Action on Smoking and Health

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Comment on NHS England press release: NHS plan will help problem drinkers and smokers

4 January 2019

Please find below the press release from NHS England about the dedicated help for smokers to quit included in the NHS Long Term Plan and quotes about this commitment from Paul Burstow co-chair of the Mental Health & Smoking Partnership and Dr Clea Harmer, co-chair of the Smoking in Pregnancy Challenge Group.

 

Paul Burstow, Chair of the Tavistock and Portman NHS Foundation Trust and co-chair of the Mental Health & Smoking Partnership, said,

“People with mental health conditions have smoking rates over twice as high as the general population.  Smoking is a leading cause of health inequalities and premature death. The commitment to funding dedicated support to quit not just for inpatients but also for smokers receiving long-term support from mental health and learning disability services is welcome. This is something the Mental Health & Smoking Partnership has called for and was outlined in the ASH Stolen Years report. It should help ensure that not just inpatients, but the majority of those with long-term mental health conditions, who live in the community, will get the help they need to quit.”

 

Dr Clea Harmer, Chief Executive of Sands and co-chair of the Smoking in Pregnancy Challenge Group, said,

“Smoking in pregnancy has flatlined in recent years and more than one in ten women in England are still smoking when their child is born with a real cost in babies’ lives. Pregnant smokers and their partners need more help to quit and the NHS Long Term Plan commitment to fund intensive support is therefore very welcome and will provide much needed additional funding for existing services. This is investment the Smoking in Pregnancy Challenge Group have long been calling for and we look forward to seeing the detailed proposals.”

 

Deborah Arnott, Chief Executive of health charity ASH, said:

“From cancer to cardio-vascular and respiratory disease, dementia to diabetes, and maternity to mental health, stopping smoking improves patients’ life expectancy and quality of life and reduces pressure on our overburdened NHS. So we’re delighted the NHS long-term plan includes provision of support to stop smoking for pregnant women, people with mental health conditions and all patients admitted to hospital. We look forward to publication of the detailed plans, and the timetable for implementation.”

 

 

NHS News Release: NHS LONG TERM PLAN WILL HELP PROBLEM DRINKERS AND SMOKERS

Problem drinkers and smokers who end up in hospital will be helped by dedicated new services as part of the NHS Long Term Plan.

As part of new NHS prevention measures, people who are alcohol dependent will be helped by new Alcohol Care Teams, while more than half a million patients who smoke, including pregnant women and their partners will also be helped to stop, in a new drive that will see all smokers admitted to hospital encouraged to quit.

The schemes come alongside action on obesity and diabetes as part of a renewed focus on prevention that will benefit patients and make the NHS fit for the future, by curbing demands on the health service.

Alcohol Care Teams will be rolled out in hospitals with the highest number of alcohol-related admissions and will support patients and their families who have issues with alcohol misuse.

This will be delivered in the 25% worst affected parts of the country and could prevent 50,000 admissions and almost 250,000 bed days over five years.

Mums to be will also benefit from NHS-funded one-to-one support to improve their own health and give their newborn babies the healthiest start in life.

The most recent figures show that women in England are amongst the most likely to smoke during pregnancy with 10% still lighting up at the time of their baby’s delivery, which doubles the risk of still birth, substantially increases the likelihood of miscarriage and triples the chances of sudden infant death.

Partners of pregnant women will also be encouraged to kick the habit to give new mums the best chance of not smoking again.

Across the country, there is significant variation in the number of pregnant women who smoke, ranging from 2% in Kensington & Chelsea to over one in five in Blackpool.

The areas with the greatest level of need will be prioritised with 600,000 people being supported to quit over the next five years.

Announcing the plans, NHS England chief executive Simon Stevens said:

“Drinking to excess can destroy families, with the NHS too often left to pick up the pieces.

“Alcohol and tobacco addiction remain two of the biggest causes of ill health and early death, and the right support can save lives.

“The NHS long term plan delivers a sea-change in care for a range of major conditions like cancer, mental ill health and heart disease, as well as stepping up to do more on preventing ill health in the first place by giving patients the support they need to take greater control of their own health and stay fitter longer.”

Alcohol-related admissions to hospital have grown by 17% over the last decade – in 2016/17 there were 337,000 estimated admissions – 2.1% of the total.

Alcohol-related harm is estimated to cost the NHS in England £3.5 billion every year.

