Link Of The Week
Vaping should be promoted by UK government, say MPs
MPs on the Commons Science and Technology Committee have taken a pragmatic view in their report on e-cigarettes, which was published today. They argue that vaping is much less harmful than smoking, and that the UK government should therefore actively support e-cigarettes to reduce the death and disease caused by tobacco.
Data published by ASH on Thursday ahead of the Committee’s report showed that vaping by young people in Britain is rare and largely confined to those who already smoke tobacco. Just 2% of youths use e-cigarettes at least weekly, while another 2% use them occasionally (once a month or less). ASH has found the vast majority of adult e-cigarette users in the UK are current or, increasingly, former smokers, most of whom are trying to stay off cigarettes or reduce the amount they smoke. Only a tiny fraction (3%) have never smoked regularly.
Hazel Cheeseman, director of policy at ASH, said: “There has been widespread concern that e-cigarettes will cause more young people to take up smoking but these fears are unfounded. Today’s data shows that despite some evidence of experimentation, regular use is rare and almost exclusively found among a declining number of children who smoke tobacco cigarettes.”
Science and Technology Committee:E-Cigarettes
The Times, Relax ban and let people vape on buses and trains, MPs urge
Gibraltar Chronicle, E-cigarettes can be key weapon in battle against smoking, insist MPs
Mail Online, Outcry as MPs back call to relax rules around smoking e-cigarettes in public while making the devices easier to get on prescription
TMSS Magazine, Stress-free e-cigarettes authorized pointers would cut smoking deaths, explain MPs
Reuters, Lawmakers want British vaping rules relaxed to help smokers quit
The Sun, E-cigarettes should be free on the NHS – and vaping in the office allowed, to slash smoking deaths
Bailiwick Express UK, Helpful or harmful – what is the truth about e-cigarettes?
The Yorkshire Post, E-cigarettes – Important stop smoking aid or public health risk?
Source: Financial Times 17 August 2018
Charities slam ‘Postcode lottery’ faced by smokers seeking support to quit
Statistics have today illustrated a large disparity in the rates of smokers across England who successfully gave up smoking using the free NHS services. Public health budget cuts have meant thousands of smokers have been left to quit without the vital support they need to make a successful attempt.
Access to the stop smoking services, which are vital in helping people quit, varies depending on how well funded local authorities are. For example, just 24% of smokers who tried to give up managed to in Cumbria in the past year, compared to Staffordshire, where success rates were 88%.
Ash, Cancer Research UK and other health organisations have long argued the tobacco industry should be forced to pay to address the harm smoking causes and it is estimated tobacco companies in the UK make a collective profit of about £1 billion a year.
Alison Cook, director of policy at the British Lung Foundation, warned NHS stop smoking services are vital in response to the statistics. She said, “It’s disappointing to see a further decline in the use of stop smoking services across England. People who get professional help to quit smoking, from their doctor or pharmacist, are most likely to succeed. This data confirms visiting the GP is still the preferred route of support for people who want to quit. Our research found this support remains a postcode lottery.’ Ms Cook urged the Government to ‘act urgently to ensure every smoker has access to the help they need to quit’.
Source: Mail Online 17 August 2018
Public review of e-cigarettes needed, says Vape Business Ireland
The Irish vape industry has called for a public hearing on cigarette alternatives after a UK committee report found that vaping was not a gateway to cigarette smoking. Vape Business Ireland (VBI) said the Irish government needed to “take heed” of the growing consensus on vaping. It said public health bodies around the world had endorsed vaping as a safer alternative to smoking.
The Irish Department of Health has said it does not have enough evidence to recommend vaping as part of the Tobacco Free Ireland programme. The initiative aims to reduce smoking rates from 22% to less than 5% by 2025.
Responding to the report by the Science and Technology Committee, Michael Kenneally, of VBI, said its members did not endorse a position that vaping is “without risk” or “safe”. He said, “Such a binary distinction is highly unscientific, for example air travel is safe, yet some planes crash,” he said. “The key is to put risk and harm in context and I think this is a position that never gets discussed in Ireland.”
