Electronic cigarettes are marketed as a cheaper, safer alternative to conventional cigarettes. As they do not produce smoke, research suggests that electronic cigarettes are relatively harmless in comparison with smoking. This briefing reviews the safety of e-cigarettes and how effective they are as an aid to stopping smoking.
Millions of cigarettes stockpiled amid fears Brexit will cause UK shortages
One of the world’s biggest tobacco companies is stockpiling £30m of cigarettes amid concerns Brexit may lead to the UK running out of cigarettes. Imperial Brands said it was building up UK reserves to mitigate possible supply disruptions caused by Britain’s exit from the European Union.
Imperial is the smallest of the big five global tobacco companies. Others include US listed companies Philip Morris and Altria, FTSE 100 compatriot British American Tobacco and Tokyo-based Japan Tobacco.
Source: Telegraph, 6 November 2018
Company stops selling some flavoured e-cigarettes in US but sales continue in UK
Vaping products that have been pulled from sale in the US over fears about underage buyers will still be sold at Sainsbury’s in the UK. The US e-cigarette company Juul, which struck a deal with the British supermarket earlier this month, has stopped the sale of several of its flavoured cartridges in the US.
The company has also stopped using social media sites including Twitter and Instagram to promote its products in an attempt to extinguish criticism that it markets its products to children. It also strengthened its age verification processes to restrict sales to those who are under 21 years old.
However, two of the flavours it has removed from sale in the US remain on sale at Sainsbury’s. The Mango and Royal Creme pods, used to add flavour to Juul’s rechargeable e-cigarettes, will not be removed in the UK, a spokesman said.
Vaping among teens in the UK remains low with less than 1% of non-smoking teens reporting current use.
Source: Telegraph, 15 November 2018
Manchester: 95 shisha pipes seized from shisha café in Rusholme
Manchester City Council is set to prosecute the owners of a Rusholme shisha café following their repeated breaches of the law. Ninety-five shisha pipes have been seized from the premises in Wilmslow Road.
The owners could now be fined up to £2,500 if successfully prosecuted in magistrates’ court. During a previous visit the owners of the café had four pipes confiscated and were warned further action would be taken if they continued breaking the law.
Two fixed penalty notices for £50 were issued during the seizure for smoking indoors in a smoke free place. One of the individuals fined was subsequently arrested by Greater Manchester Police in connection to a separate offence.
Source: Lovin Manchester, 14 November 2018
Gloucestershire: Mirror hid an illegal haul of cigarettes
Gloucestershire trading standards officers have discovered £1,700 of illegal tobacco stashed behind a mirror in a Cheltenham shop. Officers found 215 packs of cigarettes and 91 pouches of hand rolling tobacco. Counterfeit versions of Richmond, Mayfair and Amber Leaf were found alongside, Richman, Marlboro Gold and Cutters Choice.
They had visited the store to follow up a previous test purchase where an undercover trading standards officer was able to purchase a pack of counterfeit cigarettes for £3.50.
Source: Punchline Gloucester, 15 November 2018
Thailand: plain cigarette packaging to be introduced
The Public Health Ministry on Thailand has approved draft regulation which would mandate plain cigarette packaging and update the compulsory health warning pictures which are already present on packets.
The Public Health Minister said the approval came from the ministry’s national tobacco control committee. Thailand would be the first Asian nation to introduce plain packaging. A date has not been set for when the regulations might come into force.
Source: Bangkok Post, 14 November 2018
Malaysia: Smoking ban at food outlets to go ahead despite protests
The Health Minister of Malaysia has stated that the government will not compromise on the upcoming smoking ban in restaurants, food outlets and hawker stalls as it is in the public interest. On Monday, three associations representing more than 20,000 restaurant owners held news conferences to express their dissatisfaction with the move by the Health Ministry to introduce a ban on smoking at food outlets from on January 1, 2019.
The Health Minister said: “We are not ready to compromise in this issue. Smokers will have to find other places so that they can smoke as much as they want… Our business is to ensure that public eateries are safe especially for children, the elderly and (pregnant) women as it will affect those around the smokers with passive smoking.”
Source: Daily Express (Malaysia), 15 November 2018
Budget 2018: Cost of cigarettes to rise
Chancellor Philip Hammond has announced that the tobacco tax escalator will remain at 2% above inflation. This means that on top of September’s inflation rate of 2.4%, a further 24p will be added, excluding inflation, to a standard-priced pack of cigarettes. The increase will take the average price for a pack of cigarettes to over £10.
Hand rolling tobacco taxes will go up by 3% above inflation.
See also: ASH press release, ASH comment on Budget: Missed opportunity
Source: The Sun, 30 October 2018
London: Brent Council launches campaign against paan spitting
People caught spitting paan in the street could face a fine of £100, after Brent Council launched a campaign against the practice. Paan is a combination of leaf and nut, which is chewed, often with tobacco, to produce stimulant effects. It is popular in Asian communities and is widely available across Brent.
The council has urged users not to spit out the mixture onto roads and pavements as it can leave a distinctive red stain. Councillor Krupa Sheth, responsible for the environment at Brent Council, said the campaign highlights that such action will not be tolerated in the borough.
Source: Harrow Times, 29 October 2018
Finnish Medical Association seeks total ban on snus tobacco
The Finnish Medical Association (FMA) says the import of snus, an orally-ingested tobacco product, should be banned altogether. Snus is legal in neighbouring Sweden.
As part of its agenda to reduce tobacco use in Finland, a working group of the Ministry of Social Affairs and Health proposed in May that the daily limit on snus imports should be lowered from 1 kg to 100 grams.
According to the FMA, this does not go far enough.
“Selling snus is illegal in Finland. Therefore it would be more logical to completely prohibit its import, instead of just reducing the allowed amount.” the FMA said in a response to the proposal.
Source: Uutiset, 29 October 2018
Editorial: E-cigarette policy should consider environmental effects
An editorial in the American Journal of Public Health argues that health policy debates around e-cigarettes need to consider the health of the environment too. Each stage of the e-cigarette product lifecycle, including mining, manufacturing, using and disposing, could pose a potential environmental harm, wrote Yogi Hale Hendlin of the Center for Tobacco Control Research and Education at the University of California, San Francisco.
