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** 20 March 2020
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** UK
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** Covid-19: The role of smoking cessation during respiratory virus epidemics (#6)
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** UKVIA urges government to keep vape shops open during coronavirus crisis (#1)
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** Record number of people in Worcester hospitalised due to smoking (#2)
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** International
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** FDA suspends U.S. vape shop inspections as coronavirus spreads (#3)
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** Parliamentary Activity
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** Parliamentary questions (#4)
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** Link of the Week:
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** #QuitForCovid (#5)
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** UK
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**
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David Simons, medical doctor with an interest in the human drivers of infectious disease emergence, Olga Perski, Research Associate in the UCL Tobacco and Alcohol Research Group (UTARG), and Jamie Brown, Professor of Behavioural Science and Health and Co-Director of UTARG, write in the British Medical Journal blog on the opportunity for smoking cessation support to help tackle the coronavirus crisis:

Covid-19 is predominantly a disease of the respiratory tract, with emerging evidence indicating that cellular entry, viral replication and virion shedding occurs within the respiratory tract. [...] Research on a similar respiratory virus, respiratory syncytial virus, has shown that inhaled tobacco smoke increases the rate of transmission and severity of viral respiratory tract infections. Hence, it has been argued that smokers are at increased risk of contracting covid-19. Notably, smoking involves repetitive hand-to-face movements, which provide a route of entry for viral capsules. Smoking rates in countries that report sizable outbreaks of covid-19 (e.g. China, South Korea, Italy) remain high at approximately 19-27% of the population.

"Definitive evidence on whether current smokers are at increased risk of disease, morbidity and mortality from covid-19 are, to our best knowledge, not yet available. An article reporting disease outcomes in 1,099 laboratory confirmed cases of covid-19 reported that 12.4% (17/137) of current smokers died, required intensive care unit admission or mechanical ventilation compared with 4.7% (44/927) among never smokers. [...] It is plausible that rates are even higher in subgroups of the population in which high mortality from SARS-CoV-2 infection is observed (e.g. those with extant cardiovascular and respiratory conditions such as chronic obstructive pulmonary disease). This needs to be further examined.

"In the meantime, we strongly recommend that public health messages focused on how to curb the spread of SARS-CoV-2 also include country specific, evidence-based smoking cessation advice (e.g. [link removed]). Smoking has many negative effects on heart function and circulation and there is high quality evidence that preoperative smoking cessation interventions can lead to significant health benefits. [8] Smoking cessation at any time represents a huge opportunity for public health, with smokers tending to lose at least ten years of life. [9] It is likely that the current concern about the covid-19 epidemic provides a “teachable moment” in which smokers may be uniquely receptive to stop smoking advice. Smoking cessation mass media campaigns are ordinarily cost-effective, but budgets in England have been heavily reduced in recent years.

"In addition to the health benefits of stopping smoking, it is plausible that a spike in quit rates could help reduce community transmission of SARS-CoV-2. During viral epidemics, evidence suggests that multipronged approaches involving both pharmacological and behavioural interventions (e.g. travel restrictions, school closures, vaccination) are best able to bring the reproductive number below 1. [10] We hence believe that high quality smoking cessation advice should form part of public health efforts during epidemics of respiratory viruses such as covid-19."
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**
Source: BMJ, 20 March 2020
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Read Article ([link removed])


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** The UK Vaping Industry Association (UKVIA), which has links to the tobacco industry, called on the government to keep vape stores open across the country, rather than forcing them to close as part of any intensification of its coronavirus containment strategy. Closing vapes stores, the UKVIA says, would be a potentially counterproductive move that could place a further strain on the NHS.
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In an open letter to Nadhim Zahawi MP, parliamentary under-secretary of state at the Department for Business, Energy and Industrial Strategy, UKVIA cites the experience of Italy, the country in Europe hit hardest by Coronavirus so far and where the government reversed its decision to close vape stores as part of its containment programme.

