Action on Smoking and Health

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Comment on NHS England press release: NHS plan will help problem drinkers and smokers

4 January 2019

Please find below the press release from NHS England about the dedicated help for smokers to quit included in the NHS Long Term Plan and quotes about this commitment from Paul Burstow co-chair of the Mental Health & Smoking Partnership and Dr Clea Harmer, co-chair of the Smoking in Pregnancy Challenge Group.

 

Paul Burstow, Chair of the Tavistock and Portman NHS Foundation Trust and co-chair of the Mental Health & Smoking Partnership, said,

“People with mental health conditions have smoking rates over twice as high as the general population.  Smoking is a leading cause of health inequalities and premature death. The commitment to funding dedicated support to quit not just for inpatients but also for smokers receiving long-term support from mental health and learning disability services is welcome. This is something the Mental Health & Smoking Partnership has called for and was outlined in the ASH Stolen Years report. It should help ensure that not just inpatients, but the majority of those with long-term mental health conditions, who live in the community, will get the help they need to quit.”

 

Dr Clea Harmer, Chief Executive of Sands and co-chair of the Smoking in Pregnancy Challenge Group, said,

“Smoking in pregnancy has flatlined in recent years and more than one in ten women in England are still smoking when their child is born with a real cost in babies’ lives. Pregnant smokers and their partners need more help to quit and the NHS Long Term Plan commitment to fund intensive support is therefore very welcome and will provide much needed additional funding for existing services. This is investment the Smoking in Pregnancy Challenge Group have long been calling for and we look forward to seeing the detailed proposals.”

 

Deborah Arnott, Chief Executive of health charity ASH, said:

“From cancer to cardio-vascular and respiratory disease, dementia to diabetes, and maternity to mental health, stopping smoking improves patients’ life expectancy and quality of life and reduces pressure on our overburdened NHS. So we’re delighted the NHS long-term plan includes provision of support to stop smoking for pregnant women, people with mental health conditions and all patients admitted to hospital. We look forward to publication of the detailed plans, and the timetable for implementation.”

 

 

NHS News Release: NHS LONG TERM PLAN WILL HELP PROBLEM DRINKERS AND SMOKERS

Problem drinkers and smokers who end up in hospital will be helped by dedicated new services as part of the NHS Long Term Plan.

As part of new NHS prevention measures, people who are alcohol dependent will be helped by new Alcohol Care Teams, while more than half a million patients who smoke, including pregnant women and their partners will also be helped to stop, in a new drive that will see all smokers admitted to hospital encouraged to quit.

The schemes come alongside action on obesity and diabetes as part of a renewed focus on prevention that will benefit patients and make the NHS fit for the future, by curbing demands on the health service.

Alcohol Care Teams will be rolled out in hospitals with the highest number of alcohol-related admissions and will support patients and their families who have issues with alcohol misuse.

This will be delivered in the 25% worst affected parts of the country and could prevent 50,000 admissions and almost 250,000 bed days over five years.

Mums to be will also benefit from NHS-funded one-to-one support to improve their own health and give their newborn babies the healthiest start in life.

The most recent figures show that women in England are amongst the most likely to smoke during pregnancy with 10% still lighting up at the time of their baby’s delivery, which doubles the risk of still birth, substantially increases the likelihood of miscarriage and triples the chances of sudden infant death.

Partners of pregnant women will also be encouraged to kick the habit to give new mums the best chance of not smoking again.

Across the country, there is significant variation in the number of pregnant women who smoke, ranging from 2% in Kensington & Chelsea to over one in five in Blackpool.

The areas with the greatest level of need will be prioritised with 600,000 people being supported to quit over the next five years.

Announcing the plans, NHS England chief executive Simon Stevens said:

“Drinking to excess can destroy families, with the NHS too often left to pick up the pieces.

“Alcohol and tobacco addiction remain two of the biggest causes of ill health and early death, and the right support can save lives.

“The NHS long term plan delivers a sea-change in care for a range of major conditions like cancer, mental ill health and heart disease, as well as stepping up to do more on preventing ill health in the first place by giving patients the support they need to take greater control of their own health and stay fitter longer.”

Alcohol-related admissions to hospital have grown by 17% over the last decade – in 2016/17 there were 337,000 estimated admissions – 2.1% of the total.

Alcohol-related harm is estimated to cost the NHS in England £3.5 billion every year.

Alcohol Care Teams in Bolton, Salford, Nottingham, Liverpool, London and Portsmouth have already seen a reduction in A&E attendances, bed days, readmissions and ambulance call outs have significantly reduced.

