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** 27 February 2024
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** UK
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** Jeremy Hunt plans national insurance cut and vape tax for budget (#1)
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** Nearly 400,000 vape kits to be sent to smokers (#3)
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** UK trails other countries on waiting times for cancer treatment, study finds (#2)
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** International
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** New Zealand repeals smoking ban passed by Jacinda Ardern (#4)
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** Australia: Study reveals parental smoking and childhood obesity link transcends socio-economic boundaries (#6)
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** UK
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** Jeremy Hunt plans national insurance cut and vape tax for budget

Jeremy Hunt is expected to use next week’s budget to cut national insurance rather than income tax as he announces a new levy on vaping.

The chancellor has significantly scaled back his planned cuts after official forecasts suggested he will have much less money to spend than expected.

The two main tax cuts expected in the budget are a 1 percentage-point reduction in employee national insurance, at a cost of about £4.5 billion a year, and an extension of the fuel duty freeze at a cost of £1 billion a year.

The state of the public finances has forced Hunt to look for new sources of revenue. He will use his budget to announce a “vaping products levy” to be paid on imports and by manufacturers in an attempt to make the habit unaffordable for children.

The duty will be levied on the liquid in vapes, with higher levels of tax for products with more nicotine. There will be a one-off increase in tobacco duty to ensure that vaping remains a cheaper alternative, with the two measures expected to raise more than £500 million a year between them by 2028/29.

The tax is modelled on 15 similar schemes across Europe, with Germany imposing a €1.60 tax on every 10ml of vape liquid and Italy levying €1.30. So-called vape tanks are typically sold in 2ml quantities. The EU is planning a bloc-wide vaping levy.

Sunak is attempting to tread a line between stopping children taking up vaping while at the same time encouraging adult smokers to switch to e-cigarettes, which are considered far less harmful than tobacco. Ministers have acknowledged “the need to balance a price increase that acts as a deterrent with ensuring that vaping remains a more affordable option than smoking, to encourage adult smokers to switch”, according to a consultation report from earlier this month.

About six million people in Britain vape after an explosion in the popularity of the product in recent years. Young people have rapidly become the most prolific users of the products, with usage rising to 22 per cent of those aged 16 to 24.

Source: The Times, 27 February 2024
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** Nearly 400,000 vape kits to be sent to smokers

Nearly 400,000 vape kits are set to be sent to smokers in England under the government’s swap-to-stop scheme, our sister title Healthcare Leader has exclusively revealed.

At least four integrated care boards (ICBs) and more than 80 localities have expressed interest in the scheme with 379,562 ‘vape starter kits’ requested as of February 2024, data seen exclusively by Healthcare Leader has shown.

Launched in April 2023, the scheme aims to provide one million smokers with reusable vape kits by March 2025 to help them quit smoking, under the government’s smokefree policies.

The policy will see the Department of Health and Social Care (DHSC) meet the cost of those starter kits, which will be distributed via local authority stop smoking services.

NHS England maintains that nicotine vaping is ‘substantially less harmful than smoking’ and stands as ‘one of the most effective tools for quitting smoking’, although not harmless.

As of March 2023, 11.6% of children had experimented with vaping, marking a 50% increase on 2022, according to Action on Smoking and Health (ASH), while 70% of the vapes that children use are single use vapes.

Last month, the government announced it would ban disposable vapes, alongside new powers to restrict flavours specifically marketed to children.

Professor Javed Khan OBE – author of the government-commissioned ‘Khan Review: Making Smoking Obsolete’ – stated that GPs and pharmacists were ‘crying out’ for guidance on whether or not they should recommend vapes to patients who smoke.

Giving evidence to the Health and Social Care Select Committee this month, he said: ‘There is a lack of clarity and information from the DHSC and NHS England. I have met GPs and pharmacists who have said they have never seen any kind of guidance that would encourage them to direct their patients [to use vapes as an alternative to smoking].

