ASH Daily News for 7 February 2020


  • GPs agree new deal with NHS England after PCN contract row


  • Opinion: Why concerns of a teenage vaping epidemic may be overblown
  • Brazil gives big tobacco companies 30 days notice in smoking lawsuit

Parliamentary Activity

  • Parliamentary questions

Link of the Week

  • Smokefree 2030 Campaign


GPs agree new deal with NHS England after PCN contract row

The NHS has made substantial concessions to ensure doctors sign up to the GP contract for 2020-21, which includes the primary care network (PCN) agreement that incited dissatisfaction among the profession throughout January.

The British Medical Association’s general practice committee yesterday (6th February) agreed to the latest iteration of the PCN service specifications, which define what the networks will be required to deliver in the coming financial year, and to update the overall GP contract framework for 2020-24.

It comes six weeks after the NHS published its draft outline PCN specifications. The BMA rejected the first iteration on 16th January but has now agreed to a deal that cuts back on the requirements for five new PCN service specifications and includes additional funding. The contract deal agreed to now includes substantially more funding than was included in the five-year contract deal agreed a year ago – most of this is new money from the government for staff to provide more appointments, as was promised in the Conservatives’ general election manifesto.

PCNs will now need to deliver three services from April 2020: enhanced health in care homes, structured medicine reviews and work supporting early cancer diagnosis. Personalised care and anticipatory care have been dropped from this year’s contract and will be introduced from 2021-22. NHSE’s network contract has overcome a major hurdle but the General Practitioners Committee’s approval does not mean GPs are bound to sign the new contract. The BMA will now need to convince its members that the new contract is a satisfactory deal.

There will be a special conference of England’s local medical committees in the next few weeks for GPs to discuss the outcome of the negotiations and the contract. The LMCs are local bodies that represent the interests of individual GPs and practices and are distinct from the BMA which represents the interests of the profession as a whole.

Source: Health Service Journal, 6 February 2020

See also: HSJ – New GP network rules face rewrite as criticism mounts

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Opinion: Why concerns of a teenage vaping epidemic may be overblown

Clare Wilson writes in the New Scientist on the disconnect between perceptions and reality of teenage e-cigarette use in the US:

“‘How Juul hooked a generation on nicotine’ was a New York Times headline from 2018 on the new addiction apparently sweeping the youth of the US. It wasn’t the only media outlet to cover the rise in e-cigarettes, as a US government survey from that year showed that vaping among teenagers was on the rise. But the full figures from this survey have now been newly analysed and they suggest that the original coverage didn’t give the whole picture – in some ways, the results could even be seen as good news for teenagers’ health.

“Juul’s purported appeal to teens was highlighted by the US Centers for Disease Control and Prevention when it released the 2018 figures, from a yearly survey of more than 20,000 middle and high-school students which triggered a rash of alarming headlines. But an independent analysis of the full set of those figures, published this week, is more nuanced than those initial headlines. While 14% of the teens surveyed had indeed vaped in the past 30 days, only 4% of the total were regular e-cigarette users, defined as having vaped on 20 days or more over that period. Less frequent use suggests “curiosity and experimentation”, says study author David Abrams at New York University School of Global Public Health.

“And the figures suggest that, far from hooking a new generation on nicotine, comparatively few teens who have never smoked take up vaping: less than 1% of those who were vaping regularly had never smoked tobacco before. “There has been a massive focus on teens without making it clear that most of these teens would be smoking anyway,” says Abrams. But the idea of a new addiction epidemic among the nation’s youth has now taken hold. The US has recently banned all flavours of vapes apart from tobacco and menthol. Yet this could be counterproductive in terms of protecting people’s health. Research suggests that many adults are also keen on sweet-flavoured vapes, including fruit, sweets and desserts, and it can be part of the appeal of switching from smoking to vaping.

“Complicating matters is that fears over e-cigarettes have risen after reports last year of a strange lung illness linked with vaping, which has so far caused more than 50 deaths. Further investigation has revealed that these cases mainly involve people using black market cannabis vaping liquid that has been bulked up with a harmful additive, vitamin E acetate. But many media reports have implied that the danger comes from all e-cigarettes, even legal ones, which just isn’t true. Yes, we need to make sure that teenagers don’t take up vaping or smoking, but that shouldn’t come at the cost of scaring existing adult smokers from switching to vapes.”

