Around 1.1 billion people aged 15 and over smoke, with 80% living in LMICs (low and middle income
countries). Tobacco growing and consumption have become concentrated in the developing world where
the health, economic, and environmental burden is heaviest and likely to increase. July 2019.
New UK eye health map
A new eye health map of the UK has highlighted that poor lifestyle habits and inadequate health screening are putting people at ‘serious risk’ of sight loss. The map details the towns and cities in the UK with the highest risk of avoidable sight loss due to low uptake of eye tests and high prevalence of poor lifestyle.
London boroughs have the highest concentration of ‘very high’ risk, as well as Liverpool, Manchester and Sheffield, while the risk across Scotland is mostly ‘very low.’ The map correlates factors associated with avoidable sight loss, such as smoking.
Chairman of Eye Health UK, David Cartwright, said: “We are seeing a worrying number of people failing to take up their entitlement to free NHS sight tests and displaying high levels of smoking and obesity – two lifestyle factors linked to sight loss.”
Source: Optometry Today, 25 September 2018
Life expectancy progress in UK ‘stops for first time’
Life expectancy in the UK has stopped improving for the first time since 1982, when figures began. Women’s life expectancy from birth remains 82.9 years and for men it is 79.2, the figures from the Office for National Statistics, for 2015-17, show. In some parts of the UK, life expectancy has even decreased. For men and women in Scotland and Wales, it declined by more than a month. Men in Northern Ireland have seen a similar fall. For women in Northern Ireland, and for men and women in England, life expectancy at birth is unchanged.
It is not clear what is driving the trend, but some academics have argued that government austerity policies, such as cuts to social care budgets in England, must have played a part. Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, said “We still do not know how much this is a result of … a failure to go on improving smoking cessation or other preventive measures.”
A Department of Health and Social Care spokeswoman said: “As part of our long-term plan for the health service, we are taking action to help people live longer and healthier lives – cancer survival is at a record high while smoking rates are at an all-time low – backed by our additional funding of an extra £20.5bn a year by 2023-24, which will transform care for cancer and other chronic diseases.”
Source: BBC, 25 September 2018
NICE talks: How do we help people quit smoking?
In this episode, Martin Dockrell, Tobacco Control Programme Lead from Public Health England, talks about the best interventions to help people quit smoking and the truth about e-cigarettes.
North East: Newcastle shopkeeper fined for selling knock-off cigarettes
A Newcastle shopkeeper who was caught selling knock-off cigarettes has been fined £1 million. This was part of an HMRC crackdown which has seen penalties amounting to £11,550,060 being issued around the country.
Source: Chronicle Live, 24 September 2018
Australia: North Sydney smoking ban
North Sydney councillors this week unanimously passed a motion to ban smoking in all public places in Sydney’s second-largest central business district (CBD). The proposal now goes to community consultation, but Mayor Jilly Gibson reckons the community will back what may be the nation’s first CBD-wide smoking ban in a capital city.
The Mayor hopes to eventually make North Sydney the first smokefree municipality. “Why not try these big ideas?” she said. “Even if we reduce people’s smoking in the CBD by, let’s say, 50%, that would be a huge result.”
She said the latest move was not about punishing smokers but about improving the amenity of the area for residents, workers, visitors and school children. Since behaviour change is at the heart of the proposal, the Mayor said she expected the ban would be enforced through encouragement rather than fines.
Mail on Sunday, North Sydney to ban lighting up on the street – becoming the country’s first smoke-free district
Source: This Is Money, 25 September 2018
Australia: Unhealthy lifestyle responsible for 45,000 predicted cases of bowel cancer in next decade
A new study has shown that adopting a healthy lifestyle could prevent a large proportion of bowel cancers in Australia – particularly for men.
It found that current rates of smoking, being overweight, and excessive alcohol consumption could lead to 45,000 cases of bowel cancer over the next 10 years. The researchers found that 11% of the future bowel cancer burden can be attributed to ever-smoking, and 4% to current smoking.
The researchers also found an interesting interplay between smoking and alcohol: the bowel cancer burden attributable to smoking was significantly exacerbated by excessive alcohol consumption, and vice-versa.
Cancer Spectrum, The Future Colorectal Cancer Burden Attributable to Modifiable Behaviors: A Pooled Cohort Study
Source: Medical Xpress, 25 September 2018
US: FDA considers ban on online e-cigarette sales
The Food and Drug Administration (FDA) is considering banning online e-cigarette sales, according to Commissioner Scott Gottlieb.
It’s “on the table” and is something the agency is “very clearly looking at it,” Gottlieb said in Washington, during a panel discussion on vaping hosted by Axios. This comes just weeks after Gottlieb dubbed youth use of e-cigarettes an “epidemic” and announced a historic crackdown.
