ASH Daily News for 7 January 2019


  • NHS Long Term Plan commits to funding help for smokers
  • NHS plan and pressures faced
  • GPs and community care to receive more funding in new long term plan
  • Targeted public health ads


  • Argentina: New study finds smokers are more likely to quit when they determine their own nicotine intake



NHS Long Term Plan commits to funding help for smokers to quit   

The NHS will invest £183m in helping problem drinkers and smokers, who cost the service more than £6bn annually. It is planning to offer advice on quitting to every smoker admitted to hospital, including those receiving long-term mental health support and learning disability services. Mothers-to-be and their partners will also be targeted. The services are based on a scheme in Manchester that is expected to save £10m.

Overall, 600,000 smokers will be supported to quit over the next five years, with the areas where there is greatest need prioritised. The scheme is part of the NHS’s long-term plan, which will set out how the service will spend the extra £20.5bn a year it will receive by 2023-24.

Paul Burstow, the chairman of the Tavistock and Portman NHS Foundation trust, and co-chairman of the Mental Health and Smoking Partnership, welcomed the commitment.

“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,” he said.

Deborah Arnott, the chief executive of the health charity Ash, said: “Ash has long called for the NHS to provide smokers in their care with dedicated support to help them quit, as 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.

It is disappointing, however, that at the same time that the NHS is receiving additional funding, public health budgets continue to be cut, affecting the availability of community stop-smoking services, which should be provided for all smokers who want them.”

The Guardian, All Smokers admitted to hospital to be offered help to quit
Health Service Journal, Prime minister reveals NHS long term plan top priorities
The British Medical Journal, NHS to set up new alcohol and tobacco services for patients admitted to hospital

NHS plan and pressures faced

The NHS has said that it will prevent over half a million deaths over the next decade, thanks to the measures being put in place by the long-term plan. These aim to tackle diseases with earlier diagnosis and treatments, as well as a focusing on improving healthy living.

But experts from within the NHS have said this goal won’t be met unless the crises of staffing, social care and demand on A&E are first addressed. Dr Nick Scriven, president of the Society for Acute Medicine said the plan has not provided insight into how the “eternal winter in the NHS” will be addressed. Ministers have stated that both social care and staffing issues will be dealt with in depth later.

Nigel Edwards, chief executive of the Nuffield Trust think tank, has welcomed the plan, but said that workforce planning and support needs deep reform – “despite the £20.5bn to support ambitious health goals by 2023, a lack of more staff and funds could stop progress in its tracks.”

Source: The Independent, 6 January 2019

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GPs and community care to receive more funding in new long term plan

Of the £20 billion due to be spent on the NHS over the next decade, GP services in England are set to receive £4.5 billion. This will help pay for extra support in the community, which will speed up discharge from hospitals, online appointment booking and new healthy living programmes. It is thought that these new measures will help to save over 500,00 lives through spotting and treating diseases such as strokes, cancer and heart problems, earlier.

However, the money being made available to councils for stop smoking services and healthy wright programmes are being cut by more than 4% next year.

Chris Hopson, chief executive of NHS Providers, said “the focus on out-of-hospital care should help relieve the pressures on hospitals. But if we are serious about helping people to stay well and live independently for as long as possible it is vital that we also see appropriate investment and support for social care and public health.”

Source: BBC News, 7 January 2019

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Targeted public health adverts

Health Secretary Matt Hancock has said he wants public health ads to be targeted at those most likely to benefit from them, including adverts on social media. Smokers, drinkers and obese people are most likely to receive these adverts, with pregnant smokers and drinkers also set to receive emails which encourage them towards health lifestyles. He argues that public attitudes towards the health service must change for the NHS to survive, with people taking a greater responsibility for their own health.

He said: “Instead of blanket action that hits people who are basically doing the right thing, I want to see a much more targeted public health approach that uses modern techniques to identify those most at risk and delivers targeted, personalised action. But I believe that in our digital age, just as modern life is becoming more personalised to the individual, public health campaigns can and should be targeted too.”

Source: Daily Mail, 6 January 2019

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Argentina: New study finds Smokers are more likely to quit when they determine their own nicotine intake

A new study from an Argentinian smoking clinic, lead by Queen Mary University of London, has found that when patients can determine their own nicotine intake, they are far more likely to be successful in their quit attempt.

Study author Dunja Przulj said: “Smokers determine their nicotine intake while they smoke, but when they try to quit, their nicotine levels are dictated by the recommended dosing of the treatment. These levels may be far too low for some people, increasing the likelihood that they go back to smoking.”

This study is also the first to ‘pre-load’ nicotine 4 weeks before participants quit date. It’s thought that ‘pre-loading’ helps to weaken the conditioned link between smoking and reward, reducing the enjoyment of smoking.

Participants began daily 21mg nicotine patches 4 weeks before quitting, with the does level upped weekly to a total 84mg in the final week before quitting. After the quit date, the does was reduced by the same increments over 4 weeks until arriving back at the original 21mg.

It was found that 82% of participants abstained from smoking for 4 weeks after their quit date and experienced no significant increase in withdrawal symptoms, including urges to smoke, after this period. Also, cigarette consumption, enjoyment and smoke intake were significantly reduced in the preloaded pre-quit period.

Source: Medical Express, 2 January 2019

See study here:

Progressive nicotine patch dosing prior to quitting smoking: feasibility, safety and effects during the pre‐quit and post‐quit periods