity of NF-kB proteins in our cells, which turn on genes involved in the immune response, a 2018 study from the University of Warwick found.

Fever is one of the major tell-tale signs of infection with coronavirus ¿ when we come down with an infection, our temperature can rise as part of our immune response to kill it off

Fever is one of the major tell-tale signs of infection with coronavirus ¿ when we come down with an infection, our temperature can rise as part of our immune response to kill it off

Fever is one of the major tell-tale signs of infection with coronavirus — when we come down with an infection, our temperature can rise as part of our immune response to kill it off

Other research has shown that specific virus-killing cells, T-cells, also rev up their activity when temperature rises.

‘There is a belief that lowering the temperature may delay getting better and prolong illness,’ says Dr Bird. Saying that, though, fevers can be serious, so seek the advice of a GP, particularly with babies and young children.

Here, experts reveal what everyone should know about this vital measurement — and the surprising factors that can affect it.

WORK OUT WHAT’S ‘NORMAL’ FOR YOU

Our body temperature fluctuates naturally over the day — and night.

One study based on readings from more than 300 people found it is lowest between 3am and 5am and highest between 4pm and 6pm, with a difference of about half a degree celsius between the two times, according to U.S. researchers writing in the Journal of General Internal Medicine in 2018. This suggests that if you want to take a baseline temperature, first thing in the morning is the best time to measure.

However, doctors have noticed that temperature may spike on and off throughout the day in those sick with coronavirus, says Dr Patricia Macnair, a specialist in ageing and palliative care in Surrey, although it is not yet known why this might be.

‘If you’re concerned, take more than one temperature reading a day — say, morning, afternoon and evening,’ she says.

‘If you think you may be infected, keep an eye on other symptoms [for example, a dry cough, loss of smell or taste and fatigue] and if they become more severe, call 111.’

Contrary to popular belief, you don't necessarily feel hot if you have a fever. 'This is one of the big misconceptions about high temperatures,' says Dr Bird

Contrary to popular belief, you don't necessarily feel hot if you have a fever. 'This is one of the big misconceptions about high temperatures,' says Dr Bird

Contrary to popular belief, you don’t necessarily feel hot if you have a fever. ‘This is one of the big misconceptions about high temperatures,’ says Dr Bird

WE BECOME COLDER AS WE GET OLDER

Younger women with a normal body weight tend to have a higher body temperature than older men who are overweight, according to a 2011 study in the Journals of Gerontology, which analysed the body temperatures of more than 18,600 people.

The analysis also found men were generally colder than women, with scientists suggesting female hormones may play a role (as temperature tends to fall after menopause and is known to fluctuate during the menstrual cycle).

SHOULD YOU SHARE AT HOME?

It’s thought that coronavirus can live on hard surfaces such as plastic for up to 72 hours, if not longer, so right now you should not be sharing thermometers — even at home between family members.

But if you only have one at home, you can wash the end of an oral thermometer with soap and water, says London GP Dr Ross Perry, or wipe it down with an alcohol or antimicrobial wipe if you have them.

With an ear thermometer, the best solution is to use disposable tips.

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It also found women in their 20s had an average body temperature of 36.5c, while the women in their 80s had one of 36.1c. In men, a similar drop was found. ‘We don’t know why it happens, but the body generally slows down as we get older and this may be reflected in temperature,’ says Dr Macnair.

BEING FAT CAN MAKE YOU WARMER 

Also, the more someone weighed, the higher their average temperature was. Why exactly this should be so is unclear, but one theory is that inflammatory chemicals released by fat could be the cause of the increased temperature.

ELDERLY CAN HAVE BUG BUT NO FEVER 

Another fascinating theory is a lower body temperature may be associated with living longer. It’s been shown that lowering body temperature in mice increases lifespan by around 20 per cent.

As well as this lower baseline temperature in older people, their immune systems don’t trigger such intense responses to infections. As such, older people may not always develop a fever in response to infection.

‘This means you shouldn’t rely on the presence of a high temperature as the only sign of infection and people should pay extra attention to other symptoms such as pain, cough or breathlessness — and unusual levels of confusion,’ says Dr Macnair.

