Action on Smoking and Health

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ASH Daily News for 19 September 2018

International

  • Australia: Health Minister agrees to study health effects of e-cigarettes
  • Study: Chemical in cigarette smoke may damage important aspect of vision
  • Japan: Smoking cost the country $18.5 billion in 2015
  • USA: E-cigarette warnings to appear in high school toilets nationwide

Parliamentary activity

  • Parliamentary Question

International

Australia: Health Minister agrees to study health effects of e-cigarettes

Australian health minister Greg Hunt has agreed to an independent inquiry into the health impacts of nicotine e-cigarettes. This comes after several MPs raised the issue in a party meeting, saying there was widespread support within the government for making nicotine e-cigarettes legally available. Australia’s drug regulator has banned e-cigarettes, putting Australia at odds with several comparable countries, including New Zealand, Canada and the United Kingdom.

Source: The Guardian, 18 September 2018

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Study: Chemical in cigarette smoke may damage important aspect of vision

Exposure to cadmium, a chemical found in tobacco smoke, could make it more difficult for people to see in low-contrast conditions, such as low light, fog or glare, a new study suggests. Even those with 20-20 vision can experience problems with daily living if their contrast sensitivity is impaired.

“This particular aspect of vision is really important because it affects your ability to see the end of a curb or put a key into a lock in low light,” said lead author Adam Paulson of the University of Wisconsin, School of Medicine. “It’s something that at this point in time there’s no way to correct, unlike visual acuity, which you can easily correct with glasses or contact lenses.”

See also: JAMA Ophthalmology, Association of Cadmium and Lead Exposure With the Incidence of Contrast Sensitivity Impairment Among Middle-aged Adults

Source: Reuters, 18 September 2018

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Japan: Smoking cost the country $18.5 billion in 2015

Smoking caused 2.05 trillion yen ($18.44 billion) in damage to Japanese society in the fiscal year of 2015, a health ministry survey has shown. The damage mainly comes from medical costs, this includes treating cancer and other tobacco-related conditions.

“Tobacco has various effects not only on people’s health but also all aspects of society,” said Ataru Igarashi, an associate professor of medical policies at the University of Tokyo. “Health-care costs are expected to drop due to the shrinking smoking population, but tobacco is still causing significant damage. Further countermeasures are required.”

Source: Asahi, 19 September 2018

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USA: E-cigarette warnings to appear in high school toilets nationwide

The US Food and Drug Administration (FDA) will stage a massive education campaign aimed at the nearly 10.7 million teens it says are at risk of e-cigarette use and potential addiction, the agency said yesterday. In addition to placing posters in school toilets, the FDA is launching anti-vaping videos, targeted at youths, on social media.

The FDA calls e-cigarette use by minors ‘an epidemic’. The trend was flagged in a 2016 report from the US surgeon general, which cited a 900% increase in e-cigarette use by high school students between 2011 to 2015.

The new campaign is an extension of ‘The Real Cost Youth E-Cigarette Prevention Campaign’, which the FDA says is a nearly $60 million effort funded by fees from the tobacco industry.

Editorial note: The FDA’s concerns strongly contrast with the latest ASH survey on youth use of e-cigarettes in Great Britain, which found that just 2% of GB 11-18 year olds use the devices ‘at least weekly’ and that use is almost exclusively found in current or ex-tobacco smokers. You can access the ASH factsheet on GB youth use of e-cigarettes here.

Source: CNN, 19 September 2018

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Parliamentary activity

Parliamentary Question

Philip Davies Conservative, Shipley
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential effect of the WHO Framework Convention on Tobacco Control’s proposal for a worldwide ban on advertising, promoting and sponsoring e-cigarettes on the Government’s tobacco control plan; and if he will make a statement.

Steve Brine, The Parliamentary Under-Secretary for Health and Social Care answered:
The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is not proposing a worldwide ban on advertising, promoting and sponsoring of e-cigarettes. The Government supports proportionate regulation of e-cigarettes to ensure non-smokers and children are protected from accessing these products, and has implemented the European Union Tobacco Products Directive which ensures such proportionate regulation.

A search of the Department’s Ministerial correspondence database has identified two items of correspondence received in the last six months about his Department’s participation in the 8th Conference of the Parties (CoP) to the WHO FCTC in October 2018. This figure represents correspondence received by the Department’s Ministerial correspondence unit only. The Department has also answered five Parliamentary Questions related to CoP in the last six months.

As a global leader on tobacco control, the Department will engage constructively at the CoP, working closely with fellow members of the European Union and with other partners to continue to support measures proposed to reduce global harms from tobacco and ensure WHO FCTC Secretariat work proposals offer value for money.
Source: Hansard, 17 September 2018

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ASH Daily News for 12 September 2018

UK

  • Tobacco firms used to pay Suffolk council pensions
  • Shisha smoke warning campaign

International

  • Nigeria: Online stores flout country’s tobacco control law
  • US: Montana is voting on whether the tobacco industry should pay for Medicaid expansion
  • US: Study finds high levels of nicotine in popular e-cigarettes

Parliamentary activity

  • Parliamentary Questions

UK

Tobacco firms used to pay Suffolk council pensions

Tobacco firms are sill being used to grow Suffolk County Council’s pension fund, despite figures that show smoking costs Suffolk almost £160 million a year. Specifically, ASH estimates smoking costs Suffolk £98 million a year in lost working days (through smoking-related illness or dying under retirement age); £20.7 million in social care annually for those living with chronic conditions; and it costs the NHS £40 million in smoking-related admissions.

Ipswich MP Sandy Martin said, “As a county councillor I led a debate on which the county council overwhelmingly voted to disinvest from tobacco companies – they have not done so. Either they are missing the point or choosing to ignore it. It’s very frustrating that people are not making the changes they need to be – if they had more integrity they would disinvest willingly.”

Source: East Anglian Daily Times, 11 September 2018

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Shisha smoke warning campaign

The dangers of smoking Shisha will be highlighted in a new public health campaign in Liverpool.

Shisha smoking is traditionally used by people from Middle Eastern or Asian community groups, but it is becoming increasingly popular in cities such as Liverpool, particularly among young people aged 18-25. Also known as hookah, narghile, waterpipe, or hubble bubble smoking, Shisha is a way of smoking tobacco, sometimes mixed with fruit or molasses sugar, through a bowl and hose or tube. The tube ends in a mouthpiece from which the smoker inhales the smoke deep into their lungs. Studies show an hour’s smoking is the equivalent of having between 100-200 cigarettes.

