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** 29 September 2023
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** UK
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** NHS bosses urge Milton Keynes smokers to take part in Stoptober (#1)
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** Premature birth risk from smoking while pregnant higher than previously thought (#2)
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** Scientists on panel defending ultra-processed foods linked to food firms (#3)
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** More than 1 million children in UK sleep on floor or share bed, study finds (#4)
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** Sunak’s winter fund to prop-up ‘bottom line’ with ‘no new initiatives’ (#5)
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** Why are white Britons dying at higher rates than other ethnic groups? (#6)
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** Link of the week
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** Podcast: Let's talk e-cigarettes - Andrea Leinberger-Jabari (#7)
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** Public perceptions of health and social care: what are the priorities ahead of a general election? (#8)
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** UK
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** NHS bosses urge Milton Keynes smokers to take part in Stoptober

Stoptober is back this October, calling on smokers in Milton Keynes to join 2.5million others across England who have made a quit attempt with the campaign since it first launched.

Over five million adults in England still smoke, according to figures by NHS England.

Stoptober offers a range of free quitting tools including: the NHS Quit Smoking app, Facebook messenger bot, Stoptober Facebook online communities, daily emails and SMS, and an online Personal Quit Plan tool.

Dr Sarah Whiteman, chief medical director at Bedfordshire, Luton and Milton Keynes Integrated Care Board, said: “Since the first Stoptober campaign in 2012, 2.5million people have tried to quit smoking and, in the East of England, research shows that 95% of ex-smokers report seeing positive changes in their life as early as two weeks after quitting.

“And that’s before you even think what you might do with an extra £38 a week, which is the what the average smoker spends on tobacco.

“There’s lots of support available locally to help you on your way: information and advice on proven quitting methods, the range of stop smoking aids, and expert support from local Stop Smoking Services.

“When you stop smoking, good things start to happen. Why not join thousands of others across our area and make this Stoptober the month you give up for good?”

Source: MKFM, 28 September 2023

See also: Quit smoking this Stoptober ([link removed]) | Department of Health and Social Care Press Release - 95% of ex-smokers see positive changes soon after quitting ([link removed])
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** Premature birth risk from smoking while pregnant higher than previously thought

Women who smoke during pregnancy are 2.6 times more likely to give birth prematurely compared with non-smokers – more than double the previous estimate, research suggests.

The University of Cambridge study found smoking meant the baby was four times more likely to be small for its gestational age, putting it at risk of potentially serious complications including breathing difficulties and infections.

The NHS recommends that women who are pregnant should stop smoking and limit their caffeine intake because of the risk of complications to the baby.

When the toxins from smoke travel through the bloodstream to the baby, it struggles for oxygen.

When this happens it affects their development, and is linked to premature birth and low birthweight, though it has also been linked to a reduced risk of pre-eclampsia (high blood pressure during pregnancy).

The study, published in the International Journal of Epidemiology, found that compared with those without smoke exposure while pregnant, those with consistent exposure were 2.6 times more likely to experience spontaneous preterm birth.

According to the researchers, this is more than double the previous estimate of 1.27 from an analysis of multiple studies.

Additionally, babies born to smokers were found to be on average 387g lighter than babies born to non-smokers – that is, more than 10% smaller than the weight of an average newborn.

This increases the risk that the baby will have a low birth weight (2.5kg or less), which in turn is linked to an increased risk of developmental problems as well as poorer health in later life.

Source: ITV News, 28 September 2023

See also: Selvaratnam et al. 'Objective measures of smoking and caffeine intake and the risk of adverse pregnancy outcomes' International Journal of Epidemiology ([link removed])

ASH key recommendations for reducing smoking during pregnancy ([link removed])
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** Scientists on panel defending ultra-processed foods linked to food firms

The briefing, organised by the Science Media Centre, generated headlines including “Ultra-processed foods as good as homemade fare, say experts”, “Ultra-processed foods can be good for you, say nutritionists”, and “Ultra-processed foods can sometimes be better for you, experts claim”.