Source: The Times 17 August 2018
US: Report suggests millennials will see smoking deaths drop by at least 20%
Tobacco use continues to be the leading cause of preventable death and disease around the world. However, there is growing evidence suggesting vaping is an invaluable harm reduction aid and a useful smoking cessation tool.
For example, a study published in Nicotine and Tobacco Research has concluded that the generation of people born after 1997 will likely see a 21% drop in smoking-related deaths in a large part thanks to the advent of vapes. The study was led by tobacco control expert, Dr. David Levy of the Georgetown University Lombardi Comprehensive Cancer Centre.
Nicotine and Tobacco Research, The Application of Decision-Theoretic Model to Estimate the Public Health Impact of Vaporized Nicotine Product Initiation in the Unites States
Source: ChurnMag, 16 August 2018
Link Of The Week
ASH Fact Sheet on youth e-cigarette use
ASH’s Youth Smokefree GB Survey 2018, has found that youth use of e-cigarettes remains low, with 76% of 11 – 18 year olds reporting that they’ve never tried an e-cigarette, and a further 7% saying they are unaware of them.
Regular use of e-cigarettes is almost entirely confined to those who have already smoked tobacco. Youth use of e-cigarettes does not seem to be leading to tobacco use, with the 2018 survey results showing only 6% of young people are current smokers
Source: ASH, 16 August 2017
London: Fire brigade recommends vaping after cigarette causes flat fire
On Thursday morning fire fighters were called to Cann Hall Road in Leytonstone after a passer-by reported a flat fire. The cause of the fire is believed to be a discarded cigarette.
A London Fire Brigade spokesperson said: “Cigarettes are a leading cause of house fires but so many people fail to ensure they are stubbed out properly. Never leave cigarettes unattended and always ensure ashtrays are carefully emptied with all the debris. We’d rather people didn’t smoke at all but if you do, vaping is a safer option in terms of preventing fires.”
This is Local London, Fire brigade issue smoking safety warning after Eltham fire
Source: East London & West Essex Guardian, 10 August 2018
Don’t ignore lung cancer symptoms
Lung cancer is one of the most common types of cancer in the UK, as well as being one of the most serious. Almost 45,000 people are diagnosed with lung cancer in the UK every year, and those most at risk are smokers. Smoking accounts for about 80% of all lung cancer cases.
During its early phases, there are usually no warning signs of lung cancer, which makes it hard to spot in its early stages. As a result, the outlook for patients isn’t as good as it can be for other types of cancer.
However, lung cancer that’s spread to the liver can lead to a number of tell-tale signs. For example, if the tumour is large enough to block the bile ducts, it could cause yellowing of the skin and eyes.
Source: Express, 9 August 2018
US & France: When social policy saves lives
Income inequality has been on the rise on both sides of the Atlantic over the past decades, accompanied by a broad public debate about its negative consequences. Impacts on health and longevity, and the question of whether income inequality is causing inequality in health, have been a particular focus.
Some of the difference in life expectancy observed at older ages in the US could be the result of successful social health policies. The cohorts that have entered old age over the past two decades experienced strong decreases in smoking rates that were particularly dramatic among persons of higher socioeconomic status.
When the Surgeon General warned about the health risks of smoking in the 1960s, it was the wealthier parts of society who stopped smoking first, while the more disadvantaged parts of society followed that trend about a decade later. As a result, current cohorts of the elderly have experienced longer life expectancy due to smoking cessation more strongly among the rich than among the poor, implying an increased difference in life expectancy between the two groups. However, since information about the dangers of smoking reached all parts of society and smoking rates are low across the entire socioeconomic spectrum in younger cohorts, it is likely that old age mortality gaps due to smoking-related causes will decrease again once those cohorts enter retirement age.
Source: Vox, 9 August 2018
Link of the week
Panorama: Get rich or die young
Life expectancy in Britain varies dramatically depending upon where you live. The rich live longer and the poor die younger. Reporter Richard Bilton visits Stockton, the town with the country’s worst health inequality. He investigates why people in the town centre can only expect to live to 71, while their wealthier neighbours a couple of miles away will live an average of 14 years longer.