Dr Sandra Davies, Director of Public Health, said “We have had huge success in reducing the smoking rate in Liverpool… however, we risk some of this great work being undone as a result of people smoking Shisha, which has the potential to be far more harmful due to the intensity of deep inhalation of chemicals and poisons.”

Source: ITV, 12 September 2018

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International

Nigeria: Online stores flout country’s tobacco control law

Tobacco control advocates continue to criticise the Nigerian government for their lack of resolve in the fight against tobacco. More than 17,500 tobacco-related deaths have occurred in Nigeria, at least 20 billion sticks of cigarettes are consumed annually in the country, and 4.5 million adults currently use tobacco products.

In the latest hurdle, an investigation by Premium Times suggests online retailers in Nigeria are defying the Tobacco Control Law by marketing tobacco products to the public through their websites and failing to ensure prospective buyers are 18 and above.

Jumia, a retailer contacted as part of the investigation, insisted the company had not violated any law in the country, claiming it operates an online marketplace that allows vendors to sell their products through its platform while also ensuring that they abide by the provisions of relevant laws and regulations.

Source: Premium Times, 12 September 2018

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US: Montana is voting on whether the tobacco industry should pay for Medicaid expansion

In November Montana voters will get to choose whether to increase taxes on all tobacco products to fund Medicaid expansion, and the tobacco industry has spent more than $9 million to persuade them to vote “no.”

Earlier this year, a number of health organisations, including the American Heart Association, the American Cancer Society Cancer Action Network and the Montana Hospital Association, collected enough signatures to secure the ballot initiative to allows voters to determine the future of the Medicaid program. Advocates of the ballot initiative, which would raise the taxes on a pack of cigarettes by $2, say that the Medicaid expansion has helped provide health coverage to many Montanans who otherwise would not have it. “It’s one of the best things to happen to Montanans and the only way to sustain that is through a source of revenue,” said Jonathan Schleifer, executive director of the Fairness Project.

The groups’ decision to make the tobacco industry pay for permanent expansion put them up against a powerful adversary. The opposition campaign, Montanans Against Tax Hikes, is almost entirely funded by tobacco companies like Altria, Inc., which is the parent company for Phillip Morris. In its most recent state campaign finance filing, which covers the period from July 28 to August 27, Altria had given the PAC more than $7 million.

Source: Washington Post, 11 September 2018

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US: Study finds high levels of nicotine in popular e-cigarettes

E-cigarettes contain fewer toxins than conventional cigarettes. Dr Andrew Hyland, principal investigator of the national Population Assessment of Tobacco and Health Study, stated “Studies show that the overall number and levels of toxins are much lower in vaping products compared with conventional cigarettes, which, in comparison, are incredibly toxic, with thousands of chemicals and dozens of carcinogens that cause harm to every organ system in the body.”

He went on to say, “We know that many e-cigarette users are trying to quit cigarette smoking, and some cigarette smokers report that flavored e-cigarettes offer an appealing alternative when they are looking for a way to quit smoking cigarettes,” says Dr. Hyland. “Getting off of cigarettes first is much more important than what voltage or flavor people choose in an e-cigarette.”

However, with new research reporting adolescent users of Juul are absorbing nicotine at levels approaching nicotine exposure from traditional combustible cigarettes, there is concern that e-cigarettes may promote nicotine addiction in younger people. Unlike conventional cigarette advertising, which is restricted by the Food and Drug Administration (FDA), e-cigarettes in the US are legally marketed and promoted. With this concern in mind, the FDA is investigating the company behind the leading e-cigarette brand Juul.

See also:
Tobacco control, High exposure to nicotine among adolescents who use Juul and other vape pod systems (‘pods’)

Source: MedicalXpress, 11 September 2018

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Parliamentary Questions

Asked by Mr Philip Hollobone, Kettering
To ask the Secretary of State for Health and Social Care, what progress his Department has made in tendering for the grant scheme relating to external stakeholder support for the tobacco control plan.

Answered by Steve Brine, The Parliamentary Under-Secretary for Health and Social Care
The grant scheme to secure additional support to assist in the delivery of commitments made in the tobacco control plan was advertised in May and June 2018. Ten eligible organisations applied for this funding.

The Department reviewed these applications as per Cabinet Office guidelines in July and finalised this in August. Action on Smoking and Health (ASH) in a partnership application with FRESH North East scored the highest. All applicants have been informed of the results and paperwork is currently being finalised in order to award the grant to ASH and FRESH North East.

Source: Hansard, 11 September 2018

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Asked by Mr Philip Hollobone, Kettering
To ask the Secretary of State for Health and Social Care, what the strategic objectives of his departmental delegation will be at the eighth conference of the parties to the World Health Organisation framework convention on tobacco control in October 2018.

Answered by Steve Brine, The Parliamentary Under-Secretary for Health and Social Care
The United Kingdom Government will be represented at the eighth Conference of the Parties (CoP) to the World Health Organization Framework Convention on tobacco control (FCTC) by three officials from the Department and the UK Permanent Representation to the European Union. The delegation will be led by Tim Baxter, Deputy Director of Healthy Behaviours at the Department.

A figure for the costs associated with attendance at the CoP is not yet available. Every effort has been made to keep costs to a minimum to ensure value for money.

As a world leader in tobacco control the UK has been, and will continue to be, a highly active participant in the FCTC. The UK will participate in the CoP as a member state of the European Union. The UK will continue to support measures to reduce global harms from tobacco, building on its strong domestic record in reducing smoking, and will work to ensure that the work of the FCTC secretariat is both effective and provides value for money.

Source: Hansard, 11 September 2018

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Asked by Martin Vickers, Cleethorpes
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure the availability of a reliable body of independent research on heat-not-burn products.

To ask the Secretary of State for Health and Social Care, what gaps his Department has identified in the available independent research into the safety of heat-not-burn products.

To ask the Secretary of State for Health and Social Care, what discussions his Department has had with health departments of governments overseas on the development of research into heat-not-burn products.

Answered by Steve Brine, The Parliamentary Under-Secretary for Health and Social Care
The Government has committed Public Health England (PHE) to annually reviewing the evidence on e-cigarettes and novel tobacco products, such as heated tobacco products, until the end of Parliament in 2022. PHE’s current review was published in February 2018. The review looked at the latest available evidence on heated tobacco products and, based on that evidence, concluded that these products were less harmful than cigarettes, but more harmful than e-cigarettes. This is in agreement with the Committee on Toxicity (CoT), who concluded in December 2017 that there is a likely reduction in risk for smokers switching to heated tobacco products.