Now expert teams will work in up to 50 hospitals across the country to deliver alcohol checks and provide access to health within 24 hours if problems are found including counselling, medically assisted help to give up drink and support to stay off of it.

Based in hospitals, the teams will work with local community services to ensure all needs, including any other health needs, are met.

Advice sessions last for 20–40 minutes and involves personalised feedback to people about their level of health risk because of alcohol consumption, practical advice about reducing alcohol consumption, with a range of options for change, and written information to support the advice.

Every smoker admitted to hospital will be offered NHS support to quit and this also includes every patient who is receiving long term support from specialist mental health and learning disability services.

The services are based on a scheme already happening in Manchester, which is expected to save £10 million and over 30,000 hospital beds across the city.

This will be replicated across the country over the next five years so that every patient can access support including personalised bedside care, timely therapy and follow up help when they have been discharged from hospital.

Royal College of Physicians president Professor Andrew Goddard said: “We welcome the Long Term Plan’s commitment to offer help to quit for every smoker admitted to hospital, as recommended in our 2018 report Hiding in Plain Sight.  Helping people give up smoking is a cost-effective means of both improving health and reducing demand on NHS services in the future.  Every contact a health professional has with a patient is an opportunity to help the patient give up smoking – having a system in place to treat tobacco dependency with allocated funding will help make it happen.

“The focus on the management of alcohol related disease is also very welcome. It is an increasing problem in our hospitals where many patients first come to the attention of the NHS. We mustn’t forget prevention though and further measures to reduce harmful drinking are much needed.”

Duncan Selbie, Chief Executive, Public Health England said: “Investing in prevention is the smartest thing the NHS can do. Tobacco kills 1500 people a week so helping people to quit when admitted to hospital helps them, their families and the taxpayer. And it is equally smart for hospitals to have new expertise focused on supporting the most alcohol dependent people. Both measures announced today will save thousands of lives and help the NHS remain sustainable into future years.”

Background information 

Smoking at any time during pregnancy in the UK and EU15+, 2015 – p12 https://www.rcpch.ac.uk/sites/default/files/2018-10/child_health_in_2030_in_england_-report_2018-10.pdf

 Impact of smoking in pregnancy

Maternal smoking Second-hand smoke exposure
Low birth weight Average 250g lighter Average 30-40g lighter
Stillbirth Double the likelihood Increased risk
Miscarriage 24-32% more likely Possible risk
Preterm birth 27% more likely Increased risk
Heart defects 50% more likely Increased risk
Sudden infant death 3 times more likely 45% more likely

 

ENDS

 

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 coordinates and facilitates the work of the Smoking in Pregnancy Challenge Group and the Mental Health & Smoking Partnership.

 

ASH staff are available for interview and have an ISDN line. For more information send an email to press@ash.org.uk or ring 020 7404 0242. Out of hours contact Deborah Arnott (Chief Executive, ASH) on 07976 935 987 or Hazel Cheeseman (Director of Policy, ASH) on 07754 358 593.

New Tobacco Control Plan for England Published

18 July 2017

The All Party Group on Smoking and Health has welcomed the new Tobacco Control Plan for England, “Towards a Smokefree Generation”, which was published today by the Department of Health. [1]

The APPG is delighted that the Government has responded to its calls for a new Tobacco Control Plan [2] and strongly supports the Government’s aim to create a “smokefree generation”. The Plan also has specific targets to cut smoking rates among under 15 year olds, among adults, and pregnant women. Smoking remains a serious public health epidemic and remains the single largest cause of preventable deaths, with about 79,000 people dying every year from smoking related illness in England alone.

Commenting Bob Blackman MP (Chair of the APPG, Harrow West, Conservative) said:
“I very much welcome the Government’s new Tobacco Control Plan with its ambitious vision of a smokefree future. As long as sufficient funding can be found to pay for its implementation, this Plan should ensure the UK remains a global leader in tobacco control”.

The Rt Hon Kevin Barron MP (Vice Chair of the APPG, Rother Valley, Labour) said:
“The clear targets and comprehensive commitments set out in the new Tobacco Plan are welcome. We will be working with colleagues across Parliament to make sure that these commitments are turned into effective action.”

The previous five year Plan expired at the end of 2015. The latest Plan has targets from now until 2022, and the All Party Group believes that this and future Plans should not be allowed to expire until a new one has been put in place.