The letter reads: “We recognise and support the government’s intensified containment plan for the virus, but would urge you and your colleagues to look at the example of Italy [...] Dr Riccardo Polosa, a world-renowned scientist and researcher on vaping and tobacco harm reduction and founder of the Centre of Excellence for the Acceleration of Harm Reduction, successfully argued that due to the stress caused by the coronavirus, with the closure of vape shops vapers were highly likely to go back to smoking cigarettes to maintain their nicotine needs. This could be dangerous from a public health perspective and could heighten the risk of exposure of tobacco smoke to bystanders during the crisis, including families and children. It could also place a further burden on an already overstretched health system.”
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**
The UKVIA has also sent its letter to small business minister Paul Scully MP and minister for prevention, public health and primary care Jo Churchill MP.
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**
Source: Talking Retail, 19 March 2020
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Read Article ([link removed])


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Data from Public Health England shows there were 5,664 admissions to hospital attributable to smoking in Worcestershire in 2018-19 – an 8% rise on the year before. This was the highest number since records began in 2009-10, when there were just 5,166 admissions. Over the 11-year period, 52,000 people have been hospitalised due to smoking.

Almost a quarter of English local authorities also set a record for smoking-related hospital admissions last year, with around half a million admissions nationally. It was a rise of 7% on the year before, and the first increase since 2015-16.

Hazel Cheeseman, director of policy at Action on Smoking and Health said: “Most smokers start smoking as children and try many times to quit. Smokers are more likely to get sick, develop complications and take longer to recover than non-smokers. This places a real burden on the NHS. Government has pledged to do more to help smokers in the NHS which is welcome. But more action is needed to achieve Government’s vision of smoking rates of 5% or less by 2030. We are calling for a Smokefree 2030 Fund to make the high-profit tobacco industry pay for the damage it does.”

Source: Worcester News, 19 March 2020

See also:
Burnley Express - Staggering number of smokers hospitalised in Lancashire ([link removed])
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Read Article ([link removed])


** International
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**

The US Food and Drug Administration (FDA) has halted activities such as domestic compliance checks and vape shop inspections, the health regulator said on Thursday 19th March, as its staff switch to teleworking amid the fast-spreading coronavirus outbreak.

The health regulator has been scaling back domestic and foreign inspections in the wake of the outbreak. The FDA has already temporarily deferred all domestic routine surveillance facility inspections and postponed most foreign inspections through April. Although the inspections stop immediately, administrative work can continue for two weeks, the FDA’s Center for Tobacco Products said on Thursday.

Source: Reuters, 19 March 2020
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Read Article ([link removed])


** Parliamentary Activity
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**
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**
PQ1 & 2: Carbon monoxide poisoning in pregnancy and babies
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**
Asked by Liz Twist MP, Blaydon
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effect of carbon monoxide poisoning during pregnancy on the unborn child; and if he will make a statement.

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to protect (a) unborn children and (b) infants from carbon monoxide poisoning.

Answered by Nadine Dorries, Parliamentary Under-Secretary for Health and Social Care
Long-term exposure to carbon monoxide gas can damage an unborn baby. Babies exposed to carbon monoxide during pregnancy are at risk of a low birth weight; stillbirth; death that occurs within the first four weeks of birth; and behavioural problems.

Women are tested for the presence of carbon monoxide at the antenatal booking appointment and as appropriate throughout pregnancy to identify smokers, or those exposed to tobacco smoke, and offer them a referral for support from a trained stop smoking advisor. Carbon monoxide testing may also highlight a household problem and the need to take measures to prevent further exposure.

Source: Hansard, HC Deb, 19 March 2020
Link PQ1: [link removed]
Link PQ2: [link removed]
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** Link of the Week:
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**

ASH has been collaborating with others to promote the message #QuitForCovid ([link removed]) , and published:
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** A press release ([link removed]) ; and
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** Smoking and COVID-19 infographic ([link removed])
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** Fresh has also produced two videos explaining the risks related to smoking and COVID-19 and messages around encouraging smokers to quit:
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** Video with Dr Nick Hopkinson ([link removed]) , Reader in Respiratory Medicine at Imperial College London and Chair of ASH
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** Video with Dr Ruth Sharrock ([link removed]) , Respiratory Consultant at the Queen Elizabeth Hospital in Gateshead
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** You are welcome to use these materials in any media or social media you’re doing to communicate to smokers that they’re at increased risk from COVID-19.
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** Further resources will be available on the Today is the Day website ([link removed]) , which will regularly be updated over the next few weeks.
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For more information call 020 7404 0242, email [email protected] (mailto:[email protected]) or visit www.ash.org.uk

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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