Under Gottlieb, the FDA has taken the position that e-cigarettes are a less harmful alternative for adult smokers who can’t or don’t want to quit smoking conventional cigarettes. However, Gottlieb has said that can’t come at the expense of addicting an entire new generation to nicotine as vaping rises in popularity with teens.
Source: CNBC, 25 September 2018
Matt Hancock begins new role as Health Secretary
The MP for West Suffolk, Matt Hancock, said he is looking forward to starting his new role as Health Secretary after being appointed yesterday (July 9). Hancock was promoted to the cabinet as the Secretary of State for Digital, Culture, Media and Sport in a reshuffle in January. He replaces Jeremy Hunt who has taken over as Foreign Secretary following the resignation of Boris Johnson on Monday afternoon.
The Department of Health faces significant challenges over staffing levels, waiting times and patient care, despite a £20bn cash pledge from Ms May to mark its 70th anniversary.
Source: The Independent, 10 July 2018
Argyll and Bute urged to adopt anti-tobacco policy
Community leaders in Argyll and Bute are to push for a new anti-tobacco strategy already in use elsewhere in Scotland. One in six people aged 16 and over in Argyll and Bute are smokers, a meeting of the area’s community planning partnership (CPP) heard last week.
Ms Stephenson works as the smoking cessation co-ordinator with NHS Highland, which runs the HSCP together with the council. Ms Stephenson told members of the CPP: “We don’t have a tobacco policy in Argyll and Bute, so we are asking to adopt [the] policy which is in use by NHS Highland.”
Source: Helensburgh Advertiser, 10 July 2018
Barnsley: significant drop in smoking levels in the space of only 12 months
Barnsley is on course towards its target of eradicating smoking among the current primary school population as they reach maturity. Barnsley Council and other public bodies are working together to help existing smokers to quit and to ensure older children are not tempted into tobacco use, by keeping the habit hidden from children, so they do not reach their teens regarding the habit as normal.
That work has included making all the town’s major play parks voluntary smoke free zones and rolling out a similar programme for schools, starting with primaries, to discourage parents from smoking when they drop off or collect children.
Latest figures have just been released which show in 2017, 18.2% of the town’s adult population were smokers, down from 20.6% the previous year and beating a target to reduce levels to 20%.
Source: Barnsley Chronicle, 10 July 2018
Singapore: Cameras to be deployed to detect illegal smoking
The National Environment Agency (NEA) intends to deploy surveillance cameras with high-definition thermal sensors around the island to help detect smoking in prohibited areas. Smoking is now prohibited in about 32,000 premises and locations, such as entertainment outlets, shopping malls, office premises, hospitals, bus stops, covered walkways, lift lobbies, stairwells and entrances to buildings.
Cameras deployed in areas where smoking is prevalent but prohibited will record images of the person as well as the date and time. The tamper-proof thermal cameras, which can detect a person holding a lighted cigarette during the day or night, will be placed discreetly on rooftops, in common corridors and staircases of residential buildings, multi-storey car parks and other locations.
Source: The Straits Times, 10 July 2018
USA: LGBT teens are ‘far more likely’ to smoke or vape than straight teens
According to a new report out of Ohio, almost double the number of gay, lesbian, or bisexual teens smoke regular cigarettes and e-cigarettes than their straight and questioning peers. The data came out of the state’s Health Department and the Ohio Healthy Youth Environments Survey Data.
A little over 25% of trans or gender nonconforming teens have used e-cigarettes in the last 30 days and almost 20% reported having smoked. For straight teens, just over 6% have smoked and 10% have vaped in the last 30 days.
The survey was conducted during the 2016-17 school year.
Source: Gaystar News, 9 July 2018
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
This article was written by the Macular Society
A recent survey has revealed 53 per cent of people are not aware that smoking causes blindness.
The survey was conducted by national sight loss charity the Macular Societyin the lead up to Macular Week (26 June — 2 July), which raises awareness of the biggest cause of sight loss in the UK — age-related macular degeneration (AMD). Macular Week this year coincides with the 10th anniversary of smokefree legislation in England, which has made a major contribution to the prevention of macular conditions.
According to the Macular Society smoking is the biggest ‘modifiable’ risk factor when it comes to AMD and smokers are up to four times more likely to develop the condition. Passive smoking can also have an impact on your eye health.
During Macular Week the Society is highlighting the harmful effects of smoking on your eyes.
One person who was unaware of the connection between smoking and sight loss was Sylvia Webb from Amersham.
Sylvia, aged 85 who is a Macular Society volunteer, smoked for more than 30 years and was diagnosed with AMD in 1987.