Both PHE and CoT identified shortcomings in the current evidence base: there are no long term studies as these products are relatively new, and a majority of the research is carried out by the tobacco industry. The Department will review and consider where there are gaps in evidence for further independent research, and continues to collaborate and share knowledge both in the United Kingdom and internationally to help develop the research base and understanding of these products. The UK Government is also represented on the Global Tobacco Regulators’ Forum, which brings together a number of countries, as well as the European Union and World Health Organization, to discuss regulatory issues of common interest, including research into heated tobacco products.

Source: Hansard, 11 September 2018

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ASH Daily News for 26 July 2018

UK

  • NHS ‘Stop Smoking’ ads working in Essex

International

  • BAT to launch heated tobacco in US
  • USA: Study finds smokers confused about benefits of lung cancer screenings
  • Indonesia: Tobacco use becoming part of the ‘rite of passage’ for some rural boys

Parliamentary Activity

  • Parliamentary Question

UK

NHS ‘Stop Smoking’ ads working in Essex

Half of young people surveyed in Essex say they’ve been put off taking up smoking by national NHS ‘Stop Smoking adverts’ on TV. The YEAH!3 report, by Healthwatch Essex, found the adverts have discouraged young people from ever taking up smoking, many said that constant reminders of the dangers prevented them from starting. The visual impact of warnings on cigarette packets was also a common factor reported to discourage young people from smoking.

Dr David Sollis, CEO of Healthwatch Essex, said: “It is very encouraging to hear that some of the adverts currently being used by the NHS are proving successful in deterring young people from smoking. That was a very clear message that came out of the report, which is really positive. It seems, for young people who already smoke, being warned of the long-term dangers is not always the strongest incentive to quit. In fact, we found that tailoring smoking-cessation information to include more immediate side effects and consequences may benefit this group more.”

Source: Heart, 26 July 2018

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International

BAT to launch heated tobacco in US

British American Tobacco has said it received a “substantial equivalence” clearance from the U.S. Food and Drug Administration for an new version of its carbon-tipped tobacco heating product called Eclipse.

This means the product can be legally marketed in the US and BAT said it would test launch Eclipse in the United States within the next 12 months.

Source: Reuters, 26 July 2018

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USA: Study finds smokers confused about benefits of lung cancer screenings

A study by the VA Center of Innovation for Veteran-Centered and Value-Driven Care in Seattle has found that patients hold misconceptions around the benefits and limitations of lung cancer screenings. Regular cancer screenings can lower chance of death from lung cancer due to earlier detection expanding treatment options, but cannot reduce the risk of developing lung cancer for people who smoke.

To test patients’ actual knowledge about lung cancer, the researchers surveyed 83 smokers after their lungs were screened, with a series of questions. Nearly half (47%) answered the question “For people over age 55 who are current smokers, which is more likely to prevent the most premature deaths – lung cancer screening or quitting smoking?” incorrectly. This means nearly half of patients believed lung cancer screenings were at least as good as quitting smoking as a way of protecting against death.

See also: Annals of the American Thoracic Society, Smokers’ Inaccurate Beliefs about the Benefits of Lung Cancer Screening

Source: Scienmag, 26 July 2018

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Indonesia: Tobacco use becoming part of the ‘rite of passage’ for some rural boys

Indonesia has one of the highest smoking rates in the world, with 63% of men (but just 5% of women) reported to be smokers. It’s the fifth largest tobacco market in the world, in part due it’s large, expanding, population of 260 million.

Some cultures in Indonesia regard circumcision as the mark of when a boy becomes a man and often at this time boys will receive gifts. In tobacco-producing district in Magelang, Central Java, smoking has become part of the rite of passage for boys and cigarettes are now a common gift.

The Magelang regency administration launched an intensive campaign against children smoking early this year including targeting junior high school students to explain the dangers of smoking.

Source: Jakarta Post, 26 July 2018

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Parliamentary Activity

Parliamentary Question

Martyn Day Scottish National Party, Linlithgow and East Falkirk
To ask the Chancellor of the Exchequer, how he plans to ensure that the UK tobacco product track and trace system as required by Article 8 of the WHO FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products will be fully independent from the tobacco industry.

Robert Jenrick The Exchequer Secretary
The government is committed to meeting the requirements for independence from the tobacco industry as per Article 8 of the WHO FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products.

The track and trace system will be implemented under the EU Tobacco Products Directive. The implementing legislation for the Directive specifies strict and comprehensive criteria by which independence from the tobacco industry is determined. Providers of the track and trace system will need to demonstrate to HM Revenue & Customs that they satisfy this criteria both before and during the period they provide the services required as a condition of holding the respective contracts.

Source: Hansard, 26 July 2018

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ASH Daily News for 18 July 2018

UK

  • Worcestershire: Cuts to stop smoking aids
  • York: MP criticises lack of help for smokers to quit
  • Tower Hamlets: The illegal tobacco roadshow
  • Opinion: Dark money lurks at the heart of our political crisis

International

  • US: Smoking in and near public housing will be banned at the end of July
  • South Africa: Tobacco bill decrees restrictions on smoking in homes
  • West Africa: Research shows increased tax on tobacco products will curb smoking

Parliamentary Activity

  • Parliamentary Question – General debate: The Tobacco Control Plan

UK

Worcestershire: Cuts to stop smoking aids

The British Lung Foundation has found that the local authority in Worcestershire fully decommissioned its stop smoking services in April 2016, and neighbouring Clinical Commissioning Groups (CCGs) then advised that no prescriptions for nicotine patches, gum, lozenges and sprays should be written for new patients.

The findings were part of a wider study by the charity which found a 75% decline in stop smoking aids being prescribed by GPs and pharmacists in England in 2016/17 compared with 2005/6.

Alison Cook, director of policy at the British Lung Foundation, said all smokers should be able to expect their GP to provide access to stop smoking medication and cutting aids would only achieve short-term savings.

Source: The Shuttle, 18 July 2018

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York: MP criticises lack of help for smokers to quit

A report by the British Lung Foundation has found that the Vale of York Clinical Commissioning Group (CCG) no longer directly funds stop smoking prescriptions and that GPs have been asked not to prescribe stop smoking medications due to their cost. As a result, the number of prescriptions for stop smoking medications has fallen by 64% in one year.