“Anytime we make something that is disposable, we’re essentially stealing from the future… In 2015, more than 58 million e-cigarettes and refills were sold in the U.S. at grocery stores and convenience stores, which doesn’t include vape shops or online sales” Hendlin writes.
See also: BMJ Editorial: Tobacco smoke and environmental injustice
Source: Reuters, 30 October 2018
Link of the Week
Study: Early death ‘twice as likely’ in most deprived parts of England
A new study published in the Lancet has found that rates of premature mortality are two times higher in the most deprived area of England (Blackpool), compared to the most affluent areas (Wokingham, Surrey, Windsor and Maidenhead, and West Berkshire).
Although rates of premature death have fallen since 1990, half of all premature deaths in 2016 were linked to risk factors including tobacco use, unhealthy diet, alcohol and drug use, obesity and high blood pressure.
Lung cancer and COPD were among the top 4 causes of premature death along with ischaemic heart disease and cerebrovascular disease. The association with deprivation was particularly strong for lung cancer, and chronic obstructive pulmonary disease which are strongly linked to tobacco smoking.
Source: The Spectator, 26 October 2018
Opinion: WHO not taking on board expert opinion around tobacco and harm reduction
In this opinion piece Lizi Jenkins, board member at the tobacco industry funded UK Vaping Industry Association along with other figures from the global vape industry discuss the World Health Organisations stance on vaping and harm reduction.
They are critical of the WHO’s reluctance to treat vaping as distinct from smoking and highlight the importance of vaping as part of a broader harm reduction approach.
Source: Financial Times, 26 October 2018
US: Marlboro maker axes flavoured e-cigarettes
Altria, the parent company for Philip Morris which owns the popular Malboro cigarette brand, has decided to stop selling several of its e-cigarette products in the US. The company will only sell tobacco, menthol and mint flavours for its remaining vaping devices.
This follows a US Food and Drug Administration investigation into the appeal of e-cigarette marketing to under-18s. Altria also said it would support moves to make 21 the minimum age for purchasing tobacco products.
Source: BBC, 25 October 2018
Parliamentary Question 1: Smoking cessation
Asked by Jonathan Ashworth (Leicester South)
To ask the Secretary of State for Health and Social Care, what comparative assessment his Department has made of the advice on the efficacy of e-cigarettes as a stop smoking aid between Public Health England’s document entitled Stop smoking options: guidance for conversations with patients and NICE’s document entitled Stop smoking interventions and services guidance.
Answered by Steve Brine, The Parliamentary Under-Secretary for Health and Social Care
Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE) agree that, although not risk free, e-cigarettes are substantially less harmful than smoking. PHE and NICE also agree that e-cigarettes can help smokers to quit and that it is important for a smoker to quit smoking completely to get the full benefits to their health.
PHE’s document ‘Stop smoking options: guidance for conversations with patients’ and NICE’s document entitled ‘Stop smoking interventions and services guidance’ are also well aligned with advice from the British Medical Association, the Royal College of Physicians and the Royal College of General Practitioners.
Source: Hansard, 25 October 2018
Parliamentary Question 2: E-cigarettes
Asked by Jonathan Ashworth (Leicester South)
To ask the Secretary of State for Health and Social Care, with reference to Public Health England’s document, Stop smoking options: guidance for conversations with patients, published on 20 August 2018, what evidence Public Health England assessed to inform its recommendation that E-cigarettes can help people quit smoking, with similar or better results than NRT.
Answered by Steve Brine, The Parliamentary Under-Secretary for Health and Social Care
Public Health England (PHE) referenced two papers in the guidance that helped inform its recommendation. They were:
– ‘Electronic cigarettes for smoking cessation: a randomised controlled trial’ by Bullen and others.
– ‘Real‐world effectiveness of e‐cigarettes when used to aid smoking cessation: a cross‐sectional population study’ by Brown and others.
PHE’s recommendation is also supported by evidence from local stop smoking services in England, where people using e-cigarettes and stop smoking medicines consecutively have the highest rates of success, with 75% quitting successfully compared to 50% for those using medicines alone.
Source: Hansard, 24 October 2018
Parliamentary Question 3: Smoking cessation funding
Asked by Jonathan Ashworth (Leicester South)
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effect of changes in the level of funding for smoking cessation services on health inequalities.
Answered by Steve Brine, The Parliamentary Under-Secretary for Health and Social Care
Smoking rates vary considerably across the country and local authorities are best-place to take decisions about the services required to meet the needs of their populations.
Source: Hansard, 24 October 2018
Link of the Week
New NHS Maternity Statistics for England 2017-18
The NHS has published the latest annual data on maternity activity for England. Among other things, the data shows that 31% of women aged under 20 were recorded as a current smoker at their booking appointment.
Source: NHS Digital, 25 October 2018
Link of the Week
Study: E-cigarette use shifts towards lower socioeconomic groups
A new study published in the journal Addiction has found that use of e-cigarettes has shifted from more affluent early adopters to being used more widely across all socioeconomic groups.
The research, which is the first of its kind to examine use of e-cigarettes by socioeconomic group at the population level, included data from over 80,000 adults in the UK aged 16 and over. The burden of disease and premature mortality from tobacco smoke is currently heaviest among the most disadvantaged groups.
Loren Kock, lead author of the study, said: “E-cigarettes have the potential either to decrease or increase health inequalities depending on levels of smoking cessation… Our research indicates that from 2014 to 2016, e-cigarette use among smokers was generally higher among those from more affluent socioeconomic groups, with disadvantaged groups around half as likely to use an e-cigarette in 2014, but this gap was no longer evident in 2017.”
Source: UCL News, 11 October 2018
London: Smokers to be scanned in supermarket car parks in pioneering bid to cut lung cancer deaths
A new pilot scheme in West London will offer current and former smokers lung cancer scans in order to improve early detection of the disease. Lung cancer is the most common cause of cancer death in the UK, partly as a result of late diagnosis.