Alcohol Care Teams in Bolton, Salford, Nottingham, Liverpool, London and Portsmouth have already seen a reduction in A&E attendances, bed days, readmissions and ambulance call outs have significantly reduced.

Now expert teams will work in up to 50 hospitals across the country to deliver alcohol checks and provide access to health within 24 hours if problems are found including counselling, medically assisted help to give up drink and support to stay off of it.

Based in hospitals, the teams will work with local community services to ensure all needs, including any other health needs, are met.

Advice sessions last for 20–40 minutes and involves personalised feedback to people about their level of health risk because of alcohol consumption, practical advice about reducing alcohol consumption, with a range of options for change, and written information to support the advice.

Every smoker admitted to hospital will be offered NHS support to quit and this also includes every patient who is receiving long term support from specialist mental health and learning disability services.

The services are based on a scheme already happening in Manchester, which is expected to save £10 million and over 30,000 hospital beds across the city.

This will be replicated across the country over the next five years so that every patient can access support including personalised bedside care, timely therapy and follow up help when they have been discharged from hospital.

Royal College of Physicians president Professor Andrew Goddard said: “We welcome the Long Term Plan’s commitment to offer help to quit for every smoker admitted to hospital, as recommended in our 2018 report Hiding in Plain Sight.  Helping people give up smoking is a cost-effective means of both improving health and reducing demand on NHS services in the future.  Every contact a health professional has with a patient is an opportunity to help the patient give up smoking – having a system in place to treat tobacco dependency with allocated funding will help make it happen.

“The focus on the management of alcohol related disease is also very welcome. It is an increasing problem in our hospitals where many patients first come to the attention of the NHS. We mustn’t forget prevention though and further measures to reduce harmful drinking are much needed.”

Duncan Selbie, Chief Executive, Public Health England said: “Investing in prevention is the smartest thing the NHS can do. Tobacco kills 1500 people a week so helping people to quit when admitted to hospital helps them, their families and the taxpayer. And it is equally smart for hospitals to have new expertise focused on supporting the most alcohol dependent people. Both measures announced today will save thousands of lives and help the NHS remain sustainable into future years.”

Background information 

Smoking at any time during pregnancy in the UK and EU15+, 2015 – p12 https://www.rcpch.ac.uk/sites/default/files/2018-10/child_health_in_2030_in_england_-report_2018-10.pdf

 Impact of smoking in pregnancy

Maternal smoking Second-hand smoke exposure
Low birth weight Average 250g lighter Average 30-40g lighter
Stillbirth Double the likelihood Increased risk
Miscarriage 24-32% more likely Possible risk
Preterm birth 27% more likely Increased risk
Heart defects 50% more likely Increased risk
Sudden infant death 3 times more likely 45% more likely

 

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 coordinates and facilitates the work of the Smoking in Pregnancy Challenge Group and the Mental Health & Smoking Partnership.

 

ASH staff are available for interview and have an ISDN line. For more information send an email to press@ash.org.uk or ring 020 7404 0242. Out of hours contact Deborah Arnott (Chief Executive, ASH) on 07976 935 987 or Hazel Cheeseman (Director of Policy, ASH) on 07754 358 593.

ASH Daily News for 20 July 2018

UK

  • South Yorkshire: Rother Valley MP calls for Government to keep up the push to cut smoking deaths
  • NHS Response: Vaping and using nicotine patches in pregnancy
  • West Midlands: Thousands of illegal tobacco products seized in Dudley
  • Social Smoking: Just how bad is it for you?

International

Australia: Four in five lung cancers preventable through healthy lifestyle

Parliamentary Activity

  • Parliamentary debate to review the tobacco control plan

Link of the Week

  • New Secretary of State for Health and Social Care Speech

UK

South Yorkshire: Rother Valley MP calls for Government to keep up the push to cut smoking deaths

Following yesterday’s parliamentary debate to review the Tobacco Control Plan, Sir Kevin Barron, MP for Rother Valley, has written an article calling on the government to increase funding for smoking cessation services to ensure that the targets set out in the plan are met.

In the article he criticises the misrepresentation of evidence surrounding e-cigarettes in the media: “It is very unfortunate that sensationalist media reports are creating an air of uncertainty around e-cigarettes and deterring many smokers from making the switch. It would be a tragedy if thousands of smokers who could quit with the help of an e-cigarette are being put off due to false fears about their safety.”