She said: “Most people realise there’s a possibility that if you smoke you might get lung cancer or another cancer, but they don’t know you could lose your sight.
“Now I know that smoking is a very stupid thing to do and why I did it I don’t know, it’s what you did then.”
She added: “Had I thought I might lose my sight I would have been more keen to give up. I never heard of any connection and I’m still not hearing it really.”
Many of the chemicals in tobacco smoke are extremely toxic. These toxic chemicals are then transported to the delicate tissues of the eye through the bloodstream, where they damage the structure of the cells.
Cathy Yelf, chief executive of the Macular Society, said: “It is surprising how many people do not realise that smoking causes blindness. The message is often missing from anti-smoking messages, which simply concentrate on the life-threatening side effects of smoking. Sight loss, however, is a very important effect of smoking.
“If you smoke, you’re three to four times more likely to develop macular disease. If you smoke and you have certain genetic characteristics, then your risk goes up enormously. You could be 20 or more times more likely to get macular disease if you have those certain genes and you smoke. Smoking is incredibly bad for your eyes.”
For more information on macular degeneration, call the Macular Society’s helpline on 0300 3030 111 or email email@example.com
What should governments do to achieve the SDGs?
Addressing tobacco is a proven approach, with built-in revenue. Let me explain.
In 2015, the world agreed to a new blueprint for development. The United Nations adopted the Sustainable Development Goals (SDGs) as the guide to improving the lives of the world’s people, and the Earth itself, from 2016 to 2030. The SDGs replace the Millennium Development Goals which were expiring after making major strides in the fight against global poverty. Despite criticisms of the updated goals, the SDGs are a major accomplishment.
Now the hard work of translating words into action, and ultimately progress, has begun. A first step is for governments to establish priorities. The SDGs contain 17 Goals and 169 targets, making it difficult for every government to give equal weight to each of them.
There are some development targets that most governments can achieve, particularly by addressing the non-communicable diseases (NCDs) epidemic. The term NCDs may not be well known, but be prepared to hear about NCDs more and more in global discussions. NCDs — sometimes called chronic diseases — include the following devastating killers: diabetes, cardiovascular disease, cancer and chronic lung disease, which combined kill 38 million people each year. It was long thought that NCDs were ‘lifestyle’ diseases of people living in high-income countries. That is no longer the case: 28 million of these deaths occur in low income countries every year.
The fact that nearly three quarters of global NCD deaths happen in low- and middle-income countries, makes NCDs a major cause of poverty and an urgent development issue. Globally, the impact of NCDs will increase 17% in the next 10 years, 27% in Africa. Low-income countries, many of which are still grappling with heavy burdens of infectious disease, risk being overwhelmed by this wave of largely preventable obstacles to development.
One risk factor is common to the NCDs listed above: tobacco use. Tobacco use kills more than six million people every year, the majority of them in their most productive years (aged 30–69). And like NCDs generally, tobacco use is a major driver of poverty, depriving the world of between 1–2% of its GDP annually. In the 20th century, 100 million people were victims of tobacco use: in this century, it will kill one billion people, unless trends change.
Fortunately, we know the steps to take to fight the tobacco epidemic and to prove that dire forecast wrong. They’re contained in the World Health Organization Framework Convention on Tobacco Control (FCTC). The FCTC was adopted in 2005 and today has 180 Parties, which represent almost 90% of the world’s population. WHO has described FCTC measures as a ‘best buy’ in fighting NCDs. WHO Director-General Margaret Chan stated during an address at the United Nations General Assembly in 2011 that fully implementing the FCTC “would bring the single biggest blow to heart disease, cancer, diabetes and respiratory disease”.
That message was heard, and both NCDs and FCTC implementation are included in the SDGs. SDG 3 (the ‘health goal’) aspires to: Ensure healthy lives and promote well-being for all at all ages. Target 3.4 of SDG 3 is: by 2030 reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and wellbeing. And target 3.a is: strengthen implementation of the Framework Convention on Tobacco Control in all countries as appropriate.
A WHO report released in 2011 found that tobacco control efforts can be implemented in low- and middle-income countries for a cost of just US$0.11 per person per year. Even that low number is an overestimate after taking into account the revenue-generating potential of one of the FCTC’s measures: tobacco taxation. It is estimated that governments already collect nearly US$402 billion dollars in tobacco excise tax revenues each year. Yet many countries, and particularly some low-income countries, lag behind when it comes to implementing the FCTC and maximizing tobacco tax revenues.
There is ample room for governments around the world to raise tobacco taxes and generate revenue that could finance development as well as tobacco control measures. Most importantly, raising tobacco taxes is known to be one of the most effective ways to cut tobacco consumption. In South Africa, total taxes on cigarettes rose from 32% to 52% of the retail price between 1993 and 2009. This contributed to halving tobacco consumption from about four cigarettes per adult per day to two cigarettes per day over a decade, and generated a nine-fold increase in government tobacco tax revenues.