The NHS funded scheme will cost £1 million and will target over 7,000 smokers and former smokers outside supermarkets in London.
The results from the trial will help determine whether the NHS should set up a national screening program for lung cancer.
Source: London Evening Standard, 10 October 2018
Link of the Week
Blog: Tobacco smoke and environmental injustice
In this blog, Nick Hopkinson from Imperial College London highlights the environmental harm caused by the tobacco industry and makes the case for supporting low income countries to transition away from tobacco production alongside reducing tobacco consumption.
“Crucially, while profits from the tobacco industry accrue in the rich world, the largest environmental burdens fall on low and middle income countries. Of the top 10 tobacco producing countries, nine are developing and four are defined as low income, food deficit countries. Smokers in high income countries like the UK are literally and metaphorically burning the resources and the future of the most vulnerable people on our planet.
As well as squandering resource inputs, the outputs of the tobacco product life cycle pollute water and land and contribute to climate change. An estimated 4.5 trillion cigarette butts are released into the environment—toxic trash that poisons water and land. Actions to tackle this include demanding extended product liability from the industry so that it takes responsibility for the whole life cycle and externalities are costed in.
Countries need to be supported to provide and promote alternative livelihoods for tobacco farmers, but the only effective response to the environmental effect of the tobacco industry is to reduce tobacco consumption.”
Stirling study finds plain packaging led to price hike for branded tobacco
Research from Stirling University has revealed that small retailers in the UK inflated the prices of fully-branded tobacco products ahead of the introduction of standardised packaging.
Shops charged more than the RRP (recommended retail price) for fully-branded tobacco products as they became rarer, contrary to the advice of the tobacco industry who were concerned about customer loyalties shifting following the removal of fully-branded packaging.
Dr Nathan Critchlow, lead author of the study, said: “We found that…small retailers sold leading tobacco products higher than the RRPs. In particular, they increased prices above RRP for fully-branded packs as they were phased out – even those which had the prices marked on the packaging. Once the legislation became mandatory, small retailers continued to sell leading tobacco products above RRP. It is possible that they used product changes introduced under the policy, such as larger minimum pack size and removal of price marking, to opportunistically increase the profit from tobacco sales.”
Source: Central FM, 22 August 2018
Journal of Tobacco Control: Difference between recommended retail price and sales price for tobacco products in independent and convenience (small) retailers before and after the introduction of standardised tobacco packaging in the UK
Tax on vaping ruled out by ministers
Exchequer Secretary Robert Jenrick has written to the tobacco industry funded UK Vaping Industry Association (UKVIA) to confirm that the government has no plans to tax e-cigarettes, stating that: “we have no current plans to introduce a new tax on vaping products.”
The letter also highlights that were e-cigarettes to be licenced as medicines and be available on prescription they could be eligible for a lower VAT rate.
Mr Jenrick said: “I recognise the contribution the vaping industry makes to the economy in terms of jobs and revenue to the Exchequer and welcome the fact the UK has a world leading vaping industry.”
Source: The Sun, 21 August 2018
Leicester: Hospital patients and visitors smoking in no-smoking areas
The wife of a patient at Glenfield Hospital has complained about people smoking outside her husband’s room and in no-smoking zones on hospital grounds, despite the presence of a number of designated smoking shelters.
Her husband, who has cystic fibrosis and is on a high-flow oxygen machine while he waits for a lung transplant, has been forced to keep the window of his room shut because of smokedrift from people smoking outside.
Sarah MacFadyen, head of policy at the British Lung Foundation, said: “People with a lung condition such as cystic fibrosis often find that passive smoking worsens their symptoms. This is why we support calls for all hospital grounds to be smoke-free zones.”
Source: Leicestershire Live, 21 August 2018
Opinion: Look out, cigarettes have a cool young rival
Anna Thomson considers the launch of Juul e-cigarettes in the UK following a recent report into e-cigarettes by the science and technology committee.
The US e-cigarette brand, Juul, makes up just over 70% of the US e-cigarette market and made more than $1.1 billion in profits over the past year. According to James Monsees, executive and board member at Juul, the purpose of their e-cigarette is to help traditional smokers cut down on their exposure to the wide range toxic and carcinogenic compounds found in regular cigarettes.
The popularity of the brand in the US has prompted debate about whether the health benefits of Juul e-cigarettes outweigh the risks of introducing a new generation to nicotine. Despite not being advertised to teens, Juuls have allegedly become popular in some US high schools, raising concerns about the brand’s appeal to teenagers.
Following the launch of Juul in the UK, MPs have recommended that regulations on the advertising, sale, taxation and use of vaping devices should be relaxed to encourage more smokers to switch to e-cigarettes.
Sales of e-cigarettes would still be prohibited to under-18s and current UK regulation is designed to inhibit uptake of e-cigarettes among young people.
Source: The Times, 22 August 2018
Israel bans Juul e-cigarettes citing public health risk
Israel has outlawed the import and sale of e-cigarettes produced by US manufacturer Juul Labs, citing public health concerns about their nicotine content.
Israel’s Health Ministry put out a statement attributing the ban to the high concentration of nicotine in Juul e-cigarettes, saying that the device poses “a grave risk to public health.”
The ban, which Juul is planning to appeal, comes into force on September 5.
Source: Reuters, 21 August 2018
Thailand: Phuket to launch anti-smoking campaign next month
The Thai city of Phuket is set to launch a major anti-smoking campaign next month to create a clean environment for local residents and raise public awareness about Thailand’s new Tobacco Control Act.
The campaign, which launches on September 23, will be joined by a number of public and private organisations, including Action on Smoking and Health Thailand.
Phuket City Municipality Mayor Somjai Suwannasuphobna, said today the campaign was developed out of concerns for the health of non-smokers and urged parents to set a good example for their children by not smoking.