Three of the five participants on the panel have either received financial support for research from UPF manufacturers or hold key positions with organisations that are funded by them. The manufacturers include Nestlé, Mondelēz, Coca-Cola, PepsiCo, Unilever and General Mills.

Prof Janet Cade, of the University of Leeds, told the briefing that most research suggesting a link between UPFs and poor health “cannot show cause and effect” and that some items falling into the UPF bracket were foods “we would encourage such as wholemeal bread, wholegrain breakfast cereals, yoghurts and so on.

There is no suggestion that the scientists failed to declare potential conflicts of interest. Each provided declarations of interests before the briefing, which the Science Media Centre shared with journalists. However, there was no mention of their links to UPF manufacturers in any of the media coverage.

Fiona Fox, the chief executive of the Science Media Centre, said: “The SMC regularly runs background briefings where journalists can question leading scientists on topical issues so that the public get good quality evidence. We choose the scientists based on their expertise, reputation and area of research.

“The scientists who spoke at our briefing on ultra-processed foods are publicly funded academics. However, senior scientists these days are encouraged by universities and funders to have contact with a wide array of partners including industry so that scientific research has impact on wider society. We make sure that any links with industry are openly declared to journalists.”

Source: The Guardian, 28 September 2023
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** More than 1 million children in UK sleep on floor or share bed, study finds

More than a million children in the UK either sleep on the floor or share a bed with parents or siblings because their family cannot afford the “luxury” of replacing broken frames and mouldy linen, according to the children’s charity Barnardo’s.

The charity says increasing “bed poverty” reflects growing levels of destitution in which low-income families already struggling with soaring food or gas bills often find they are also unable to afford a comfortable night’s sleep.

Acute hardship was forcing families to adopt desperately improvised sleeping arrangements, it says in a report published on Friday. An estimated 700,000 children were sharing beds, while 440,000 children slept on the floor, leaving them tired, anxious and finding it hard to concentrate at school.

Parents and kids were often forced to share a bed, the Barnardo’s research found. Some parents would sleep on sofas or chairs to vacate their bed for their children. Other children would spend the night on mattresses or blankets on the floor, sometimes without sheets or duvets.

More than 336,000 families could not afford to replace or repair beds in the last year, Barnardo’s estimates. More than 204,000 families said their children’s bed or bedding was mouldy or damp because putting the heating on was too expensive and more than 187,000 said they couldn’t afford to wash or dry bedding.

Source: The Guardian, 29 September 2023

See also: Barnardo's - No crib for a bed: the impact of the cost-of-living crisis on bed poverty ([link removed])
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** Sunak’s winter fund to prop-up ‘bottom line’ with ‘no new initiatives’

Extra NHS funding which the prime minister announced last week for ’winter’ will in fact be used to cover trusts’ additional costs linked to strike action, and ‘will not be available to support new initiatives’, HSJ has learned.

It comes amid growing concerns over the NHS’s finances this year after the positions reported by integrated care systems in the four months to August were around £800m worse than planned.

Last week, Rishi Sunak announced an additional £200m to “bolster the health service during its busiest period”, saying the funding injection would “boost resilience and help patients get the care they need quicker”.

But in a note sent to local finance chiefs on Friday (15 September), seen by HSJ, NHS England said the extra cash would instead be held back for now, and be used later in 2023-24 to cover costs expected to be caused by industrial action.

Deputy chief financial officer Ed Waller wrote: “At this point, the government is asking the NHS to maintain its current levels of activity and to minimise the impact of strikes on patient care.

“…Given the ongoing discussions about the wider impact of industrial action, we are not allocating the £200m to systems immediately.

“As we discussed, this funding will be required to meet the incurred and ongoing additional costs of industrial action and will provide support to continuation of current activity levels in that context this winter. It will not be available to support new initiatives.”