EAR THERMOMETERS ARE BEST FOR HOME

The most accurate body temperature reading, often used in intensive care units, comes from using a rectal thermometer as it measures inside the body rather than on the periphery.

But as you’re unlikely to want to use this approach at home, the next best option is in the ear, which takes the temperature of the tympanic membrane (the eardrum), says Dr Bird.

The eardrum shares the same blood supply as the hypothalamus, so it gives a good idea of what’s happening internally.

Ear thermometers use an infrared light to measure energy coming off the eardrum (pictured, Braun ThermoScan 7 Ear Thermometer, £49.99, argos.co.uk)

Ear thermometers use an infrared light to measure energy coming off the eardrum (pictured, Braun ThermoScan 7 Ear Thermometer, £49.99, argos.co.uk)

Ear thermometers use an infrared light to measure energy coming off the eardrum (pictured, Braun ThermoScan 7 Ear Thermometer, £49.99, argos.co.uk)

Ear thermometers use an infrared light to measure energy coming off the eardrum (pictured, Braun ThermoScan 7 Ear Thermometer, £49.99, argos.co.uk).

But don’t test the temperature in the ear if you have been lying on it, as this can lead to higher readings if the ear is warm, a study in Turkey found.

Use the other ear instead — then stick with that ear when measuring throughout the day to get the most accurate assessment of changes in body temperature.

Ear thermometers also shouldn’t be used if you have an ear infection, as the ear will already be hot due to inflammation.

If you do have to use an oral thermometer, avoid using it within 20 to 30 minutes of a hot or cold drink, food, exercise or smoking, suggests Dr Ross Perry, a GP in London. This is because all of these can temporarily raise temperature in the mouth and, in the case of exercise, throughout the body.

‘Leave the thermometer under the tongue for one or two minutes, and try to stay still for the most accurate reading,’ he says.

Despite the convenience, forehead strips or taking temperature in the armpit are believed to be the least accurate as they are truly external. ‘If you do have to take a temperature under the arm, add 1c to the figure to get a more accurate reading,’ says Dr Bird.

YOUR MIND CAN BRING ON A FEVER

Stress can cause a rise in body temperature — a condition that’s called psychogenic fever.

It’s most common in children and adolescents, with an analysis by researchers in Japan in 2007 finding that stress or psychological and emotional agitation accounted for 18 per cent of unexplained cases of fever in children.

IF YOU FEEL HOT, IT COULD BE A COLD 

Contrary to popular belief, you don’t necessarily feel hot if you have a fever.

‘This is one of the big misconceptions about high temperatures,’ says Dr Bird.

‘If you feel hot, you almost certainly don’t have a fever, more likely a cold.

‘When we have a fever we usually feel cold and shivery and want to wrap ourselves up,’ he explains.

‘You do, however, feel hot to touch, so feeling the forehead with the back of a hand is actually a very good way to tell whether you have a fever if you don’t have a thermometer.

‘If your skin feels cold, you almost certainly don’t have one.’

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BARNEY CALMAN: Cystic fibrosis sufferers finally get ‘wonder drug’ after endless talks

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Dare we dream? Amid the flurry of tweets in response to our articles over the past fortnight that predicted the Government would soon strike a deal for a lifesaving cystic fibrosis drug, this simple sentence stood out. 

It summed up the hopes – and fears – of thousands of British families blighted by this horrible illness, which kills many sufferers before they reach their 40s. 

Last Tuesday, the drug, Kaftrio, was approved – and the dream finally became a reality, just as we had said it would. It was a watershed moment, and an end to many months of uncertainty. And the relief last week among both campaigners and those involved in the negotiations was palpable. 

The deal is, we can reveal, the biggest of its kind in NHS history – potentially amounting to £1billion over the next four years. 

But thousands of patients can now plan a future – one that’s not defined by pain, infections, hospital visits and gradually failing lungs. For those who are severely ill, the drug isn’t simply a lifeline, but a chance to live normally again. 

Over the past six months, in the run-up to last week’s announcement, the MoS has published a series of reports, lifting the lid on the secretive negotiations between NHS England and drug company Vertex on access to cystic fibrosis drugs. 