Public Health England has said that e-cigarettes are at least 95 per cent less harmful than cigarettes and that the main chemicals in e-cigarettes have not been associated with any serious risk.

Source: Retford Guardian, 20 July 2018

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NHS Response: Vaping and using nicotine patches in pregnancy

The NHS has responded to a recent study from the US which linked vaping and the use of nicotine patches in pregnancy to cot death (Sudden Infant Death Syndrome). The UK media’s reporting of the study was sensationalised, playing down the fact that the research was on rats, and the findings related to rats with depleted serotonin.

The researchers found that exposure to nicotine during pregnancy limited the ability of serotonin-deficient rats to recover back to normal breathing and heart rates following a period of oxygen deprivation.

The NHS recommends that smokers planning a pregnancy should use nicotine replacement therapies, such as patches, to help them quit smoking before trying for a baby.

Source: NHS Choices, 20 July 2018

Editorial Note: Francine Bates, Chief Executive of The Lullaby Trust and co-chair of the Smoking in Pregnancy Challenge Group (SPCG), put out this statement: “We don’t think parents should worry about the findings of this study as it was conducted on laboratory rats, not human babies. Research that has been conducted on women who used NRT patches in pregnancy showed that there was no increase in infant mortality up to the age of two years old, compared to women who used a placebo. While there is currently no research linking electronic (or ‘e’) cigarettes to an increased risk of sudden infant death syndrome (SIDS), using an e-cigarette appears to be much safer than continuing to smoke during pregnancy and once your baby is born. Tobacco cigarettes contain toxins that cause harm to an unborn baby by starving them of oxygen, but these toxins are not present in e-cigarettes or NRT.”

“Smoking tobacco cigarettes before or after pregnancy significantly increases the chance of SIDS. That’s why we strongly encourage any pregnant women or new parents who smoke to keep their baby smoke-free. Whilst it’s always best for pregnant women to quit using nicotine completely, those who find it hard to do so should not stop using NRT or e-cigarettes on the basis of this research. We would advise anyone who is concerned about smoking to contact their midwife or GP who can offer advice and refer them to stop smoking services.”

SPCG Guide: Use of electronic cigarettes in pregnancy

Study: https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP275885

Read Article

West Midlands: Thousands of illegal tobacco products seized in Dudley

Over 150,000 illegal cigarettes and 1,000kg of tobacco were seized by Dudley Council last year as part of their efforts to crack down on illegal tobacco.

The operation has resulted in two prosecutions with several more pending, and several shops have had their alcohol licences suspended or revoked for dealing with illegal tobacco products.

Councillor Ruth Buttery, Dudley’s cabinet member for health and wellbeing, said: “Whilst all tobacco is harmful, the illegal tobacco market, and in particular the availability of cheap cigarettes, undermines government health policies aimed at reducing the cost to the NHS of treating diseases caused by smoking.”

Source: Stourbridge News, 19 July 2018

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Social Smoking: Just how bad is it for you?

Although many people who smoke socially might not describe themselves as a smoker, they are not exempt from many of the health issues associated with smoking. Social smokers are still susceptible to lung infections, smoking-related cancers, shorter life expectancy and accelerated signs of ageing.

Even if social smokers aren’t addicted to nicotine they can still be addicted to the psychoactive experience of smoking in social situations. Professor Robert West, an expert on smoking from the University College London, describes the desire to smoke occasionally as a “situational craving” – explaining why you may only feel like a cigarette when you drink. “One way addiction works is by forming an association between situations where a person would typically smoke, which then creates the impulse to smoke when they find themselves in that situation again,” he says.

Even light smoking can cause DNA mutations which increase the likelihood of developing cancer. Dr Richard Russell, Consultant Respiratory Physician and medical advisor to the British Lung Foundation, said: “It’s the toxic chemicals you are inhaling. Even occasional smoking puts your health at risk – the only safe level of smoking is nothing at all.”

Source: Sheerluxe, 19 July 2018

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International

Australia: Four in five lung cancers preventable through healthy lifestyle

Researchers at the University of New South Wales (UNSW) in Sydney have found evidence to suggest that the majority of lung cancers are related to smoking.

Using data from the Centre for Big Data Research in Health, the researchers showed that lung cancer risk remained elevated for 40 years after people stopped smoking, with the risk approximately halving every 10 years.