Smoking in Pregnancy Challenge Group welcome NHS England progress in reducing stillbirths
An estimated 600 stillbirths could be prevented every year if maternity units adopted national best practice, calculates NHS England in the wake of an independent evaluation of the Saving Babies Care Bundle guidance. There are currently around 665,000 babies born in England each year, but despite falling to its lowest rate in 20 years, one in every 200 is stillborn.
The Smoking in Pregnancy Challenge Group, a coalition of health organisations, welcomed the progress made, but insisted that work still needed to be done to ensure a consistent approach around the country, including providing effective support to help women quit smoking during pregnancy.
Professor Linda Bauld, deputy director of the UK Centre for Tobacco and Alcohol Studies and co-chair of the Smoking in Pregnancy Challenge Group, said: “Too many places are still not implementing best practice for supporting women to quit smoking. This has a real cost in babies’ lives. It’s good to see this NHS initiative is having an impact but eight years after national guidance was issued there is no excuse for variation in practice.”
See also: Public Health England, Health of women before and during pregnancy: health behaviours, risk factors and inequalities
Source: OnMedica, 30 July 2018
Warwickshire: Illicit tobacco factory disguised as potato farm
A large illicit tobacco factory has been discovered on a farm in Warwickshire, with the farm being disguised as a potato processing business. Nearly 7 tonnes of illicit tobacco was found hidden in hundreds of potato bags. A cutting machine, counterfeit packaging and over 10,000 cigarettes were seized.
Source: Convenience Store, 30 July 2018
Stockton: E-cigarettes are making a difference in the fight to cut smoking
Encouraging the use of e-cigarettes to reduce the number of smokers in Stockton has been defended amid an agreement to fund services helping people kick the habit until 2020. Both Stockton and Hartlepool Councils have held a joint contract with North Tees and Hartlepool NHS Foundation Trust to fund stop smoking services.
Councillor Jim Beall, Stockton’s cabinet member for adult social care and health, told panellists at a meeting on Thursday how the council’s “targeted approach” had reaped rewards so far and praised the role e-cigarettes had played. He said: “The good news is smoking figures are coming down through medication and e-cigarettes – that’s something to celebrate.”
Source: Teeside Live, 30 July 2018
Scotland: More 18-24 year old girls than boys smoking in Argyll and Bute
Teenage girls in Argyll and Bute are to be the focus of a renewed drive to cut down on smoking in the area. The move follows a recent report that found smoking rates were higher among young women aged 18-24 than among young men of the same age, in Argyll and Bute.
Argyll and Bute’s Health and Social Care Partnership (HSCP) is now set to repeat its programme aimed at mid-secondary school pupils to discourage them from smoking. It will also continue its projects for younger secondary pupils, along with those in the late stage of primary school, on the dangers of tobacco.
A spokesperson for the HSCP said: “Within the 18 to 24 years old age group [in Argyll and Bute], the most recent report in 2015 reveals 24% of females smoke compared to 18% of males.”
Source: Helensburgh Advertiser, 31 July 2018
Health inequalities lead to striking differences in life expectancy between the rich and poor in England
The life expectancy gap between rich and poor people in England has been widening for nearly two decades. Stockton-on-Tees is the town with England’s biggest gap in life expectancy.
In Stockton-on-Tees, those living in the wealthier areas can expect to live as much as 18 years longer than those in the more deprived parts of the town. Nationally, on average, a boy born in one of the most affluent areas of England will outlive one born in one of the poorest parts by 8.4 years.
Smoking rates are typically much higher in more deprived groups, something that exacerbates the differences in life expectancy.
See also: Public Health England, Health state life expectancies by national deprivation deciles, England and Wales: 2014 to 2016
Source: BBC News, 30 July 2018
USA: Study suggests residential smoking bans will help more low-income smokers quit
Enforcing residential bans on smoking could help large numbers of low-income people quit smoking, according to an analysis of federally funded national surveys by a California research team. The finding comes as public housing authorities across the country face a July 31st deadline from the U.S. Department of Housing and Urban Development (HUD) to implement indoor no-smoking policies.