BARNEY CALMAN: The deal is, we can reveal, the biggest of its kind in NHS history - potentially amounting to £1billion over the next four years

BARNEY CALMAN: The deal is, we can reveal, the biggest of its kind in NHS history - potentially amounting to £1billion over the next four years

BARNEY CALMAN: The deal is, we can reveal, the biggest of its kind in NHS history – potentially amounting to £1billion over the next four years 

What was discussed during these talks is ‘commercially sensitive’, hence their shadowy nature – and patients were increasingly surprised that we knew so much. 

There are limits to what I can say, in order to protect the identity of our sources, but I’d like to take this opportunity to clarify a few points. We ran our first report last November, revealing that the Government had just signed a £100million deal for the now pretty much ‘obsolete’ cystic fibrosis drug Orkambi. 

It followed a row over cost for the tablets that began in 2017 – a dispute that dragged on so long that by the time an agreement was reached at the end of October 2019, the newer and vastly more effective Kaftrio was already being given to patients in America (where it’s known as Trikafta). 

When Orkambi was introduced in July 2015, it was the best drug on offer. Patients, of course, wanted access – the drug would, and has, made a difference. 

But overall the health improvements were often modest, many didn’t benefit, and many suffered intolerable side effects. Alone, it wasn’t worth the money. 

However, the drug’s maker, Vertex, was asking the NHS to invest in the future: buy Orkambi now, at the high price being asked for, and you can have Kaftrio when it comes out in a few years for no extra cost. A so-called pipeline deal. 

NHS England and its financial advisers, the National Institute for Health and Care Excellence (NICE), refused. Things became acrimonious. 

Vertex was repeatedly and publicly accused by our politicians and health chiefs of ‘poor practice’ for not ‘complying’ with their wishes and told they ‘ought to know better’. But by mid-2018 it was apparent from clinical trial results that Kaftrio was ‘the one’ everyone had been waiting for – ‘almost a cure’. 

BARNEY CALMAN: Over the past six months, in the run-up to last week's announcement, the MoS has published a series of reports, lifting the lid on the secretive negotiations between NHS England and drug company Vertex on access to cystic fibrosis drugs

BARNEY CALMAN: Over the past six months, in the run-up to last week's announcement, the MoS has published a series of reports, lifting the lid on the secretive negotiations between NHS England and drug company Vertex on access to cystic fibrosis drugs

BARNEY CALMAN: Over the past six months, in the run-up to last week’s announcement, the MoS has published a series of reports, lifting the lid on the secretive negotiations between NHS England and drug company Vertex on access to cystic fibrosis drugs

The company, really, held all the aces. And then, in May 2019 came a shocking decision that still makes little sense: the NHS agreed to take the triple therapy ‘off the table’ in talks, in order to get Orkambi at a lower price. 

In the run-up to the General Election, health chiefs had been under increasing pressure from Ministers to close the deal. But this ultimately meant three days after Kaftrio was approved in America, Orkambi – by then a five-year-old medicine that had been superseded – was given to UK patients. 

We were approached with the story by a group of whistleblowers, who told us how the NHS had not only ‘bought the wrong drug’ – but also that there was little hope of a resolution over Kaftrio. These were not the kind of people who normally talk to the press. But with a progressive condition such as cystic fibrosis, every single day counts – and they felt they could not afford further delay or deadlock. 

By making public what had been going on, they hoped to heap pressure on dealmakers to come to an agreement swiftly. And it worked. 

After our report, both parties returned to the negotiating table. Talks faltered again in May, but then came a breakthrough. Again, we ran stories to let them know that the world was watching. And finally, last week, came the result everyone had longed for. But did it have to be so difficult? 

The main lobbyists, the CF Trust, are a focal point in the cystic fibrosis community, providing ground-level support to families, giving advice and funding research. To say they are an integral part of thousands of patients lives is no understatement. 