One chief executive officer of a local health system, speaking anonymously, said the money was effectively being used to “balance the bottom line”.

Other senior sources, plus analysis of published finance reports, suggest ICSs have missed their financial plans by a combined £800m after four months of the year.

Source: HSJ, 18 September 2023

See also: Government press release - £200 million to boost NHS resilience and care this winter ([link removed])
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** Why are white Britons dying at higher rates than other ethnic groups?

White Britons die at higher rates than any other ethnic group, according to new data from the Office for National Statistics. This finding comes despite the disproportionate impact of Covid on ethnic minorities and the negative effect that racism has on health outcomes.

The results are not perfect. For various reasons, records for ethnic minorities are less likely to be linked successfully, but Veena Raleigh, epidemiologist and senior fellow at think-tank The King’s Fund, says it is “as comprehensive, up to date and representative” a profile of ethnic differences in mortality as we are likely to get.

“We should be acting on this data,” she adds. “It’s really important that policy interventions and services are evidence-based and tailored to reflect the specific issues affecting each community.”

One of the key reasons for lower death rates for ethnic minorities is that a larger share are migrants, who tend to be healthier than the population as a whole. Academic research has found this to be the case in a range of developed countries, including the UK and US.

The so-called “healthy migrant effect” is believed to be driven by self selection — for instance, better educated people are likely to be both better off and more likely to migrate — and lifestyle choices. According to the Commission on Race and Ethnic Disparities, white Britons are more likely than most other ethnic groups to smoke and to drink to excess, which are big risk factors for common killers like cancer.

However, as migrants assimilate, many adopt these unhealthy behaviours, with adverse health consequences. Previous ONS research has found that, between 2012 and 2014, migrants who had arrived in the UK from 1991 onwards had lower death rates in England and Wales than both UK natives and those migrants who arrived before 1991. This was true for all ethnic groups except Pakistanis.

Mortality rates from diabetes and cardiovascular diseases like hypertension are known to be higher for South Asian and Black people, while common cancers like lung cancer kill white Britons at a higher rate.

Deprivation and geography are also key determinants of health that need to be considered alongside ethnicity.

Death rates among the most deprived 10 per cent of the population are almost twice as high as in the least deprived 10 per cent, according to the ONS data.

Raleigh says that there is an urgent need to address the large and growing disease burden across all ethnic groups.

“The growing mountain of [the] long-term sick is having a huge negative effect on population health and the economy. The NHS is firefighting long waiting lists but what we also need to focus on is reducing the demand for healthcare,” she says.

“That will put the NHS and the economy on a more sustainable footing and above all it will make individuals and communities healthier.”

Source: Financial Times, 29 September 2023

See also: ONS – Inequalities in mortality involving common physical health conditions, England: 21 March 2021 to 31 January 2023 ([link removed])

Research The Healthy Immigrant Effect: Patterns and Evidence from Four Countries ([link removed])

Commission on Race and Ethnic Disparities – Ethnic disparities in the major causes of mortality and their risk factors – a rapid review ([link removed])
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** Link of the week
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** Podcast: Let’s talk e-cigarettes – Andrea Leinberger-Jabari

In the latest episode in the Let’s talk e-cigarettes podcast series, Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and Ailsa Butler interviews Andrea Leinberger-Jabari from the Public Health Research Center at New York University, Abu Dhabi, United Arab Emirates.
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** Public perceptions of health and social care: what are the priorities ahead of a general election?

The Health Foundation have published their analysis of findings from the fourth wave of their programme of public perceptions research with Ipsos that tracks the public’s views on health and social care in the UK every 6 months. They found that across the NHS, social care and public health, the public’s expectations for the year ahead are negative overall – albeit slightly less negative than 6 months ago. Around half expect the general standard of NHS (54%) and social care (52%) services to get worse, while half (50%) think the public’s overall health and wellbeing will get worse.
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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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