Alison Cook, director of policy at the British Lung Foundation said, “Our report shows that for patients in the city of York, services are only open to people in a priority group. This leaves some smokers without any support to stop smoking. The postcode lottery for treatment needs to end, and it must not be forgotten that tobacco dependency is an illness that requires urgent treatment.”

York MP Rachael Maskell has branded the treatment of smokers in York as “incredibly judgemental,” stating, “It’s disgraceful that the CCG will not fund stop smoking services while at the same time denying access to surgery. This has an impact on socially deprived areas because people will not be able to afford these treatments.”

Source: The Press, 18 July 2018

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Tower Hamlets: The illegal tobacco roadshow

Today the illegal tobacco roadshow will be in Chrisp Street Market, Tower Hamlets, to give advice to people wanting to quit smoking and raise awareness about the impact illegal tobacco. This will also be an opportunity for residents to raise any concerns they may have about fake cigarettes and tobacco being sold in their area.

Between 10am and 5pm residents will have the opportunity to meet health support services and the council’s trading standards team (including the dogs responsible for locating illegal tobacco).

John Biggs, Mayor of Tower Hamlets, said: “Tower Hamlets has a zero tolerance approach to illegal tobacco and this is a fantastic opportunity for residents to find out more about the work we do. Illegal tobacco is sold cheaply but has particular health risks, and this is something we need to protect our residents from. It also encourages and often funds other crimes in our community.”

Source: Tower Hamlets, 17 July 2018

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Opinion: Dark money lurks at the heart of our political crisis

In this opinion piece George Monbiot takes a look at organisations such as the Institute of Economic Affairs (IEA) that refuse to reveal who funds them, and the impact this is having on our democracy.

“The problem is exemplified, in my view, by the IEA. In the latest reshuffle, two ministers with close links to the institute, Dominic Raab and Matthew Hancock, have been promoted to the frontbench, responsible for issues that obsess the IEA: Brexit and the NHS.

Hancock, in his former role as cabinet office minister, notoriously ruled that charities receiving public funds should not be allowed to lobby the government. His department credited the IEA with the research that prompted the policy. This rule, in effect, granted a monopoly on lobbying to groups such as the IEA, which receive their money only from private sources. Hancock has received a total of £32,000 in political donations from the IEA’s chairman, Neil Record.

So what is this organisation, and on whose behalf does it speak? If only we knew. The only hard information we have is that, for many years, it has been funded by British American Tobacco (BAT), Japan Tobacco International, Imperial Tobacco and Philip Morris International. When this funding was exposed, the IEA claimed that its campaigns against tobacco regulation were unrelated to the money it had received.”

Source: The Guardian, 18 July 2018

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International

US: Smoking in and near public housing will be banned at the end of July

People won’t be able to smoke in or near public housing starting on the 31st of July. Lit cigarettes, cigars and pipes will have to be kept at least 25 feet away from public buildings, though e-cigarettes will still be permitted.

The policy was announced two years ago by the Department of Housing and Urban Development, but the agency gave the nation’s more than 3,300 local public housing authorities nearly two years to begin enforcement.

The rule will be part of residents’ leases, accompanied with information about how to quit smoking. Though tenants who break this rule could be evicted, HUD has said eviction after just one violation “is not grounds for eviction,” and that smoking on public housing premises is a civil violation, not a crime.

Source: CNN, 13 July 2018

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South Africa: Tobacco bill decrees restrictions on smoking in homes

The latest South African Tobacco Bill has included provisions which protect domestic workers or gardeners from secondhand smoke. People who smoke in the presence of this workforce could now be fined or jailed. The Bill also stipulates that you may not smoke in your home if you use it for teaching, tutoring or commercial childcare.

The Health Department’s Popo Maja said: “The bill seeks to ensure that employees are treated equally, including those working in private spaces. A private space used as a workplace will be regulated like other workplaces.”

Source: IOL, 17 July 2018

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West Africa: Research shows increased tax on tobacco products will curb smoking

This week at a dissemination event in Senegal for the Action Research Project on Tobacco Taxation in West Africa, the Consortium for Economic and Social Research (CRES) called for increased taxation of tobacco products in the West African region to curb smoking.

Abdoulaye Diagne, the Executive Director of CRES said, “Tobacco consumption is only declining significantly and continuously in countries that have adopted a policy of strong and steady increase in the selling price of tobacco products through a significant increase in tax levels.”

Smoking accounts for the death of six million people worldwide annually. However, a WHO forecast said that by 2020 tobacco will kill more than 10 million victims per year and remain the leading cause of death.

Source: Journal du Cameroun, 17 July 2018

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Parliamentary Activity

Parliamentary Question

Question from Jim Shannon, Shadow DUP Spokesperson (Health)
“To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that people who smoke are aware of the health risks caused by smoking.”

Answer from Steve Brine, Parliamentary Under Secretary for Health and Social Care
“Alerting the public to the serious risks of smoking, and supporting smokers to quit, are priorities for Public Health England (PHE) and are at the centre of the Government’s Tobacco Control Plan for England, published last year.

PHE runs a programme of smoking cessation marketing activity including an annual television and digital advertising campaign focused on tobacco health harms. Information on the harms smoking tobacco causes is available on the Smokefree website and via the Smokefree National Helpline. Further information on PHE’s smoking cessation campaigns, including the harm caused by smoking, is available at the following link: www.nhs.uk/smokefree

PHE provides clinical tools and blogs to support health professionals to advise their patients about the risks of smoking. PHE also supports Health Education England and the National Centre for Smoking Cessation and Training, which provide a range of resources and guidance to help people stop smoking.”

Source: Hansard, 17 July 2018

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General debate: The Tobacco Control Plan

On Thursday the 19th of July there will be a General Debate on the Tobacco Control Plan in the Main Chamber. You will be able to watch the debate online here.

Source: Parliamentary Calendar

See Parliamentary Calendar

ASH Daily News for 11 July 2018

UK

  • South West: More smokers in Poole admitted to hospital this year
  • West Midlands: Fines for smoking on Sandwell Hospital grounds
  • East Midlands: Young adults in West Lindsey giving smoking the red card

International

  • Indonesia: Tobacco control and children’s rights

Parliamentary Activity

  • Parliamentary Question

UK

South West: More smokers in Poole admitted to hospital this year

Poole has seen a small rise in the number of smoking related hospital admissions in 2017, bucking the regional and national trend which shows steadily decreasing rates of smoking related admissions. NHS figures show that there were 1,665 hospital trips across the borough for diseases linked to smoking, 30 more than in 2016.

