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Opinion: The time for action on prevention is now
Writing for the NHS Confederation blog, Stephen Eames, the Chief Executive of Humber and North Yorkshire ICB, discusses shifting resources to prevention even if there are other urgent pulls on these resources.
Eames writes that in Humber and North Yorkshire, a key strategy has been to shift the dial to prevention to address the things that make people ill before their time. Eames states that the most important factor in health inequalities is smoking with half the difference in life expectancy between the richest and poorest caused by higher rates of smoking prevalence.
Eames points to a survey commissioned by Cancer Research UK and Action on Smoking and Health that finds only a third of ICBs are confident they will be able to fully implement new tobacco dependency services by 2023/24. Additionally, only 13% of ICPs had specific targets to reduce smoking.
Eames writes about the work they do in the North East where smoking rates have fallen faster. They have been using their health inequalities money to fund mass media campaigns which has been proven to be cost effective way to reduce smoking. Eames also states that they are using this money to fund work on illicit tobacco and to implement targeted enhanced quit support by embedding stop smoking services with lung checks.
Eames concludes by saying leaders must make the choice to shift the dial to prevention work, even if there are other urgent pulls on these resources.
Source: NHS Confederation blog, 12 June 2023
See also: ASH & CRUK - Report on ICBs | ASH - Briefing for Joint Forward Plans
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E-cigarette firm accused of fuelling underage vaping quoted in government PR
The government has been criticised for its “completely inappropriate” endorsement of an e-cigarette manufacturer blamed for fuelling an “epidemic” of underage vaping in the US.
A quote from Juul Labs was included in a press release about the prime minister’s plan to close a loophole allowing free samples to be given to children.
The press release – which included quotes from Rishi Sunak, England’s chief medical officer Chris Whitty and health minister Neil O’Brien – portrayed the company as a leader in combating youth vaping, saying it “takes steps to ensure its products do not appeal to and are not used by anyone who is under age, and encourages others in the sector to do the same”.
It also included a quote from Joe Murillo, a former tobacco executive and chief regulatory officer at Juul Labs, in which he praised the UK government’s policy and called for more to be done “to combat underage use of these products”. Although the quote was removed from the press release after being issued it appears to have directly resulted in positive media coverage for Juul, with Murillo’s quote republished by national newspapers.
But it failed to mention that the company has been blamed more than any other for fuelling an “epidemic” of youth vaping in the US, and in recent months has agreed to pay out more than $1bn to settle claims it unlawfully promoted its products to children.
Health experts and campaigners said the UK government’s promotion of Juul as a champion of tackling youth vaping was “naive” and “inappropriate” and raised questions about potential influence behind the scenes. Deborah Arnott, chief executive of Action on Smoking and Health, said her ‘“jaw dropped” when she saw the “completely inappropriate” endorsement, which she said “gave the impression” that the company had been given “a seat at the table in determining how vapes should be regulated”. “The government needs to make clear that its policy on youth vaping is going to be determined by the evidence, not the interests of the industry,” she said.
Research suggests the use of e-cigarettes among young people is relatively low but increasing. NHS figures for 2021 showed that 9% of 11- to 15-year-old children used e-cigarettes, up from 6% in 2018.
Charities are calling for tighter restrictions on marketing e-cigarettes and on the use of the packaging and flavours they say make the products appealing to children. to remove references to the company.
Source: The Guardian, 3 June 2023
See also: ASH – Resources on youth vaping | ASH – 2023 Youth vaping survey
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Vape warning to parents as pupils hospitalised linked to e-cigarettes
Two head teachers in Hampshire have written to parents warning of some hospital admissions among schoolchildren who have been using suspected illegal vapes.
One student suffered a seizure and fell unconscious, with others experiencing accelerated heart rates and confusion after using e-cigarettes. The pupils involved are all believed to have been using vapes with contents that “were not what they appeared to be”, the schools said.
It follows warnings from health officials about the proliferation of illegal vapes which could contain dangerous chemicals, which are being sold to children. One in ten secondary schoolchildren vape, the latest NHS figures show, despite it being illegal to sell e-cigarettes to under-18s.
Rishi Sunak, the prime minister, this week announced measures to reduce vaping among teenagers, including closing a loophole that allows free vapes to be given to under-18s. Teachers will also be given briefing packs about the dangers of vaping in the coming weeks.
Health officials believe that vapes can be a useful tool to help smokers quit tobacco but have said that they should not be used by those who do not already smoke or by children.
Writing in The Times this week, Sir Chris Whitty, the chief medical officer for England, said: “Companies trying to addict children for profit are behaving in a shameful way. Companies are marketing products targeted specifically at children using colours, flavours and cheap disposable options, whatever they may claim.