Dr Maarit Laaksonen, Senior Research Fellow at UNSW, said: “More than three out of four lung cancers are caused by ever smoking. Current smoking is responsible for more than half of lung cancers and past smoking for nearly a quarter. Our findings strongly support the dual importance of preventing the uptake of smoking and assisting quitting.”

Source: MedicalXpress, 19 July 2018

Centre for Big Data Research in Health: Population-level relevance of risk factors for cancer

Read Article

Parliamentary Activity

Parliamentary debate to review the tobacco control plan

The transcript of yesterday’s Government Debate on the Tobacco Control Plan can be found here.

Source: Hansard, 19 July 2018

Link of the Week

New Secretary of State for Health and Social Care Speech

Today, Matt Hancock, the new Secretary of State for Health and Social Care, delivered his debut speech setting out his priorities for the health and social care system.

He talks extensively about the importance of preventative measures to ease the pressures on staff, improve patient outcomes and keep people out of hospital: “prevention… is mission critical to making the health and social care system sustainable.”

Source: gov.uk, 20 July 2018

Read Speech

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

Read Answer

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

New Tobacco Control Plan for England Published

18 July 2017

The All Party Group on Smoking and Health has welcomed the new Tobacco Control Plan for England, “Towards a Smokefree Generation”, which was published today by the Department of Health. [1]

The APPG is delighted that the Government has responded to its calls for a new Tobacco Control Plan [2] and strongly supports the Government’s aim to create a “smokefree generation”. The Plan also has specific targets to cut smoking rates among under 15 year olds, among adults, and pregnant women. Smoking remains a serious public health epidemic and remains the single largest cause of preventable deaths, with about 79,000 people dying every year from smoking related illness in England alone.

Commenting Bob Blackman MP (Chair of the APPG, Harrow West, Conservative) said:
“I very much welcome the Government’s new Tobacco Control Plan with its ambitious vision of a smokefree future. As long as sufficient funding can be found to pay for its implementation, this Plan should ensure the UK remains a global leader in tobacco control”.

The Rt Hon Kevin Barron MP (Vice Chair of the APPG, Rother Valley, Labour) said:
“The clear targets and comprehensive commitments set out in the new Tobacco Plan are welcome. We will be working with colleagues across Parliament to make sure that these commitments are turned into effective action.”

The previous five year Plan expired at the end of 2015. The latest Plan has targets from now until 2022, and the All Party Group believes that this and future Plans should not be allowed to expire until a new one has been put in place.

ENDS

Notes and Links

The All Party Parliamentary Group on Smoking and Health is chaired by Bob Blackman MP. The secretariat is provided by ASH. The purpose of the APPG is to monitor and discuss the health and social effects of smoking; to review potential changes in existing legislation to reduce levels of smoking; to assess the latest medical techniques to assist in smoking cessation; and to act as a resource for the group’s members on all issues relating to smoking and public health. You can learn more about the APPG here.

References

[1] Towards a smoke-free generation: tobacco control plan for England. Department of Health. July 2017.
[2] All Party Parliamentary Group on Smoking and Health. Burning Injustice: Reducing tobacco-driven harm and inequality. January 2017.

ASH Welcomes New Tobacco Control Plan for England: Funding needed for it to succeed

18 July 2017

Action on Smoking and Health has welcomed the Government’s new Tobacco Control Plan for England, “Towards a Smokefree Generation”, published today. [1] The previous Plan expired at the end of 2015, and pressure has been growing from parliament and the public health community for the Government to renew its commitment to tackling smoking. There is also strong public support, with 76% supporting continued government action to limit smoking. [2]

ASH particularly welcomes the Government’s vision of a “smokefree generation”, defined as a smoking prevalence rate of 5% or less. Since the introduction of the last Tobacco Control Plan smoking rates have fallen from 20.2% [3] to 15.5% [4] and if this rate of decline can be sustained a smokefree generation could be achieved by 2030.

Over the next five years until the end of 2022 the targets are to:

  • Reduce smoking prevalence among adults from 15.5% to 12% or less
  • Reduce the proportion of 15 year olds who regularly smoke from 8% to 3% or less
  • Reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less

Deborah Arnott ASH Chief Executive said:

“ASH congratulates Steve Brine for showing his commitment to tobacco control by getting the new Plan published only weeks after taking over as Public Health Minister. The vision of a “smokefree generation” it sets out is a welcome step change in ambition from the last Tobacco Control Plan for England and should be achievable by 2030.”