ENDS

Notes and Links

The All Party Parliamentary Group on Smoking and Health is chaired by Bob Blackman MP. The secretariat is provided by ASH. The purpose of the APPG is to monitor and discuss the health and social effects of smoking; to review potential changes in existing legislation to reduce levels of smoking; to assess the latest medical techniques to assist in smoking cessation; and to act as a resource for the group’s members on all issues relating to smoking and public health. You can learn more about the APPG here.

References

[1] Towards a smoke-free generation: tobacco control plan for England. Department of Health. July 2017.
[2] All Party Parliamentary Group on Smoking and Health. Burning Injustice: Reducing tobacco-driven harm and inequality. January 2017.

ASH Welcomes New Tobacco Control Plan for England: Funding needed for it to succeed

18 July 2017

Action on Smoking and Health has welcomed the Government’s new Tobacco Control Plan for England, “Towards a Smokefree Generation”, published today. [1] The previous Plan expired at the end of 2015, and pressure has been growing from parliament and the public health community for the Government to renew its commitment to tackling smoking. There is also strong public support, with 76% supporting continued government action to limit smoking. [2]

ASH particularly welcomes the Government’s vision of a “smokefree generation”, defined as a smoking prevalence rate of 5% or less. Since the introduction of the last Tobacco Control Plan smoking rates have fallen from 20.2% [3] to 15.5% [4] and if this rate of decline can be sustained a smokefree generation could be achieved by 2030.

Over the next five years until the end of 2022 the targets are to:

  • Reduce smoking prevalence among adults from 15.5% to 12% or less
  • Reduce the proportion of 15 year olds who regularly smoke from 8% to 3% or less
  • Reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less

Deborah Arnott ASH Chief Executive said:

“ASH congratulates Steve Brine for showing his commitment to tobacco control by getting the new Plan published only weeks after taking over as Public Health Minister. The vision of a “smokefree generation” it sets out is a welcome step change in ambition from the last Tobacco Control Plan for England and should be achievable by 2030.”

 The Plan calls for a shift in emphasis from national to local action in order to achieve the vision of a “smokefree generation”. But this comes at a time of severe government cuts in public health funding which threaten successful implementation of the Plan.

 Commenting on this Deborah Arnott said:

“Funding must be found if the Government is to achieve its vision of a “smokefree generation”. The tobacco industry should be made to pay a through a licence fee on the ‘polluter pays’ principle. Tobacco manufacturers are some of the most profitable companies on earth; they can easily afford the costs of radical action to drive down smoking rates.”  

The Plan sets out specific commitments including to:

  • Continue to use mass media campaigns to promote smoking cessation and raise awareness of the harms of smoking.
  • Reduce the inequality gap in smoking prevalence between those in routine and manual occupations and the general population
  • Provide access to training for all health professionals on how to help patients quit smoking.
  • Promote links to “stop smoking” services across the health and care system and full implementation of all relevant NICE guidelines by 2022.
  • Implement comprehensive smokefree policies, including integrated tobacco dependence treatment pathways, in all mental health services by 2018; and improve data on smoking and mental health; in order to better support people with mental health conditions to quit smoking.
  • Maximise the availability of safer alternatives to smoking.
  • Maintain high duty rates for tobacco products to make tobacco less affordable.
  • Continue to uphold its obligations under the WHO FCTC.

The Plan highlights the challenges:

  • There are still 7.3 million smokers in England, and more than 200 people a day die from smoking related illness that could have been prevented.
  • The difference in life expectancy between people in the poorest and richest social groups in England is about 9 years on average, and the difference in smoking rates accounts for about half this difference.
  • Smoking costs our economy in excess of £11 billion a year, including £2.5 billion to the NHS, £5.3 billion to employers (because of lost output due to sickness and smoking breaks), £4.1 billion to the wider society due to lost output. There are further costs including around £760 million from increased social care costs to local councils.

The last Spending Review in 2015 announced cuts in public health funding of 3.9% a year amounting to a real terms reduction of at least £600 million a year by 2020/21, on top of the £200 million in year cut to the 2015/16 budget.[5]  A November 2016 survey of local authority tobacco control leads in England [6] found significant budget cuts for smoking cessation services and that in a growing number of authorities there is no longer a specialist stop smoking service accessible to all smokers.  A recent analysis by the King’s Fund found that in 2017/18 local authority funding for wider tobacco control faces cuts of more than 30% and that stop smoking services is one of the top four services in absolute planned cuts (£16 million). [7]