“Unsafe, illegal vapes have also been pushed in our communities, with recent reports showing they can contain dangerous chemicals like lead and nickel. High levels of inhaled lead damages children’s central nervous systems and brain development. Some products contain nicotine when claiming they do not, or contain harmful cannabis THC chemicals.”
Deborah Arnott, the chief executive of the health charity Action on Smoking and Health (Ash), said: “The most important immediate step the government could take now is to put a tax on the cheap disposables, which are the vape of choice for children as well as being bad for the environment. Children are very price sensitive and the most popular disposable vape, Elf Bar, can be bought for as little as £2.99.
“A tax of £5 per disposable vape would make them much less affordable for children and could be implemented far more quickly than the ban on disposables that some have called for.”
Source: The Times, 2 June 2023
Editorial note: The e-cigarettes mentioned in this article are suspected to be illegal. All e-cigarettes and e-liquids must be ‘notified’ with the MHRA to be sold legally. People can check whether a specific vaping product has been registered with the MHRA here. People who vape should only use products which have been notified and meet UK standards.
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America: Lung cancer pill cuts risk of death by half, says ‘thrilling’ study
A pill taken once a day cuts the risk of dying from lung cancer by half, according to “thrilling” and “unprecedented” results from a decade-long global study.
Taking the drug osimertinib after surgery dramatically reduced the risk of patients dying by 51%, results presented at the world’s largest cancer conference showed.
Lung cancer is the world’s leading cause of cancer death, accounting for about 1.8 million deaths a year. The results of the late-stage study, led by Yale University, were presented at the American Society of Clinical Oncology’s (Asco) annual meeting in Chicago.
“Thirty years ago, there was nothing we could do for these patients,” said Dr Roy Herbst, the deputy director of Yale Cancer Center and lead author of the study. “Now we have this potent drug.
“Fifty per cent is a big deal in any disease, but certainly in a disease like lung cancer, which has typically been very resistant to therapies.”
Herbst, the assistant dean for translational research at Yale School of Medicine, said the pill was proven to be “practice-changing” and should become the “standard of care” for the quarter of lung cancer patients worldwide with the EGFR mutation.
Some patients in the UK, US and other countries are already able to access the drug, he said, but more should benefit.
After five years, 88% of patients who took the daily pill after the removal of their tumour were still alive, compared with 78% of patients treated with a placebo. Overall, there was a 51% lower risk of death for those who received osimertinib compared with those who received placebo.
Angela Terry, the chair of EGFR Positive UK, a lung cancer charity, said the findings were “very exciting” and “hugely significant”.
“A five-year overall survival rate of 88% is incredibly positive news,” she said. “Having access to a drug whose efficacy is proven and whose side-effects are tolerable means patients can be confident of and able to enjoy a good quality of life for longer.”
Source: The Guardian, 4 June 2023
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Australia’s teenage smoking rates rise for first time in 25 years, research reveals
The proportion of teenagers smoking has increased for the first time in 25 years in a situation health experts have labelled “alarming”.
Data analysed by Cancer Council Victoria’s Centre for Behavioural Research in Cancer (CBRC) has revealed a threefold increase in the proportion of 14 to 17-year-olds smoking tobacco in the past four years, from 2.1% in 2018 to 6.7% in 2022.
The research also revealed an increase in e-cigarette use. Fewer than 1% of 14 to 17-year-olds reported vaping in 2018, but that figure increased to 11.8% in 2022 and 14.5% in early 2023.
Sarah Durkin, the acting head of the CBRC and the lead researcher on the report, said the rise in smoking and vaping was threatening the work Australia had done to reduce smoking.
“It’s alarming,” Durkin said. “This is the first time we’ve seen an increase in teen smoking since the early- to mid-1990s.
“The earlier a person starts experimenting with cigarettes, the greater their likelihood of becoming a regular, long-term user. And we know cigarettes kill up to two in three long-term users.”
She said it was likely teenagers were using vapes before moving on to tobacco.
Between 2018 and 2022, the proportion of Australians smoking or vaping rose from 12.8% to 16.5%.
The share of people using both e-cigarettes and tobacco has increased across all age groups, with the steepest rises for those under 35. The percentage of 14 to 17-year-olds who smoke and vape has increased from 0.3% in 2018 to 4.4% in 2022.
Source: The Guardian, 2 June 2023
Editorial note: The experience in Australia is not being seen in teen smoking in the UK. Recent increases in youth use of e-cigarettes has not also resulted in an increase in youth smoking. Australia has tighter controls on vaping products than the UK limiting their sale and promotion.
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.
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