Data shows that smoking rates in England are decreasing, with the exception of smoking rates for pregnant smokers which have remained unchanged since 2016.

Deborah Arnott, chief executive of charity Action on Smoking and Health (ASH), said: “ASH supports the government’s vision, set out in the Tobacco Control Plan for England, of a smokefree generation. But smoking must become history for all of society not just for the wealthy. Cuts in public health funding and lack of treatment for smoking on the NHS mean poorer more heavily addicted smokers, including those who are pregnant, are not getting the help they need to quit.”

Source: Daily Echo, 10 July 2018

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West Midlands: Fines for smoking on Sandwell Hospital grounds

Sandwell Hospital is aiming to go ‘smokefree’ from next summer, as hospital bosses seek to stop smoking outside hospital entrances.

Penalties will be applied to anyone caught breaking the new rules, which accompany a wider expectation from Public Health England that all hospitals will eventually become smokefree, providing support and treatment to help smokers quit. The trust which runs Sandwell General opted to implement the new policy in 2019 in light of major delays to the opening of the new Midland Metropolitan Hospital.

Toby Lewis, chief executive of the trust said, “We will continue to invest time, care and money to supporting people in our community to quit smoking. We will institute a fining system for anyone, staff, patients or visitors who smoke on our sites after the now agreed date.”

Source: Express & Star News, 10 July 2018

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East Midlands: Young adults in West Lindsey giving smoking the red card

Rates of smoking among 18-24 years olds are on the decline as more and more young people choose not to smoke.

Office of National Statistics data shows that in West Lindsey, Lincolnshire, the percentage of the population who have never smoked has risen by 21% since 2011. This is consistent with UK-wide declines in smoking rates among 18-24 year olds, which have dropped from over 25% in 2011 to 17.8% in 2017.

Duncan Selbie, chief executive of Public Health England, said, “Smoking rates have dropped by almost a quarter in five years, a triumphant step in eliminating the nation’s biggest killer…we are tantalisingly close to creating the first ever smokefree generation in England.”

Source: Gainsborough Standard, 10 July 2018

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International

Indonesia: Tobacco control and children’s rights

Indonesia has the highest uptake of smoking among youths in the world. Weak tobacco control policies and the tobacco industries’ aggressive marketing strategies have contributed to a male smoking rate of 67.4%.

The last two decades have seen smoking rates double for 10-14 year olds and triple for 5-9 year olds, culminating in a smoking rate of 41% for Indonesian children aged 13-15. Despite regulations banning smoking on school premises, many schools are surrounded by cigarette advertisements which target young people.

Indonesia also has among the cheapest cigarette prices in Southeast Asia and cigarettes can be purchased in single sticks which are easily affordable for children. The Convention on the Rights of the Child, ratified by Indonesia in 1990, commits the government to protecting children’s right to health. If children are to be protected from the harmful effects of smoking, the tobacco control community must show that smoking undermines this human right.

Source: The Jakarta Post, 11 July 2018

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Parliamentary Activity

Parliamentary Question

Tony Lloyd MP, Labour, Rochdale
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce lung health inequalities in deprived areas.

Steve Brine, Secretary of State for Health and Social Care
Two of the most significant respiratory health issues that impact deprived areas are poor air quality and smoking.

Minimising health inequalities is a core part of Public Health England’s (PHE’s) Mission and Strategic Vision for 2020. PHE was commissioned by the Department to review the evidence for effective interventions on air quality and provide recommendations that will significantly reduce harm from air pollution and impact on health inequalities at the local level.

PHE (Public Health England) has also published a number of reports on urban design which aim to support reductions in air pollution.

Smoking is a leading cause of a number of respiratory diseases including lung cancer and chronic obstructive pulmonary disease and is the leading cause of health inequalities. The Government’s Tobacco Control Plan for England, published in July 2017, re-emphasises the important role of local areas in providing support for smokers to stop smoking. As part of a comprehensive programme of national and local tobacco control activity, this is an important means of tackling inequalities in lung health in disadvantaged communities.

Source: TheyWorkForYou, 9 July, 2018

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ASH Daily News for 6 July 2018

UK

  • Londis recommends stores replace tobacco gantries
  • Blog: Duncan Selbie, Public Health Matters

International

  • Increasing number of holiday destinations completely banning vaping
  • Swedish study: Mother’s health linked to foetus’s future fertility

Parliamentary Activity

  • Oral evidence given by Simon Stevens at the Health Select Committee
  • Parliamentary business: Lord Faulkner’s speech in the NHS debate

Link of the week

  • Launch of the Smoking in Pregnancy Challenge Group report: Review of the Challenge 2018

UK

Londis recommends stores replace tobacco gantries

Londis has recommended to its stores to replace visible tobacco gantries with craft alcohol and vaping products in its new and refitted stores. It has said that this move could significantly increase sales.

The symbol group’s brand director Martin Swadling said the strategy would help future-proof the company’s estate. “Tobacco is still important, but it’s declining and selling it from a big cupboard isn’t using space very well,” he said.

Raj Aggarwal, of Spar Wigston in Leicester, said weekly vape sales increased from £100 to £400 after he replaced his gantry with e-liquids. He said: “Traditional gantries aren’t relevant anymore because customers immediately ask for certain brands or the cheapest pack. Vaping is more profitable. We make between 25% to 40% margins.”

A retailer, who asked not to be named, said weekly alcohol sales grew by £1,600 when she replaced her gantry with craft gin this year. “There’s no future in tobacco gantries. Ours was replaced with 22 gin products and we added lights to make it more attractive. Alcohol sales rose immediately,” she said.

Source: Better Retailing, 3 July 2018

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Blog: Duncan Selbie, Public Health Matters

On Tuesday new PHE and ONS smoking prevalence figures for England showed that rates have dipped below 15% for the first time representing a near quarter reduction over the past five years. Notwithstanding, smoking remains the nation’s biggest killer and there is still much to do to achieve the first-ever smokefree generation in England.

Source: Public Health England, 6 July 2018

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International

Increasing number of holiday destinations completely banning vaping

Holidaymakers are being urged to check vaping laws before their summer getaway after five more destinations banned e-cigarettes with punishment ranging from fines to prison. India, the Philippines, Lebanon, Cambodia and Vietnam have all recently clamped down on the devices.
In some countries the punishment can be particularly strict. In Thailand, tourists face a 10-year jail sentence for bringing e-cigarettes or e-liquid refills into the country.