‘They need that clarity. If we are convinced that it is safer to do swap-to-stop – with all these kits about to go out – and if we agree with the principle that vaping is a good, quick tool because it has been proven to be relatively successful, then let’s clarify that for all of the health professionals asking for it.’

Source: The Pharmacist, 26 February 2024

See also: ASH - Use of e-cigarettes among young people in Great Britain ([link removed]) | OHID - The Khan review: making smoking obsolete ([link removed]) | DHSC - Disposable vapes banned to protect children's health ([link removed]) | DHSC - Smokers urged to swap cigarettes for vapes in world first scheme ([link removed])
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** UK trails other countries on waiting times for cancer treatment, study finds

Cancer patients in the UK wait up to seven weeks longer to begin radiotherapy or chemotherapy than people in comparable countries, research has revealed.

In the first research of its kind, experts at University College London analysed data from more than 780,000 cancer patients diagnosed between 2012 and 2017 in four comparable countries: Australia, Canada, Norway and the UK. Eight cancer types were included: oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancer.

The average time to start chemotherapy was 48 days in England, 57 in Northern Ireland, 58 in Wales and 65 in Scotland. The shortest time was 39 days in Norway.

In radiotherapy, the UK fared even worse. It took 53 days on average for treatment to begin in Northern Ireland, 63 in England, 79 in Scotland and 81 in Wales.

The research also found that in the UK, a lower proportion of people with cancer were given chemotherapy and radiotherapy than in other countries. Fifty-nine per cent of ovarian cancer patients in the UK received chemotherapy, compared with 67% in Canada, 72% in Norway and 73% in Australia. The same was true for pancreatic cancer patients: 27% in the UK, compared with 41% in Canada, 44% in Norway and 47% in Australia.

Dr John Butler, a cancer surgeon and clinical lead for the International Cancer Benchmarking Partnership, said: “Lower use of chemotherapy and radiotherapy in the UK could impact people’s chances of survival, especially for older patients.”

He said cancer survival in the UK remained about 10 to 15 years behind that in other countries. “This study captures missed opportunities for patients in the UK to receive life-prolonging treatment.”

The Department of Health and Social Care said it had invested significantly in cancer care since the period covered by the research, including £162m on radiotherapy equipment and £2.3bn on community diagnostic centres.

“Survival rates are also improving across almost all types of cancer,” a spokesperson added.

Source: The Guardian, 27 February 2024

See also: Sean McPhail, PhD. Matthew E Barclay, PhD, Shane A Johnson, MA, Ruth Swann, PhD, Riaz Alvi, MSc, Andriana Barisic, MPH, et al. Use of chemotherapy in patients with oesophageal, stomach, colon, rectal, liver, pancreatic, lung, and ovarian cancer: an International Cancer Benchmarking Partnership (ICBP) population-based study ([link removed](24)00031-7/fulltext#seccestitle10) , The Lancet Oncology, March 2024

Sean McPhail, PhD, Matthew E Barclay, PhD, Ruth Swann, PhD, Shane A Johnson, MA, Riaz Alvi, MSc, Andriana Barisic, MPH, et al. Use of radiotherapy in patients with oesophageal, stomach, colon, rectal, liver, pancreatic, lung, and ovarian cancer: an International Cancer Benchmarking Partnership (ICBP) population-based study ([link removed](24)00032-9/fulltext) , The Lancet Oncology, March 2024
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** International
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** New Zealand repeals smoking ban passed by Jacinda Ardern

New Zealand is repealing the smoking ban passed under former prime minister Jacinda Arden’s government to pave the way for a smoke-free generation amid backlash from researchers and campaigners over its risk to Indigenous people.

The new coalition government led by prime minister Christopher Luxon confirmed the repeal will happen on Tuesday, delivering on one of the actions of his coalition’s ambitious 100-day plan.

“The coalition government is committed to the Smokefree 2025 goal, but we are taking a different regulatory approach to reducing smoking rates and the harm from smoking,” says associate health minister Casey Costello.

