From Action on Smoking and Health <[email protected]>
Subject ASH Daily News for 8 December 2020
Date December 8, 2020 2:22 PM
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** 8 December 2020
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** UK
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** Public health grant cuts worst in most impoverished areas (#1)
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** Beating cancer by improving the public’s health: the road ahead in England (#2)
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** David Player obituary (#3)
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** International
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** US: Altria Group Inc announces FDA authorisation of IQOS 3 for sale in the United States (#4)
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** Parliamenatry Activity
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** Parliamentary question (#5)
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** UK
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** The poorest parts of England have seen the most significant cuts to councils' public health budgets, a new study from the Institute for Public Policy Research (IPPR) North suggests.

Since 2014, IPPR North says the public health grant has been cut by around £13.20 per person across England. However, IPPR North’s analysis finds that there is a significant amount of regional variation. For example, across the Midlands, the cut works out at £16.70 per person, while across northern England it is £15.20 per person. At a regional level, the North East was worst affected, with cuts of £23.24 per person.

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** Anna Round, a senior research fellow at IPPR and one of the co-authors of the report, says that the cuts have exacerbated long-standing health inequalities between rich and poor, north and south. She said: “The north and the Midlands are the areas with the worst levels of health, so obviously it's worrying that some of that investment in making health better has actually been cut most in the areas that most need it. That cut has led to a reduction in some of those really important programmes that get to work on the things that cause ill health. So, programmes like drug and alcohol reduction, things to help reduce rates of obesity and smoking.”

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** A spokeswoman for the Department for Health and Social Care in England said the recent Spending Review had committed to maintaining the public health grant - and that £10 billion had been provided to councils to help cope with the pandemic.
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** Source: BBC, 8 December 2020

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** See also: IPPR North - State of the North 2020/21: Power up, level up, rise up ([link removed])
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** Matt Sample, Policy Advisor Cancer Research UK, discusses the need to level-up the nation’s health and how Public Health England (PHE) plays a central role in protecting and improving the health of the nation.

In the article, Matt highlights that PHE is responsible for managing vital data that can help tackle health inequalities and improve cancer services. He points out that the replacement of PHE by March 2021 without setting out a clear plan for the future of PHE’s health improvement, and broader functions risk undermining progress towards achieving the Government’s ambition of a smokefree generation by 2030.

Matt goes on to highlight the principles which the new health improvement system should follow and what needs to be protected. This includes: Prioritising cancer prevention, awareness and public education campaigns about the harms of smoking and other modifiable risks factors, supporting cancer screening, protecting data to improve care and drive research; and seizing the opportunity to improve health and prevent cancer.

He says that the decision to restructure “how we deliver public health in England is an opportunity to not only prioritise but strengthen, how we work towards making the country healthier.” He goes on to conclude that “the Government missed an opportunity to do this in the recent spending review, with funding for public health frozen. This follows years of significant underinvestment in public health and given the impact of COVID will make it much harder for the Government to meet [its] ambitions to tackle inequalities across the UK. That’s why it’s so important to get new health improvement structures right. These efforts are crucial to a future where fewer people develop or die of cancer. The UK Government must seize this opportunity.”

Source: Medical Xpress, 7 December 2020

See also: Cancer Research UK - Beating cancer by improving the public’s health: the road ahead in England ([link removed] )
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** David Player was a leading public health figure determined to take on the tobacco and alcohol industries. In the 1970s, public health campaigns were heavily focused on the individual, exhorting people to give up bad habits or adopt healthier ones, while ignoring the importance of social and political determinants on personal behaviour. The commercial sector, meanwhile, was pushing health-damaging products with only rudimentary controls on their activities. David Player, as director of the Scottish Health Education Unit (SHEU) and then director general of the Health Education Council (HEC), was determined to change that.

David, who has died aged 93, was a trailblazer. He made the plea: “Let’s have no victim-blaming. The ideal of public health requires public commitment to health rather than a shift of responsibility to the individual.” He favoured a two-pronged approach: creating health-promoting environments, while exposing the commercial forces that damage health. He worked in general practice in Cumbria, serving poor mining communities, where he saw at first hand the effects of poverty on health. This inspired him to return to Glasgow University to gain a diploma in public health in 1960. He was appointed medical officer of health for Dumfries, where he set up innovative services and also worked at national level on strategic issues. Then he served as director of prison psychiatry in Scotland before becoming director of the SHEU in 1972, and a decade later director general of the HEC.

He used sports sponsorship to promote the smoke-free message, including SHEU sponsoring the Scottish football team in the 1982 World Cup in Spain – the first anti-smoking team in the world. To support those thinking of quitting, in 1984 he helped launch National No Smoking Day, which became an annual event. He also challenged tactics designed to make the tobacco industry look good, such as funding the Health Promotion Research Trust, which, however, explicitly excluded research on the health effects of smoking. David referred to this funding as “blood money.”

In 1986, the HEC announced that it would withhold grants from researchers who received any funding from this tobacco industry source. Much soul-searching in academia eventually led to a shunning of unethical funding sources in many British universities. With economic recession in the 80s, he became particularly concerned about unemployment and increasing inequalities in health. David commissioned an update of the evidence in the 1980 Black Report on health inequalities, which was eventually published in March 1987 as an HEC occasional paper entitled The Health Divide.

The report was described as “political dynamite” by the chair of the HEC, Sir Brian Bailey, who cancelled the scheduled press conference on the morning of the launch; too late, however, to stop media interest. When rumours started to circulate of possible suppression by the Thatcher government, a perfect media storm ensued. David was in his element, gleeful at the way the publicity was spreading the findings of The Health Divide and provoking serious concern.

He could not save the HEC, though. Powerful vested interests had already successfully lobbied for its closure, scheduled for the end of March 1987 and the debacle over The Health Divide sealed his fate, as he was rejected for the leadership of the HEC’s successor.

Source: The Guardian, 17 November 2020
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** International
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** Altria Group Inc announced yesterday that the US Food and Drug Administration (FDA) has authorised IQOS 3, Philip Morris International’s electrically heated tobacco system, for sale in the United States.

In its decision, the FDA noted that international survey data reviewed by the agency found no evidence of increased uptake of IQOS by youth or young adults, while use patterns available for a previously authorised version of IQOS within the US have not raised new concerns regarding product use in youth and young adults.

Source: Financial Times, 7 December 2020
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** Parliamentary Activity
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** Smoking: DHSC

Asked by Alex Norris Labour, Nottingham North

To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 10 November 2020 to Question 97688, how many times enforcement action for non-compliance with the requirements of the Tobacco and Related Products Regulations 2016 has taken place.

Answered by Jo Churchill, Parliamentary Under-Secretary of State, Department of Health and Social Care

Enforcement of the Tobacco and Related Products Regulations (TRPR) 2016 is carried out by local trading standards. The Department will be undertaking a post implementation review of TRPR shortly.

The Department has funded the Chartered Trading Standards Institute (CTSI) to provide annual tobacco control surveys on trading standards activities relating to tobacco control legislation enforcement. The latest CTSI survey for 2019-20 is available at the following link:
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** [link removed] ([link removed])

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** It is too early to assess the level of compliance with the ban on menthol cigarettes which was introduced in May this year.

Source: Hansard, 7 December 2020
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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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