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** 30 April 2021
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** UK
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** NHS England boss to step down in July (#1)
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** Up to 14% died of cancer in medieval Britain, study suggests (#2)
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** International
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** US: FDA proposes ban on menthol cigarettes (#3)
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** European markets dip as tobacco firms hit by menthol ban plans (#4)
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** Parliamentary Activity
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** Parliamentary question (#5)
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** Links of the Week
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** Cochrane review: E-cigarette for smoking cessation living systematic review (#6)
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** Podcast: Let’s talk e-cigarettes (#7)
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** Recruitment: Public Affairs Manager, OHA (#8)
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** UK
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**
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** Sir Simon Stevens, NHS England’s chief executive for seven years, will step down in July. The government has announced he will become a member of the House of Lords. However, senior sources have told HSJ Sir Simon does not have another job immediately lined up and plans to take a break before starting another role. His scheduled departure has been rumoured in NHS circles for the last two years.

Key milestones in Sir Simon’s leadership have included the Five Year Forward View publication in 2014, the current five-year funding deal and associated NHS Long-Term Plan in 2018-19, the merger with NHS Improvement overhaul of their leadership, and responding to the coronavirus pandemic.

Much of the seven-year period was marked by government austerity measures, during which Sir Simon was credited with securing relatively generous funding settlements from the Treasury. In a break with most top public service leaders, he was willing to speak out publicly during Budget negotiations if he felt the funding on offer was insufficient. This reputation has led to him being described by commentators as chancellor Rishi Sunak’s “real opponent” and “the most politically skilled public service leader of his generation.”

Before joining NHSE, Sir Simon had held various roles for the Minnesota-based UnitedHealth Group, including executive vice president. Still, he was best known in the NHS as a highly influential adviser to Tony Blair from 2001 to 2004, and before that to Labour health secretaries Frank Dobson and Alan Milburn.

In his early career, he worked as a general NHS manager within mental health services in North Tyneside and Northumberland, before becoming a group manager at Guy’s and St Thomas’ hospitals in London. He was a friend of Boris Johnson when they both attended Balliol College, Oxford, at the same time.

Source: Health Service Journal, 29 April 2021

See also: HSJ - Stevens’ leaving note: ‘The NHS’ reputation has never been higher’ ([link removed])
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** Analysis of bones from the sixth to 16th centuries reveals cancer may have killed more than one in 10 adults in medieval Britain, research suggests.

The study authors carried out inspections, X-rays, and CT scans on the remains of 96 men, 46 women and one individual of unknown sex, excavated from six cemeteries in Cambridge and the surrounding area. The team focused on the spine, pelvis and femurs – sites that were the most likely to bear signs of cancer if it had spread to the bones.

The results revealed that five individuals, a minimum prevalence of 3.5%, were deemed to have had cancer, with one showing signs of a type of blood cancer. All were middle-aged or older. Once the team considered the proportion of cancers that spread to the bone and the sensitivity of CT scans for picking up signs of such spread, they estimated that between 9% and 14% of the medieval population had such a disease when they died. That, the team said, was much higher than the estimate of less than 1% suggested by previous archaeological studies, based on cancer lesions visible on the bone surface.

The team said the three- to four-fold greater prevalence of cancer in modern times could be because of a range of factors, including the rise in life expectancy, tobacco use, increase in industrial pollutants, and increased travel and population densities which could help DNA-damaging viruses to spread.

Source: The Guardian, 30 April 2021

See also: University of Cambridge press release - Cancer rates in medieval Britain were around ten times higher than previously thought, study suggests ([link removed])
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** International
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** The US Food and Drug Administration (FDA), on Thursday, 29th April 2021, proposed a ban on menthol cigarettes and flavoured cigars, a long-awaited win for tobacco control advocates and civil rights groups.

The proposed ban can take years to implement and might throw the health regulator into protracted legal battles with the deep-pocketed tobacco industry, which has repeatedly fought attempts to block anti-tobacco regulations. For decades, tobacco control groups have argued that mentholated cigarettes contribute to disproportionate health burdens on Black communities and often draw young people into smoking.

