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** 30 September 2019
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** UK
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** New data shows smoking in the North West costs £1.7 billion (#1)
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** New costs could wipe out public health grant uplift (#2)
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** Watchdog dossier reveals 200 adverse effects linked to vaping (#3)
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** International
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** Big tobacco burnt as deaths and bans hit vaping market (#4)
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** US academic criticises UK vaping stance (#5)
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** US vaping death toll rises to 13 as health regulators look into cannabis vapes (#6)
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** UK
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** Smoking in the North West cost society at least £1.7bn in 2018, according to calculations carried out for Action on Smoking and Health (ASH). Last year there were 845,000 smokers in the North West. The £1.7bn cost to society breaks down as follows:
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* £332 million fell to the NHS
* £102 million fell to local authorities in the cost of social care
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** £553 million to employers in smoking breaks, sickness and absenteeism
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** £643 million fell to wider society due to lost economic activity from early deaths and unemployment due to smoking
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** An online tool has been developed by ASH which gives a breakdown of the full cost of smoking by geographical region, local authority and ward.

ASH Chief Executive Deborah Arnott said:
“Smoking takes a heavy toll on communities, local services and society at large. Disease and disability from smoking harms current smokers, ex-smokers and those exposed to secondhand smoke, often young children and those yet to be born.

If the Government succeeds in ending smoking in England by 2030, this can be stopped. But to achieve such an ambitious goal needs funding. The tobacco industry does the damage, the Government must make it pay to put things right.”

Source: Warrington Worldwide, 30 September 2019

ASH Ready Reckoner 2019 update ([link removed])
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Read Article ([link removed])


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** Talks are understood to have been held between the Department of Health & Social Care and NHS England on a requirement for councils to use the public health grant to cover the cost of pay rises for NHS public health provider staff on 'Agenda for Change' contract terms. These include health visitors, and also costs associated with the expansion of impact trials for the HIV drug pre-exposure prophylaxis (PReP).

Councils this year received £3.13bn in public health grant funding, an £85m reduction from 2018-19. An increase in the grant of inflation plus 1%, as announced by Public Health England chief executive Duncan Selbie, would amount to an estimated extra £85m in 2020-21, taking the grant back to last year’s level. The cumulative £90m cost of the potential new burdens on the public health grant would exceed the pledged £85m uplift in 2020-21.

A senior director of public health, who asked not to be named, said: “If this turns out – contrary to what [health and social care secretary] Matt Hancock and [chancellor] Sajid Javid have both said – to be just inflation or even worse inflation with new burdens like PrEP and Agenda for Change added, councils will feel they have been misled and government has reneged on yet another promise.”

“The agencies who campaigned for fair funding will feel government has been disingenuous. Flat growth with burdens will still mean cuts to services and redundancies. Because the money for agenda for change was already in the NHS system this means yet another bung for the NHS and yet another cut for public health.”

The public health grant is £850m lower in real terms in 2019-20 than the allocation in 2015-16.

Source: Local Government Chronicle, 27 September 2019
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Read Article ([link removed])


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** The Medicines and Healthcare Products Regulatory Agency (MHRA) health watchdog has recorded 74 reports detailing 200 health problems suspected to have been caused by e-cigarettes between 2014 and 2019, according to a newly published dossier. Of the 74 cases reported via the organisations “yellow card” alert scheme, 49 were classified as serious. Vaping has been linked to 200 adverse effects on UK e-cigarette users, including heart disorders, chest pains and pneumonia.

The MHRA insisted that all health problems are reviewed. It emphasised they are not proof that the adverse effects were due to e-cigarettes, but a suspicion by people reporting ailments that the device is to blame. The dossier contains all the reports in the five-year period.

Professor John Britton, director of the UK Centre for Tobacco and Alcohol Studies, said that while the 200 adverse effects in the dossier must be taken seriously, they represented a small number compared with the illnesses caused by smoking traditional cigarettes.

“You have to set this in the context that every year we admit thousands of people to hospital with symptoms of pneumonia caused by smoking,” he said.

Source: The Times, 29 September 2019
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** International
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** Alison Cooper, chief executive of Imperial Brands, has issued a profit warning to the City of London, stating that increased regulatory uncertainty had led to a “marked slowdown” in the US vaping market and that a growing number of wholesalers and retailers were not ordering or allowing promotion of vaping products. The big tobacco manufacturers have been investing huge amounts developing and marketing e-cigarettes.

With a number of US states, India and the retail giant Walmart moving ahead with vaping sales bans, the Trump administration threatening to outlaw flavoured e-cigarettes and health officials recommending people stop vaping amid an investigation into lung illnesses and deaths, the future of e-cigarettes in the American market has been thrown into doubt.

There is concern that the backlash risks driving vapers back to tobacco. Analysts at Liberum said that the “hysteria and misplaced conflation has led to a Reuters poll that showed 63% of adults in the US disagreed with the statement that ‘vaping is healthier than traditional cigarettes’.”

Deborah Arnott, chief executive of the Action on Smoking and Health charity, said tobacco companies had entered the vaping market fearing that otherwise it could be its “Kodak moment” but were “likely to be the winners” from stricter regulation on e-cigarettes or from consumers switching back to combustibles.

Source: The Times, 27 September 2019
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** Professor Stanton Glantz, director of the Centre for Tobacco Research Control & Education in San Francisco, has said that the vaping-related lung disease which has been prevalent in the US may hit Britain.

Public Health England says the crisis in the US is strongly associated with the vaping of cannabis oils, sometimes with vitamin E acetate, a cutting agent used by black-market dealers, something that is prohibited in the UK. The agency says it has not issued a health alert, believing the “evidence on the causes of the cases in the US is not yet conclusive”.

Professor John Newton, director of health improvement at Public Health England, said the problems in the US should not deter smokers from using e-cigarettes to stop smoking.

“Smoking causes 200 premature deaths in England every day, but vaping has helped hundreds of thousands of smokers quit tobacco,” Newton said. “The evidence remains clear that vaping isn’t risk-free but it is far less harmful than smoking. It would be tragic if smokers who could quit with the help of e-cigarettes did not do so because of false fears about their safety.”

Source: The Observer, 29 September 2019
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** Two more people have died of a severe lung illness linked to vaping - bringing the US death toll to 13. There has been another death in Oregon and the first death in Mississippi from the e-cigarette-related illness. It comes after the US Centers for Disease Control (CDC) revealed that there are now 805 confirmed cases of people with the deadly lung disease linked to vaping.

This figure is up 52% from the 530 reported a week ago. The deaths in Oregon and Mississippi follow a spike in people being struck down with mysterious and life-threatening lung diseases in the US. The previous 11 deaths occurred in the states of Kansas, Indiana, Missouri, Florida, Georgia, Minnesota, California, Oregon and Illinois.

However, authorities are still struggling to identify a single product or chemical in e-cigarettes behind the outbreak. Mitch Zeller, a director at the Food and Drug Administration, said: "The focus is on the supply chain."

The illness was first reported in April and all patients are known to have used e-cigarettes — some containing the cannabinoid THC. Symptoms can include fatigue, coughing, breathlessness and vomiting or diarrhoea.

The US Food and Drug Administration (FDA) believes vape liquid containing THC - the psychoactive agent in cannabis - could be to blame and have issued a warning. But many patients have said they have no knowledge about the substances they might have used - making treatment complicated.

Source: The Sun, 27 September 2019

See also:
CDC announcement: Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping ([link removed])

FDA announcement: E-Cigarette Products: Safety Communication - Due to the Incidents of Severe Respiratory Disease Associated with Use of an E-Cigarette Product ([link removed])
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Read Article ([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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