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** 15 September 2023
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** UK
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** E-cigarettes associated with greatest chance of smoking cessation, suggests Cochrane review (#3)
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** Stillbirths in UK rose in 2021 for first time in seven years (#1)
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** BBC correction: How dangerous is vaping - and why the concern over young vapers? (#2)
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** Health alliance agrees: Britain needs a sugar tax (#4)
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** More people smoking in Luton compared to last year (#5)
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** International
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** Strict new vaping rules for Australia: Fruity flavour fans face a devastating blow - here's what you need to know (#6)
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** Link of the week
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** Cllr Jim Dickson interview with Times Radio - Should smoking outside pubs be banned? (#7)
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** Big Alcohol: Explained (#8)
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** UK
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** E-cigarettes associated with greatest chance of smoking cessation, suggests Cochrane review

Results from a Cochrane review have revealed that e-cigarettes, varenicline and cytisine were found to be most effective in helping people quit smoking at six months or longer, with no clear differences in effectiveness between the three.

Researchers reviewed 319 randomised controlled trials, published between April 2012 and April 2022, which included data from more than 150,000 participants. The majority of the studies were conducted in the United States or Europe.

The meta-analysis, published on 12 September 2023, compared the effectiveness of smoking cessation treatments, tolerability, and potential to cause serious harm.

The review revealed that 10–19% of people were likely to quit smoking using an e-cigarette, 12–16% using varenicline and 10–18% using cytisine. There were no clear differences in serious adverse events between the three treatments.

Commenting on the review, Jon Foster, policy manager at Asthma and Lung UK, said: “Vaping can be a helpful way to give up smoking.

“There is really clear evidence that swapping tobacco for vaping leads to a substantial reduction in exposure to substances that can cause cancer, lung disease and heart disease.

“However, if you don’t smoke, starting to vape isn’t a good idea, especially if you have a lung condition. More research is needed on how long-term vaping can affect the lungs and overall health,” he added.

Also commenting on the review, Deborah Arnott, chief executive of Action on Smoking and Health, said: “E-cigarettes are the best option for smokers wanting help to quit.

“Not only are they as effective as varenicline and cytisine, but more to the point, they’re widely available and cheap,” she said.

“The government has promised 1 million free vapes to smoking cessation services and while the scheme’s not yet up and running, there’s no need for stop smoking services to wait.”

In April 2023, the government announced a world-first national ‘Swap to stop’ scheme, which aimed to offer 1 million vape starter kits and behavioural support to smokers in England, with the aim of encouraging them to swap cigarettes for e-cigarettes.

Source: The Pharmaceutical Journal, 14 September 2023

See also: Cochrane Review - Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta‐analyses ([link removed])
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** Stillbirths in UK rose in 2021 for first time in seven years

Stillbirths have risen for the first time in seven years, with striking increases seen in babies of black ethnicity and from the most deprived backgrounds.

The findings in the perinatal mortality report from the group Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE-UK) highlight widening inequalities, with babies of black ethnicity more than twice as likely to be stillborn compared with white babies.

Overall, stillbirths in 2021 (the most recent data reported by hospitals) increased to 3.54 per 1,000, from 3.33 per 1,000 in 2020, ending a run of year-on-year reductions across the UK since 2013.

Prof Elizabeth Draper, an epidemiologist at the University of Leicester and MBRRACE-UK’s perinatal lead, said the overall increase could be linked to reduced access to services during the pandemic.

“This was right in the middle of the pandemic and pregnant women were very worried,” she said. “Our hope is – and we are fairly confident – that rates will come down again next year.”

However, Draper said the widening inequalities seen in minority ethnic groups and babies born to the most deprived mothers were deeply concerning and “clearly something that needs more investigation”.

Robert Wilson, who leads the joint policy unit for the Sands and Tommy’s baby loss charities, said the report painted “an alarming picture”.

