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** 11 June 2021
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** UK
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** Opinion: Once unthinkable, a smokefree Britain may soon be a reality (#1)
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** Addiction treatment harder to get since councils took over, says Tory MP (#2)
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** Analysis of child deaths in England shows the importance of care for premature and young babies (#3)
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** Parliamentary Activity
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** Parliamentary questions (#4)
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** Links of the Week
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** Backbench Business debate – Tobacco Control Plan (#5)
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** Delivering a Smokefree 2030: The All Party Parliamentary Group on Smoking and Health recommendations for the Tobacco Control Plan 2021 (#6)
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** UK
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** Gaby Hinsliff, a Guardian columnist, argues that a “softly softly” voluntary ban on smoking may be the best way to achieve a smoke-free Britain.

Hinsliff highlights Oxfordshire County Council’s example, who recently unveiled plans to become the first county in Britain to be officially smokefree. Oxfordshire has taken a “softly softly” approach, not officially banning smoking in public places but strongly discouraging things like cigarette breaks outside officers or smoking in parks and cars.

The author points out that this kind of approach works because, as ASH’s YouGov poll this week showed, almost one in four smokers themselves think the Government could do more to tackle smoking. Moreover, perceptions of what is socially acceptable have already shifted, with things like smokefree sidelines at grassroots kids’ football matches, smokefree school gates, and a ban on smoking outside hospitals now common.

The critical thing about these interventions is that they signal what Hinsliff calls a “social disapproval” of smoking. They work because, as Hinsliff points out, “smoking isn’t actually much fun in and of itself”. Even amongst young people, smoking is becoming uncivilised, with the biggest fall in smoking prevalence over the last decade among 18- to 24-year-olds. A smokefree Britain is achievable because, in Hinsliff’s words, “without the illusion of glamour or the sheen of rebellion, there’s nothing much left”.

Source: The Guardian, 11 June 2021
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Read Article ([link removed])


**
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** Fewer people are being treated for alcohol and drug problems since responsibility for their care was shifted from the NHS to local councils in England, a former Conservative health minister has found.

Patients’ care has become poorer, specialist detoxification beds are now harder to access, and the cost of treatment has spiralled, freedom of information (FoI) requests show. The duty to commission public health services, including services for people dependent on drink, drugs or both, was passed from the NHS to local councils in 2013 as part of the health service shake-up by the then health secretary, Andrew Lansley.

Dr Dan Poulter – who works part-time as a psychiatrist at an NHS mental health trust and being an MP – with his assistant, Jonathon Foster, and addictions psychiatrist Dr Emily Finch, submitted FoI requests to local councils to examine how the change was working out. They said: “The evidence is conclusive: commissioning of addictions services by cash-starved local authorities has been a failed experiment. The reality is that an inferior addictions service is currently being delivered to patients by a fragmented patchwork of largely non-NHS providers.”

In 2012 the Department of Health lauded the switch of responsibility as “a critical step in the transition towards the establishment of a new public health system”. But Poulter and colleagues said the evidence showed the change had been very damaging, resulting in “serious shortcomings in the current provision of alcohol and inpatient detoxification services”.

While addiction budgets have shrunk since 2013 amid Whitehall’s cuts to the public health grant given to councils, costs have risen as NHS providers of this care have been replaced in many places by an array of non-NHS, third-sector and private operators.

Poulter and his co-authors said: “Between 2013-14 and 2019-20, total expenditure in England on these treatments rose from approximately £27.137million to approximately £34.605 million per annum – an increase of 27.5% – and yet the number of people receiving inpatient detoxification fell by 176 (4%) during the same period.” They pointed out that addicts were at greater risk of relapsing because the growing number of non-specialist courses of detoxification treatments being bought by councils usually did not include follow-up care such as mental health support.

Councillor David Fothergill, chairman of the Local Government Association’s community wellbeing board, rejected Poulter’s plea for the commissioning of addiction services to be handed back to the NHS. He said: “Councils are committed to ensuring that all those who need help with alcohol and drug misuse get the right support and treatment. Vulnerable people are being given another chance to find work, rebuild relationships, improve their health and secure safe accommodation. Any suggestion of moving public health responsibilities would be irrational, deeply disruptive and clearly undermine the progress made so far.”

Source: The Guardian, 10 June 2021
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Read Article ([link removed])


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An analysis of child deaths in England by the University of Bristol National Child Mortality Database (NCMD) team has found that smoking by a parent or carer was the leading modifiable factor in child death.

The latest report from Bristol’s National Child Mortality Database (NCMD) program, which gathers information on all children who die in England below 18 years, analysed the characteristics of the 3,347 child deaths between 1 April 2019 and 31 March 2020 in England. Of the children who died, 63% were under one year old, 69% were born preterm (before 37 weeks), and 42% of all child deaths occurred before the children were 28 days old.