 The Plan calls for a shift in emphasis from national to local action in order to achieve the vision of a “smokefree generation”. But this comes at a time of severe government cuts in public health funding which threaten successful implementation of the Plan.

 Commenting on this Deborah Arnott said:

“Funding must be found if the Government is to achieve its vision of a “smokefree generation”. The tobacco industry should be made to pay a through a licence fee on the ‘polluter pays’ principle. Tobacco manufacturers are some of the most profitable companies on earth; they can easily afford the costs of radical action to drive down smoking rates.”  

The Plan sets out specific commitments including to:

  • Continue to use mass media campaigns to promote smoking cessation and raise awareness of the harms of smoking.
  • Reduce the inequality gap in smoking prevalence between those in routine and manual occupations and the general population
  • Provide access to training for all health professionals on how to help patients quit smoking.
  • Promote links to “stop smoking” services across the health and care system and full implementation of all relevant NICE guidelines by 2022.
  • Implement comprehensive smokefree policies, including integrated tobacco dependence treatment pathways, in all mental health services by 2018; and improve data on smoking and mental health; in order to better support people with mental health conditions to quit smoking.
  • Maximise the availability of safer alternatives to smoking.
  • Maintain high duty rates for tobacco products to make tobacco less affordable.
  • Continue to uphold its obligations under the WHO FCTC.

The Plan highlights the challenges:

  • There are still 7.3 million smokers in England, and more than 200 people a day die from smoking related illness that could have been prevented.
  • The difference in life expectancy between people in the poorest and richest social groups in England is about 9 years on average, and the difference in smoking rates accounts for about half this difference.
  • Smoking costs our economy in excess of £11 billion a year, including £2.5 billion to the NHS, £5.3 billion to employers (because of lost output due to sickness and smoking breaks), £4.1 billion to the wider society due to lost output. There are further costs including around £760 million from increased social care costs to local councils.

The last Spending Review in 2015 announced cuts in public health funding of 3.9% a year amounting to a real terms reduction of at least £600 million a year by 2020/21, on top of the £200 million in year cut to the 2015/16 budget.[5]  A November 2016 survey of local authority tobacco control leads in England [6] found significant budget cuts for smoking cessation services and that in a growing number of authorities there is no longer a specialist stop smoking service accessible to all smokers.  A recent analysis by the King’s Fund found that in 2017/18 local authority funding for wider tobacco control faces cuts of more than 30% and that stop smoking services is one of the top four services in absolute planned cuts (£16 million). [7]

Collective action by local authorities working together on tobacco control, as encouraged by the Plan, has been very effective in the North East [8] and can deliver economies of scale. However, local authorities facing such severe cuts cannot deliver public health improvement without support from the NHS. The Plan sets out a clear role set out for the NHS in supporting smokers to quit. The NHS must now live up to the commitment set out in the Five Year Forward View to a “radical upgrade in prevention and public health”. [9]

Furthermore ASH urges the government to introduce licensing of the tobacco industry at all levels from manufacturers to wholesalers and retail outlets. [10] Opinion poll results show 76% of the public support the licensing of tobacco retailers, and 71% support requiring tobacco manufacturers to pay for the costs of regulation of the industry. [2] The four major tobacco companies are some of the most profitable businesses [11] in the world, and could easily afford to pay more, through a licence system, to mitigate the damage their products cause, on the “polluter pays” principle.

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 on 020 7404 0242 or out of hours Deborah Arnott on 07976 935 987 or Hazel Cheeseman on 07754 358 593.
References

[1] Towards a smoke-free generation: tobacco control plan for England. Department of Health. July 2017

[2] Smokefree: The First Ten Years. ASH. June 2017. Opinion research carried out by YouGov for ASH. Total sample size was 12696 adults. Fieldwork was undertaken between 16th February 2017 and 19th March 2017

[3] HM Government. Healthy Lives Healthy Futures: A Tobacco Control Plan for England. March 2011.

[4] Statistics on smoking in England: NHS Digital 2017

[5] Impact of the 2015 Spending Review on health and social care. Joint submission to the Health Select Committee by the Nuffield Trust, Health Foundation and the King’s Fund. 17 December 2015

[6] A survey of local authority tobacco control leads in England November 2016, conducted by ASH, funded by Cancer Research UK

[7] David Buck. Chickens Coming Home to Roost: local government public health budgets for 2017/18.  King’s Fund 12 July 2017.

[8] Fresh North East. Achievements.