The study analyses data from the National Cancer Institute funded Tobacco Use Supplement to the U.S. Census Bureau’s Current Population Survey—which asked about smoking habits, whether people allowed smoking in their homes, and whether they were able to quit—over a 10-year period from 2002 to 2011.
It found that, while low-income smokers were significantly less likely to live in smokefree homes, those who did live in such homes were much more likely to be successful quitters. Implementing smokefree policies in low-income housing is one way to increase the number of smokefree homes, and the authors said this has the potential to affect a large group of vulnerable people.
Source: Medical Xpress, 30 July 2018
USA: Study finds smokers who use e-cigarettes are at equal risk of oral cancer as those who only smoke
Scientists at the University of California, San Francisco discovered dual-users of e-cigarettes and tobacco may not be at less risk from cancers of the throat and mouth than they were when they were only smoking cigarettes.
Researchers looked at markers of overall nicotine intake, and levels of a group of carcinogens called tobacco-specific nitrosamines (TSNAs). When they measured these in the urine of some 49,000 Americans who smoke, use smokeless tobacco and non-smokers, they found that there were more similarities between users of smokeless tobacco and smokers than between the former and non-smokers.
However, those only using e-cigarettes were found to have lower levels of the two chemicals associated with oral and lung cancers. It was only dual-users of tobacco (including smokeless products) and e-cigarettes who had a similar risk for these cancers.
Note: the research has not been published yet; the findings were revealed in a poster-presentation
Source: Eureka Alert, 28 July 2018
This interactive visual was created by the ONS. It illustrates smoking prevalence in every local authority in England, as well as a breakdown by gender. The tool also shows how smoking rates have changed over the period from 2012-2016.
In November 2017 ASH submitted a response to the Mayor of London’s Better Health for All Londoners consultation. The consultation was designed to help develop a strategy for addressing health inequalities in London. You can read the ASH submission by using the link below.ASH submission to the Mayor Of London consultation on health inequalities
16 September 2016. News Release on behalf of the Smoking in Pregnancy Challenge Group
Work in the North East to cut smoking in pregnancy by nearly 1/3 has been hailed as an example for the rest of England to follow by a coalition of national health and baby charities.
Francine Bates, Chief Executive of the Lullaby Trust and Professor Linda Bauld who are Co-Chairs of the Smoking in Pregnancy Challenge Group, along with ASH which co-ordinates the group, praised the rapid fall in North East maternal smoking rates after a four year initiative to help midwives raise smoking as a crucial issue affecting unborn babies’ health.
Every woman in the North East is now routinely given carbon monoxide monitoring when they first see a midwife – and those with high readings referred to a stop smoking service, following the NICE guidance[i]. For those women still smoking at 12 weeks, a midwife leads a detailed discussion highlighting the potential harm to the unborn child – resulting in rates falling from 22.2% of women smoking at the time they gave birth in 2009-10 down to 15.6% in 2016.
Fresh – the North East’s tobacco control office funded by all 12 local authorities – has overseen the rollout of the “babyClear” approach[ii] which works in two ways:
The Smoking in Pregnancy Challenge Group, including ASH, the Royal College of Midwives, Tommy’s and the Lullaby Trust, published a report[iii] in 2013 calling for more action to fully embed the NICE (National Institute for Health and Care Excellence) guidance around smoking in pregnancy and renewed the call for action in a review of progress in 2015.[iv] The Group recommends midwives raise smoking as an issue, use carbon monoxide monitoring to check high levels of exposure to tobacco smoke; and refer all smokers to local stop smoking services.
Deborah Arnott, chief executive of health charity ASH, which co-ordinates the Challenge Group, said:
“The North East has made great strides in reducing smoking in pregnancy by a combination of hard work and a well thought out, evidence-based approach. If the government is to meet its commitment to reduce the rate of stillbirths, neonatal and maternal deaths in England by 50% by 2030 all of England needs to follow their lead.”
Francine Bates, Chief Executive of The Lullaby Trust and Co-Chair of the Challenge Group said:
“The North East region is to be hugely congratulated for the work they are doing to support women to stop smoking in pregnancy.
