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** 18 February 2020
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** UK
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** ASH Chair Nick Hopkinson: The path to a smoke-free England by 2030 (#1)
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** Long read: The great vape debate — are e-cigarettes saving smokers or creating new addicts? (#2)
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** New smoke-free outdoor spaces pave the way for tobacco free future in Manchester (#3)
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** E-cigarettes at risk of exploding if charged incorrectly, UK government warns (#4)
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** Funding needed for community pharmacists to tackle patients' smoking and drinking, say pharmacy bodies (#5)
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** UK
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**

The UK has made important progress in tackling the tobacco epidemic through policies such as taxation to reduce the affordability of tobacco products and the introduction of standardised packaging and display bans, as well as by advancing smoke-free legislation, most recently a ban on smoking in cars with children present. The health secretary has acknowledged that the smoke-free 2030 ambition “is extremely challenging” and will require “bold action,” so it is important to consider what additional strategies are needed.

The scale and pace of many tobacco control activities depends on adequate funding. This has been limited by cuts both to public health funding and to local authority budgets more broadly. A key proposal therefore is to hold the tobacco industry, which makes about £1.5bn (€1.8bn; $1.9bn) a year profits in the UK, responsible for the harm that it causes by introducing a “polluter pays” levy from tobacco companies that will feed into a smoke-free 2030 fund. The tobacco industry levy would raise around £300m a year, a figure based on restoring funding for tobacco control to the level present before 2010 and the amount recommended per capita by the US Centers for Disease Control.

Preventing children from taking up smoking is essential to deliver a smoke-free future and reduce the risk of future ill health. A further increase [in the age of sale] from 18 to 21 would drive additional reductions, particularly as adolescence is a high risk time for the development of addiction and people are less likely to start smoking once they are in their 20s.

For clinicians, the key priority is to ensure that all patients have access to timely and effective treatment for tobacco dependence and plans to deliver the Ottawa model of comprehensive hospital initiated smoking cessation programmes across the NHS should be accelerated and extended to primary care.

The political promise has been made, and a smoke-free 2030 is essential if the government is to deliver its manifesto commitment to increase healthy life expectancy by five years by 2035. With political will and engagement across the health and social care system it is also achievable.

Source: BMJ, 17 February 2020

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A transatlantic schism has opened up over vaping and health. In the US, the war on vaping is being pursued by activists, politicians and scientists who believe that tobacco companies are cynically promoting e-cigarettes as a means to get people addicted to nicotine, which will – sooner or later – lead them to cigarettes. In the UK, anti-smoking campaigners and health experts counter that for many adult smokers, vaping offers the best hope of avoiding a premature death.

The science is furiously disputed. Academics on both sides are accused of cherry-picking data to suit their own prejudices. PHE is a global authority on health issues such as vaccination and obesity, but on vaping, it is looking increasingly isolated. Deborah Arnott, head of Action on Smoking and Health (Ash) in the UK, says that Britain is losing ground in the e-cigarette debate because of the virulent campaign in the US against vaping. “The noise is causing problems in how we are perceived,” Arnott said. “We’re being written off.”

What should be settled by science has become a clash of faiths. In the US, the debate is dominated by those who believe people should “just say no” to drugs. In the UK, there is more support for the idea of “harm reduction”, in which addicts take controlled amounts of their drug, be it alcohol, heroin or in this case, nicotine, to keep them stable.

PHE’s support for e-cigarettes as a tool to help people quit smoking is shared by other respected health bodies, such as the Royal College of Physicians and Cancer Research UK. They point out that the UK regulates smoking and vaping far more rigorously than the US. The UK has rules on age, and health warnings, and caps on the nicotine content. Marketing to young people is forbidden – e-cigarettes cannot be advertised on TV. There is less nicotine in Juul pods or e-cigarette cartridges sold in the UK: Juul in the US contains up to 59mg per ml, while nicotine levels in e-cigarettes across Europe are capped at 20mg per ml by an EU directive enshrined in British law. In the US, at this point, there is no middle ground between unrestricted sales and an outright ban.

Source: The Guardian, 18 February 2020
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New smoke-free outdoor spaces are being introduced across Greater Manchester. Grants are being offered to help voluntary, community and social enterprise sector organisations create smoke-free spaces or hold tobacco-free events. The funding aims to tackle the acceptability of smoking together with other people in public.

New applications have been invited for the second round of funding bids to the Greater Manchester Smokefree Grants Fund, with more than £6,000 having already been allocated. There are almost 400,000 adult smokers in Greater Manchester. Making Smoking History is the city's strategy to cut the number of smokers by a third — 115,000 fewer by 2021.

Andrea Crossfield, who leads the Making Smoking History programme for Greater Manchester Health and Social Care Partnership, said: “Smoking is still by far the greatest cause of ill health and early death in Greater Manchester. We need to encourage a culture shift away from smoking and reducing the visibility and acceptability of smoking in public spaces will help us go some way to achieving this. That’s why new smokefree spaces and events are so important – and they have public backing too. he Greater Manchester Smokefree Grants Fund is a great opportunity for community organisations to get involved and play their part in a tobacco free future.”

Source: The Bolton News, 17 February 2020
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E-cigarette users have been urged by the Government to use manufacturer-recommended chargers and batteries in their devices amid fears of potential fires and explosions. The Office for Product Safety and Standards (OPSS) has warned about the risks of incorrectly charging e-cigarettes and vapes after a growth in the number of people using the devices.

Working with the Chartered Trading Standards Institute (CTSI), the Government has launched a campaign to encourage battery safety following rare incidents of the devices exploding or causing fires potentially linked to the power source.

Many vapes and e-cigarettes are powered by 18650-style batteries, which are slightly larger than the common AA battery. While this size of battery is widely available to purchase, the bodies have said consumers should only use those recommended by the manufacturer as 18650 batteries can vary in chemistries and voltages. E-cigarette users have also been urged to solely use the charger supplied with the device, and not a phone charger.

Source: Mirror, 17 February 2020
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Community pharmacists need adequate funding and resources to discuss patients’ drinking, smoking and wellbeing with them, pharmacy organisations have said in response to a National Institute for Health and Care Excellence (NICE) consultation.

NICE’s draft quality standard ‘Community pharmacies: promoting health and wellbeing’ says community pharmacies are “well placed” to offer health and wellbeing advice to “everyone in the local community”, which could include pharmacy teams offering support on stopping smoking, cutting down on drinking and managing their weight.

Responding to a consultation on the draft standard, which began on 17 January 2020 and closed on 14 February 2020, the Pharmaceutical Services Negotiating Committee (PSNC) said that while community pharmacy teams have the “skills and desire” to be able to provide more health and wellbeing advice to people, they may not have the “time or financial capacity to undertake this work at all times”.

“Community pharmacy teams already offer health and wellbeing advice to people who have a long-term condition or need support to adopt a healthier lifestyle,” the PSNC’s response said.

“However, community pharmacies are currently under considerable capacity and financial strain, with cuts to NHS funding having been imposed in recent years and workload increasing, as a result of increased patient and NHS demands.”

The National Pharmacy Association (NPA) also welcomed the standard but said that “for effective outcomes” from NICE’s quality standard, adequate resources and funding were needed.

The NICE quality standard will be discussed at a post-consultation meeting on 10 March 2020 and is expected to be published on 2 June 2020.

Source: Pharmaceutical Journal, 17 February 2020
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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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