Source: National News Bureau of Thailand, 22 August 2018
US e-cigarette group Juul launches in Britain
The San Francisco vaping start-up, Juul, launched in the UK on Tuesday, gaining access to the second-largest e-cigarette market in the world. Since launching in 2015, Juul now accounts for approximately 70% of all e-cigarette sales in the US.
The company has dedicated itself to eliminating “combustible cigarettes from the face of the earth”, and wants to help the £7.4 million smokers in the UK transition to less harmful forms of nicotine consumption and ultimately stop smoking altogether.
Deborah Arnott, chief executive of Action on Smoking and Health (ASH) in the UK, said: “e-cigarette use in the UK has stagnated since 2013, to the detriment of public health. If Juul takes off in the UK as it did in the US it could reboot the market and hasten the arrival of the smoke-free future we’re all hoping for.”
Source: Financial Times, 17 July 2018
Blackburn: Smokers supported to stop smoking on Hospital site
Senior figures at East Lancashire Hospitals Trust (ELHT) are offering smokers at Royal Blackburn Hospital support to help them quit.
Kevin McGee, chief executive of the ELHT, said: “What we now do is challenge in a very positive way anybody that does smoke and offer them support and offer them help. What I would say to anyone is to respect that this is a no smoking site.”
Source: This is Lancashire, 17 July 2018
Essex: Plastic box being used as an ashtray starts fire in block of flats
Fire crews have identified a plastic box being used as an ashtray as the cause of a small fire in a block of flats in Westbourne Grove, Essex.
No one was injured and smoke damage was limited to the stairwell where the box was located.
A spokesman from the fire service said: “This incident could have been worse if the fire had spread; cigarettes are the most deadly cause of house fires and this incident shows how important it is to ensure they are put right out in a suitable ashtray.”
Source: Echo News, 17 July 2018
Blackpool: Pregnant smokers to get vouchers as part of new Stop Smoking Service
Pregnant smokers in Blackpool could receive shopping vouchers and other incentives to give up smoking. This is one of a number of schemes being considered by health officials in the resort, which has a smoking in pregnancy rate of 27.8%, the highest in the UK.
The proposed new stop smoking service will offer more support to smokers to help them quit, including advice in leaflets and websites, advice on nicotine replacement therapies, and access to helplines in a bid to make the service more accessible.
Councillor Amy Cross, Blackpool Council’s cabinet member for reducing health inequalities, said: “Supporting mothers-to-be to quit smoking during pregnancy helps give unborn children a good, healthy and fair start in life. Smoking during pregnancy is a major health problem and is associated with various adverse effects during pregnancy, including an increased risk of miscarriage, premature birth, low birthweight and stillbirth.”
Source: Blackpool Gazette, 17 July 2018
Sunderland: School pupils hope anti-smoking film will go viral
Pupils from Whitburn Church of England Academy in Sunderland, have produced an anti-smoking film they hope will go viral. The video was produced as part of a campaign led by South Tyneside Council and the Customs House Theatre who worked with students across the region to develop a creative campaign persuading peers to say no to smoking.
A 2017 borough health survey found smoking rates of 5% for Year 8 pupils (12-13) and 11% for Year 11 pupils (15-16), with 11% of primary school pupils stating that someone they live with smoked in the same room as them.
Councillor Tracey Dixon, lead member for independence and wellbeing, said: “Who better to lead the fight against tobacco than our creative young people! I think it’s fantastic that these students are leading the way in South Tyneside.”
Source: Sunderland Echo, 17 July 2018
India: Tobacco companies fight pictorial warnings in Supreme Court
Tobacco industry representatives have objected to a recent Supreme Court decision to increase the size of pictorial warnings on tobacco packaging from 40% of the pack size to 85%.
The Court’s decision was motivated by a petition to help consumers take informed choices when purchasing tobacco. One of the main advantages of pictorial warnings compared to warning messages is that they convey the dangers of tobacco to people who are illiterate.
The Court justified the policy on the grounds that: “[the government] want the pictorial message to be such that it would inform consumers about the evil effects of the product.”
Source: Times of India, 17 July 2018
Link of the Week
The more you smoke, the greater your risk of a heart rhythm disorder
A recent study published in the European Journal of Preventative Cardiology has found that smoking more regularly increases the risk of a heart rhythm disorder called atrial fibrillation. Atrial fibrillation is the most common heart rhythm disorder and contributes to strokes and premature death.
The researchers from Imperial College London found a 14% increase in the risk of atrial fibrillation for every ten cigarettes smoked per day, with the risk increasing for every additional cigarette smoked.
Dr Dagfinn Aune, author of the study and postdoctoral researcher at Imperial College London, said: “Our results provide further evidence of the health benefits of quitting smoking and, even better, to never start smoking in the first place. This is important from a public health perspective to prevent atrial fibrillation and many other chronic diseases.”
Source: Science Daily, 12 July 2018
European Journal of Preventive Cardiology: Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies
How to future-proof your heart against smoking related diseases
Coronary heart disease is the most common and most preventable form of heart disease, and is strongly linked to smoking.
Despite falling rates of mortality from heart disease, more people are living with it and suffering a serious range of health problems as a result.
Maureen Talbot, a cardiac nurse at the British Heart Foundation, said: “As older people are at an increased risk of heart disease anyway, because the risks increase with age, those who do smoke should stop as soon as they can.” She highlights the importance of the smoking ban in bringing smoking rates down and asserts that “quitting is probably the single biggest change you can make.”
Source: The Telegraph, 12 Jul 2018
Essex: E-cigarette shop in Clacton helps customers stop smoking
An e-cigarette shop in Clacton is working with Tendring Council and Essex County Council to support people who want to quit smoking.
The shop, Vaporever, is providing one-to-one support and e-cigarette interventions to help people switch from smoking to vaping, with the ultimate goal of overcome their tobacco addiction.
Lynda McWilliams, Tendring Council’s cabinet member for health and education, said: “I am pleased to support this initiative as part of our Livewell Campaign to help people becoming fitter and healthier in Tendring. We are working closely with our public health colleagues at Essex County Council to find innovative ways of helping people to quit smoking. I hope that smokers will use this service and ultimately kick the habit, in order to lead healthier and longer lives.”