“Maternal smoking is now the single biggest modifiable factor for sudden infant deaths. This programme will undoubtedly have saved many babies’ lives and greatly improved health outcomes for families previously exposed to second-hand smoke. I hope that other parts of the country will take note and implement a similar systematic approach.”
Professor Linda Bauld, Co-Chair of the Smoking in Pregnancy Challenge Group and Professor of Health Policy at the University of Stirling said:
“The North East of England has taken a lead in implementing evidence-based recommendations from NICE and the Smoking in Pregnancy Challenge group.
“The progress that has been achieved is impressive and provides a valuable example for other parts of the country. These changes have undoubtedly saved lives – not just for babies and infants but also for mothers, as pregnancy provides a unique opportunity for women to stop smoking and stay stopped over the longer term.
“The region have also evaluated their approach through independent research and I look forward to the publication of those results, which will provide invaluable evidence for us to continue to make the case for action that contributes to continued declines in smoking in pregnancy in the future.”
Ailsa Rutter, Director of Fresh, said:
“Most women who smoke will have started in their teens or younger, and we recognise it is an addiction that is not always easy to quit. Women need the facts but also to know there is excellent free support to quit smoking where they will be supported and helped, not have the finger wagged at them.
“Some women can find the facts quite shocking – but most are very glad they have been told and come to expect this as part of their ante-natal care.”
Peter Kelly, North East Public Health England Centre Director, said: “Supporting women in having a healthy pregnancy is essential for their health and their unborn child. Stopping smoking is a critical element of a healthy pregnancy and it is very encouraging to see such progress in the North East.”
Following babyClear’s launch in 2012, around 450 midwifery staff and 150 Stop Smoking Service advisers have received skills training to discuss the issues with women in a factual, blame-free way, as well as being provided with equipment to deliver interventions.
When a smoker inhales, the 5000 chemicals in smoke, such as arsenic, benzene and formaldehyde, are absorbed through the lungs and move into the bloodstream. In pregnant women, these chemicals are passed to the unborn baby, depriving them of vital oxygen. Exposure to CO may cause harm to an unborn child, including low birth weight, perinatal death (stillborn and deaths within the first four weeks of birth), and behavioural problems.
A report by the Royal College of Physicians published in 2010 (Passive smoking and children) found maternal smoking causes up to 5,000 miscarriages, 300 perinatal deaths (stillbirths and sudden infant deaths within the first four weeks of birth) and 2,200 premature births a year nationwide. In the North East that breaks down to 360 miscarriages, 22 perinatal deaths (stillbirths and sudden infant deaths with the first four weeks of birth) and 160 premature births.
Research with midwives by NHS North East and Newcastle University in 2010 found not all midwives felt confident or equipped to raise smoking during pregnancy, with many wanting more training and resources such as CO monitors. Feedback from wards has also found women come to expect smoking being raised as an issue, and does not affect the positive relationship they have with their midwife.
Figures published in August 2016 revealed the North East has also seen the biggest fall in overall adult smoking rates in England since 2005, from around 29% of people smoking down to 18.7% in 2015.
The Smoking in Pregnancy Challenge Group, which includes the Royal College of Midwives (RCM), Royal College of Paediatrics and Child Health (RCPCH), the third sector and academia, was established in 2012 in response to a request by the Rt Hon Anne Milton MP, the then Public Health Minister.
The challenge to the Group was to produce recommendations for accelerating progress towards the Government ambition of reducing the rate of smoking at the time of delivery to 11% or less by 2015.
In June 2013 the Group produced recommendations on how the Government ambition for reduced rates of smoking in pregnancy could be achieved. (Smoking Cessation in Pregnancy – A Review of the Challenge)
The Group continues to collaborate to and in 2015 published a review of progress and updated recommendations. More information about the Challenge Group is available on the Groups webpage.
19 July 2016. A new report published by the House of Commons Health Committee on the Impact of the Spending Review on Health and Social Care has recognised that “cuts to public health budgets set out in the Spending Review threaten to undermine the necessary upgrade to prevention and public health set out in the Five Year Forward View”. It goes on to call such cuts a “false economy” which it suggests may “create avoidable costs in the future.” 160718-Health-Committee-impact-of-the-spending-review-on-health-and-social-care.docx
Thursday 16 June 2016
The Smoking in Pregnancy Challenge Group , a coalition of health and baby charities, today welcomed the news that smoking rates among pregnant women have continued to fall but warned that progress could be jeopardised if services to help people quit continue to be cut around the country.
