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** 25 January 2021
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** UK
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** Former Edinburgh MP wants smoking tackled after COVID-19 (#1)
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** International
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** Smoking causes half of Indigenous Australian deaths over 45, study shows (#2)
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** US: California’s ban on flavoured tobacco sales blocked as referendum qualifies for ballot (#3)
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** Link between anxiety and smoking clear, but relationship remains unknown (#4)
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** Chinese vaping group RLX doubles in value on Wall Street debut (#5)
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** UK
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** John Barrett, who was Liberal Democrat MP for Edinburgh West from 2001 until 2010, has called for “political leadership” to address smoking once the COVID-19 crisis has passed. Barrett said smoking-related disease puts massive but "totally avoidable" pressure on the NHS and should no longer be accepted as the norm.

Mr Barrett said "COVID has resulted in more than 5,000 deaths in Scotland and the pressure on the NHS has been huge – but every single year in Scotland roughly twice that many people die through smoking. The latest numbers show 10,000 deaths a year from smoking and about 33,500 hospital admissions – and that's what we will return to as life as normal."

Barrett added that “everyone hopes the vaccine means we will soon be heading back to normality, but normality is actually the NHS under pressure. People say the NHS needs more funding – what the NHS actually needs is people to look after themselves and reduce the demand on the NHS. Let's not return to life as normal, let's not say ‘that's fine’. The Scottish Government should get its act in order and accept there is a bigger killer out there which has been acceptable for many years and that when COVID is dealt with that's what we ought to tackle with the kind of urgency with which we tackled COVID.”
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** Source: Edinburgh Evening News, 24 January 2021
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** International
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** Smoking-related illnesses cause half of all deaths of Aboriginal and Torres Strait Islander peoples over the age of 45, accounting for 10,000 premature preventable deaths in the past decade alone, a new study has found. The study, published in the International Journal of Epidemiology today (Monday 25th January), is the first population-specific study to analyse smoking mortality rates in Aboriginal and Torres Strait Islander peoples.

Led by researchers from the Australian National University (ANU), it pulled data from 1,388 Aboriginal people from New South Wales who participated in the 45 and up study, a longitudinal study run by the Sax Institute of 267,153 people aged 45 and older who were randomly selected from the NSW population. Lead author on the paper Dr Katie Thurber said the study demonstrated both the importance of having population-specific data and the need to invest more in tobacco control programs specifically tailored to Aboriginal and Torres Strait Islander communities.

About 40% of all Aboriginal and Torres Strait Islander adults self-identified as smokers in 2019, down from 54.5% in 1994. ANU associate professor Raymond Lovett, a co-author on the study and Ngiyampaa man, said high rates of smoking stemmed from colonial practices of paying Aboriginal and Torres Strait Islander workers in rations, which included tobacco. That practice did not end until the 1970s. “If you worked, particularly in rural areas, you were paid in tobacco. That has got a large part to play in why smoking rates are so high,” he said.

While demographic factors of lower incomes and high unemployment also contributed to high smoking rates among some Aboriginal populations, Lovett said it did not account for all the difference. Aboriginal and Torres Strait Islander peoples with a tertiary education and a higher income were less likely to smoke, but more likely to smoke than non-Indigenous people of the same demographic which, Lovett says, shows modern-day health impacts cannot be separated from colonial legacy.

Lovett said that existing health interventions targeting smoking among Indigenous populations should be boosted in response to this research. However, Lovett also stressed that 80% of people who quit smoking did so unaided, without medical intervention. “Sometimes we medicalise tobacco control to such an extent that people think they can’t do it, they can’t stop or quit, alone,” he said, adding that “Part of our suite of education is to say actually the majority of people quit unassisted.”

Source: The Guardian, 24 January 2021
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** See also: International Journal of Epidemiology ([link removed]) (The study had not been published on the Journal website at the time of writing)
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** A California law banning the sale of flavoured tobacco products was placed on hold on Friday 22nd January 2021, after state officials said submission for a referendum by the tobacco industry qualified for the November 2022 ballot. The announcement means the law approved last year by the California Legislature and signed by the state governor is suspended until California voters decide late next year whether to affirm or repeal the ban.

“It’s a sad day for California when the money of Big Tobacco is able to delay the inevitable while continuing to addict and kill more Californians,” said former state Senator Jerry Hill , who authored the law before he left office.

More than 1 million signatures in support of holding a referendum on the ban had been submitted by the California Coalition for Fairness, a group funded largely by tobacco companies including R.J. Reynolds Tobacco Co., Philip Morris USA and its affiliated U.S. Smokeless Tobacco Co. The tobacco industry has reportedly raised more than $21 million (around £15.3 million) so far for the campaign to overturn the state ban.

Source: Los Angeles Times, 22 January 2021
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Research shows higher rates of anxiety disorders among smokers than the general population. However, a study released last year in Current Psychiatry Reports said that despite "robust evidence" linking smoking and anxiety, there are "considerable discrepancies for the precise role of anxiety in smoking onset, severity, and cessation outcomes." Lorra Garey, research assistant professor at the University of Houston and the study's lead author, said alcohol and substance abuse could be clouding the true connection. Another complicating factor is the two-way relationship between smoking and anxiety.

"It's this perpetual loop feeding into itself. You have anxiety contributing to smoking … and then you have people becoming addicted to nicotine and experiencing acute withdrawal with symptoms that mimic anxiety," said Garey. "These things are so interrelated it's hard to tease apart," she said. "Ultimately, we need more rigorous research to really track the different factors over time to fully understand them."

Another problem, according to said Brian Hitsman, associate professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago, is that smokers often mistakenly think having a cigarette will reduce their anxiety. "It's in their head that smoking is an effective way to manage their emotional distress, but it's probably only making them feel better because it's helping manage their nicotine withdrawal," he said, adding that "smoking actually increases your heart rate and causes changes in the body that are opposed to relaxation."
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Source: Medical Xpress, 22 January 2021

See also: Current Psychiatry Reports - The role of anxiety in smoking onset, severity, and cessation-related outcomes: A review of recent literature ([link removed])
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** China’s biggest e-cigarette maker doubled in value on its Wall Street debut on Friday 22nd January, with shares jumping from $12 to $25 by the end of market trading, as investors look for access to what is potentially the world’s largest vaping market. The New York Stock Exchange IPO of RLX Technology, which was founded in 2018, is the first big listing in the US by a Chinese company this year.

RLX has benefited from a boom in vaping in China. The country holds huge potential for e-cigarette makers, with an estimated 286.7m adult smokers in 2019, according to the company’s market prospectus. The industry has grown despite China issuing an effective ban on online sales of e-cigarettes in 2019. RLX controls about 63% of China’s e-cigarette market, according to the prospectus.
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** Source: Financial Times, 22 January 2021
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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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