ASH Daily News for 22 July 2019


  • Chief Medical Officer calls for global health effort
  • Boris Johnson’s Brexit plans under threat from ministers’ resignations
  • Welsh tax-raising powers could improve population health
  • Scotland: Indoor smoking ban tied to heart attack decline in older adults, study suggests
  • Tobacco industry documents link vaping with rise in nicotine use


  • Spain: Catalonia plans to introduce outdoor smoking ban


Chief Medical Officer calls for global health effort

Countries must work together to tackle global health risks, England’s outgoing chief medical officer has said. In her final annual report, Prof Dame Sally Davies said focusing on domestic issues could risk failing to control global threats such as Ebola. And she said learning from other countries would also ensure the NHS was not left behind.

Prof Davies said: “Investing in global health is the smart thing to do because it is in our mutual interest. It creates a better world for us and for future generations. It helps to keep our population safe. We should invest in systems and solutions that contribute to making health more equitable, secure and sustainable.”

Another focus for global health initiatives should be the rise of non-communicable diseases including heart disease, strokes and cancer, said Dame Sally. They are set to be the leading causes of death across low-income countries by 2021.

In a range of contributions to the report, other academic and health contributors discuss the role of tobacco as a cause of non-communicable diseases, with Dame Minouche Shafik, Director of the London School of Economics and Political Science, highlighting the important role excise taxes on tobacco, alcohol and sugary drinks play in improving population health.

Source: BBC News, 22 July 2019

Annual Report of the Chief Medical Officer, 2019

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Boris Johnson’s Brexit plans under threat from ministers’ resignations

Boris Johnson’s expected entrance into Downing Street this week is set to be dampened by a carefully timed series of resignations by senior ministers, who will retreat to the backbenches with a vow to thwart any moves towards a no-deal Brexit.

Both Philip Hammond, the chancellor, and David Gauke, the justice secretary, have announced that they will step down on Wednesday, immediately before Johnson is likely to head to Buckingham Palace, highlighting the perilous political climate for Theresa May’s expected successor. It comes amid predictions that the Conservatives’ already wafer-thin working Commons majority of three could entirely disappear by the time MPs return from their summer recess, with mooted defections to the Lib Dems coming on top of a predicted by-election defeat in Brecon and Radnorshire.

In addition, there are predictions that other ministers and junior ministers opposed to no deal, such as the international development secretary, Rory Stewart, could follow. It is understood that the business secretary, Greg Clark, another key cabinet voice against no deal, has no plans to resign.

Source: The Guardian, 21 July 2019

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Welsh tax-raising powers could improve population health

A new review published by Public Health Wales finds that Wales’ new tax-raising powers could be used to improve population health and reduce deaths from non-communicable disease. The review found that novel approaches to tax on high fat, high salt or high sugar foods have helped reduce purchasing and consumption behaviour of these foods in other countries, including in Mexico and Hungary.

Aimed at health policy leaders, the review explores how novel fiscal policies might help Wales meet the United Nations’ Sustainable Development Goals of reducing premature mortality from non-communicable diseases – which includes diabetes, cardio-vascular disease and cancers – by one third by 2030.

Professor Mark Bellis, Director of Policy and International Health, WHO Collaborating Centre on Investment for Health & Wellbeing, based at Public Health Wales, said: “It is important that taxation is not seen in isolation, but as a tool to use in combination with other health-focused policies. To be effective, tax interventions may need to be supported with subsidies for healthier options and other policies that help reduce health-harming behaviours, support people who live in more disadvantaged communities, and guide consumers towards healthier consumption”.

Source: Wales24/7, 22 July 2019

Public Health Wales. A Taxing Issue? The Tax System and Healthier Lifestyles in Wales. 2019

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Scotland: Indoor smoking ban tied to heart attack decline in older adults, study suggests

Heart attack rates dropped among older adults in Scotland in the decade after a nationwide indoor smoking ban took effect, a new study suggests. Scotland banned smoking in all enclosed public spaces and workplaces in 2006. There was a 17% reduction in heart attacks in the first year after the ban took effect, compared to just a 4% decline over the same period in England, where public smoking rules didn’t change until July 2017.

Among men and women aged 60 and older, the smoking ban was followed by a roughly 13% reduction in heart attacks over the study period. The ban didn’t appear to impact heart attacks for younger people, however.

In a previous study of the smoking ban, the researchers found a reduction in heart attacks among both smokers and non-smokers, she said. In a separate study, they also found that the number of smokers trying to quit increased immediately prior to the ban.

While these studies were not designed to prove whether or how the ban directly prevented heart attacks, “there is likely to be a contribution from both encouraging smokers to quit and from protecting both non-smokers and smokers from other people’s secondhand smoke,” according to co-author Dr. Jill Pell.

Source: Reuters, 19 July 2019

Circulation: Cardiovascular Quality and Outcomes. 2019

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Tobacco industry documents link vaping with rise in nicotine use

Documents published by British American Tobacco and seen by the Mail on Sunday, claim that the emergence of vaping and the use of other ‘reduced risk’ tobacco products has reversed a decline in nicotine use. Between 2007 and 2012, the number of nicotine users in BAT’s top 40 markets outside of the US fell steadily from 366 million to 345 million but its internal data showed the total had climbed to 362 million by 2017.

BAT’s research found just 18% of those who used its vaping devices were smokers who had quit. In a briefing to financial analysts late last year, chief executive Nicandro Durante revealed that a study found 5% of vapers had never smoked before, 8% were relapsed smokers and 70% both smoked and vaped.

According to the independent Royal Society for Public Health, nicotine on its own is no more harmful than caffeine. E-cigarettes are promoted by Public Health England as aids for giving up smoking.

Source: This is Money, 20 July 2019

Editorial note:
In the UK in 2018, over half (52%) of e-cigarette users are ex-smokers with 44% being current tobacco smokers and 4.2% having never smoked. The main reason given by current vapers for use of e-cigarettes is to help them stop smoking.

ASH: Use of e-cigarettes (vapourisers) among adults in Great Britain. 2018

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Spain: Catalonia plans to introduce outdoor smoking ban

Smoking is set to be banned on the outdoor terraces of bars and restaurants in Catalonia as well as in bus shelters and on train platforms, under proposals from the region’s health authority. The ban would also extend to open-air sports facilities and inside cars.

The proposed changes, which could come into force within a year, are expected to meet resistance from the hospitality industry. Since smoking was banned indoors, the number of venues with outdoor spaces has grown, with terraces serving as de-facto smoking areas.

At present, smoking is permitted only on terraces that are entirely or mostly in the open air. However, the health authorities claim the law is frequently flouted in substantially enclosed outdoor spaces and plans a series of inspections.

At a national level, the Spanish government is considering raising the price of tobacco and banning smoking in cars when children are passengers. A packet of 20 cigarettes costs less than €5 (£4.50) in Spain compared with about £12 in the UK.

Source: The Guardian, 21 July 2019

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