“The situation described in this report is simply unacceptable,” Wilson said. “This requires a comprehensive response from all levels of government that matches the urgency and scale of the issue.”

The government has set targets for halving the number of stillbirths and neonatal deaths by 2025 compared with 2010 levels, but the latest figures suggest the UK is not on track to meet this.

Birte Harlev-Lam, the executive director midwife at the Royal College of Midwives, said: “We should not forget that behind these statistics there are women and families who have experienced loss, and the huge impact that has. What is clear from this report is that we need to address health inequalities and improve care for black women and those living in the most deprived areas and their babies.”

Source: The Guardian, 14 September 2023

See also: MBRRACE-UK report - Perinatal Mortality Surveillance ([link removed])
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** BBC correction: How dangerous is vaping - and why the concern over young vapers?

Editorial note: On 13th September, ASH Daily News included an BBC news article titled “How dangerous is vaping - and why the concern over young vapers?” which discussed the call for a ban on disposable vapes in the UK, the use of vapes as smoking cessation devices and concerns over the prevalence of vaping among young people.

The article included a quote by Prof John Britton, honorary professor at the University of Nottingham, which stated that “in 40 or 50 years' time, we will start to see people developing lung cancer, chronic bronchitis and other serious lung conditions as a result of their vaping.”

The article has now been updated to clarify that “those numbers are likely to be small - and far smaller than the health issues caused by smoking.”

The full revised quote is below:

But Prof John Britton, who advised the government on the issue, says in 40 or 50 years' time, we will start to see people developing lung cancer, chronic bronchitis and other serious lung conditions as a result of their vaping. But those numbers are likely to be small - and far smaller than the health issues caused by smoking.

See also: ASH – Use of e-cigarettes among young people in Great Britain ([link removed]) | ASH – Vaping Mythbuster ([link removed])

Source: BBC News, 13 September, 2023
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** Health alliance agrees: Britain needs a sugar tax

New taxes are needed to cut adult sugar intake and rates of cancer, diabetes and heart problems, dozens of health organisations have urged in a report.

The authors, the Recipe for Change coalition, include the Royal College of Paediatrics and Child Health, Royal Society for Public Health, British Heart Foundation, Association of Directors of Public Health and the charity Sustain.

The broad membership will add to pressure on the government to go further in its efforts to tackle high rates of obesity and improve the national diet.

Katharine Jenner, director of the Obesity Health Alliance, another of the coalition’s members, said:

“Hundreds of policies to address obesity have failed to deliver, because they have relied on individuals having to change their behaviour, in a food environment that is rigged against them.

“The food we buy is jam packed with sugar and most of our food comes ready salted — we need to put healthier food on the shelves by introducing a levy on industry to encourage them to change their recipes.”

The health and productivity gains could be worth £77.9 billion to the economy over the same time period, the modelling suggests.

The “sugar tax” on soft drinks, formally known as the Soft Drinks Industry Levy, has cut the amount people consume and has driven industry efforts to reformulate, according to government analysis.

However, reduction targets for salt and sugar in other products remain voluntary, and have failed to hit government targets.

Polling suggests broad public support for a levy. Sixty-eight per cent said they would back further food levies if the revenues raised were invested in children’s health, and 73 per cent supporting action by ministers to require food manufacturers to reduce sugar and salt from everyday foods.

The government claims that it is still “taking firm action to tackle obesity”, including by restricting where stores can display less healthy foods, and introducing calorie information on menus.

Source: The Times, 14 September 2023

See also: Obesity Health Alliance campaign – Recipe for change ([link removed])
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** More people smoking in Luton compared to last year

Smoking rates in Luton increased last year, new figures show.

Charity Action on Smoking and Health said the figures are a "wake up call" as rates across the country are not falling fast enough to meet the Government's target of five per cent or less by 2030.

Figures from the Office for National Statistics show 21.1 per cent of adults in Luton smoked in 2022 – up from 14.1 per cent the year before.