BARNEY CALMAN: We were approached with the story by a group of whistleblowers who told us how the NHS had not only ¿bought the wrong drug¿ from Vertex (pictured, HQ in Boston, US) - but also, that there was little hope of resolution over Kaftrio

BARNEY CALMAN: We were approached with the story by a group of whistleblowers who told us how the NHS had not only ¿bought the wrong drug¿ from Vertex (pictured, HQ in Boston, US) - but also, that there was little hope of resolution over Kaftrio

BARNEY CALMAN: We were approached with the story by a group of whistleblowers who told us how the NHS had not only ‘bought the wrong drug’ from Vertex (pictured, HQ in Boston, US) – but also, that there was little hope of resolution over Kaftrio

But, as contentious as it is, there are some who say the Trust should not have campaigned for Orkambi, when the superior Kaftrio was on the near horizon. 

As far back as 2018, Kaftrio was already transforming the health of patients in trials. But when the drug was ‘taken off the table’ in talks, prior to the Orkambi deal last year, there appeared to be no public objection from them. 

It was common knowledge in the medical world by that time just how important Kaftrio was, so even some of those inside the Trust felt this was a missed opportunity. By the time the Kaftrio agreement was being thrashed out this year, the Trust appeared to have neither the ear of the Government, nor the drug company. 

Indeed, just a few weeks ago staff were reportedly told by boss David Ramsden that access to Kaftrio was ‘a long way off’ – at the very point that Ministers and Vertex were moving to close the deal. 

On Twitter, where cystic fibrosis campaigners are highly active, the Trust dismissed our reports that an agreement was close, saying it would be ‘months’ before anything happened. 

Given there was such urgency for the medicine during the Covid-19 pandemic – those with cystic fibrosis are at high risk – the mixed messages caused anxiety and upset. And, of course, the Trust was wrong in this instance. 

A CF Trust spokesman said: ‘We are incredibly proud to have worked alongside the cystic fibrosis community in the long campaign for life-saving medicines. The four-year battle to secure Orkambi was a critical step and it remains the only medicine suitable for many children. We have and will always fight for those with cystic fibrosis.’ 

And, to their credit, the Government and health chiefs have listened, and delivered. They did the deal they should have done almost a year ago – and, some feel they would have, if they’d been better advised by the CF Trust. 

In the end, the patients, parents, and concerned supporters who fought for Kaftrio dared to dream, and they won.  

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Breast cancer patients to be spared surgery thanks to ‘magnetic’ seed smaller than a grain of rice 

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Advanced breast cancer patients may be spared debilitating surgery thanks to a magnetic ‘seed’ implanted in the armpit. 

The pioneering device – smaller than a grain of rice – helps surgeons spot cancerous tissue so it can be removed without damaging surrounding healthy tissue. 

At present, some women have an operation to remove all the lymph glands under their arms, as this can be the first area that tumour cells spread into, but this can have irreversible repercussions. 

Lymph glands, or nodes, are a vital part of the lymphatic system, which helps the body fight off infection. Removing them disrupts the circulation to and from the arms, and women can be left with chronic pain and swelling, known as lymphoedema. 

Advanced breast cancer patients may be spared debilitating surgery thanks to a magnetic 'seed' - called Magseed -  implanted in the armpit

Advanced breast cancer patients may be spared debilitating surgery thanks to a magnetic 'seed' - called Magseed -  implanted in the armpit

Advanced breast cancer patients may be spared debilitating surgery thanks to a magnetic ‘seed’ – called Magseed –  implanted in the armpit

The pioneering device - smaller than a grain of rice - helps surgeons spot cancerous tissue so it can be removed without damaging surrounding healthy tissue (stock photo)

The pioneering device - smaller than a grain of rice - helps surgeons spot cancerous tissue so it can be removed without damaging surrounding healthy tissue (stock photo)

The pioneering device – smaller than a grain of rice – helps surgeons spot cancerous tissue so it can be removed without damaging surrounding healthy tissue (stock photo)

The new implant, called Magseed, acts as a marker, allowing surgeons to flag and remove only cancerous nodes, sparing the healthy ones. 

When women are first diagnosed with breast cancer, they undergo a series of tests. X-rays are taken to see if the cancer has spread to the lymph nodes in the underarm area – which happens in half of all cases. 