Source: New Scientist, 31 January 2020

See also: Nicotine & Tobacco Research – Youth vaping and tobacco use in context in the United States: results from the 2018 National Youth Tobacco Survey

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Brazil gives big tobacco companies 30 days notice in smoking lawsuit

British American Tobacco Plc and Philip Morris International, will have until early March 2020 to defend themselves in a lawsuit in Brazil over compensation for tobacco-related diseases. Since last year, the companies have refused to receive subpoenas delivered to their local subsidiaries in the lawsuit brought by the Brazilian solicitor general’s office.

Souza Cruz Ltda, Philip Morris Brasil Industria e Comercio Ltda and Philip Morris Brasil SA, which produce 90% of the cigarettes sold in Brazil, maintained they were subsidiaries only and notifications had to be sent directly to their parent companies’ headquarters in Britain and the United States. But the federal judge hearing the case in Porto Alegre, Graziela Bündchen, ruled on Tuesday 4th February that the companies are the operational wings of the parent companies and fully capable of relaying the notifications to their head offices. She gave them 30 days to present their defenses.

The solicitor general’s office said in a statement on Thursday that the cigarette companies had tried to delay the lawsuit, which will now be able to proceed in seeking “the just compensation the Brazilian people deserve.” The landmark lawsuit was filed by the AGU in May against the two multinational companies seeking to recover the public health costs for the treatment of 26 tobacco-related diseases over the previous five years.

Source: Reuters, 6 February 2020

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Parliamentary Activity

Parliamentary questions

PQ1: Smuggling

Asked by Kenny MacAskill, East Lothian
To ask the Chancellor of the Exchequer, how much money was accrued by (a) his Department and (b) HMRC in compensation as a result of (i) court orders and (ii) other recovery and penalty mechanisms in relation to illicit tobacco in each of the last 10 years.

Answered by Simon Clarke, the Exchequer Secretary
Due to the way HMRC records and retains information it is not possible to provide a complete response to the question. HMRC regularly reports its performance against the strategy to tackle illicit tobacco and the latest published data can be found at HMRC do not hold the requested information relating to court orders but the Ministry of Justice may be able to provide this data.

Source: Hansard, 6 February 2020

PQ2: Child smoking

Asked by Gregory Campbell, East Londonerry
To ask the Secretary of State for Health and Social Care, what estimate he has made of the prevalence of smoking among 15 year olds.

Answered by Jo Churchill, the Parliamentary Under-Secretary for Health and Social Care
The latest data from the NHS Digital Survey on ‘Smoking, Drinking and Drug use among Young People in England’ shows that in 2018, 5% of 15-year olds were regular smokers, down from 7% in 2016.

Source: Hansard, 6 February 2020

PQ3: NHS Long Term Plan

Asked by Andrea Jenkyns, Morely and Outwood
To ask the Secretary of State for Health and Social Care, with reference to the NHS Long Term plan, what steps his Department is taking to help people stop smoking in areas where smoking is more prevalent.

Answered by Jo Churchill, the Parliamentary Under-Secretary for Health and Social Care
The NHS Long Term Plan commits to the provision of tobacco dependence treatment services for all people who smoke who are admitted overnight to hospital, pregnant women and higher risk outpatients by the end of 2023/24.
The NHS Long Term Plan Implementation Framework, published in June 2019, outlines how these commitments will be delivered; encouraging local systems, to develop local plans to tackle health inequalities and best meet the needs of the populations they serve.

Source: Hansard, 6 February 2020

Link of the Week

Smokefree 2030 Campaign

On Monday, 3rd February, ASH with partners in the Smokefree Action Coalition, launched a campaign to achieve the Government’s ambition for England to be Smokefree by 2030.

The Roadmap to a Smokefree 2030 sets out the key policies and opportunities that will help drive down smoking prevalence, starting with legislation to require tobacco companies to finance a Smokefree 2030 Fund to pay for tobacco control activity at a local, regional and national level.

Individuals and organisations can get involved by endorsing the Roadmap to show your support for achieving a Smokefree 2030.
• Endorse as an individual
• Endorse as an organisation

See Campaign Page