It contrasts with trends across England, where the national rate of smokers reached 12.7 per cent, the lowest level on record.

Deborah Arnott, ASH chief executive, said: "Smoking rates are falling, but not nearly fast enough to deliver on the Government’s ambition of five per cent or less by 2030. Financial stress and poor mental health are on the rise, which we know makes it harder for smokers to quit."

She added the Government must "step up" its support for smokers by investing in campaigns to motivate smokers to quit and discourage young people from starting.

Ms Arnott said the growth in vaping among adult smokers and ex-smokers was welcome as vaping is a very successful aid to quitting smoking.

However, she added there is a worrying growth in vaping among teens and young adults with 15.5 per She said: "The Government’s response to the consultation on youth vaping due imminently must contain concrete measures to prohibit child-friendly branding, and put products out of sight and out of reach in shops, as well as a tax on the pocket money priced disposable vapes most popular with children."

The Department of Health and Social Care said it is looking to "balance the public health opportunities vaping offers to smokers, while protecting young people and non-smokers from using them".

Source: Luton Today, 14 September 2023

See Also: Office for National Statistics - Adult smoking habits in the UK: 2022 ([link removed])
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** International
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** Strict new vaping rules for Australia: Fruity flavour fans face a devastating blow - here's what you need to know

The government has launched secret talks on introducing a strict near-complete ban on vaping in Australia but has hidden the new proposals from the public.

The Therapeutic Goods Administration - which oversees the approval of prescription drugs and medicines for the government - has revealed the secret plans in an official consultation paper.

It outlines four proposals including a widespread ban on all single-use vapes, fruit-flavoured vapes, personal importation of vaping products and all vaping ads.

Only therapeutic nicotine vapes on prescription, available through chemists, would be allowed under the reforms - and they will only be tobacco or mild mint-flavoured.

The consultation process comes as health minister Mark Butler revealed details of the government's latest crackdown on vaping on Wednesday, which has less severe restrictions than those being proposed by the TGA.

In the latest clampdown, vape and tobacco products will be stamped with updated graphic warnings and include health promotion inserts, while packet sizes and filter designs will become standardised.

The legislation will also take aim at vapes by limiting the use of appealing names that downplay a product's potential harm and including vape products in advertising restrictions.

It will also attempt to improve transparency about product contents, advertising activities and sales volumes.

The health minister's bill is part of the federal government's plan to reduce the national smoking rate to less than 10 per cent by 2025, five per cent or less by 2030 and 27 per cent or less for Indigenous communities.

Source: Daily Mail, 13 September 2023
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** Link of the week
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** Cllr Jim Dickson interview with Times Radio - Should smoking outside pubs be banned?

Cllr Jim Dickson, Labour Co-op Councillor for Herne Hill at Lambeth Council and Cabinet Member for Health and Social Care, was interviewed by Times Radio about the proposed ban on smoking outside pubs. Local councillors from across London have written to the government to call for the introduction of a national smokefree condition for pavement seating outside pubs, cafes and restaurants.

Cllr Dickson stated that a national smokefree pavement licence condition is a “sensible next step” as “we all move to having a smoke free Britain by 2023”. He goes on to say that these “incremental steps both help people to give up, they discourage people from smoking and most importantly they protect other people”.

See also: London Tobacco Alliance – Smokefree Pavement Licences ([link removed])

ASH – Smokefree pavement Licences ([link removed])
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** Big Alcohol: Explained

The Institute of Alcohol Studies (IAS) has launched a new film series explaining the world of alcohol harm, research, and policy for the use of public health professionals, early career researchers, and those in the charity sector. The series will include 9 films on: Big Alcohol, Price, Marketing, Availability, Health, Consumption, Transport, Violence and Crime, and Alcohol Across Society.

The first in series, Big Alcohol: Explained, looks at: who the main players are in the multinational alcohol industry, what their growth and profit strategies are, how they influence health policy and shift blame of harm onto consumers, and why they damage the economy.
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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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