Collective action by local authorities working together on tobacco control, as encouraged by the Plan, has been very effective in the North East [8] and can deliver economies of scale. However, local authorities facing such severe cuts cannot deliver public health improvement without support from the NHS. The Plan sets out a clear role set out for the NHS in supporting smokers to quit. The NHS must now live up to the commitment set out in the Five Year Forward View to a “radical upgrade in prevention and public health”. [9]

Furthermore ASH urges the government to introduce licensing of the tobacco industry at all levels from manufacturers to wholesalers and retail outlets. [10] Opinion poll results show 76% of the public support the licensing of tobacco retailers, and 71% support requiring tobacco manufacturers to pay for the costs of regulation of the industry. [2] The four major tobacco companies are some of the most profitable businesses [11] in the world, and could easily afford to pay more, through a licence system, to mitigate the damage their products cause, on the “polluter pays” principle.

ENDS

 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 or Hazel Cheeseman on 07754 358 593.
References

[1] Towards a smoke-free generation: tobacco control plan for England. Department of Health. July 2017

[2] Smokefree: The First Ten Years. ASH. June 2017. Opinion research carried out by YouGov for ASH. Total sample size was 12696 adults. Fieldwork was undertaken between 16th February 2017 and 19th March 2017

[3] HM Government. Healthy Lives Healthy Futures: A Tobacco Control Plan for England. March 2011.

[4] Statistics on smoking in England: NHS Digital 2017

[5] Impact of the 2015 Spending Review on health and social care. Joint submission to the Health Select Committee by the Nuffield Trust, Health Foundation and the King’s Fund. 17 December 2015

[6] A survey of local authority tobacco control leads in England November 2016, conducted by ASH, funded by Cancer Research UK

[7] David Buck. Chickens Coming Home to Roost: local government public health budgets for 2017/18.  King’s Fund 12 July 2017.

[8] Fresh North East. Achievements.

[9] NHS England. Five Year Forward View. October 2014.

[10] ASH response to HMRC Consultation on Tobacco Illicit Trade Protocol – licensing of equipment and the supply chain. May 2016.

[11] Branston, JR. and Gilmore, A. The extreme profitability of the UK tobacco market and the rationale for a new tobacco levy. University of Bath, 2015.

England a decade after the smoking ban – heading for a smokefree future

1st July 2017

Since the introduction of smokefree legislation in England ten years ago, there has been significant growth in support for this and other legislation introduced by government, particularly among smokers themselves, reports public health charity ASH.

The last decade has also seen the UK become a world leader in implementation of the World Health Organisation’s tobacco treaty. [1] [2] Our smoking prevalence rates for adults 18+ are now neck and neck with Australia (15.5% in England and 15.6% in Australia) [3] [4], the first country in the world to put cigarettes in standardised ‘plain’ packaging. This is due to a faster decline in smoking in England over the last five years. (Smoking rates in England fell by 0.88 percentage points per annum in compared to 0.57 percentage points per annum in Australia between 2010 and 2016).[5] [6]

The ASH report released today, Smokefree: The First Ten Years, also notes increasing public support for further measures such as a licensing scheme for tobacco retailers and a levy on the tobacco industry to pay for measures to reduce smoking prevalence. The data comes from ten years of the data for England in the ASH Smokefree GB survey carried out by YouGov. [7]

Back in 2007 when smokefree laws in England came into effect, 78% of all respondents to the survey were in favour. In the ten years since, support has grown to 83%, primarily due to an increase in support from smokers from 40% to 55%. The overall change is entirely due to changing attitudes among smokers – support among non-smokers has been stable.

This pattern is repeated elsewhere. In 2008, 48% of smokers supported a ban on smoking in cars with children. Prior to the implementation of the new law in October 2015, 74% of smokers expressed support, rising to 82% in 2017. The same trend applies to a potential ban on smoking in outdoor children’s play areas. While support for this from non-smokers has grown slightly from 83% of non-smokers in 2009 to 85% this year, support from smokers has strengthened significantly – from 52% of smokers in 2009 to 64% this year.

Deborah Arnott, Chief Executive of ASH, said:
“Over the last decade the ASH YouGov survey is evidence of high, and growing, public appetite for government action to reduce smoking prevalence. It’s especially telling that one of the most important factors in this growth is support by smokers – and this is happening at the same time as the numbers of people smoking have fallen to the lowest on record.”