Source: Clacton Gazette, 11 July 2018
India: Despite ban, cigarettes still sold near city schools
A study conducted by the Tamilnadu People’s Forum for Tobacco Control (TNPFTC), has uncovered extensive violations of India’s blanket ban on sale of cigarettes in the vicinity of educational institutions. The ban exists to prevent students from having easy access to tobacco products.
S. Cyril Alexander, state convener of the TNPFTC, said: “We had found 12 shops selling tobacco products around a popular private school”.
The TNPFTC found that many teachers were unaware of the ban, believing that only illegal tobacco products like gutka were banned.
Souce: Times of India, 13 July 2018
USA: Smoking will be banned in public housing nationwide at end of July
The US is set to implement a nationwide ban on smoking in public housing in order to reduce the prevalence of smoking related diseases. The ban will take effect on 31 July and affect over 940,000 housing units.
The new rules, enforced by the Department of Housing and Urban Development, will prohibit the use of cigarettes, cigars and pipes in all public housing units and common areas, as well as any outdoor area within 25 feet of public housing grounds.
Source: CBS News, 12 July 2018
Air China flight’s sudden descent linked to co-pilot vaping
China’s aviation regulator has attributed an emergency descent by an Air China aircraft to a co-pilot using an e-cigarette during the flight.
The Boeing 737 was flying to the Chinese city of Dalian from Hong Kong on July 10 when it deployed oxygen marks and dropped to 10,000 feet (3,048 m), before climbing again to continue to its destination.
State-owned China News reported: “In the preliminary investigation, the co-pilot was found to be using an e-cigarette. Vapour diffused into the passenger cabin and relevant air conditioning components were wrongly shut off, without notifying the captain, which resulted in insufficient oxygen.” This triggered an alarm and prompted the crew to perform an emergency pressure relief procedure, which then released the cabin’s oxygen masks.
Source: Reuters, 13 July 2018
Link of the Week
Change is in the air: Going smokefree the Northumbria way
Northumbria Healthcare is sharing learning from going smokefree, which the Trust achieved in March this year.
The presentations from the ‘Change is in the air’ conference can be downloaded and address the key challenges in implementing the Tobacco Control Plan for England, review the latest evidence on e-cigarettes, and provide information and guidance to support health practitioners in making their services smokefree.
Barnsley: Increasing numbers of smokers quit following intensive work by health officials
New figures released by the Office of National Statistics show that Barnsley achieved a 2.4 per cent reduction in adult smoking rates in 2016-17. The smoking rate fell from 20.6 per cent in 2016 to 18.2 per cent in 2017, exceeding a target to reduce levels to 20 per cent.
Barnsley Council is working to help existing smokers quit and to ensure that children and young people are not tempted by tobacco use, by making parks and school grounds voluntary smokefree zones and discouraging parents from smoking when they drop off or collect children from school.
Kaye Mann, Barnsley Council’s senior health improvement officer, said: “Evidence tells us that is the best way to stop them from smoking, to denormalise it. When they don’t see it as normal to do so, they don’t start. As well as getting the current generation to quit, it is about stopping people taking it up. The aim so to create a smoke free generation by 2025.”
Source: The Star, 5 July 2018
Peers and parents may have influenced drop in childhood smoking
A recent study has found that socioeconomic status and parental/peer behaviour are strongly linked to the risk of childhood smoking.
Researchers at Pennsylvania State University in University Park analysed data from two groups of UK children, one born in 1970 and the other born 2000-2002. They found that 14.5 per cent of the 1970 cohort had smoked at last one cigarette by age 10-11, while that was true for only 2.4 percent of the 2000-2002 cohort.
Two of the biggest factors influencing smoking rates for the 2000-2002 cohort were educational backgrounds and smoking prevalence among the children’s mothers. The authors of the study state that: “childhood smoking in today’s young people in the UK is now more strongly linked to early life disadvantages compared to a generation ago.”
Source: Reuters, 11 July 2018
USA: Research suggests E-cigarette flavourings may have adverse health effect
A study at Boston University has found that electronic cigarette liquids sweetened with flavourings like clove and vanilla may damage cells in the blood vessels and heart even when they don’t contain nicotine.
Researchers applied common e-cigarette flavourings to samples of endothelial cells, which line arteries and veins as well as the inside of the heart. Five common flavours, including mint and cinnamon, impaired production of nitric oxide which could contribute to an increased risk of heart disease or strokes.
Source: Reuters, 11 July 2018
Editorial Note: The study concludes that short-term exposure to flavours may have relevance to cardiovascular issues. The researchers note that more serious issues such as cell death were induced only at high concentrations unlikely to be achieved under normal conditions of use.
Arteriosclerosis, Thrombosis, and Vascular Biology: Flavorings in Tobacco Products Induce Endothelial Cell Dysfunction
Ireland: Young filmmakers lift prize for anti-smoking film
A group of young people representing Nenagh Training Centre in Tipperary have come second in the Short Film Competition Senior Category at this year’s Irish Cancer Society X-HALE Youth Awards 2018.
The group’s short film entitled ‘Get off the Nicotine Road’, was among a number of other anti-tobacco films produced as part of the event which aimed to raise awareness about the harm caused by tobacco. According to recent statistics produced by Healthy Ireland, 16 per cent of Irish children aged nine or older have smoked cigarettes in their lifetime and 6 per cent are classified as current smokers.
Donal Buggy, head of services at the Irish Cancer Society, said that young people “have a vital role to play on the journey to Ireland becoming a tobacco-free country”.
Source: Tipperary Star, 12 July 2018
Link of the week
Retailers in the dark over new tobacco codes
Clarity is being called for on new track and trace regulations for tobacco products.
The regulations which are set to be introduced in May 2019 as part of the EU Tobacco Products Directive, will create a new method of tracking the sale of legitimate tobacco products through the supply chain, requiring retailers to apply for and receive a unique ‘economic operator identifier code’ for their businesses and a ‘facility identifier code’ for each of their stores. Without the codes, retailers will not be able to buy tobacco legally.
