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** 13 April 2021
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** UK
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** Liver cancer rates in UK have doubled since 1997, according to study (#1)
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** Northern Ireland: Spice vaping warning issued by Public Health Agency (#2)
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** COVID-19: 4.6m people missed out on hospital treatment in England in 2020 (#3)
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** David Cameron faces unprecedented formal inquiry into Greensill scandal (#4)
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** International
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** E-cigarettes with a cigarette-like level of nicotine are effective in reducing smoking, finds US study (#5)
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** WHO urges Arab directors to cut smoking from dramas watched during Ramadan (#6)
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** UK
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** A paper has detailed the variation in the number of people being diagnosed with liver cancer across the UK. Liver cancer rates have doubled across the UK over the last two decades, increasing from 4.4 per 100,000 in 1997 to 9.6 per 100,000 in 2017, with the highest incidence rates in 2017 seen in men in Scotland, compared to men and women in the other UK nations.

The research, published last week in JHEP Reports, found that between 2015-17 there were around 6,100 new liver cancer cases in the UK every year, the equivalent of 17 new cases every day. Between 1997 to 2017, 82,024 people were diagnosed with primary liver cancer and 58, 348 people died from their confirmed liver cancer across the UK. Age-standardized incidence and death rates of liver cancer were more than twice as high in men than in women.

The latest study, funded by the British Association for the Study of the Liver and including work by Cancer Research UK funded researchers, revealed that the rate of people being diagnosed with liver cancer in Scotland doubled, from 5.83 cases per 100,000 people in 1997 to 11.71 per 100,000 by 2017. The rate of people dying from confirmed liver cancer in Scotland doubled between 1999 and 2017.

However, though incidence and mortality rates have increased in the last 20 years throughout the UK, survival has also increased, with the proportion of people surviving their liver cancer for one, two and five years around two times higher over the study period.

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** Source: Medical Xpress, 12 April 2021

See also: JHEP Reports - Primary liver cancer in the UK: Incidence, incidence-based mortality, and survival by subtype, sex, and nation ([link removed](21)00008-2/fulltext)
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** Northern Ireland: Spice vaping warning issued by Public Health Agency (#2)

Northern Ireland’s Public Health Agency (PHA) has issued a reminder for vapers to make sure that they are vaping regulated substances, following reports of young people becoming ill after vaping ‘spice’. The reports suggested that the young people thought that they were purchasing cannabis oil but were unknowingly supplied with the synthetic drug ‘spice’, requiring hospital treatment as a result.

The PHA recommends that users do not vape potentially unknown substances like cannabis oil as ''there is no way to know if what you’ve been sold is what you’re actually taking''. The PHA issues alerts on the dangers of vaping a liquid form of spice and on consuming other drugs through its Drug and Alcohol Monitoring and Information System (DAMIS).

Source: Newry Times, 13 April 2021
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**

An analysis of NHS hospital activity by the Health Foundation has revealed that more than 4.5 million people missed out on hospital treatment in England last year due to the disruption to the NHS caused by COVID-19. The number of patients having planned surgery such as a joint replacement fell from 16.62 million in 2019 to just under 12 million last year, a drop of 4.64 million people, and many patients had to turn to crowdfunding to pay for cancer drugs and operations.

GPs referred 6 million fewer people to have diagnostic tests and treatment in hospital as a result of the disruption to care, patients’ reluctance go to hospital in case they caught Covid and a desire not to add to the pressure on the overstretched NHS. They referred 14 million patients in 2020, compared with 20 million in 2019.

The Health Foundation estimates that the millions of “missing patients” could send the overall NHS waiting list soaring from its already record high 4.6 million people to 9.7 million by 2024 if three-quarters of those people belatedly seek treatment now that the pandemic is easing. The number of people forced to wait more than a year for their operation has rocketed from 1,613 before the pandemic to 304,044 in January this year, and more than 1 million people have been waiting at least six months, even though 92% of patients are supposed to be treated within 18 weeks under the referral to treatment scheme. The Health Foundation warns that this could coalesce into a major political problem.