Higher tobacco prices also discourage young people from starting to smoke, as noted by philanthropist and former entrepreneur Bill Gates:
“Among the revenue proposals I have examined, tobacco taxes are especially attractive because they encourage smokers to quit and discourage people from starting to smoke, as well as generate significant revenues. It’s a win-win for global health.”
According to WHO, raising cigarette excise taxes by 1 international dollar per pack in all countries would lead to a 42% increase in the average retail price of cigarettes (by 63% in low-income countries and by 25% in high-income countries) and would lead to a decrease in daily smoking that could result in 66 million fewer smokers globally and prevent 15 million deaths. Furthermore, this would generate an additional 190 billion international dollars in revenue through cigarette excise taxes. This extra revenue can help create the fiscal space needed by countries around the world to finance development priorities. For example, if all of the extra revenue from raising cigarette excise taxes was allocated to government health budgets, then the public expenditure on health could increase by 4% globally.
The world’s governments recognized this when they endorsed tobacco taxation as a potential revenue source to finance development activities at the Financing for Development conference in Addis Ababa in July 2015. Governments, through this United Nations process, formally recommended that all governments raise taxes on tobacco products as a way to fund their life-enhancing development initiatives and more specifically their efforts to meet the UN development goals.
In addition, governments used the WHO FCTC process to developed guidelines designed to assist governments in their efforts to raise tobacco taxes and to make them more effective. The latest round of FCTC negotiations adopted a set of Guidelines for implementation of the FCTC Article that addresses tax and price measures to reduce tobacco use (Article 6). The Guidelines are documents negotiated between all the Parties to the FCTC, creating a consensus on how to best implement a particular article of the FCTC. Through the adoption of the Article 6 Guidelines in November 2014, countries agreed on a very important concept: every country should have a long-term tobacco tax policy, including target tax rates tied to specific health objectives. The Guidelines recommend that:
“Parties should establish coherent long-term policies on their tobacco taxation structure and monitor on a regular basis including targets for their tax rates, in order to achieve their public health and fiscal objectives within a certain period of time. Tax rates should be monitored, increased or adjusted on a regular basis, potentially annually, taking into account inflation and income growth developments in order to reduce consumption of tobacco products.”
Comprehensive tobacco control programmes and increases in tobacco taxes will help countries around the world achieve SDG 3 (Ensure healthy lives and promote well-being for all at all ages) and decrease the global NCD burden. In addition, fighting tobacco use would advance progress on many other goals in the SDGs, including Goal 1: end poverty in all its forms everywhere; Goal 2: end hunger, promote sustainable agriculture; Goal 8: promote economic growth; and Goal 13: combat climate change.
In 2017, the high-level political forum on sustainable development will be convened under the auspices of the UN Economic and Social Council, and Goal 3 is one of the 7 goals that will be reviewed in depth, meaning that special attention will be given to the tobacco target and the tobacco indicators included under SDG3.
So what are we waiting for?
NCDs and tobacco use are an enormous barrier to development worldwide; a barrier that threatens to overwhelm and drain government resources. One billion lives hang in the balance this century because of tobacco alone.
World leaders have signalled that taking action is essential to attaining sustainable development by 2030. All countries must seize this opportunity and invest in one of the ‘best buys’ to reach development objectives: strengthen tobacco control and raise taxes on tobacco products. It will pay dividends in the health of our citizens and in accelerating development overall. The tobacco related epidemic is a development challenge the world can overcome in the next 15 years.
Follow Laurent Huber on Twitter: www.twitter.com/LaurentHuber
Exposure to tobacco smoke via both active and passive smoking has been shown to increase the risk of developing meningococcal disease. July 201632. Smoking and Meningococcal Disease
Provides an overview of the smokefree legislation including details of enforcement, exemptions and penalties.FaG: Implementation of the smokefree law
Smoking causes around 80% of deaths from lung cancer, around 80% of deaths from bronchitis and emphysema, and about 14% of deaths from heart disease. More than a quarter of all cancer deaths can be attributed to smoking.FaG: Smoking and Disease
ASH response to Welsh Government consultation on smoking in prisons.ASH_welshprisonsconsultationresponse.pdf
This fact sheet focuses primarily on waterpipe use and regulation in the UK. Oct 2015.28. Waterpipes (shisha)
ASH response to the Department of Health’s consultation on ‘Local Authority public health allocations 2015-16: In-year savings’.LA-spending-cuts-ASH-response-to-DH-consultation.pdf