It was the world’s first policy of its kind (gradually raising the age of sale of tobacco) and inspired other governments, including that of the UK, to consider similar measures. Ms Ardern – the flagbearer of the smoking ban – was widely believed to be the inspiration behind Rishi Sunak’s announcement at the Conservative Party conference last month that he would effectively outlaw smoking among younger generations.

"I will soon be taking a package of measures to cabinet to increase the tools available to help people quit smoking," Ms Costello said, adding that regulations on vaping would also be tightened to deter young people.

Introducing Smokefree Environments and Regulated Products Amendment Bill, she said it will deliver on the government’s 100-Day commitments and “repeal three parts of the last government’s Smokefree legislation: the retail reduction scheme, denicotinisation, and the smokefree generation measures”.

The decision has sparked a huge backlash from researchers and experts saying the actions lack logic and evidence, describing it as “shameful”.

Many researchers have raised fears that it could have a greater impact on Maori and Pasifika populations, groups with higher smoking rates.

“Repealing the legislation flies in the face of robust research evidence; it ignores measures strongly supported by Māori leaders and it will preserve health inequities,” co-director professor Janet Hoek of Otago University’s Aspire Aotearoa Research Centre said.

“Large-scale clinical trials and modelling studies show the legislation would have rapidly increased the rates of quitting among smokers and made it much harder for young people to take up smoking.”

Source: The Independent, 27 February 2024
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** Australia: Study reveals parental smoking and childhood obesity link transcends socio-economic boundaries

A study into parental smoking and childhood obesity has challenged previous notions by revealing that the links between the two are not confined to a specific socio-economic group.

The data shows a strong correlation between parents who smoke and their children’s consumption of high calorie unhealthy foods and drinks, across social classes.

Using longitudinal data on 5,000 Australian children collected over a 10-year period, the research found those living with parents who smoke, on average, eat less healthy, higher calorie food such as fruit juice, sausages, fries, snacks, full fat milk products, and soft drinks.

Lead researcher Dr Preety Srivastava said the findings are a reminder that obesity – which continues to be a leading public health concern globally – is an issue across all classes and social groups.

“Australia has one of the highest rates of childhood obesity among rich nations, with data indicating one in four Australian children are overweight or obese in 2017-18,” she said.

Preety Srivastava said it was important to understand that parental smoking had a greater potential impact than just the risks of passive smoke exposure. Another significant way that smoking affects children's health is through parents’ role in modelling dietary behaviours to their kids.

“Previous studies show that compared to non-smokers, smokers have a higher preference for high energy and high fat foods due to the loss of taste sensitivity caused by nicotine and other chemicals found in cigarettes.

“In households where either or both parents smoke, children are exposed to more of these ‘high flavour’ foods possibly due to the altered taste preference of their parents.”

Although the bulk of evidence shows that low-socioeconomic families experience higher risks of obesity and smoking than other groups, the research found the link between parental smoking and childhood obesity to be prevalent across socio-economic classes.

“We separated the data into three socio-economic groups – lower, middle and upper – and found that all three equally demonstrated the link between parents who smoke and obesity in children.

“We did, however, find that mothers smoking behaviour could have a significantly greater negative impact on childhood obesity than fathers smoking behaviour.

“As they’re often the primary caregivers of their children and handle household tasks such the food shopping and cooking, it is possible that mothers who smoke have a more significant influence on their children’s diet.”

The implications of these findings are far-reaching and emphasise the need for targeted public health interventions to curb parental smoking and promoting healthier diets for children.

Source: Eurek Alert, 26 February 2024

See also: Preety Srivastava, Trong-Anh Trinh, Karen T. Hallam, Leila Karimi & Bruce Hollingsworth, The links between parental smoking and childhood obesity: data of the longitudinal study of Australian children ([link removed]) , BMC Public Health, January 2024
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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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