For the first time since the start of the national child death review process in 2008, factors that are considered to be modifiable in children’s deaths have been analysed on a national scale and included in this report. Across all death categories, the most frequent modifiable factor identified was smoking by a parent or carer. The next most frequently identified factor was gaps in service delivery, while challenges with access to services and poor communication also feature in the most frequently identified modifiable factors. Others include substance and alcohol misuse by a parent or carer, postnatal care, and unsafe sleeping arrangements.

Overall, there were approximately 28 child deaths for every 100,000 children living in England. Several other key findings relating to ethnicity, deprivation, and location of death (where this data was recorded) are as follows:

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** 62% of children who died were from a White ethnic group, while 19% were from an Asian or Asian British background, 9% were from a Black or Black British background, and 7% were from a mixed ethnic background.
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** There were approximately three times as many deaths of children who were resident in the most deprived neighbourhoods compared to those from the least deprived areas.
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** 78% of child deaths occurred within a hospital setting.
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NCMD now recommends further improvements in the completeness and quality of child death data collected to enhance future analyses. Karen Luyt, NCMD program lead and the report’s senior author, said: “As a society, it is incumbent upon us to learn from these tragedies and identify ways in which we can change things to reduce the number of children who die in the future.”

This report states a clear call to action for all professionals involved in planning or providing services to children to play an active part in reducing the number of children who die, encouraging them to use the data within to implement changes to address the issues it highlights.

Source: Medical Xpress, 10 June 2021

See also: Second Annual Report - National Child Mortality Database Programme ([link removed])
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Read Article ([link removed])


** Parliamentary Activity
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**
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** PQ1: Alcoholic Drinks and Tobacco: Misuse

Asked by Crispin Blunt, Reigate

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of (a) the likelihood of alcohol and tobacco being misused, (b) the risk of alcohol and tobacco misuse causing harmful effects sufficient to constitute a social problem and (c) the effectiveness of excluding alcohol and tobacco from control of harmful drugs under the Misuse of Drugs Act 1971.

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

No recent assessment has been made.

The Government is committed to supporting the most vulnerable at risk from alcohol misuse, including through establishing alcohol care teams in hospitals and supporting children of alcohol dependent parents. We will be publishing a new Tobacco Control Plan later this year setting out plans for England to become a smoke-free country by 2030.

Source: Hansard, 10 June 2021 ([link removed])


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** PQ 2 -3: WHO Framework Convention on Tobacco Control (Grouped questions)

2. Asked by Mark Pawsey, Rugby

To ask the Secretary of State for Health and Social Care, if he will ensure that the UK delegation to the Ninth Framework Convention on Tobacco Control Conference in November 2021 takes the opportunity to speak about the UK’s progress on the implementation of tobacco harm reduction policies and the role of vaping in making that progress.

3. Asked by Mark Pawsey, Rugby

To ask the Secretary of State for Health and Social Care, pursuant to the Answer on 18 May 2021 to Question 170 on Tobacco, in the context of the decision of the Ninth Session of the Conference of the Parties (COP9) to the WHO Framework Convention on Tobacco Control and the Second Session of the Meeting of the Parties (MOP2) to the Protocol to Eliminate Illicit Trade in Tobacco Products to meet virtually, if he will extend the UK’s delegation to include (a) advocates for the Government’s harm reduction policies and (b) consumers as per the recommendations of the all-party Parliamentary group for Vaping's inquiry into COP9 of the Framework Convention on Tobacco Control published on 31 March 2021.

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

Departmental officials will be attending the virtual Ninth World Health Organization Framework Convention on Tobacco Control Conference of the Parties (COP9). Officials from Her Majesty’s Revenue and Customs will be attending the virtual Second Session of the Meeting of the Parties (MOP2). As COP9 and MOP2 are Government-led events, no other representatives will be attending.

Whilst the agenda and papers for COP9 and MOP2 have not been circulated, officials will use the opportunity to speak about the United Kingdom’s progress on the implementation of tobacco control policies. This will include, where relevant, the role of nicotine replacement therapy and e-cigarettes in supporting smokers to quit.

Source: Hansard, 10 June 2021 ([link removed])
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** Links of the Week
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** Yesterday, 10 June 2021, during a Backbench business debate, MPs from Labour, Conservative, DUP, Alba Party debated the APPG report's recommendations for England's new tobacco control plan in Parliament, to which the Minister responded.

The Minister responded that the new plan would expand on the success of the 2017 plan, and it will build momentum to support communities and groups where rates are not falling enough. The Minister reiterated her commitment and support that the new tobacco control plan “will be bold enough for smoke-free 2030. I am determined to protect the population from the harms of tobacco. As we build back better, we must make smoking a thing of the past, to improve the health of the nation and level up society, freeing up the billions of pounds spent on smoking by disadvantaged families and protecting the NHS.”
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The debate can be watched here: [link removed]

Source: Hansard, 10 June 2021
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Read Transcript ([link removed])


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** On Wednesday, 9 June 2021, the All Party Parliamentary Group on Smoking and Health published a major new report on the action needed to secure a smokefree country by 2030. The report was launched at an online event attended by the Public Health Minister, Jo Churchill MP.

You can view a recording of the launch here: [link removed] ([link removed])
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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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