Smoking at Time of Delivery data , published by the Government today, shows that 10.6% of women were smoking at the end of their pregnancy in 2015/16 compared to 11.4% in 2014/15. This means the Government has met its ambition to reduce smoking rates among pregnant women to less than 11% by 2015. However, these figures hide the variation between different parts of the country. Areas where smoking rates and deprivation are high have rates many times that of more affluent areas.
In many places local authorities and local maternity services have been working hard to encourage more pregnant women to quit. However, cuts to the public health budget nationally means there are fewer resources available locally to fund vital quit smoking support which can improve a person’s chances of quitting by up to four times.
Reducing rates of smoking in pregnancy has been an important Government priority with ambitions in the last Tobacco Control Plan for England . It is also key to achieving other priorities such as the Government’s commitment to halve the number of still born babies . The Smoking in Pregnancy Challenge Group have called on Government to include strong new ambitions in the forthcoming new Tobacco Control Plan and to end the difference in rates between rich and poor areas .
Professor Linda Bauld, Professor of Health Policy at University of Stirling and Co-Chair of the Smoking in Pregnancy Challenge Group said:
“We must invest in a full range of measures or smoking in pregnancy rates will start to rise. This cannot be done in a piecemeal way – we must ensure that fewer women are smoking when they become pregnant, more women are encouraged to quit quickly and greater support is offered to those who need it.”
Francine Bates, Chief Executive of The Lullaby Trust and Co-Chair of the Smoking in Pregnancy Challenge Group said:
“Higher smoking rates among poorer pregnant women is a major cause of inequality. Investment in services to support women to quit is needed by every local authority. If we do not support women to quit when they become pregnant we are locking in a lifetime of inequality.”
Deborah Arnott, Chief Executive, Action on Smoking and Health said:
“There has been significant progress in reducing the numbers of women smoking during pregnancy. The new Tobacco Control Plan should set an ambitious vision for reducing rates further and clearly identify how this can be achieved.”
 The Smoking in Pregnancy Challenge Group was set up in 2012 following a challenge from the then Public Health Minister. It is coalition of organisations and is co-ordinated by Action on Smoking and Health: http://www.smokefreeaction.org.uk/SiP.html
 Statistics on Women’s Smoking Status at Time of Delivery, England – Quarter 4, 2015-16 http://bit.ly/1UaHBu1
 The Tobacco Control Plan for England ran between 2011 and 2015 and included the ambition to reduce rates of smoking in pregnancy to less than 11% by 2015.
 In November 2015 the Government announced plans to halve the number of stillbirths and infant deaths by 2030: https://www.gov.uk/government/news/new-ambition-to-halve-rate-of-stillbirths-and-infant-deaths Smoking is a major cause of stillbirths and infant death – estimated to be responsible for a third of perinatal deaths: ASH Factsheet on Smoking and Reproduction
 The Smoking in Pregnancy Challenge Group published a report in October 2015 calling for new Government targets to reduce smoking rates among pregnant women alongside a comprehensive range of measures: Smoking Cessation in Pregnancy: A review of the Challenge
This briefing explains why smoking is a major contributory factor and what can be done to reduce health inequalities caused by smoking. It examines the relationship between smoking and socio-economic status, and certain social groups such as people with mental health conditions, prisoners, looked-after children and ethnic minorities.ASH Briefing: Health inequalities and smoking
ASH’s submission focuses on what the effect of these proposals might have on: (a) Differences in outcomes in richer and poorer areas and inter-authority competition and (b) the long-term future of redistribution to poorer areas and impacts on development.DCLG-Select-Committee-evidence-on-business-rates-ASH-Response.pdf
ASH’s response to the Health Select Committee inquiry into the impact of the Comprehensive Spending Review on health and social care.ASH-CRUK-HSC-submission-2015.pdf