Source: Daily Mail Online, 6 July 2018

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Swedish study: Mother’s health linked to foetus’s future fertility

Women who are overweight or who smoke during pregnancy are more likely to have daughters who develop polycystic ovary syndrome, a nationwide Swedish study has found.

Polycystic ovary syndrome affects about one in 10 women and is the most common cause of female infertility. It is typically characterised by ovarian cysts, irregular menstrual cycles and high testosterone levels. The exact causes are unknown, but mounting evidence suggests that the syndrome can be triggered by environmental factors in the uterus.

Source: New Scientist, 3 July 2018 (Print only)

See also: BJOG, An International Journal of Obstetrics and Gynaecology, Prenatal exposures and birth indices, and subsequent risk of polycystic ovary syndrome: a national registry‐based cohort study

Parliamentary Activity

Oral evidence given by Simon Stevens at the Health Select Committee

Simon Stevens’ oral evidence to the Health & Social Care Select Committee on Monday 2 July 2018 covered the issue of smoking cessation – see below for extracts.

“It is pretty clear that we will have to keep pushing harder on smoking, and smoking cessation is part of that. That cannot all be done through local authority commissioned services; we are going to have to look at whether the NHS can embed smoking cessation in more of the routine contacts that we have with vulnerable groups who are still smoking. ASH and the Royal College of Physicians have put out an important set of proposals in the last 10 days, which we will take a very careful look at.”

“The point is that smoking has been going down, and we want it to go down even further. ASH talks about 5% as being the smoking level at which you could say that we are almost smoke free. As a result of the judgments that Public Health England has made, we have a big hypothesis in this country that moving on a harm minimisation basis away from smoked tobacco to e-cigs represents a good thing to do.

“That is different from the judgment that some other countries have come to, but it is the judgment that our public health experts have come to. We absolutely have to look at smoking because of its obvious impact on cardiac disease and cancer. We know that two fifths of cancers are preventable, so, to the extent that we can give ourselves headroom for continued gains there, it means that whatever funding the country wants to put into health services we can actually deploy on new therapies for conditions that could not otherwise have been prevented.”

Source: Parliament, 2 July 2018

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Parliamentary business: Lord Faulkner’s speech in the NHS debate

Lord Faulkner spoke in the debate on the 5th July in the House of Lords on the Creation of the NHS in 1948, and the case for integration of health, mental health, social and community care to equip the NHS for the next 70 years. He asked the Minister to confirm that he would ensure that NHS England takes into account the evidence and the recommendations set out in the recent RCP report on treating tobacco dependency as it develops the new Plan for the NHS.

Watch full debate here (Lord Faulkner’s speech starts 16:26:34)

Lord Shaugnessy’s response to Faulkner’s challenge

In response to Lord Faulkner’s challenge the Minister said, “Our Tobacco Plan lays out an ambition to reduce smoking among adults to 12% or less and I can confirm that the Plan does align with the RCP report recommendations.”

Watch Lord Shaugnessy’s response

Source: Parliament live TV, 5 July 2018

Parliamentary Activity

Launch of the Smoking in Pregnancy Challenge Group report: Review of the Challenge 2018

This report details how smoking in pregnancy rates have stalled in the last few years at just below 11%. The current ambition is to reduce SATOD rates to less than 6% by 2022. However on the current sluggish trajectory, by 2022 SATOD rates will be around 8.7%. The Challenge Group report makes a number of policy recommendations to address the ongoing slowdown.

Download Report

ASH Daily News for 22 June 2018

UK

  • Liam Fox caught in fresh “lobbyists as advisers” scandal
  • Warwickshire raids find 15,000 illicit cigarettes

International

  • Ireland: Offer e-cigarettes to help smokers quit, says senator

Parliamentary Activity

  • Parliamentary Questions

Link of the week

  • Scottish Government’s latest Tobacco-Control action plan

UK

Liam Fox caught in fresh “lobbyists as advisers” scandal

Transparency campaigners have accused International Trade Minister Liam Fox of “having trouble again seeing the line between adviser and privately-backed lobbyist” after it emerged that one of Fox’s key advisors has also become an advisor to one of the UK’s biggest corporate lobbying firms. Shanker Singham, who recently joined the Institute of Economic Affairs (IEA), is now a senior adviser to the trade minister.

Singham is a member of Liam Fox’s ‘committee of experts’, a five-person group advising him on trade deals. Singham, a one-time Washington lobbyist, is director of the International Trade and Competition Unit at the IEA.

Hazel Cheeseman, director of policy at the campaign group Action on Smoking and Health (ASH), said: “The Institute for Economic Affairs has long acted as a paid lobbying agency for the tobacco industry. It’s very worrying to see one of their staff playing such a key role in shaping Britain’s trade deals as we leave the EU.”

Source: Open Democracy, 21 June 2018

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Warwickshire raids find 15,000 illicit cigarettes

Almost 15,000 cigarettes and more than 9kg of hand rolling tobacco were seized in raids on shops carried out by Warwickshire County Council’s Trading Standards Service, supported by Warwickshire Police and Border Force.

Tobacco sniffer dogs were used to hunt for counterfeit and non-duty paid cigarettes and tobacco hidden in corner shops, mini supermarkets and parked vehicles. Officers used local intelligence to identify shops where cheap illegal cigarettes were being sold.

Andy Crump, Warwickshire County councillor, said: “The sellers of cheap illegal cigarettes don’t care who they sell to, making it easier for children and young people to obtain cigarettes and get hooked on smoking and making it harder for adults to quit.”

Source: Talking Retail, 21 June 2018

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International

Ireland: Offer e-cigarettes to help smokers quit, says senator

Catherine Noone, a Fine Gael senator has urged the government to develop their policy on e-cigarettes, to reduce the number of smokers in Ireland.

The Department of Health has said it does not have enough evidence to recommend vaping as part of the Tobacco Free Ireland programme. The initiative aims to reduce smoking from the current rate of 22% to under 5% by 2025.

Noone pointed out that England and Scotland have policies that recommend e-cigarettes.
She said: “I’m known for having nanny state policies on alcohol, sugar and things like that, so I’m not in favour of e-cigarettes really. I think they look a bit ridiculous but they help people quit smoking and we need to develop a policy that recognises that. They [government] said there is not enough evidence but neighbouring countries that support their use have the same evidence. If we want people to stop smoking we have to help them any way we can and if e-cigarettes work, we need to offer them.”