Nodes that are enlarged are considered to be a sign of cancer. 

Surgeons may also carry out a minor procedure called a biopsy, which involves taking a tiny piece of tissue from problem lymph nodes and testing it.

Historically, breast cancer patients with cancerous lymph nodes had surgery to remove the disease, followed by chemotherapy and drugs to control any spread. 

The new implant, called Magseed, acts as a marker, allowing surgeons to flag and remove only cancerous nodes, sparing the healthy ones (stock photo)

The new implant, called Magseed, acts as a marker, allowing surgeons to flag and remove only cancerous nodes, sparing the healthy ones (stock photo)

The new implant, called Magseed, acts as a marker, allowing surgeons to flag and remove only cancerous nodes, sparing the healthy ones (stock photo)

Now, many patients have chemotherapy and medication first, which makes the tumours smaller and subsequent surgery to remove them more straightforward. But chemotherapy also reduces the size of cancerous lymph nodes. 

In the past, before chemotherapy, a minor procedure was performed to attach clips to cancerous nodes, marking them out to be removed during surgery. But when the lymph nodes shrink during chemotherapy, these become loose and can slip off, so surgeons struggle to tell which have been identified as cancerous. 

‘The result is that surgeons remove unnecessary amounts of healthy tissue to be sure they’ve removed the cancer,’ say Mr Peter Barry, consultant oncoplastic breast surgeon at the Royal Marsden Hos­pital in London. 

Now, due to the Magseed’s ribbed texture, it stays in place on the lymph node throughout the patient’s chemotherapy treatment. 

WHAT’S THE DIFFERENCE… between dynamic and static stretching? 

Stretching helps loosen the body and prevents injury. Static stretching involves moving a joint or muscle as far as it can go, such as reaching down to touch your toes, and then holding that position for a length of time. 

It is an effective way of cooling down after exercise. 

Dynamic stretching is a good way of slowly warming up the muscles. Instead of holding a position, you repeatedly move the joints and muscles in a controlled fashion, such as continuous high-knee marching. 

This elevates the heart rate and body temperature, and therefore flexibility, ahead of the main activity. 

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A few weeks before chemotherapy, the tiny magnetic screws are implanted in the problem lymph nodes via a series of injections in the armpit area. The procedure lasts less than five minutes, under local anaesthetic, with surgeons using ultrasound scans to guide them. 

Surgery to remove the cancer takes place six months later, after the first course of chemotherapy treatment has finished. 

On the morning of the surgery, a specialised X-ray, known as a CT scan, is performed to show the position of the glands. The patient is then taken into theatre, where a magnetic wand, called Sentimag, is used to locate each Magseed, helping the surgeon identify the previously marked lymph nodes, which are then removed, leaving behind as much healthy tissue as possible. 

A test is performed on the extracted nodes, to look for signs of cancer. 

‘This tells us immediately whether the chemotherapy has worked – and if a patient needs more treatment,’ says Mr Barry. 

‘If it has, there’s no need to remove any further tissue.’ 

If cancer is detected, patients return two weeks later for another operation to remove more nodes. 

Jeevarani Sivapryan, 40, from Surrey, was diagnosed with breast cancer in July 2018. It had spread to nearby lymph nodes. 

After diagnosis, the mother-of-three had the Magseed injected in her cancerous node, prior to a six-month course of chemotherapy. 

The next year, in February, she underwent surgery. With the help of the Magseed, her surgeon removed the breast tumour, the cancerous node and a few surrounding it. 

Tests to see if the chemotherapy had eradicated the disease came back negative so no further lymph nodes needed to be removed. 

‘To be given this early-warning sign that my chemotherapy had worked was fantastic,’ she says. ‘I have a tiny scar under my armpit where it was inserted and removed, but that’s it. Anything which reassures women with breast cancer that their disease has gone is a massive achievement.’

