ASH Daily News for 24 July 2019


  • Who are the smokers that haven’t quit?
  • UK disease prevention plan labelled a ‘missed opportunity’
  • Government aims to increase NHS screening uptake with more ‘tailored’ programmes


  • China: Plans for e-cigarette regulation
  • Australia: North Sydney Council bans smoking in central business district



Who are the smokers that haven’t quit?

Although smoking rates have fallen dramatically since 1974, some groups remain much more likely to smoke, including social housing residents, manual workers, those with mental health conditions and people living in certain parts of the UK. Achievements such as the 2007 indoor smoking ban and ongoing increase in the retail price of cigarettes have been less effective for poorer and mentally ill smokers — even if they are as likely to try to quit as other groups.

These groups can exhibit higher levels of dependence, making it harder to give up. They are also more likely to be around other smokers, which normalises the behaviour and makes it harder to quit successfully. They may also have to deal with stress-factors such as income instability, poor housing and living in run‐down neighbourhoods.

A different approach may be needed to help these groups, including free tailored individual support, mobile stop-smoking services, online resources, financial incentives and e-cigarettes. Doctors asking patients if they smoke could also help to identify would-be quitters who ‘don’t want to bother the NHS’ or are facing multiple health conditions.

Source: BBC, 24 July 2019

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UK disease prevention plan labelled a ‘missed opportunity’

There is ongoing debate over whether the Prevention Green Paper can successfully close the health gap between the rich and poor. Deborah Arnott, chief executive of Action on Smoking and Health, welcomed the government’s target to end smoking by 2030 but warned that to achieve that goal would “require innovative new policies and funding”.

Andrew Goddard, president of the Royal College of Physicians, said that making sure people stay physically and mentally well was “too important to be a political football . . . too important to be quietly released on a Monday evening, hours before the announcement of our new prime minister”. He also said that the biggest omission from the paper was a clear understanding of the link between poverty and ill health.

Jo Bibby, director of health at the Health Foundation, a charity, said the green paper was a “missed opportunity” to tackle rising health inequalities in England. She added that it was perhaps unsurprising at a time of political uncertainty that the government had stepped back from the “bold action” required. “This should concern us all when ambitious whole-government action is urgently needed to tackle the root causes of ill health — including poverty and deprivation, poor housing, poor quality work, social isolation and poor-quality environments,” added Ms Bibby.

Source: Financial Times, 23 July 2019

See also
BMJ: Prevention green paper lacks ambition, say critics
Daily Mirror: UK plans for smoke-free nation by 2030 – but NHS cuts could scupper scheme

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Government aims to increase NHS screening uptake with more ‘tailored’ programmes

Yesterday’s Prevention Green Paper has committed to ensuring that screening in the NHS becomes ‘more personalised and stratified by risk’ in order to focus interventions where needed. The NHS Health Check scheme, a check-up for adults aged 40 to 74 commissioned by local councils, will be reviewed under the proposals. Under possible new plans for NHS Health Checks, evidence for a specific ‘MOT’ when approaching retirement age will be reviewed, alongside ways to increase its uptake among high-risk groups, such as lung cancer screening among smokers.

Helen Donovan, professional lead for public health at the Royal College of Nursing, said “One way to earn the faith of healthcare professionals would be to urgently pledge to restore cuts to the public health grant which local authorities rely on to deliver essential preventative services such as sexual health and smoking cessation services.”

Source: Nursing in Practice, 23 July 2019

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China: Plans for e-cigarette regulation

China is planning to regulate e-cigarettes “in an attempt to stave off a new gateway addiction”. China has over 300 million tobacco-smokers — nearly a third of the world’s total — but e-cigarettes are not yet as popular as they have proven in the USA and elsewhere.

“The supervision of electronic cigarettes must be severely strengthened,” said Mao Qunan, head of the National Health Commission’s (NHC) planning department. He also said that the NHC “is working with relevant departments to conduct research on electronic cigarette supervision and we plan to regulate electronic cigarettes through legislation.”

China is concerned about recent studies that claim that, among adolescents, e-cigarettes provide a gateway toward full-fledged smoking. “We want to reduce the smoking rate and prevent young people from trying tobacco,” said Mao.

Enforcing anti-smoking measures can be difficult in China as the state-run tobacco monopoly provides the government with one trillion yuan (£116 billion) in taxes and profits in 2018; more than 5% of central government’s revenue. China’s tobacco regulator shares offices and senior officials with the state-owned China National Tobacco Corp — a near-monopoly and by far the world’s biggest cigarette producer. The tobacco regulator submitted plans for e-cigarette standards to the World Trade Organisation in May.

Source: Mail on Sunday, 23 July 2019

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Australia: North Sydney Council bans smoking in central business district

North Sydney councillors have unanimously supported a call to ban smoking in public spaces in the North Sydney central business district (CBD), a commercial hub which attracts around 60,000 workers each day. Smokers will not be fined until the council reviews in March 2020 whether the self-regulated ban is working. There will be a three-month public awareness campaign to notify residents and workers of the change, before the council will erect signs to signal the start of the ban. The ban will cover all shared public spaces including streets, plazas and parks, and outdoor seating areas in front of restaurants and cafés.

“This is about setting community standards and encouraging our residents and CBD workers to be part of this positive social change,” Councillor Jilly Gibson said. “It’s about cleaner air, cleaner streets and a cleaner harbour. I’m going to encourage everyone in the community to be part of policing this change.”

Council papers said 577 public submissions on the proposal were overwhelmingly in favour of the ban, with 80% of respondents supporting the council’s plan.

Source: Sydney Morning Herald, 23 July 2019

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