Source: The Times, 22 June 2018

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Parliamentary Activity

Parliamentary Questions

PQ1: Tobacco Control Plan

Kevin Barron Chair, Committee on Standards, Chair, Committee on Privileges

To ask the Secretary of State for Health and Social Care, with reference to his Department’s single departmental plan, for what reason the intention to work with Public Health England to deliver the new Tobacco Control Plan under Objective 1.1 was removed in the update of 23 May 2018.

Steve Brine The Parliamentary Under-Secretary for Health and Social Care

The Single Departmental Plan published on 23 May 2018 is a concise summary of the highest level objectives for the financial year 2018-19 rather than a comprehensive account of all the activities the Department is planning to undertake. The fact that a commitment or activity has not been included in the summary does not imply that there is no intention to work on it.

The Government is continuing to reduce harm caused by tobacco. Last year we published a new tobacco control plan to build on that success and on 7 June 2018 we published a delivery plan setting out actions for meeting the aims of the tobacco control plan and how progress will be monitored. A copy of the delivery plan is available at the following link: https://www.gov.uk/government/publications/tobacco-control-plan-delivery-plan-2017-to-2022

Source: Hansard, 21 June 2018

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PQ2: Effect of plain cigarette packaging

Royston Smith Conservative, Southampton, Itchen
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effect of the introduction of plain cigarette packaging on smoking.

Steve Brine The Parliamentary Under-Secretary for Health and Social Care
The Standardised Packaging of Tobacco Products Regulations 2015 came into force on 20 May 2016. It is too soon to effectively evaluate the impact of this legislation. However, the Government is committed to completing and publishing a full post-implementation review before 20 May 2021 and to publishing subsequent reports at intervals not exceeding five years.

Source: Hansard, 21 June 2018

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Link of the week

Scottish Government’s latest Tobacco-Control action plan

The Scottish Government recently launched their latest Tobacco-Control plan. It’s an ambitious document where they recommit to their aim of creating a ‘tobacco-free’ generation by 2034.

Source: Scottish Government

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ASH Daily News for 13 June 2018

UK

  • North West: Smokers urged to take care following fires in Blackburn

International

  • Netherlands: Smoking clogs up parts of the brain crucial for memory – increasing the risk of dementia, study finds
  • Romania: BAT to Invest 800 Million Euros in Factory

Parliamentary Activity

  • Parliamentary Question

UK

North West: Smokers urged to take care following fires in Blackburn

Smokers across Lancashire are being warned to take extra care when it comes to disposing of their cigarette ends after a series of fires in a town centre.

Blackburn Fire Station station said they had been called out to a number of small incidents in Blackburn town centre, where compost and earth in planters is so dry that fires have been easily sparked by passers-by using them as an ashtray

Source: Lancashire Telegraph, 12 June 2018

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International

Netherlands: Smoking clogs up parts of the brain crucial for memory – increasing the risk of dementia, study finds

Smoking clogs an area of the brain crucial to memory, according to new research.

When someone smokes, it causes a build-up of calcium in the hippocampus, part of the brain associated mainly with memory, in particular long-term memory. The study found that found those who smoked – or were diabetic – were more likely to have these ‘calcifications’ on CT scans.

The research team studied 1,991 patients with an average age of 78 who had visited a memory clinic at a Dutch hospital between 2009 and 2015, looking at the link between vascular risk factors like high blood pressure, diabetes and smoking and brain calcifications.

The findings may explain the link between cigarettes and dementia – and provide another reason to stub out the habit.

See also: Radiology: Hippocampal Calcifications: Risk Factors and Association with Cognitive Function

Source: Daily Mail, 12 June 2018

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Romania: BAT to Invest 800 Million Euros in Factory

British American Tobacco (BAT) announced on June 11 that it will invest 800 million euros over the next five years in its factory in Ploiești, Romania. The investment will support the expansion of BAT’s controversial ‘heat not burn’ tobacco products in countries across Europe during the second half of 2018.

A completely new manufacturing hall will be built dedicated to producing specially designed tobacco ‘heat not burn’ sticks – called Neostiks – which work with the glo tobacco heating device.

Source: Emerging Europe, 12 June 2018

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Parliamentary Activity

Parliamentary Question

Philip Davies, Conservative MP, Shipley

To ask the Secretary of State for Justice, how many incidents of (a) violence and (b) disturbance there has been in each prison since the implementation of the smoking ban.

Philip Davies, Conservative MP, Shipley

To ask the Secretary of State for Justice, what assessment he has made of trends in the level of violence in prisons between (a) inmates and (b) inmates and prison staff since the implementation of the ban on tobacco.

Philip Davies, Conservative MP, Shipley

To ask the Secretary of State for Justice, how many prisons that have implemented a ban on smoking tobacco have put in place special measures including increased security to manage prisoners’ behaviour.

Rory Stewart, the Minister of State, Ministry of Justice.

The information requested in 149636 could only be obtained at disproportionate cost as the implementation of smoke-free prisons was rolled out at different times.

An analysis was carried out earlier this year on the impact of the tobacco ban on Prison Safety and Security. There is no conclusive evidence of an increase in violence in prisons attributable to the tobacco ban. No additional security measures have been implemented in any prison following the implementation of the tobacco ban.

Source: Hansard HC, 12 June 2018

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ASH Daily News for 12 June 2018

UK

  • Glasgow health board signs ASH Scotland’s Charter for a Tobacco-Free Generation

International

  • Cigarette butts and filters the most common pieces of litter on Europe’s beaches
  • Global Electronic Cigarette Market expected to generate $26.83bn of revenue in 2023

Parliamentary Activity

  • Parliamentary Question

UK

Glasgow health board signs ASH Scotland’s Charter for a Tobacco-Free Generation

Scotland’s largest health board has thrown its weight behind a health charity’s goal to create a tobacco-free generation by 2034.

The director of NHS Greater Glasgow and Clyde (NHSGGC), John Matthews OBE, has signed ASH Scotland’s Charter for a Tobacco-Free Generation, designed to further help drive down smoking rates. Despite the continuing drop in Greater Glasgow and Clyde’s smoking rates, smoking remains the biggest single preventable cause of ill-health and premature death in Scotland.

John Matthews OBE, chair of the board’s Public Health Committee, said: “Tobacco is still the most common preventable cause of death in Scotland with smoking to blame for around a quarter of all deaths.

