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** 29 July 2024
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** NOTE: We are changing the email address that you will receive daily news from. It will no longer arrive from [email protected] and will now come from [email protected]. If you do not receive Daily News tomorrow please ensure the new email address has not been directed to your junk folder.
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** UK
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** Campaigners turn up heat on Philip Morris-linked inhalers (#1)
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** Bolton: Eight in 100 pregnant women still smoking in borough (#2)
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** GPs capping patient numbers could have ‘catastrophic’ effect on A&E, says NHS chief (#3)
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** Why we might never know the truth about ultra-processed foods (#4)
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** UK
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** Campaigners turn up heat on Philip Morris-linked inhalers

Public health groups have urged doctors and patients to consider avoiding inhalers linked with Philip Morris International, with the NHS having spent more than £433 million on the devices since the tobacco company acquired Vectura three years ago.

The acquisition of the respiratory drugs company in 2021 by Philip Morris, the maker of Marlboro cigarettes, triggered a backlash from the public health sector as the Wiltshire-based Vectura develops inhalers and medicines, including for smoking-related conditions.

Since the takeover, the NHS has prescribed 11.9 million Vectura-associated products and the monthly amount spent on the inhalers has risen from £13.4 million in September 2021 to £14.5 million in March this year, according to a recent analysis by The Pharmaceutical Journal of data published by OpenPrescribing.

Sarah MacFadyen, head of policy at Asthma + Lung UK, the charity, encouraged patients to pursue alternative devices through their doctors. “Addictive tobacco products cause and exacerbate lung disease, so Philip Morris’s takeover of Vectura has been widely condemned,” she said.

“The priority, however, is for people to always ensure they have the best treatment they need to manage their lung condition well and for healthcare professionals to make sure their patients have the medication that is safe and works for them.

“If people feel uncomfortable using an inhaler brand linked to the tobacco industry, they should speak to their healthcare professional about trying an alternative device. For most people, there are a range of alternatives that are just as effective and safe.”

Nicholas Hopkinson, a professor of respiratory medicine at The National Heart and Lung Institute of Imperial College, said: “There are many inhalers available, so there is no reason to start anyone on a tobacco industry-linked one. With all the possible alternatives, most people can switch to another one if they want.”

Action on Smoking and Health, the campaign charity, said: “The aim should be to try to avoid tobacco industry-linked devices wherever possible. However, it would not be appropriate to absolutely prohibit their use to allow for the occasional instance where not using them would genuinely cause a deterioration in an individual patient’s condition.”

Claire Anderson, president of the Royal Pharmaceutical Society, the professional membership body for pharmacists, said: “It’s disappointing that prescribers are faced with this ethical dilemma. While clinicians must provide the most clinically appropriate medicine, many who regularly prescribe Vectura products for patients with respiratory conditions now find themselves indirectly funding a company that has contributed to those very diseases.”

Source: The Times, 26 July 2024

See also: Tobacco Tactics page on Vectura ([link removed])

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** Bolton: Eight in 100 pregnant women still smoking in borough

Eight in 100 pregnant women are still smoking although the figure fell for a sixth year in succession in Bolton.

The borough is above the average for England and for Greater Manchester according to data from the NHS.

The figure for the 12 months to March 2024 of around eight in 100 pregnant women smoking is a lot lower than the figure for the 12 months to March 2018 of around 14 in 100 pregnant women smoking.

In England the ambition is for less than six per cent of expectant mothers to smoke although, ideally, not one expectant mother would smoke due to the harm to the health of the baby before and after birth.

Lynn Donkin, Bolton's Director of Public Health, said: "Over recent years we are seeing reductions in smoking rates amongst expectant mothers thanks to campaigns such as the Greater Manchester Smokefree Pregnancy programme.

"If you are pregnant and living in Bolton your midwife can refer you and your partner to the specialist stop smoking service at Royal Bolton Hospital, where a midwife or a support worker will support you throughout your pregnancy."
In 2018, NHS Greater Manchester started a Smokefree Pregnancy scheme in partnership with councils and NHS Foundation Trusts.

Across Greater Manchester the proportion of pregnant women smoking is down by almost 40 per cent since the start of the scheme. Jane Pilkington, NHS Greater Manchester's Director of Population Health, said: "We are thrilled to see such a decrease in smoking at time of delivery.

"This reflects the dedication of our team and, most importantly, the women who quit smoking for their health and their babies' health. We will continue to strive for a future where every pregnancy in Greater Manchester is smokefree."
Some of the risks of pregnant women smoking include premature labour, miscarriage, stillbirth and sudden infant death.

