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** 5 March 2024
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** UK
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** Generation Z drives a resurgence in cigar and pipe smoking (#3)
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** Blackburn with Darwen contraception and stop smoking service deal (#1)
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** More than 400 illicit vapes seized in Cumbria since April 2023 (#2)
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** NHS funding faces biggest real-terms cuts since 1970s, warns IFS (#4)
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** UK
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** Generation Z drives a resurgence in cigar and pipe smoking

Cigars are often seen as a habit of a bygone era, associated with elder statesmen such as Winston Churchill or the glamour of early Hollywood stars.

But new research shows they are staging a resurgence, as Generation Z increasingly opt to smoke tobacco in cigars and even pipes rather than cigarettes.

Young adults have driven a five-fold increase in non-cigarette tobacco smoking over the past decade. Some 772,800 people exclusively smoked using the cigars or pipes in England in September 2023, up from 151,200 in September 2013.

Use is highest in those aged 18-24, with three per cent of 18-year-olds exclusively smoking cigars or pipes in 2023, compared with just one per cent of 65-year-olds. This is a reversal of the situation ten years ago when older adults were far more likely to use cigars.

The research by University College London, funded by Cancer Research UK, analysed results of a monthly smoking survey involving a nationally representative sample of adults.

Another key factor is likely to be a ban on menthol cigarettes, which came into force in the UK in May 2020 under an effort to tackle youth smoking. However, this ban on the “minty” flavours does not apply to non-cigarette tobacco products, and the study said this loophole means the tobacco industry has “launched new products that bypass the legislation”.

Experts said they were particularly concerned about the rise in cigarillos — a type of small cigar wrapped in tobacco leaf — which are very similar to cigarettes to smoke but significantly cheaper.

Overall around one in ten smokers in 2022-23 exclusively used non-cigarette tobacco. Dr Sarah Jackson, lead author of the paper and principal research fellow at UCL’s Institute of Epidemiology and Health, said: “This ten year long study captures the shift in trends of non-cigarette tobacco use and paints a concerning picture. Although rates of cigarette smoking have fallen, our data show there has been a sharp rise in use of other smoked tobacco products, particularly among young people.”

Deborah Arnott, chief executive of the charity Action on Smoking and Health (Ash), said: “The largest single non-cigarette product category is cigars, which include cigarillos, a type of cigarette wrapped in cigar leaf.

“They’re just like cigarettes to smoke, but because they’re classed as cigars they’re not subject to plain packaging, there’s no ban on menthol flavours and pack sizes smaller than 20 are legal.

“A pack of ten cigarillos can be bought for half the price of a pack of cigarettes, making them more attractive to price-sensitive young people.”

She added: “Since 2016 when plain packs legislation came into force sales volumes for cigars have grown by 90 per cent and the majority of that growth will be due to cigarillos. This is a serious loophole in the legislation which needs to be fixed and fixed now.”

Source: The Times, 5 March 2024

See also: Sarah E Jackson, Lion Shahab, Jamie Brown, Trends in Exclusive Non-Cigarette Tobacco Smoking in England: A Population Survey 2013–2023 ([link removed]) , Nicotine & Tobacco Research, 2024
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** Blackburn with Darwen contraception and stop smoking service deal

The authority's public heath boss Cllr Damian Talbot has approved continuing the £284,400 a year Local Improvement Services (LIS) agreement, which provides them for at least three years from April 1.

It provides:
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** The delivery of the Stop Smoking Service and Nicotine Replacement Therapy (NRT) Dispensing Service;
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** The provision of an Emergency Hormonal Contraception (EHC) service involving the supply of Levonorgestrel where appropriate;
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** The provision of a service for Intrauterine Contraceptive Device (IUCD); and
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** The provision of the service for the Long Acting Reversible Contraception (LARC).
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**
Cllr Talbot's decision notice says: "The LIS services will be offered via all GP practices and pharmacy settings in the Blackburn with Darwen area who can comply with the service specifications for the relevant services.

"The estimated value for the Local Improvement Services (LIS) in 2023/24 is £284,400 analysed as follows: Nicotine Replacement Therapy - £118,000; Stop Smoking Service - £41,400; Emergency Hormonal Contraception - £55,000; Intrauterine Contraceptive Device - £35,000; Contraception - £35,000.