The FDA statement sent shares of Altria Group Inc, British America Tobacco Plc, and Imperial Brands Plc were down about 1%. According to brokerage Jefferies, US menthol cigarettes accounted for about 25% of BAT’s profit, 20% for Altria and 15% for Imperial. Altria and Reynolds America, a unit of BAT, said they would evaluate the proposal, while Imperial’s US business, ITG Brands, said it was disappointing but not unexpected.

Menthol cigarettes are banned in many US states, including California and Massachusetts and smoking rates have been declining for many years. However, they still account for more than a third of the industry’s overall market share.

The FDA’s action came in response to a lawsuit filed by the African American Tobacco Control Leadership Council and Action on Smoking and Health (US), which sued the agency over its failure to respond to a citizen petition from 2013 that urged it to ban menthol cigarettes.

Source: Reuters, 29 April 2021

See also: BBC News - Why the proposed US ban on menthol cigarettes is controversial ([link removed])

Financial Times - US proposes ban on menthol cigarettes popular with black smokers ([link removed])
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** Europe’s main financial markets dipped into the red at the close of play on Thursday (29 April) as tobacco stocks slipped after US regulators proposed a ban on menthol cigarettes.

Shares in British American Tobacco (BAT) and Imperial dropped lower after the announcement, although the prices were already down for the week after earlier reports suggesting the ban was on the cards.

The FTSE 100 closed 2.19 points lower, or 0.03%, at 6,961.48 on Thursday. In mainland Europe, German stocks were the biggest losers while the French Cac finished just lower, having reached a 20-year high earlier in the day.

Source: Yahoo Finance, 29 April 2021
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** Parliamentary Activity
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**
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**
PQ1: Litter: Tobacco

Asked by Jim Shannon, Strangford

To ask the Secretary of State for Environment, Food and Rural Affairs, what steps his Department is taking to tackle tobacco waste litter.

Answered by Rebecca Pow, Parliamentary Under-Secretary of State for the Environment and Rural Opportunities

We believe that the tobacco industry must take responsibility for the litter created by their products. Our most recent composition survey found cigarette butts represent 66% of all littered items, and preliminary research has shown an estimated cost to UK local authorities and other duty bodies of £40 million per year for the collection and disposal of littered cigarette butts, rising to £46 million when including those disposed of in public bins.

Last year, I met with tobacco industry representatives and asked them to consider what more they could to address smoking related litter and whether a voluntary producer responsibility scheme could be developed for tobacco waste products.

Having considered further evidence, the Government has now decided that a regulatory approach may now be required to ensure that the industry takes sufficient financial responsibility for the litter created by its products and to prevent them from undermining public health policy.

We plan to commission new research into regulatory options this year, including consideration of extended producer responsibility principles.

The Environment Bill will allow us to legislate for extended producer responsibility schemes, which could be applied to tobacco products. Cigarette and tobacco product packaging is already covered by the proposed packaging producer responsibility scheme, which is currently undergoing a second phase of consultation.

Source: Hansard, 29 April 2021
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** Links of the Week
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** The Cochrane Library has published an update to the Cochrane living systematic review of electronic cigarettes for smoking cessation.

The update builds confidence and certainty in the evidence that e-cigarettes can be effective smoking cessation aids, which are more effective and no more harmful than routinely offered NRT, like patches and gum.

Source: Cochrane Library, 29 April 2021
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View Review ([link removed])


**

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** Jamie Hartmann-Boyce and Nicola Lindson discuss the April 2021 update to their Cochrane living review of electronic cigarettes for smoking cessation. This podcast is a companion to this Cochrane Review and shares the evidence from monthly searches and review findings.

This update includes six new studies that have been added since the 2020 version of the review, and the researchers are pleased to see the first inclusion of an RCT studying e-cigarette pod devices. There is still moderate certainty that nicotine containing e-cigarettes help more people to quit at 6 months or longer than e-cigarettes without nicotine or NRT (nicotine replacement therapy).
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**
Also available on iTunes and Spotify.
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**

Obesity Health Alliance (OHA) is currently recruiting for an experienced and passionate public affairs professional.

This role is advertised as full time. However, the recruiter would consider part-time hours working 3 days a week - working 21 hours, or 4 days a week - working 28 hours.

The application deadline is 3rd May 2021.
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For more information email [email protected] (mailto:[email protected]) or visit www.ash.org.uk
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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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