However, with less than one year to go before implementation, there is still a lack of clarity over the time that retailers will be given to apply, the Association of Convenience Stores (ACS) said. ACS chief executive James Lowman said: “The illicit trade in tobacco is a damaging criminal enterprise that cost the Treasury over £2.5 billion last year in lost duties and VAT.”
Clarity on when retailers are able to apply will support them to sell tobacco legally.
Source: Convenience Store, 30 May 2018
Cambridge: Football team back no smoking campaign ‘Kick Ash’
An innovative no smoking programme led by young people in Cambridgeshire has scored winning support from its local football club – Cambridge United.
Kick Ash, an award-winning campaign led by young people to prevent smoking in under 16’s across the county is being endorsed by the club who will be promoting the initiative in its programme, website and newsletter.
Supported by a partnership involving Cambridgeshire County Council, Cambridgeshire PSHE service and Everyone Health’s CAMQUIT Stop Smoking Service, the programme works with 10 secondary schools across the county and their partner primary schools to encourage all young people to be proud to be smoke free.
Since launching in 2009, 952 year 10 students have been trained in county secondary schools to become Kick Ash mentors, who provide informal support to young people who want information and advice on smoking as well as supporting an education programme for year 6 pupils in partner primary schools and year 8 pupils in secondary schools.
Source: Cambridgeshire County Council, 14 June 2018
Stafford: Council use World Cup inspired anti-litter initiative to keep the town clean
Stafford Borough Council has put up a cigarette butt ballot box bin on the wall of the town’s Civic Centre. The bin poses the question: “Will England do well in Russia” and has two slots for people to put their cigarette ends in – one for yes and the other for no.
Smokers will be encouraged to cast their votes on the performance of the England Football Team during the World Cup using their cigarette butts.
In the last year more than 170 people have been fined or taken to court for discarding rubbish, with the majority of litter being cigarette butts. Money from the fines is spent on helping tackle environmental issues.
Source: The Stone and Eccleshall Gazette, 14 June 2018
EU challenges Belgium’s attempt to outlaw menthol cigarettes before 2020
The Belgian Minister of Public Health, Maggie De Block wants to ban methanol tobacco before the European 2020 deadline.
The Minister of Public Health prepared a royal decree draft, transposing the European Directive into Belgian law, but without taking into consideration the exemption granted to methanol tobacco.“Protection of health, especially for young people, justifies the application of this measure at the earliest” stated Mrs De Block.
The European Commission have sent the Belgian government a warning threatening to take this to the EU Court of Justice. European Administration reminded them that the directive text indicates that the banning of menthol tobacco “should extend over a long period to allow consumers enough time to switch to other products”.The European Commission is awaiting a response on Belgians intentions, but the cabinet has said it will go-ahead to ban methanol before the European 2020 deadline.
Source: The Brussels Times, 15 June 2018
France: Minister orders tobacco industry to stub out cigarette butt pollution
France will force tobacco companies to help end the scourge of cigarette butts that litter streets and contaminate water, unless they take voluntary action in the next three months, a government minister said on Thursday 14th June.
The city of Paris picks up 350 tonnes of cigarette butts every year despite wall-mounted ashtrays and the threat of a 68 euro fine for anyone caught throwing butts on the street.
“If no effective commitments are proposed by September, the government will force the industry to get involved in the collection and elimination of its waste,” Junior Environment Minister Brune Poirson said ahead of a meeting with industry representatives.
The government has not said what measures it might impose, but one official said a mandatory recycling scheme was an option.
Source: Reuters, 14 June 2018
USA: Smokers don’t believe vaping is less harmful than smoking
A growing proportion of U.S. adults do not believe that e-cigarettes are less harmful than smoking, according to an analysis of the U.S. Population Assessment of Tobacco and Health (PATH) study data from 2013 to 2015 presented yesterday at the fifth Global Forum on Nicotine conference.
The analysis of the latest PATH data suggests that the proportion of adult current smokers who believed e-cigarettes were just as, or more, harmful than smoking increased substantially from 43% in 2013 to 57% in 2015.
In the wider adult population (including non-smokers) the perception was even more skewed with the analysis showing the proportion of the adult population believing that e-cigarettes were as harmful, or more harmful, than smoking increasing from 54% in 2013 to 65% in 2015.
Source: EurekAlert! 14 June 2018
USA: Study suggests flavouring chemicals in E-cigarettes may harm blood vessels
A new study by researchers from Boston University on endothelial cells suggests that the flavour additives used in e-cigarettes can impair blood vessel function.
In the study, the researchers looked at the effects of nine chemical flavourings often used in e-cigarettes on endothelial cells – the cells that line the blood vessels and the inside of the heart. Flavours tested included menthol, burnt flavour, vanilla, cinnamon, clove, butter, strawberry, banana and spicy cool. Their analysis revealed that all nine flavours had detrimental effects on endothelial cells.
The researchers noticed that when blood vessels were exposed to these flavouring additives, normally released chemicals to promote blood flow were decreased and inflammation increased, indicators of short-term toxicity.
Source: The Mirror, 14 June 2018
Link of the week
Rapid review of compliance with the Tobacco and Related Products Regulations: 2017
The Tobacco & Regulated Products Regulations 2016 (TRPR) came into full effect in May 2017 following a 12 month transition period.
This report from the Chartered Trading Standards Institute presents the findings from phase 3 of monitoring carried out by Trading Standards and focuses on the compliance of nicotine inhaling products with these Regulations.
Essex: Elderly homeowner escapes fire caused by discarded cigarette
Firefighters were called to a house fire on Wednesday morning after an elderly occupant was awoken by the sound of burning, they were able to evacuate with the help of neighbours.
An investigation found that the fire had been caused accidentally by a discarded cigarette, which had ignited the shed in the property’s back garden. The fire had then spread to the adjacent back wall of the home and quickly reached the upstairs.
This is the second time in three days that firefighters have attended a serious fire at a domestic property caused by inappropriately discarded cigarettes.