WEIRD SCIENCE: The man who became a giant overnight 

A 64-year-old man from the Netherlands developed a condition overnight whereby he perceived everyone - and everything - to be tiny (pictured, 2016's The BFG film)

A 64-year-old man from the Netherlands developed a condition overnight whereby he perceived everyone - and everything - to be tiny (pictured, 2016's The BFG film)

A 64-year-old man from the Netherlands developed a condition overnight whereby he perceived everyone – and everything – to be tiny (pictured, 2016’s The BFG film)

Would you like to be a few inches taller? 

A 64-year-old man from the Netherlands developed a condition overnight whereby he perceived everyone – and everything – to be tiny. 

Despite being of average build, in his mind he’d become a giant. 

Doctors reported he would buy extra-large clothes and would avoid doors and corridors for fear he wouldn’t fit through them. 

However, brain scans revealed he’d suffered a stroke, resulting in significant damage to the regions of the brain involved in spatial awareness and leaving him in a permanently ‘shrunken’ world. 

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HEALTH NOTES: Thousands of children miss out on jabs because their mothers have mental health issues

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At least 5,000 children in the UK miss out on potentially lifesaving vaccines every year because their mothers have mental health problems, research has revealed. 

Conditions such as depression, anxiety and eating disorders leave mothers less likely to attend routine appointments where injections are given to protect under-fives against measles, mumps, rubella, whooping cough and diphtheria. 

The Manchester University team tracked almost 480,000 families over 12 years and found infants whose mothers had psychiatric struggles were 14 per cent less likely to get all their jabs than those whose mothers were healthy. 

Dr Cemre Su Osam, from the university’s Centre for Women’s Mental Health, who co-authored the study, said the findings were a ‘public health concern’.

At least 5,000 children in the UK miss out on potentially lifesaving vaccines every year because their mothers have mental health problems, research has revealed (stock photo)

At least 5,000 children in the UK miss out on potentially lifesaving vaccines every year because their mothers have mental health problems, research has revealed (stock photo)

At least 5,000 children in the UK miss out on potentially lifesaving vaccines every year because their mothers have mental health problems, research has revealed (stock photos)

Blowing away sleep apnoea

Learning to play a wind instrument could help the five million Britons blighted by the condition sleep apnoea. 

Research shows that blowing into instruments that use two reeds, such as the oboe, firms up muscles in the airways. In sleep apnoea, soft tissue in the throat restricts intake of air, causing snoring. 

Learning to play a wind instrument could help the five million Britons blighted by the condition sleep apnoea (stock photo)

Learning to play a wind instrument could help the five million Britons blighted by the condition sleep apnoea (stock photo)

Learning to play a wind instrument could help the five million Britons blighted by the condition sleep apnoea (stock photo)

This disrupts breathing and wakes sufferers every few minutes, putting them at risk of high blood pressure. Scientists at the Academic Centre for Dentistry in Amsterdam used data from studies involving patients who took up wind instruments.

The results, in the Journal Of Clinical Sleep Medicine, showed they snored less and woke less often. 

A charity project that is posting free family photographs to dementia patients is hoping they’ll ease lockdown isolation and spark buried memories. 

Research shows that looking at pictures of loved ones can increase feelings of comfort and safety among people with early-stage dementia. 

The joint initiative, by the Alzheimer’s Society and printing firm Citizen Systems, is offering 25,000 free photo postcards. 

Family members can simply upload their pictures at myphotomessages.com and type in a message, and the card is delivered in a few days.

Twice as many younger smokers have quit the habit due to Covid-19 fears compared with those over 50, according to research by University College London (stock photo)

Twice as many younger smokers have quit the habit due to Covid-19 fears compared with those over 50, according to research by University College London (stock photo)

Twice as many younger smokers have quit the habit due to Covid-19 fears compared with those over 50, according to research by University College London (stock photo) 

Young smokers fear Covid

Twice as many younger smokers have quit the habit due to Covid-19 fears compared with those over 50, according to research by University College London. 

Despite facing half the risk of death from the virus than their elders, the study shows that Britons under 30 were much more likely to give up smoking in an effort to avoid becoming seriously ill. 

Pressure group Action On Smoking And Health suggest several factors could be behind the pattern, including less peer pressure in pubs and bars, financial insecurity and moving back to the family home.

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