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** 10 November 2020
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** UK
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** The UK to miss healthy life expectancy target by 50 years, warns think-tank (#1)
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** Trade bodies demand clarity on tobacco forestalling rules (#2)
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** North West: Keep It Out campaign leads to dozens of illegal tobacco reports in Bolton (#3)
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** International
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** Australian Study: Children exposed to tobacco smoke at home have worse heart function as adults (#4)
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** UK
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** The government is set to miss a flagship manifesto target for improving the nation’s health, according to a centre-right think-tank, which argues that ministers must become directly accountable for tackling the inequalities that have come into sharp focus during the COVID-19 pandemic.

The report for Policy Exchange, led by Richard Sloggett, former policy adviser to health secretary Matt Hancock, warns that the government’s calculations show it is on course to miss by half-a-century its pledge to add five years to the length of time people are living in good health by 2035. The think-tank’s conclusions come amid an increasingly pressing debate in Westminster about where responsibility should lie for key aspects of improving public health after the decision to abolish Public Health England, which was deemed to have performed poorly during the coronavirus pandemic.

Richard Sloggett, the senior fellow for health and social care at Policy Exchange, said the government’s ambition to extend the time people lived in good health was “laudable and needed”. But without a new way of approaching prevention and public health, it “looks set to fall well short and could even go backwards from where things are today.”

The report calls for the creation of an Institute for Health Improvement housed in the department of health and reporting to ministers and the Chief Medical Officer. Policy Exchange also says new ministerial targets are needed for improvements in healthy life expectancy and calls for the publication of a new national disease prevention strategy and greater oversight of the performance of the local government on public health. It also calls for a “new deal” for public health supported by a Treasury review of funding for the Public Health Grant, and a greater focus by the NHS on prevention, with some responsibilities — such as screening and registries that store information about people with a specific disease — passing from Public Health England to the health service.

Policy Exchange acknowledges its recommendations are not radical. “The pandemic and indeed recent structural overhauls of our health system has shown that the best policy response is often not to create huge structural changes to deliver what is needed but rather to increase investment and focus on structures that exist.”

Source: Financial Times, 10 November 2020

See also: ASH response to the Policy Exchange report: Saving a lost decade ([link removed])
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** Clarity over tobacco duty and anti-forestalling have been urged by representatives of the UK retail and wholesale industry.

Trade bodies the Association of Convenience Stores (ACS) and the Federation of Wholesale Distributors (FWD) have called for more information regarding tobacco supplies. The cancelled Autumn Budget has led to confusion in the sector, particularly around anti-forestalling regulations which are designed to prevent retailers from taking advantage of a shift in duty by stockpiling product.

ACS chief executive James Lowman and FWD chief executive James Bielby had written a joint letter urging clarity in the situation. In a letter, they urged the government to lift the pre-Budget allocation rules on the stock to ensure that businesses can obtain enough supply to meet demand from customers and has raised concerns that stock shortages could lead to an increase in the illicit market.

In response, Kemi Badenoch MP said: “While it was confirmed there would not be a Budget this autumn, final decisions on the timing of tobacco duty rate changes are still to be made. An announcement will be made in due course. In the meantime, anti-forestalling restrictions remain in place.”

Source: Convenience store, 9 November 2020
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** A campaign on illegal tobacco has led to a massive increase in the reports of sales in Bolton.
The Keep it Out campaign, which reveals the actual cost of “cheap” illegal tobacco and the links to organised crime saw 42 reports of sales in the town between March and October. It has also led to more than 1.7 million illicit cigarettes and over 100kg of illegal hand-rolling tobacco being seized across Greater Manchester in that time.

The campaign is run by Greater Manchester Health and Social Care Partnership, in collaboration with local authority Trading Standards and enforcement partners from across the region.

Andrea Crossfield, Making Smoking History lead at the Greater Manchester Health and Social Care Partnership said: “The crackdown on illegal tobacco is part of Greater Manchester's wider efforts to cut smoking rates and make smoking history for future generations. All tobacco kills, but illegal tobacco is getting kids hooked on a lethal addiction and cheaper prices undermine smokers' quit attempts. Whether legal or illegal, all tobacco contains a toxic cocktail of chemicals which will kill one in two long term smokers. It's not just about the impact on our health though; the illegal tobacco market is fuelled by organised crime, and that's why we're raising awareness of the harm it brings to our neighbourhoods too and encouraging people to report illegal sales.”

Source: The Bolton News, 9 November 2020
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** International
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** The more secondhand tobacco smoke children breathe at home while growing up, the higher chance they have of developing markers of decreased heart function as adults, according to preliminary research.

The researchers wanted to understand the impact of prolonged secondhand smoke exposure during childhood on heart function in adulthood. They examined the health records of more than 1,100 adults who are participants in the ongoing childhood determinants of adult health study, an Australia-wide research project initiated in 1985 that investigates the importance of childhood factors in the later development of risk factors for heart disease and stroke. About half (54%) of the participants were exposed to secondhand smoking at home during childhood. The participants’ most recent evaluation was between 2014 and 2019.

The severity of childhood smoking exposure was calculated three ways: the number of smokers in the home; the number of years each child was exposed to tobacco smoking by household members; and the severity of exposure index. In the adult evaluation, ultrasound imaging was used to measure the global longitudinal strain (GLS) of the left ventricle, the heart’s major pumping chamber. GLS indicates how much the muscles of the left ventricle shorten as they help squeeze blood out of the heart, compared with the muscles’ resting length between heartbeats.

Findings from the study show that adult global longitudinal strain declined significantly: With each additional member of the child’s household who smoked, which ranged from 0-5 smokers; with more years of childhood exposure to tobacco smoke; and with higher scores on the childhood severity of exposure index.

Chigoze Ezegbe, the lead author of the study, said: “Recognising that adult cardiovascular health is influenced by factors across the lifespan including childhood may be important in advocacy initiatives and in implementing interventions to reduce the risks. These could include messages and programs that can help prompt parents to protect their children from tobacco smoke and the associated long-term health risks.”

Source: Medical Xpress, 9 November 2020

See also: Abstract –P1917 - Childhood Passive Smoke Exposure is Associated With Subclinical Left Ventricular Dysfunction in Adulthood - Childhood Determinants of Adult Health Study ([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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