Source: The Guardian, 13 April 2021
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** Boris Johnson has ordered an unprecedented formal inquiry into lobbying by former prime minister David Cameron on behalf of the collapsed company Greensill Capital. The independent investigation will examine the firm’s role in government, supply chain financing and communications by employees, including Cameron. It is understood that the inquiry will also have licence to recommend changes to lobbying regulations.

The decision on Monday 12th April follows the release of a 1,700 word statement by Cameron on Sunday evening after a slew of damaging stories about his lobbying efforts on behalf of Greensill, including messages to the chancellor, Rishi Sunak, two junior ministers, senior civil servants and a No 10 special adviser. Cameron said he had reflected on his conduct and accepted that he should have communicated “through only the most formal of channels”.

Campaigners including Transparency International have said the saga “highlights deep flaws in the UK’s approach” and that an inquiry should cover the lack of transparency in lobbying, enforcing the ministerial code, and the revolving door between government and the private sector. The group said ministerial meetings that are meant to be reported are often left unpublished and unpoliced and have called for a change in the direction of the US, Canada, Ireland and Scotland, where attempts to influence ministers must be reported by lobbyists themselves.

The independent review will be led by Nigel Boardman, a corporate lawyer and senior consultant at Slaughter and May, a multinational law firm that previously challenged the Cameron administration when the then prime minister proposed to change lobbying rules. Johnson has denied that the inquiry is simply an attack on his old rival, instead saying that it was clear that the public deserved a transparent explanation of the scandal.

Source: The Guardian, 12 April 2021
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** International
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** A new study has found that how effective an e-cigarette is in delivering nicotine has a major impact on a user’s chances of successfully reducing smoking and their related exposure to the harmful tobacco-related carcinogen NNAL. The study, published in The Lancet Respiratory Medicine journal, found that e-cigarettes with nicotine delivery like a combustible cigarette that deliver an amount of nicotine akin to a cigarette are most associated with reduced smoking and the related protection from NNAL exposure.

The research, led by researchers from Virginia Commonwealth University and Penn State College of Medicine, involved 520 participants who were not initially interested in reducing smoking and who were not using an e-cigarette device at the time of the study, but who did smoke more than nine cigarettes a day. Over 24 weeks, the participants were given an e-cigarette device filled with either 0, 8, or 36 milligrams per milliliter of liquid nicotine, to reflect a range of nicotine delivery from none, low (8 mg/ml), or cigarette-like (36 mg/ml). The participants were also provided with smoking reduction instructions.

At weeks 0, 4, 12 and 24, the researchers sampled participants’ urine, testing for the tobacco-specific carcinogen known as NNAL. They found that participants using e-cigarettes filled with the cigarette-like level of liquid nicotine had significantly lower levels of NNAL at week 24 compared to baseline and compared to levels observed in the non-e-cigarette control condition. This shows that even people who may not be intending to quit when beginning to vape can do so if vapes are able to provide the same levels of nicotine as cigarettes.

Source: Scienmag, 12 April 2021

See also: The Lancet Respiratory Medicine - Effect of an electronic nicotine delivery system with 0, 8, or 36 mg/mL liquid nicotine versus a cigarette substitute on tobacco-related toxicant exposure: a four-arm, parallel-group, randomised, controlled trial ([link removed](21)00022-9/fulltext)
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** The World Health Organization (WHO) has called for the advertising of tobacco and smoking products in popular Arabic-language television dramas to be banned ahead of the holy month of Ramadan when viewing figures are expected to spike as families settle down to watch soap operas after breaking their fast at sunset with an iftar meal, or with suhoor in the pre-dawn hours.

The WHO says that scenes featuring smoking may have contributed to a rise in the use of tobacco products among young people, highlighting that the consumption of tobacco is concerningly high in the Eastern Mediterranean region among young people of both sexes. WHO has called for notes warning about the dangers of smoking to be flashed on the screen during scenes featuring tobacco products.


Source: The New Arab, 12 April 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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