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** 12 July 2019
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** UK
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** Perinatal care: mental health support expands but weight and smoking services remain static (#1)
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** Study: Effective stop smoking treatments less likely to be prescribed to people with mental health conditions (#2)
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** Illegal tobacco haul seized in Croydon (#3)
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** International
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** US: Most Americans want less nicotine in cigarettes, report says (#4)
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** Link of the week
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** What a difference a place makes: the growing impact of health and wellbeing boards (#5)
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** UK
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Whilst there has been significant expansion in mental health support for women during pregnancy and postnatally, there has been no improvement in access to specialist services on weight management and smoking services, according to a survey of NHS maternity and neonatal services in England, Scotland, and Wales led by the Royal College of Obstetricians and Gynaecologists with support from other royal colleges and academic institutions.

The survey gathered data from all 151 eligible trusts and health boards across Britain as of January 2019 - It shows how maternity and neonatal services have changed since the last survey in January 2017. The number of trusts and health boards that participate in a perinatal mental health network has increased from 70% to 93% in England.

However, the audit found no improvement in the percentage of trusts and health boards that offer specialist smoking cessation and weight management support—available at 72% and 45% of trusts respectively. Latest figures from NHS Digital show that just under 11% of pregnant women are smokers at the time of delivery in 2018-19, similar to the level recorded in 2017-18.

Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said: “Funding cuts to local public health budgets are unacceptable and investment in these services will not only support women to be as healthy as possible before, during, and after pregnancy, but give their babies the best possible start in life, and save money in the long term by preventing future health problems.”

Source: The British Medical Journal, 11 July 2019
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** Royal College of Obstetricians and Gynaecologists: National Maternity and Perinatal Audit ([link removed])
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Read Article ([link removed])


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** A new study, drawing on data from nearly 200,000 smokers, from researchers at the Universities of Bath and Bristol has found people with mental health conditions are less likely to be prescribed varenicline. The researchers found that, compared to smokers without mental health conditions, smokers with mental health conditions were 31% less likely to be prescribed varenicline than nicotine replacement therapy (NRT).

The researchers also found that smokers with mental health conditions who were prescribed varenicline were 19% more likely to have successfully quit at two years follow-up, than smokers who were prescribed NRT. There was little 'evidence that varenicline was adversely associated with poorer mental health outcomes'. Varenicline was also not associated with worse mental health outcomes.

Lead researcher, Dr Gemma Taylor from the University of Bath's Addiction & Mental Health Group with the Department of Psychology said "Our results, in combination with results from clinical trials, suggest that doctors should rethink prescription practice in view of the benefits varenicline could bring to help those with mental health conditions stop smoking."

Professor Ann McNeill, Professor of Tobacco Addiction, King's College London and co-Chair of the Mental Health and Smoking Partnership, said that doctors should "be pulling out all the stops to help these smokers to quit, but this research involving nearly 200,000 smokers, shows that this is not happening."
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** A 2019 report by ASH suggested that in some parts of the country, GPs are no longer prescribing varenicline. There is also preliminary evidence of this occurring in a related study being run by University of Bath's Addiction & Mental Health Group, in which trial participants have been declined varenicline by their GP surgery and told to seek varenicline elsewhere.
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**
Source: News Medical, 11 July 2019
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** Nicotine and Tobacco Research: Prescribing Prevalence, Effectiveness, and Mental Health Safety of Smoking Cessation Medicines in Patients With Mental Disorders ([link removed])
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See also
ASH: A Changing Landscape: Stop Smoking Services and Tobacco Control in England ([link removed])
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Read Article ([link removed])


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Almost 10,000 illegal cigarettes have been seized by Croydon Council and HM Revenue and Customs officers. Specialist dog teams were used during the raid, held to coincide with a month-long push by trading standards teams across London. The Croydon inspections were carried out at six locations around the borough, with two of them found to be selling tobacco products suspected to be illegal and on sale without duty having been paid on them.

Councillor Hamida Ali, cabinet member for safer Croydon and communities, said: “This co-ordinated effort between council staff and HMRC is important because illegal tobacco sales damage people’s health and our economy."
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Source: Talking Retail, 11 July 2019
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Read Article ([link removed])


** International
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** A clear majority of Americans support lowering the amount of nicotine in cigarettes, according to a report released Thursday 11th July by the US Centers for Disease Control and Prevention (CDC).
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"Lowering nicotine levels in cigarettes could help current smokers quit and make it less likely for future generations to become addicted to these products," said Corinne Graffunder, director of the CDC's Office on Smoking and Health. More than 80% of US adults favoured less nicotine, the new report found, and current smokers were just as likely to support lower levels as those who had never picked up a cigarette. The new report did not address e-cigarettes or tobacco products other than cigarettes.

Researchers surveyed more than 4,000 people across the country and found that older adults - those over age 65 - were most likely to support lower levels of nicotine. Support for the move was slightly higher in women than men, researchers found.

A 2014 report from the Office of the Surgeon General argued that lowering nicotine to non-addictive levels could help eliminate smoking. And last year, the US Food and Drug Administration sought public comments on regulations to this effect. Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the FDA's move "a bold plan" and said that "there is no other single action our country can take that would prevent more young people from smoking or save more lives."

Source: CNN, 11 July 2019
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** CDC: U.S. ([link removed](19)30210-7/fulltext) Adults’ ([link removed](19)30210-7/fulltext) [link removed](19)30210-7/fulltextAttitudes Toward Lowering Nicotine Levels in Cigarettes ([link removed](19)30210-7/fulltext)
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** See also
Time: Most Americans, including smokers, like the idea of less-addictive cigarettes ([link removed])
CNBC: CDC says 8 in 10 US adults support limiting nicotine in cigarettes as FDA preps new rules ([link removed])
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** Editorial note: Concerns have been raised about whether, even if it is effective in theory, the nicotine-reduction strategy is implementable in practice, particularly in the US context. For more information, see Lynn Kozlowski's article linked to below.
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Kozlowski, L.T. Prospects for a nicotine-reduction strategy in the cigarette endgame: Alternative tobacco harm reduction scenarios. ([link removed]) International Journal of Drug Policy. Volume 26, Issue 6, June 2015, Pages 543-547.
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Read Article ([link removed])


** Link of the week
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** The Local Government Association (LGA) have published a new report, What a difference a place makes: the growing impact of health and wellbeing boards.

The report
capturing the achievements, challenges and learning from 22 effective health and wellbeing boards (HWBs) across the country, all of which are making good progress on integrating health and care, improving wellbeing and tackling the wider determinants of health.
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Read Report ([link removed])
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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