In November 2017, ASH and UKCTAS submitted a response to a NICE consultation. The consultation was examining a draft guideline on smoking cessation. You can read the submission below.ASH and UKCTAS submission to NICE consultation on draft smoking cessation guideline
Cigarette smoking can affect fertility in both women and men, sexual function in men, pregnant women’s health, the health of an unborn child, and the health of young children. Dec. 2016.07. Smoking and Reproduction
This report provides an overview of the health impact of smoking and smokeless tobacco on on oral health.Tobacco and Oral Health
18 August 2016.
Figures published today show a further significant 15% decline in the number of smokers seeking help to quit from the Stop Smoking Services in England. The services are as effective as ever, increasing smokers’ chances to quit by up to fourfold over cold turkey but they are reaching fewer smokers. Of particular concern is the decline in smokers who need the services most, such as pregnant smokers who find it particularly difficult to quit unaided. 
The NHS England Five Year Forward (FYFV) view forecast a £22 billion shortfall in funding for the NHS by 2020 which could only be plugged if there was “a radical upgrade in prevention and public health”.  Smoking kills more people than the next six causes of preventable premature death put together, so tackling smoking is core to a successful prevention strategy. However, government funding cuts to public health budgets have led to cuts in stop smoking services, making it increasingly difficult for them to deliver. 
Between April 2015 and March 2016 68,082 fewer smokers set a quit date with the Stop Smoking Services in England, compared with the previous year. This is the 4th consecutive year to show a fall in the number of people using the services. At the 4-week follow-up 195,170 people – 51% – reported that they had successfully stopped smoking. 
Stop Smoking Services remain effective and incredibly cost-effective. A review found that over ten years of operation, the English Stop Smoking Services increased their reach and impact threefold. In 2010/11 it is estimated that they helped more than 20,000 people to achieve long term abstinence. 
Services offer the best way of helping people to quit and to stay smokefree. With proper investment they can be very successful in attracting smokers from lower socio-economic groups where smoking prevalence is highest. 
Dr Andy McEwen, Executive Director of the National Centre for Smoking Cessation and Training (NCSCT) said:
“The Stop Smoking Services provide a vital lifesaving service for smokers addicted to tobacco and the real difference they make to hundreds of thousands of people each year is shown by the latest figures. They are proven to be effective and cost-effective, and it’s therefore very worrying that some local authorities are downgrading or even decommissioning their services. Such an approach is short-sighted and will end up costing lives and harming communities.
We need a fresh approach to measuring the success of the services with a focus on quality of care rather than simply the number of people they see, which is largely not under the control of the services.”
Deborah Arnott, chief executive of health charity ASH said:
“Smoking is responsible for half the difference in life expectancy between the richest and poorest in society. Stop smoking services provide the support smokers need to quit successfully, but they are under threat from local authority budget cuts.
The government needs to ensure that local authorities continue to be funded to provide specialist stop smoking services targeted at those with greatest need if they are to succeed in reducing health inequalities. The obesity strategy has not delivered, the government promised a new tobacco control strategy this summer which we await with interest. It needs to deliver if the Prime Minister is to succeed in her ambition to improve the life chances of the poorest in society.” 
Notes and Links:
 Five Year Forward View NHS England, 2015
 Reading between the lines. Results of a survey of tobacco control leads in local authorities in England. ASH/Cancer Research UK, 2016
 West, R. et al. Performance of English stop smoking services in first 10 years: analysis of service monitoring data. BMJ2013;347:f4921 doi: 10.1136/bmj.f4921
 Statement by the new Prime Minister, Theresa May 13 July 2016
A briefing for local councillors on the importance of the Stop Smoking Services is available from our Local Resources section.
19 July 2016. A new report published by the House of Commons Health Committee on the Impact of the Spending Review on Health and Social Care has recognised that “cuts to public health budgets set out in the Spending Review threaten to undermine the necessary upgrade to prevention and public health set out in the Five Year Forward View”. It goes on to call such cuts a “false economy” which it suggests may “create avoidable costs in the future.” 160718-Health-Committee-impact-of-the-spending-review-on-health-and-social-care.docx
|Terms of service for Doctors|
|The National Health Service (General Medical Services) Regulations 1992 (amendment)
(External Web Page)
|Legislation in Force Paragraph 12 of Schedule 2 of this piece of legislation requires doctors to advise patients about the significance of diet, the use of tobacco, consumption of alcohol and the misuse of drugs.
Wherever appropriate, doctors must advise against smoking as part of the service they provide to their patients.
|NRT on prescription on the National Health Service|
|The National Health Service (General Medical Services) Regulations 2001 (amendment)
(External Web Page)
|Legislation In Force On National No Smoking Day 2001, the public health minister Yvette Cooper announced that nicotine replacement therapies (NRT) such as patches, lozenges and gum were to be made available on prescription from local general practitioners.