Source: The Maldon Standard, 23 May 2018
Study finds cigarette smoke directly damages muscles in the body
We already know that smoking restricts a person’s ability to exercise because it makes their muscles weaker. It is widely believed this muscle weakness is because the lungs become inflamed and eventually destroyed by habitual smoking, therefore limiting activity and exercise.
Research shows that components in cigarette smoke also directly damage your muscles. The research, published in The Journal of Physiology, indicates that smoking decreases the number of small blood vessels that bring oxygen and nutrients to muscles in the legs.
Reducing the amount of oxygen and nutrients muscles can receive can impact metabolism and activity levels, both of which are risk factors for many chronic diseases including chronic obstructive pulmonary disease (COPD) and diabetes.
The Journal of Physiology: Cigarette smoke directly impairs skeletal muscle function through capillary regression and altered myofiber calcium kinetics in mice
Source: Medical Express, 24 May 2018
USA: Money motivates smokers to quit
A smoking cessation study published in The New England Journal of Medicine found financial incentives in conjunction with free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone.
The study utilised groups of employees, with the most successful being the group that chose the cessation products they wanted plus $600 in an account with the threat that they would lose the money if they didn’t stay smokefree for six months. Their success rate was 12.7% which was better than those who got e-cigarettes or free cessation aids alone.
New England Journal of Medicine: A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation
Source: Reuters, 23 May 2018
USA: Scientists warn of the dangers of cinnamon flavoured e-cigarette liquid
Cinnamon-flavoured e-cigarettes may damage the lungs, a study has found.
Scientists in the US carried out tests in which they investigated the effects of 7 flavoured nicotinefree e-liquids on primary human alveolar macrophages, neutrophils, and natural killer (NK) cells (airway cells). Cinnamaldehyde-containing e-liquids (cinnamon flavour) had the most immunosuppressive effects across the different end points and cell types examined.
The researchers concluded that cinnamaldehyde has the potential to impair respiratory immune cell function, illustrating an immediate need for further toxicological evaluation of chemical flavouring agents to inform regulation governing their use in e-liquid formulations.
Source: American Journal of Physiology, 1 August 2017
Editorial note: The author of the article about Youtube removing e-cigarette content featured in yesterday’s Daily News (23/05/2018), Martin Cullip, is also known as Dick Puddlecote.
See tobacco tactics: http://www.tobaccotactics.org/index.php/Martin_Cullip
Smoking with your car door open while you have children on board could land you a fine
It has been illegal to smoke in your car with a person under the age of 18 on board since 2015. Anyone that smokes in a car with a fully or partially enclosed roof while they have a child on board can be fined – even if the windows or sunroof are open, or the air conditioning is on.
However, drivers who smoke out the door of their parked car while there are kids on board can still be fined. This is because cigarette smoke could still travel back inside the vehicle and affect young passengers. According to the DVSA, the law doesn’t apply to “a convertible car with the roof completely down”.
Anyone caught by police for committing the offence will be fined £50 for each person smoking in the vehicle, and the driver can be fined even if they are not the one smoking.
Source: The Sun, 14 May 2018
Wakefield: Midwives given carbon monoxide detectors in an attempt to reduce smoking in pregnant women
Midwives will be given carbon monoxide detectors as part of plans to reduce the number of women who smoke during pregnancy. This follows a successful trial programme in the north east, where women were screened for signs of smoking at their first appointment with a midwife, and were put in touch with support services at an early stage.
Smoking rates among pregnant mums in Wakefield are the highest in the country, with figures suggesting that 18.1% of mums-to-be in Wakefield use cigarettes while carrying their unborn children. Across the Mid Yorkshire NHS Hospitals Trust, which runs Pinderfields, Pontefract and Dewsbury hospitals, the figure is 20% – a rate which was described as “alarming” by a trust director last week.
Vicky Salt from Action on Smoking and Health (ASH) said “Smoking during pregnancy is still a leading cause of stillbirths and neo-natal deaths in the UK. It’s very important also that midwives and healthcare professionals who are treating pregnant women make them aware of the damage smoking can do to the foetus and to themselves.”
Source: Pontefract and Castleford Express, 14 May 2018
South Lanarkshire: Shops urged to ‘challenge 25’ on sales of e-cigarettes
Retailers in South Lanarkshire are being reminded that the sale of e-cigarettes to anyone under the age of 18 is against the law, and being encouraged to use a ‘challenge 25’ approach.
The advice comes from the council’s Consumer and Trading Standards team, 12 months on from the introduction of the Health (Tobacco, Nicotine etc. and Care) Scotland Act 2016, which changed the legislation on the sale of nicotine vapour products, bringing them into line with existing rules for the sale of tobacco. This also comes in the wake of a series of ‘test purchase’ visits in which more than half of young volunteers failed to be challenged or asked for ID, when trying to buy nicotine vapour products.
Source: South Lanarkshire Council, 14 May 2018
Commonwealth countries should take bold action to slash number of lifestyle-related deaths
Each year around 10 million Commonwealth citizens die as a result of lifestyle-related illnesses, with cardiovascular and chronic respiratory diseases, diabetes and cancer accounting for more than seven million fatalities. Governments must take bold action if they are to tackle the non-communicable diseases (NCDs) that blight the lives of millions of Commonwealth citizens.
In a new report commissioned by the Commonwealth, recommendations such as establishing 100% smokefree public spaces are set out in a bid to cut the number of preventable deaths. Other proposals included raising taxes on tobacco to 75% of sale price and requiring companies to include graphic warnings or produce plan packaging.
Source: The Commonwealth, 14 May 2018
Paul Girvan, South Antrim
To ask the Secretary of State for Health and Social Care, whether his Department plans to prohibit smoking on publicly owned property not covered by the Health Act 2006.
Steve Brine, Public Health and Primary Care Minister
There are no plans to introduce further prohibitions of smoking on publicly-owned property not covered by the Health Act 2006. Smokefree policies have been successfully introduced across the Government estate through administrative means, without relying on a statutory ban.