Source: Bolton News, 29 July 2024

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** GPs capping patient numbers could have ‘catastrophic’ effect on A&E, says NHS chief

Industrial action by GPs could have a “catastrophic” impact on A&E units, the 111 telephone advice service and mental healthcare, a senior NHS leader has told the Guardian.

Family doctors who run GP surgeries across England are about to finish voting on whether to reduce the care they provide – including limiting the number of patients they see to 25 a day – in protest at the previous government increasing their budget by only 1.9% this year.

The ballot of GP partners being run by the British Medical Association (BMA) closes on Monday, with the result known soon afterwards. They are expected to vote in favour of taking industrial action – but not striking – that would start on Thursday.

The outcome of the ballot could pose another headache for Wes Streeting, the health secretary, who is holding talks with junior doctors aimed at resolving their long-running pay dispute during which they have gone on strike 11 times over the past 17 months in pursuit of a 35% rise.

“If all GPs implemented the patient cap, that could have a catastrophic effect on the entire healthcare system”, said Matthew Taylor, the chief executive of the NHS Confederation. “General practice is now supporting more patients than before the Covid pandemic, so any reduction in their activity will put more pressure on other services, including A&E.”

As many as 3m GP appointments a month could disappear if family doctors push ahead with reducing the number of patients they see from what can be 50 a day to just 25, according to estimates by primary care leaders, speaking on condition of anonymity. The cap is one of nine options for industrial action suggested to GPs by the BMA.

Dr Katie Bramall-Stainer, the chair of the BMA’s GPs committee, told Streeting in a letter earlier this month that “general practice, the most efficient and productive part of the NHS, is collapsing” because of underfunding, the closure of 2,000 practices since 2010, a relentless rise in the demand for care and the fact that each GP is looking after a caseload of more than 2,300 patients.”

The “secondary impacts and consequences” of action by GPs could also affect the availability of mental health services, including care for those undergoing a crisis, and lead to “potential pressure/congestion on urgent and emergency care, elective and discharge pathways”, it added.

Source: The Guardian, 28 July 2024

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** Why we might never know the truth about ultra-processed foods

Ultra-processed foods (UPFs), like chicken nuggets, packaged snacks, and fizzy drinks, are heavily criticized by nutritionists. In the UK, UPFs make up 56% of calorie intake, especially among children and low-income individuals. Defined by extensive industrial processing and numerous ingredients, UPFs are often high in fat, sugar, or salt, and resemble fast food.

While recent research shows many pervasive health problems, including cancers, heart disease, obesity and depression are linked to UPFs, there’s no proof, as yet, that they are caused by them.

The kind of study needed to prove definitively that UPFs cause health problems would be extremely complex, suggests Dr Nerys Astbury, a senior researcher in diet and obesity at Oxford University.

It would need to compare a large number of people on two diets – one high in UPFs and one low in UPFs, but matched exactly for calorie and macronutrient content. This would be fiendishly difficult to actually do.

Participants would need to be kept under lock and key so their food intake could be tightly managed. The study would also need to enrol people with similar diets as a starting point. It would be extremely challenging logistically.

And to counter the possibility that people who eat fewer UPFs might just have healthier lifestyles such as through taking more exercise or getting more sleep, the participants of the groups would need to have very similar habits.

There's also confusion about what counts as a UPF. They usually have more than five ingredients, including additives like flavor enhancers and emulsifiers, and range from obvious examples (sugary cereals) to less expected ones (supermarket hummus).

Critics argue the term UPF is vague and induces unnecessary fear about food. Processing itself isn't harmful; it ensures safety, longevity, and reduces waste. The Food Standards Agency and other bodies are cautious about acting on UPFs until there's clear evidence of harm.

“If you make a cake or brownie at home and compare it with one that comes already in a packet that’s got taste enhancers, do I think there’s any difference between those two foods? No, I don’t,” Dr Astbury tells me.

The body responsible for food safety in England, the Food Standards Agency, acknowledges reports that people who eat a lot of UPFs have a greater risk of heart disease and cancer, but says it won’t take any action on UPFs until there’s evidence of them causing a specific harm.

Dr Adrian Brown, specialist dietician and senior research fellow at University College London, says demonising one type of food isn’t helpful, especially when what and how we eat is such a complicated issue. “We have to be mindful of the moralisation of food,” he says.

Source: BBC News, 28 July 2024

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