Prior to the announcement, NRT drugs were included in schedule ten of the General Medical Services, which lists drugs that GPs cannot prescribe.
From 17 April 2001 in England and from May 1 2001 in Wales, nicotine replacement therapies were made available to the general public on prescription.
The therapies are available to smokers aged over 18 years of age and to smokers under 18 years on the recommendation of a healthcare professional.
|Availability of NRT on the High Street|
|The Medicines General Sale List Order 2001 (amendment)
(External Web Page)
|Legislation In Force This amendment to the Medicines General Sales List altered the status of many nicotine replacement therapies from being a controlled drug available when supplied under the supervision of a pharmacist (Pharmacy only), to one available on the high street (General sales).
These amendments came into force on 31 May 2001.
Thursday 16 June 2016
The Smoking in Pregnancy Challenge Group , a coalition of health and baby charities, today welcomed the news that smoking rates among pregnant women have continued to fall but warned that progress could be jeopardised if services to help people quit continue to be cut around the country.
Smoking at Time of Delivery data , published by the Government today, shows that 10.6% of women were smoking at the end of their pregnancy in 2015/16 compared to 11.4% in 2014/15. This means the Government has met its ambition to reduce smoking rates among pregnant women to less than 11% by 2015. However, these figures hide the variation between different parts of the country. Areas where smoking rates and deprivation are high have rates many times that of more affluent areas.
In many places local authorities and local maternity services have been working hard to encourage more pregnant women to quit. However, cuts to the public health budget nationally means there are fewer resources available locally to fund vital quit smoking support which can improve a person’s chances of quitting by up to four times.
Reducing rates of smoking in pregnancy has been an important Government priority with ambitions in the last Tobacco Control Plan for England . It is also key to achieving other priorities such as the Government’s commitment to halve the number of still born babies . The Smoking in Pregnancy Challenge Group have called on Government to include strong new ambitions in the forthcoming new Tobacco Control Plan and to end the difference in rates between rich and poor areas .
Professor Linda Bauld, Professor of Health Policy at University of Stirling and Co-Chair of the Smoking in Pregnancy Challenge Group said:
“We must invest in a full range of measures or smoking in pregnancy rates will start to rise. This cannot be done in a piecemeal way – we must ensure that fewer women are smoking when they become pregnant, more women are encouraged to quit quickly and greater support is offered to those who need it.”
Francine Bates, Chief Executive of The Lullaby Trust and Co-Chair of the Smoking in Pregnancy Challenge Group said:
“Higher smoking rates among poorer pregnant women is a major cause of inequality. Investment in services to support women to quit is needed by every local authority. If we do not support women to quit when they become pregnant we are locking in a lifetime of inequality.”
Deborah Arnott, Chief Executive, Action on Smoking and Health said:
“There has been significant progress in reducing the numbers of women smoking during pregnancy. The new Tobacco Control Plan should set an ambitious vision for reducing rates further and clearly identify how this can be achieved.”
 The Smoking in Pregnancy Challenge Group was set up in 2012 following a challenge from the then Public Health Minister. It is coalition of organisations and is co-ordinated by Action on Smoking and Health: http://www.smokefreeaction.org.uk/SiP.html
 Statistics on Women’s Smoking Status at Time of Delivery, England – Quarter 4, 2015-16 http://bit.ly/1UaHBu1
 The Tobacco Control Plan for England ran between 2011 and 2015 and included the ambition to reduce rates of smoking in pregnancy to less than 11% by 2015.
 In November 2015 the Government announced plans to halve the number of stillbirths and infant deaths by 2030: https://www.gov.uk/government/news/new-ambition-to-halve-rate-of-stillbirths-and-infant-deaths Smoking is a major cause of stillbirths and infant death – estimated to be responsible for a third of perinatal deaths: ASH Factsheet on Smoking and Reproduction
 The Smoking in Pregnancy Challenge Group published a report in October 2015 calling for new Government targets to reduce smoking rates among pregnant women alongside a comprehensive range of measures: Smoking Cessation in Pregnancy: A review of the Challenge
ASH’s submission focuses on what the effect of these proposals might have on: (a) Differences in outcomes in richer and poorer areas and inter-authority competition and (b) the long-term future of redistribution to poorer areas and impacts on development.DCLG-Select-Committee-evidence-on-business-rates-ASH-Response.pdf
This Research Report examines asthma and smoking: the causes and the consequences.ASH Research Report: Asthma and smoking
A joint letter from ASH and NCSCT to local councils regarding the prescribing of nicotine-containing products whilst ensuring compliance with Article 5.3 of the FCTC.ASH/NCSCT letter re prescribing nicotine containing products
Tobacco smoking seriously affects internal organs, particularly the heart and lungs, but it also affects a person’s appearance by altering the skin, body weight and shape. Sept. 2018.10. How Smoking Affects the Way You Look