Source: Hansard, 14 May 2018
15 April 2018
In a strongly worded submission to the Select Committee on Science and Technology ASH and the UK Centre for Tobacco and Alcohol studies warn that smoking on TV and in films encourages children to take up smoking . They point out that children in the UK are still exposed to significant amounts of smoking on screen and that it is the amount of smoking that is important, not whether it is glamourised or not.
The submission includes new survey results showing that 81% of 11-15 year olds and 88% of 16-18 year olds report seeing smoking in films. For TV the numbers reporting seeing smoking on TV were 68% of 11-15 year olds and 77% of 16-18 year olds.  One of the worst examples, included in the submission, was last summer’s reality TV programme Love Island. The series, which was very popular with teenagers, delivered an estimated 47 million gross tobacco impressions to children aged under 16.  The proportion of Oscar-listed films containing smoking this year was 86%, up from 60% four years ago, with smoking featuring by far and away most heavily in a PG rated British film, ‘Darkest Hour’.
Professor John Britton said:
“Seeing people smoking in the media can increase the likelihood that a young person takes up smoking by as much as 40%. It doesn’t matter whether the people smoking are heroes or villains, glamourous or otherwise. All smoking content is a role model which results in some young people becoming addicted to a lethal product for life.”
Deborah Arnott, chief executive of ASH, said:
“Our surveys show children reporting high awareness of smoking on screen, particularly in films and TV. Ofcom and the BBFC, which regulate these sectors, need to take the necessary steps to warn parents of the risks and protect our children from the harmful effects of tobacco imagery.”
The submission includes new figures calculated by Cancer Research UK which show that despite declines in smoking prevalence a large number of young people are still taking up smoking causing significant harm to their health and wellbeing. Between 2014 and 2016 around 127,000 children a year started smoking for the first time , equivalent to 17 classrooms of secondary school children a day. Research shows that over 60% of those who try smoking go on to become regular smokers.
Smoking remains the leading cause of preventable premature death, killing over half all long-term smokers. While much of the damage is long-term there are immediate impacts too. Young smokers have a lower level of lung function than those who have never smoked and smoking reduces the rate of lung growth. 
George Butterworth, Senior Policy Manager at Cancer Research UK, said:
“Smoking is an addiction of childhood, not an adult choice. New figures published by Cancer Research UK show that 127,000 children start smoking each year in the UK. The introduction of standardised packaging of tobacco products, backed up the complete ban on advertising, leaves smoking in the entertainment media as the main way smoking is promoted to children. Yet parents seem unaware of the risks.”
Now that all advertising, promotion and sponsorship is banned in the UK, smoking in the entertainment media has become an increasingly important factor in youth smoking initiation. Yet a Yougov survey for ASH found that parents remain unconcerned about such exposure with 42% saying that there is the right amount of smoking on TV, 31% saying they don’t know, and only 23% saying there is too much. When it comes to adults with children under 18 in their household concern is even lower, with 20% of adults with thinking there is too much smoking on TV, and 45% that it is the right amount. 
The relevant regulators are Ofcom (TV and video on demand) and the BBFC (film and videos/DVDs including video games). The ASH and UKCTAS recommendations to the regulators, which they would like to see the Select Committee endorse , are that:
ASH and UKCTAS have already shared the evidence with Ofcom and are having very constructive discussions with Ofcom. Ofcom has agreed to review the evidence we have provided it with and undertake its own analysis of the impact of smoking depictions on young people, preparatory to making any decisions about how to proceed. ASH and UKCTAS have written to the BBFC this week with a copy of our submission asking to meet to discuss our recommendations with them.
Notes and Links:
Action on Smoking and Health is a health charity working to eliminate the harm caused by tobacco use. For more information see: www.ash.org.uk/about-ash
ASH receives funding for its programme of work from Cancer Research UK and the British Heart Foundation.
ASH staff are available for interview and have an ISDN line. For more information contact ASH on 020 7404 0242 or out of hours Deborah Arnott on 07976 935 987
 Survey conducted by YouGov for ASH online, via parents for 11-15 year olds and directly with 16-18 year olds. The 2018 survey had a sample of 2291 and the figures have been weighted and are representative of all GB 11-18 year olds. The fieldwork was carried out between 28th February and 17th March.
 Barker AB, Opazo Breton M, Cranwell J, et al. Population exposure to smoking and tobacco branding in the UK reality show ‘Love Island’. Tobacco Control Published Online First: 05 February 2018. doi: 10.1136/tobaccocontrol-2017-054125
 Data calculated by the Statistical Information Team at Cancer Research UK using Smoking, Drinking and Drug Use in Young People in England 2016 data. Figures are the average per year between 2014 and 2016. Percentage of new smokers was calculated for each single-year age band, and ‘smoker’ was defined as ‘regular’, ‘occasional’ or ‘used to smoke’. For example, percentage of new smokers aged 13 in 2016, was calculated by subtracting the percentage of smokers aged 12 in 2015, from the percentage of smokers aged 13 in 2016. This calculation was used for ages 12, 13, 14 and 15; for age 11 all smokers were considered new smokers. 2015 figures were estimated as the average of 2014 and 2016, as no 2015 survey was carried out. Percentage of new smokers in England was applied to UK population estimates to obtain number of new UK smokers.
 National Statistics. Schools, pupils and their characteristics: January 2017. Figure G: Average one-teacher class size: secondary schools 20.8
 Max Birge, Stephen Duffy, Joanna Astrid Miler, Peter Hajek; What Proportion of People Who Try One Cigarette Become Daily Smokers? A Meta-Analysis of Representative Surveys, Nicotine & Tobacco Research, , ntx243, https://doi.org/10.1093/ntr/ntx243
 U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014
 Survey conducted online by YouGov for ASH. Fieldwork for 2018 survey was undertaken between 8th February and 6th March. Total sample size was 12767 GB adults and the figures have been weighted and are representative of all GB adults (aged 18+).
This briefing examines the impact of the EU Tobacco Products Directive on e-cigarette regulation in the UK.The impact of the EU Tobacco Products Directive on e-cigarette regulation in the UK