Signing this charter today is important as it shows our continued commitment to reducing smoking and our determination to ensure that all children will grow up free from the harmful effects of tobacco.”

Source: Glasgow Live, 12 June 2018

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International

Cigarette butts and filters the most common pieces of litter on Europe’s beaches

The European Environment Agency (EEA) has released new data about litter found on Europe’s beaches. Based on nearly 700,000 collected items, disposable plastics are the biggest contributor to marine litter, with cigarette butts and filters being the most commonly found individual items.

A new EEA analysis on marine litter showcases data collected by volunteer groups at beaches across Europe’s four regional seas — the Baltic Sea, the Black Sea, the Mediterranean Sea and the North-East Atlantic Ocean.

Using the EEA’s Marine LitterWatch mobile app, volunteer groups collected litter data at 1,627 beach clean-up events between 2014 and 2017.

Source: Chartered Institution of Wastes Management, 8 June 2018

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Global Electronic Cigarette Market expected to generate $26.83bn of revenue in 2023

The global electronic cigarette market is expected to be worth $26,839 million by 2023, up from $8,610 million in 2016, registering a compound annual growth rate of 17.4% from 2017 to 2023.

The figures are based on data from the commercial research organisation Research and Markets.

Source: Cision PR Newswire, June 2018

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Parliamentary Activity

Parliamentary Question

Desmond Swayne Conservative, New Forest West

To ask the Secretary of State for Health and Social Care, what assessment he has made of the level of vendor compliance with the tobacco and related products regulations in respect of vaping; and if he will make a statement.

Steve Brine The Parliamentary Under-Secretary for Health and Social Care

The Department commissioned the Chartered Trading Standards Institute (CTSI) to assess compliance with the Tobacco and Related Products Regulations 2016 including e-cigarettes. The CTSI published its latest report ‘A Rapid Review of Nicotine Inhaling Product Compliance with the Tobacco and Related Products Regulations’ in May 2018 and is available at the following link: https://www.tradingstandards.uk/news-policy/tobacco-control/tobacco-compliance-and-rapid-reviews

Source: Hansard, 11 June 2018

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ASH presents new data on e-cigarettes to Science and Technology Select Committee

Tuesday 27th March

Action on Smoking and Health today appeared before Parliament’s Science and Technology Select Committee to provide evidence for the Committee’s inquiry into e-cigarettes. New data from the charity, published today, was presented to the committee providing the most recent figures on the level of use and attitudes towards e-cigarettes.

The latest figures come from the annual ASH Smokefree GB survey completed in March by polling agency YouGov [1].

The new figures show that:

  • Use of e-cigarettes continues to increase among ex-smokers and smokers with 23% of ex-smokers now reporting that they currently use or used to use an e-cigarette.
  • Use among young people remains low at 4% and almost exclusively among those who smoke with 0.4% of young people who don’t smoke saying they currently use an e-cigarette
  • The accuracy of people’s understanding about the relative harm from vaping compared to smoking has improved between 2017 and 2018 among adults with 50% of adults correctly identifying that vaping is less harmful than smoking in 2018 compared with 43% in 2017. Although the proportion who believe vaping is as or more harmful than smoking remains similar to 2017 at 25%
  • However, the accuracy of young people’s perceptions of the harms from e-cigarettes compared with smoking appear to have got less accurate over the same period with 31% in 2018 stating they believe vaping to be as or more harmful than smoking compared to 28% in 2017.

Appearing in front of the Committee were ASH Chief Executive Deborah Arnott and Director of Policy Hazel Cheeseman. They also represented the Smoking in Pregnancy Challenge Group [2] and the Mental Health and Smoking Partnership [3].

Key issues they raised with the committee included:

  • The public health opportunity represented by e-cigarettes. The popularity of e-cigarettes as an alternative to smoking has been unprecedented, contributing to the number of people who have quit smoking.
  • The regulatory process in the UK has been a success in protecting young people while facilitating uptake among adult smokers, but there is room for improvement. There is potential to further increase uptake of e-cigarettes among smokers through reviewing the process for medicinal licencing and ensuring products can be made available as licenced medications on prescription.
  • There continues to be a pressing need to improve public understanding of the relative risk from vaping compared to smoking. Health professionals must provide accurate and consistent advice to smokers.

Deborah Arnott, Chief Executive of Action on Smoking and Health, said:

“We are pleased to be sharing this evidence with the Science and Technology Committee. It is important that policymakers and the public understand the potential benefits of e-cigarettes in reducing the harm caused by tobacco. Good evidence should continue to inform the approach we take to regulation in this country as we seek to maximise the benefit to public health from e-cigarettes.”

ENDS

Notes and Links

 Action on Smoking and Health is a health charity working to eliminate the harm caused by tobacco use. For more information see: www.ash.org.uk/about-ash. ASH receives funding for its programme of work from Cancer Research UK and the British Heart Foundation.

ASH staff are available for interview and have an ISDN line.

For more information contact ASH: 020 7404 0242, or out of hours, Deborah Arnott on 07976 935 987 or Hazel Cheeseman on 07754 358 593.
References

[1] ASH supplementary evidence to the Science & Technology Committee. The adult survey is conducted by YouGov for ASH Fieldwork for 2018 survey was undertaken between 8th February and 6th March. The survey was carried out online. Total sample size was 12767 GB adults and the figures have been weighted and are representative of all GB adults (aged 18+). The youth survey is also conducted by YouGov for ASH The survey is conducted online via parents for 11-15 year olds and directly with 16-18 year olds. The 2018 survey had a sample of 2291 and the figures have been weighted and are representative of all GB 11-18 year olds. The fieldwork was carried out between 28th February and 17th March.

The full evidence provided by ASH is here: http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/science-and-technology-committee/ecigarettes/written/75354.html

[2] The Smoking in Pregnancy Challenge Group is a coalition of voluntary sector, academia and professional groups. For more information and full membership see here: http://smokefreeaction.org.uk/smokefree-nhs/smoking-in-pregnancy-challenge-group/

The full evidence provided by the Group is here: http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/science-and-technology-committee/ecigarettes/written/75321.html

[3] The Mental Health and Smoking Partnership is a coalition of voluntary sector, academia and professional groups. For more information and full membership see here: http://smokefreeaction.org.uk/smokefree-nhs/smoking-and-mental-health/

The full evidence provided by the Partnership is here:

http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/science-and-technology-committee/ecigarettes/written/75317.html

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