"The LIS service is fully funded from the annual Public Health grant allocations. There are no additional financial implications for the council.

"There are no changes to the existing arrangements and resource capacity needed."

The proposal takes effect on April 1 for between three and five years.

The renewal of the existing arrangement will ensure continuity of service, Cllr Talbot adds.

Source: Lancashire Telegraph, 5 March 2024
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** More than 400 illicit vapes seized in Cumbria since April 2023

More than 400 'non-compliant' vapes have been seized from shops in the Westmorland and Furness area since April last year.

Between April 2023 and the end of February 2024, 451 vapes - also known as e-cigarettes - were seized locally, according to a council report.

Trading Standards data shows up to a third of vape products sold in the UK may not comply with government regulations.

Two premises were also found to have sold vapes to underage consumers.

It followed a Trading Standards initiative which tested the extent of underage purchasing across shops in the area.

The report stated that 27 premises were visited across Penrith, Dalton, Kendal, Ulverston and Barrow, with two shops found to have sold vapes to an underage volunteer.

Last November, a vaping taskforce was set up in Furness specifically to address the issue of youth vaping.

The report states the aim of the taskforce is to take a 'collaborative and community-informed approach' to protect those under the age of 18 from the potential dangers of vaping.

Many illicit vape products, which do not comply to government regulations, have been found to have over-capacity tank sizes or contain a higher-than-permitted concentration of nicotine.

In addition, the report states CADAS (Cumbria Addictions: Advice and Solutions) has been commissioned to deliver a preventative programme in local schools "to respond to the growing concern and increase in incidence and reporting of young people using e-cigarettes".

Members of the health and adult overview and scrutiny committee will discuss the report later this week.

Source: BBC News, 4 March 2024
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** NHS funding faces biggest real-terms cuts since 1970s, warns IFS

NHS funding faces the biggest cuts in real terms since the 1970s, an influential analysis shows, amid growing pressure on Jeremy Hunt to prioritise public service funding over tax cuts in the budget.

It comes as the Guardian has learned that the chancellor is planning to clamp down on the NHS’s annual £4.6bn bill for agency workers who cover for doctor and nurse shortages at the frontline.

Health spending in England is due to suffer a 1.2% cut – worth £2bn – in the new financial year starting next month, despite the NHS facing extra costs from continuing pay strikes and the expansion of its workforce, according to an analysis by the Institute for Fiscal Studies (IfS).

The health budget, almost all of which the NHS gets, is to go from £168.2bn in 2023-24 to £166.2bn in 2024-25, after adjustment for inflation, in 2022-23 prices.

Without a government rethink the reduction in funding will force the NHS to cut staffing numbers, staff pay, the services it provides to patients or all three, the thinktank warned.

Its intervention comes as Hunt is considering cutting billions more from his public spending plans to pay for further reductions in either income tax or national insurance in this week’s budget.

Hospital doctors voiced alarm that, with the NHS already in “an eternal crisis” in which it cannot meet the growing demand for care, pressing ahead with the planned cut could be “terminal” and would harm patients.

Dr Tim Cooksley, the immediate past president of the Society for Acute Medicine, said: “On this background, rumours of a funding cut could be the final straw for many colleagues and would undoubtedly cause severe harm to large numbers of patients.

“There is consensus that the situation in the NHS has never been so challenging. Funding is only part of the solution but a crucial one. A reduction at this stage could be a terminal event.”

David Phillips, an associate director at the IFS who carried out the analysis, said: “Existing [government spending] plans entail real-terms cuts of around 1.2% in [NHS] day-to-day spending [in 2024/25] – the largest reduction since the 1970s following the 1976 IMF crisis, except for the last two years as temporary funding related to the Covid-19 pandemic expired.

“A real-terms reduction in health spending would require some combination of reductions in staffing, pay and service provision.”

Phillips also disclosed that the government had to give the Department of Health and Social Care an emergency injection of £4.4bn of extra Treasury funding during the course of the current financial year to ensure that it – and the NHS – did not bust their budgets. The DSHC had not publicised that.

Source: The Guardian, 4 March 2024

See also: Institute for Fiscal Studies Health spending planned to fall in England and Scotland in 2024–25, suggesting a top-up likely ([link removed])
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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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