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** 3 March 2020
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** UK
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** Former Chief Medical Officer: Pointless to challenge government on austerity (#1)
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** Free e-cigarettes provided in Northamptonshire to help people quit (#2)
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** No decline in Doncaster smoking rate since 2015 (#3)
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** UK
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The Health Services Journal interviewed Dame Sally Davies who served as Chief medical officer between 2011 and 2019 and now remains the UK special envoy on antimicrobial resistance a non-executive director of Genomics England, the day before the publication of Sir Michael Marmot’s “10 years on” report (marking 10 years since the publication of the landmark report Fair Society, Healthy Lives) which says Conservative-led governments of the last 10 years have overseen a reduction in life expectancy due to austerity policies.
“We have ended a period of austerity in a place that is worrying for the health of the public,” says Dame Sally. “Are they interrelated? I feel they may be, but the proof isn’t there.”
Dame Sally reveals she made a conscious choice not to challenge the governments she served over austerity. “Marmot was making a lot of noise and not getting anywhere. I didn’t think that I would get anywhere, so I didn’t go there,” she said.
Dame Sally’s strategy was to use whatever influence she had to focus on areas where progress was possible — such as the fight against antimicrobial resistance, reducing alcohol consumption and measures to discourage smoking. “I think we didn’t do too badly,” she says. “You don’t get politicians to move until they get the problem [and] they know they won’t lose votes. Tobacco is the classic [example] — 50 years from knowing it kills you to getting the ban in public places” in this context, she says, she is pleased with the increased speed with which politicians and the public are beginning to understand the threats posed by a range of public health issues.
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** Driving change also means having to learn to work with industry, she says. “I would argue that the sugar levy has been very interesting because it’s driven innovation and different ways of making drinks with far fewer calories. The smoking ban and standardised packaging has probably helped drive vaping. I’m not particularly supportive of vaping — I would treat it like tobacco — [but it] is much safer than cigarettes [...] You shouldn’t be fighting industry; you should be taking them with you because you’re trying to push them to innovate, to be first movers in the global market."
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** Dame Sally says she was initially in favour of moving public health out of the NHS and into local government and praises the contracting rigour councils have bought to the procuring of services. But she has since changed her mind about the move following disinvestment in tobacco control and other services. Agreeing with the Health Service Journal’s suggestion that not having Sir Simon Stevens to defend its funding has hurt public health, she adds: “Why would he put effort and money into public health when he wasn’t going to get the credit for it?” If public health was returned to the NHS, Dame Sally believes it would be much easier to persuade NHS England to make the “trade-offs” needed to shift a higher proportion of health funding towards prevention. “We would do better to nest a lot of the public health back into the NHS. I would leave some things with local authorities, but drug treatment services, women’s contraception, sexual health they definitely [belong in the NHS].”
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Source: Health Service Journal, 3 March 2020
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** Northamptonshire's stop smoking service are providing free e-cigarettes to local smoker joining the services' 12 week behavioural support programme. The service will also be doing a roadshow with a series of workplace interventions providing e-cigarettes and voucher incentives to smokers wanting to quit. The initiative is funded by the East Midlands Cancer Alliance.
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** Northamptonshire County Council Cabinet Member for Public Health and Wellbeing, Cllr Ian Morris said: “Whilst not entirely risk free, vaping is considerably safer than smoking. The consequences of continuing to use tobacco – which kills one out of every two lifetime users – far exceed any potential harm posed by e-cigarettes. Public Health Northamptonshire is encouraging all smokers to engage with the Stop Smoking Service for expert support and advice as soon as possible and to consider switching to e-cigarettes to help them quit for good. Despite significant reductions in the amount of people smoking in Northamptonshire over the last 20 years, there are still more than 87,000 smokers in the county with tobacco taking the lives of hundreds of residents annually and costing the local economy more than £160 million."
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Source: Northamptonshire Telegraph, 2 March 2020
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** Figures show that just under 20% of adults in Doncaster smoke, equivalent to around 48,000 people, with the rate having remained at a similar level since 2015. In 2015 smoking prevalence in Doncaster was 19.6%, it increased slightly to 19.8% in 2016 before falling back to 19.6% where it remains in 2018 (the latest data available). The rate of smoking in Doncaster is around 5% higher than the England average (14.4%).
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** Doncaster Council did have a target to reduce the smoking rates in the borough to 10% by 2020. This has now been amended to 2030. Figures also show that just under 16% of pregnant women smoke (again, around 5% higher than the England average).
A new plan is being developed to reduce smoking in the borough and to stop around 1,300 people - mainly children - from starting. Rolled out in five stages, the council plan a mass information campaign to change attitudes by encouraging people not to smoke in hospital grounds, school gates, outdoor eating areas, parks, pedestrianised areas of the town centre, bus stops and in Doncaster markets (where tobacco products will be banned from sale).
Dr Rupert Suckling, director of public health at Doncaster Council, said: “Tobacco is still the leading cause of preventable ill health and premature deaths in the borough. Despite high quality specialised smoking cessation services in Doncaster, as many people are starting to smoke each year as quit resulting in no overall reduction in smoking numbers. Our call to action focuses on preventing children and young people from starting smoking, by creating an environment in Doncaster where it is an accepted social norm to be smoke-free.”
Source: Doncaster Free Press, 2 March 2020
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