The public also recognises the need for further action by government, support for which has grown over the last decade. Despite the many measures that have been introduced during this period, the proportion of respondents who think the government is not doing enough to tackle smoking has risen from 29% in 2009 to 39% in 2017. In total in 2017 over three quarters (76%) of adults surveyed support the government’s activities to limit smoking or think they could do more, while only 11% believe that the government is doing too much.

Specifically, there is strong support for:

  • Licensing the sale of tobacco products – supported by 76% of respondents in 2017
  • Banning smoking in all cars – supported by 62% of respondents in 2017
  • Charging tobacco companies a levy to fund measures to reduce smoking prevalence – supported by 71% of respondents in 2017.

Public appetite for further action by government is supported by the evidence. Despite the decline in smoking it remains the leading cause of preventable premature death, responsible for half the difference in life expectancy between the rich and the poor. [8] If current rates of decline are sustained in the general population fewer than one in 20 people will smoke by 2030, but much more needs to be done to reduce health inequalities so that no-one is left behind. The average population smoking rate of 15.5% masks wide differences across the population; for example 40% of those with mental health conditions smoke [9] and 26.5% of those in routine and manual occupations. [10] Every day since the last Tobacco Control Plan for England expired on 31st December 2015, hundreds of under 16s have started smoking. [11]

The evidence of the last decade is that tobacco control policies are popular and effective, when they are part of a comprehensive strategy and are properly funded. ASH is calling on the Government to publish the new Tobacco Control Plan with tough new targets and a commitment to reducing inequalities without further delay.

ASH Chief Executive Deborah Arnott said:
“On 1 July 2007 it will be the 10th anniversary of the implementation of smokefree legislation in England – a worthy date for publication of the next Tobacco Control Plan, with a commitment to delivering a smokefree future for our children.”

ENDS

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.

The data on public opinion in this press release are taken from Smokefree: The First Ten Years. ASH. June 2017. The full report is available here.

A more detailed briefing on the tenth anniversary of the introduction of smokefree legislation in England is available here on the ASH website

ASH staff are available for interview and for more information and an ISDN line available for interviews. Please contact ASH on 020 7404 0242 or out of hours Deborah Arnott on 07976 935 987 or Hazel Cheeseman on 07754 358 593.

References

[1] The UK is top of the European Tobacco Control Scale which quantifies the implementation of tobacco control policies at country level, and is based on six policies described by the World Bank.
[2] The UK was given the American Cancer Society tri-annual Luther Terry award in 2015 for exemplary leadership by a government ministry.
[3] Statistics on smoking in England: NHS Digital 2017
[4] National Drug Strategy Household Survey for Australia 2016 Australian Institute of Health and Welfare 2016
[5] Selbie D. It’s time for a truly tobacco free NHS. Public Health England 6 December 2016.
[6] National Drug Strategy Household Survey for Australia 2010 Australian Institute of Health and Welfare 2016
[7] Smokefree: The First Ten Years. ASH. June 2017. Full report available on request from ASH and online from 1 July 2017
ASH Smokefree Survey. These surveys were carried out online by YouGov for ASH
 2007 Total sample size was 1,562 adults in England. Fieldwork was undertaken between 17th – 19th April 2007. The survey was carried out online. The figures have been weighted and are representative of all English adults (aged 18+).
 2008 Total sample size was 1,054 adults in England. Fieldwork was undertaken between 20th – 25th February 2008. The survey was carried out online. The figures have been weighted and are representative of all English adults (aged 18+).
 2009 Total sample size was 10,895 adults in England. Fieldwork was undertaken between 25th – 30th March 2009. The survey was carried out online. The figures have been weighted and are representative of all English adults (aged 18+)
 2015 Total sample size was 10,017 adults in England. Fieldwork was undertaken between 26th February to 12th March 2015. The survey was carried out online. The figures have been weighted and are representative of all English adults (aged 18+).
 2017 Total sample size was 10,488 adults in England. Fieldwork was undertaken between 16th February 2017 and 19th March 2017. The figures have been weighted and are representative of all English adults (aged 18+).
[8] Fair Society, Healthier Lives (The Marmot Review), University College London, 2010
[9] ASH. The Stolen Years. London 2016.
[10] Statistics on smoking in England: NHS England 2017
[11] Hopkinson, NS., Lester-George, A., Ormiston-Smith, N., Cox, A. & Arnott, D. Child uptake of smoking by area across the UK. Thorax 2013. doi:10.1136/thoraxjnl-2013-204379

ASH response to Welsh Government consultation on smoking in prisons

ASH response to Welsh Government consultation on smoking in prisons.

ASH_welshprisonsconsultationresponse.pdf

 

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