[9] NHS England. Five Year Forward View. October 2014.

[10] ASH response to HMRC Consultation on Tobacco Illicit Trade Protocol – licensing of equipment and the supply chain. May 2016.

[11] Branston, JR. and Gilmore, A. The extreme profitability of the UK tobacco market and the rationale for a new tobacco levy. University of Bath, 2015.

Lord Rennard calls for a new Tobacco Control Plan

On Thursday 29 June 2017, in the run up to the tenth anniversary of smokefree legislation in England, Lord Rennard gave a speech in the House of Lords calling for the publication of a new Tobacco Control Plan. This was a part of the Queen’s Speech debate and is republished below.

Lord Rennard (Image courtesy Liberal Democrats CC-BY-SA 4.0)

 

My Lords, in the recent general election we heard quite a lot about the cost of trying to sustain our health and social care systems, but too little about action to make people healthier. The gracious Speech did not provide much hope that the new Government recognise that this is an important and continuing priority. I will focus my remarks on tobacco control. I speak as a former trustee of Action on Smoking and Health, and I am currently a vice-chair of the All-Party Group on Smoking and Health.

Those of us most concerned about this issue have recently had two things to celebrate. The first is the decline in smoking prevalence, which is shown by new data to be just 15.5% of adults in England — the lowest level on record. This is a huge achievement and the effort to bring it about will save many lives over the coming years. Particularly encouraging is the fact that the greatest decline in smoking rates has been among young adults aged 18 to 24. The reduction in smoking rates is testament to the success of the comprehensive approach adopted by previous Governments.

Secondly, in England, we are about to celebrate the 10th anniversary of smoke-free legislation, with Scotland having bravely led the way some two years earlier. This legislation has had a tremendous impact on public health, including significant declines in heart attacks and strokes, and hospital admissions for asthma attacks in children. The passage of the legislation required the efforts of many people to combat the fierce resistance and fundamental dishonesty of the tobacco industry. Since that time, a cross-party approach to tackling tobacco has continued to do much, for example in passing legislation to prohibit smoking in cars with children and putting cigarettes in drab-coloured, plain packaging.

Every step forward has been resisted, but tough tobacco legislation is no longer seen as something for which the tobacco industry can win significant support to block or delay for very long. A public survey for Action on Smoking and Health showed that 76% of respondents supported government action to limit smoking or wanted more to be done. Against that backdrop, the UK has widely been acknowledged as a world leader in tobacco control, and in 2015 received the prestigious American Cancer Society’s tri-annual award for exemplary leadership by a government department, as well as the World Health Organization’s World No Tobacco Day medal last year. The Government then committed £15 million to support implementation of the World Health Organization’s international tobacco treaty, the Framework Convention on Tobacco Control, in poorer countries between now and 2021.

That is a record to be proud of, but we cannot be complacent about the issue of tobacco control. Despite our successes over the last decade, smoking remains a public health epidemic. Every day, hundreds of children start smoking, and tobacco still kills around 80,000 people in this country every year. Smoking is responsible for half the difference in life expectancy between rich people and poor people — a difference of nine years — and that is a burning injustice. The smoking rate among people with a mental health condition is 40% and smoking is the leading modifiable risk factor for stillbirth and sudden infant death. Yet 18 months after the expiry of the tobacco control plan for England, no new plan has been put in its place. That is in contravention of our obligations as a party to the international tobacco treaty, which requires us to have a comprehensive strategy in place.

The obligations are based on good evidence that it is through such strategies that countries can be most effective in driving down smoking prevalence. We have been very effective in the last decade, with a comprehensive approach to tackling tobacco. If we are to be effective in the next decade, the Government urgently need to publish their next plan, with ambitious new targets to reduce health inequalities and lead us towards a smoke-free future.

In answer to a Question from me on 23 February, and further questions from across the House, the Minister made some very encouraging remarks about tobacco control. He said that a new tobacco control plan would be published shortly and that it was in an advanced state of preparation. In an earlier debate in the other place in December 2015, the former Health Minister, Jane Ellison, committed the Government to publishing a new strategy in summer 2016. It is now summer 2017. A year and around 80,000 more deaths from smoking-related illnesses later, we have waited long enough.

Earlier this week, the Government reiterated the commitment made before the election to publishing a new plan “shortly”, so I hope that today the Minister can go further and confirm a date for publication of a new tobacco control plan before the House rises for the Summer Recess.

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