ASH Daily News for 28 January 2020



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UK

  • Smoking ban in cars carrying kids linked to 72% fall in teens’ tobacco smoke exposure in England
  • Comment: Clear leadership from the Government is needed on public health

International

  • Australia: Guidance for doctors updated to recommend vaping as quitting aid

 

UK

Smoking ban in cars carrying kids linked to 72% fall in teens’ tobacco smoke exposure in England

The law banning smoking in cars carrying children, has seen the proportion of children exposed to secondhand tobacco smoke fall by 72% in England, according to an analysis of survey data published online in the journal Thorax.

The legislation was introduced in England in October 2015 and in Scotland in December 2016, with the aim of cutting children’s (under 18s) exposure to the harms of secondhand tobacco smoke, to which they are especially vulnerable. Researchers focused on 13-15 year olds to avoid issues with parents reporting answers for younger children, potentially compromising the accuracy of the data. Children were asked how often, over the past year, they had travelled in a car with an adult who smoked during the journey.

15,318 responses were received for teens in England, and 822 for their peers in Scotland. The proportion of children exposed to secondhand tobacco smoke in Scotland fell from 3.4% in 2012 to 2.2% in 2014, and to 1.3% in 2016. The equivalent figures for England were 6.3% and 5.9% before the ban took effect and 1.6% after it came into force, representing an absolute reduction of 4.1% and a fall of 72% when compared with the period before the ban. Girls and those from areas of higher deprivation were more likely to report secondhand tobacco smoke exposure in a car.

Whilst causation can’t be determined, as this is an observational study, the researchers concluded that: “the design permits observed changes to be plausibly ascribed to the policy intervention […] Our results suggest that banning smoking in private vehicles carrying children has been successful in its main aim of reducing their exposure to tobacco smoke.”

Source: EurekAlert!, 27 January 2020

Thorax – Impact of banning smoking in cars with children on exposure to second-hand smoke: a natural experiment in England and Scotland

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Comment: Clear leadership from the Government is needed on public health

Dr Jeanelle de Gruchy, President of the Association of Directors of Public Health (ADPH), writes in the Municipal Journal on the priorities for public health in 2020:

“A new year, a new me! Ah, the opportunity the new year brings to set new health goals. And so much easier today, with all the inspiring social public health movements, such as Dry January and Parkrun. Social movements, social media, digital technology. The level of public engagement demonstrates the huge appetite that exists for wellbeing. This is cause for celebration.

“[…] We need to create the conditions that enable us all to be as healthy as possible. This should be the nation’s new year’s resolution. Before the General Election, the Association of Directors of Public Health published a Manifesto for Public Health setting out what we thought the Government’s priorities should be. This is an agenda for 2020 and the decade ahead.

“Firstly, wellbeing should be built into the fabric of Government decision-making when it comes to both policy-making and funding allocation. Wales has already made a vital step towards realising this ambition, through the introduction of the Wellbeing of Future Generations Act. Similarly, in Scotland, there is a vision for national wellbeing in the form of the National Performance Framework. England must follow with its own Wellbeing Act

“Secondly, lets address the worrying level of inequalities across the country. This means understanding and acting on the social determinants of health – income and employment, school readiness and attainment, housing – and of course that green space near you big enough for a Parkrun. It also means addressing the commercial drivers of smoking, alcohol use and poor diet, expanding the use of the ‘Polluter Pays’ principle.

“Thirdly, it is time for a multi-year funding settlement for public health. More investment is urgently needed in public health and prevention. Increasing spending on the NHS is essential but it must be matched with a long-term settlement for the home of prevention: local government […] In addition, further investment is needed across a wide range of policy areas at a national level including housing, transport and welfare to tackle the root causes of ill health. The Government should act immediately to confirm the Public Health Grant allocations for 2020/21.

“[…] Finally, binding national targets to reduce child poverty are fundamental. Poverty is the most significant determinant of children and young people’s health in the UK. Currently, 4.1 million children in the UK are living in poverty. 2020 was meant to be the year we ended it for good. There are glimpses of light. The Department of Health and Social Care has recommitted to making prevention a priority and we look forward to the progression of the Prevention Green Paper […] Public health is a team sport. In 2020 we all need to play our part – clear leadership from the Government will be essential. Directors of Public Health are fit and ready to go. If we work together, we can all win.”

Source: The Municipal Journal, 8 January 2020

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International

Australia: Guidance for doctors updated to recommend vaping as quitting aid

In an updated guide on supporting smokers to stop, the Royal Australian College of General Practitioners (RACGP) has recommended that e-cigarettes can be used as a smoking cessation aid.

Chairman of the expert advisory group behind the guide Nicholas Zwar said the recommendation that e-cigarettes could help people quit smoking came with many caveats: “The [therapies] that have been tested and been through therapeutic approval would be the first choice, but if you have someone who has not succeeded in quitting using those methods and they are interested in nicotine vaping, there is some evidence of benefit and they could be considered” he said.

He added that it was probably safer than smoking, given e-cigarettes did not have the large number of toxic combustibles and carcinogens found in cigarettes. Professor Zwar said the long-term health effects of vaping were not clear, but when considered in relation to helping people stop smoking it “can be considered” as a potential aid.

Source: The Sydney Morning Herald, 28 January 2020

See also: Daily Mail – Doctors ‘cautiously’ recommend smokers take up vaping to help them quit cigarettes which have more toxic chemicals and carcinogens

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