ASH Daily News 11 April 2017



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  • Government launches new litter strategy
  • Considerable scope for improving how local areas tackle smoking
  • Ireland: Hiqa report on cost-effectiveness of smoking cessation
  • Malaysia: The battle against illicit cigarettes

Government launches new litter strategy

Secretary of State for Environment Food and Rural Affairs, Andrea Leadsom has announced a new Government Litter Strategy for England. The three strand approach focuses firstly on making it easier for people to dispose of litter, secondly on encouraging children to become advocates for a cleaner environment and thirdly on tougher enforcement measures.

Every year littering costs councils nearly £800 million across England. It is hoped that new tougher penalties including fines of £150 for dropping litter will deter people from damaging the environment.

The Government has recognised the prevalence of smoking related litter and restated its commitment to reducing smoking rates as the most effective way to tackle this problem. The Strategy states the Government support supporting smokers to quit through use of stop smoking services and through Public Health England’s social marketing campaigns such as Stoptober. Councils have implemented a range of schemes to cut down smoking related litter and support quitting including, teaming up with local retailers to offer vouchers (which can offset the cost of a fixed penalty) as a reward for litterers who attend a smoking-cessation course and successfully stop smoking for at least 4 weeks.

The Government has also established a new anti-litter task force which has been tasked with developing new ways to cut plastic bottles, cigarette ends and fast food packaging.

See also:
HM Government: Litter Strategy for England
The Sun: You could be fined up to £150 for dropping a cigarette under new litterbug laws that could also see drivers held responsible for passengers hurling garbage out of your car
Northamptonshire Telegraph: Northamptonshire MP wants heavier fines for litter bugs

Source: The Telegraph, 10th April 2017
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Considerable scope for improving how local areas tackle smoking

Amanda Sandford, Information Manager at Action on Smoking and Health (ASH) discusses the need for integrated working to tackle smoking prevalence at a local level.

Severe pressure is being applied to the NHS and social care services and with an aging population this is only likely to increase. Several reviews have already pointed out the need to focus more on preventing ill health if we are to lessen this burden. In October 2014, NHS England published the Fiver Year Forward View stating that without further annual efficiencies and real-term funding increases, there would be a “mismatch between resources and patient needs of nearly £30bn a year by 2020-21”. The report went on to recommend “a radical upgrade in prevention and public health”.

Further a King’s Fund report estimated that even after additional government funding, there remains a predicted shortfall of more than £20bn by 2020. This funding gap is highly unlikely to be closed by efficiency savings alone, so radical action is needed to improve public health through preventative strategies.

Smoking is key to this. Across the UK, smoking is responsible for nearly 100,000 deaths a year. And for every death it’s estimated that about 20 smokers will be suffering a smoking-related disease. This costs the NHS an estimated £2 billion per year. The good news is that there is strong evidence of the cost-effectiveness of interventions to reduce smoking, particularly through stop smoking services. NICE has estimated that for every £1 invested, £2.37 will be saved on treating smoking-related disease and lost productivity.

However, faced with central government funding cuts, local authorities and CCGs are having to make difficult decisions regarding the prioritising of public health services. ASH research found that almost three out of five councils cut their smoking cessation budgets last year. Additionally, a number of CCGs are now refusing to fund the prescription of nicotine replacement therapy and other pharmacotherapies by GPs.

Cutting these services is a false economy as smokers who are given professional support in addition to pharmacotherapies are up to four times more likely to quit as those attempting to quit unaided. For tobacco control to work effectively at local level, there needs to be a close relationship between local authorities and the trusts and CCGs in their area. As survey of tobacco control leads for ASH found that relationships with GPs and CCGs were not as strong as their potential contributions to tobacco control warrant. Other research by the British Thoracic Society found that smoking cessation in secondary care was “woefully short” of national standards, with regards to helping people to stop smoking and enforcing smoke free premises.

This suggests that there is considerable scope for improved communication and co-operative working between NHS bodies and local authorities to tackle smoking.

Source: National Health Executive, 7th April 2017
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Ireland: Hiqa report on cost-effectiveness of smoking cessation

A study by the Health Information and Quality Authority (Hiqa) into cost-effective methods of helping smokers quit has found that state investment in interventions is effective and provides good value for money. About €40 million a year is spent on stop-smoking medications and the review advised that using e-cigarettes and the drug varenicline, alone or in combination with nicotine replacement therapy, were found to be the most cost-effective.

The report also called for pregnant women to be given counselling to help them quit and noted that the poorer an individual’s background the more likely they are to smoke.

The report said that evidence on the success of e-cigarettes in helping smokers to quit was promising, and that the risk to bystanders from “passive vaping” appears to be very low.

Máirín Ryan, director of health technology assessment at Hiqa, said: “A decision to advocate e-cigarette use should take into consideration any additional information on the long-term safety of e-cigarette use, and any emerging data in relation to concerns about the social normalisation of e-cigarettes leading to increased uptake among people who have never smoked, or later migration to tobacco cigarettes.”

Alan Buckley, spokesman for Vape Business Ireland, a lobby group, said that information about vaping should be made available through the HSE’s Quit campaign to make people aware of the options available.

Mr Buckley also questioned Hiqa’s remarks about the danger that non-smokers could take up vaping. “The 2015 Healthy Ireland Survey shows that 99.9 per cent of vapers are ex-smokers, so we remain unclear where this concern comes from as the report does not in itself provide any research or even anecdotal evidence to back this up,” he said.

See also:
Irish Mirror: E-cigarettes are a cost-effective way to help smokers quit, HIQA claims

Source: The Irish Times, 11th April 2017
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Malaysia: The battle against illicit cigarettes

According to a new survey the percentage of illicit cigarettes in Malaysia has reached a concerning 57.1%, as at December 2016. The Neilsen Cigarette Study 2016 has revealed that the estimated illicit trade is 11 billion sticks amount to a loss in Government revenue of RM 4.4 million (nearly £800,000).

This illicit industry is seen as a partial reason why the number of smokers is rising not falling and according to the Health Ministry 7 out of 10 youths are buying illicit products.

The Government has announced it will focus on enforcement activity to cut the illicit industry and increase tax on cigarettes but without an immediate timescale.

Source: Malaysia Chronicle, 10th April 2017
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