From Action on Smoking and Health <[email protected]>
Subject ASH Daily News for 07 July 2021
Date July 7, 2021 1:08 PM
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** 07 July 2021
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** UK
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** Smoking during pregnancy falls to lowest rate since records began (#1)
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** Bill confirms end of compulsory NHS competition, gives minister new powers (#2)
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** Integrated care systems to set own constitution and pay (#3)
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** LGB people 'more likely to have mental health issues' and to smoke and drink (#4)
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** Blog post - Smoking in attributable deaths in England: When the information changes (#5)
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** Parliamentary Activity
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** Parliamentary questions (#6)
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** UK
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Data from NHS Digital has shown that the proportion of women smoking during pregnancy in England has fallen to its lowest levels since records began in 2006-7. The data reveals that 9.5% of pregnant women smoked in 2020-21 compared with 10.4% the year before. However, NHS Digital noted that that was "still above the current national ambition of 6% or less."

Thirty-two of 134 clinical commissioning groups who provided data in the fourth quarter met the 6% national ambition, with smoking during pregnancy declining six times faster between 2019-20 and 2020-21 compared with the previous four years. The data also revealed that 8.9% of women were smoking at the time their baby was delivered in the fourth quarter of 2020-21, slightly down on 9.5% in the third quarter.

Figures show that the fastest rates of decline in recent years have been seen in places in the north of England where there are comprehensive strategies to tackle smoking in the community, as well as intensive support for pregnant women. In Greater Manchester, for example, smoking at the time of delivery has fallen from 12.6% in 2017/18 to 9.8% in 2020/21, and this follows the introduction of shopping vouchers to encourage pregnant women to engage with quitting support.

Despite the progress, Deborah Arnott, Chief Executive of ASH, said that the Government has a long way to go: “The Government are rightly ambitious to end smoking, but it will not be achieved through warm words alone. We need a bold, ambitious strategy that changes the lives of young men and women across the whole country so that every family starts in a smokefree home.”

Source: Pharmacy Magazine, 6 July 2021

See also: ASH press release - During the pandemic smoking in pregnancy fell below 10% for the first time since records began BUT Government still not on track to reach target of 6% or less by 2022 ([link removed])
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Read Article ([link removed])


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** Explanatory notes published alongside the Government’s Health and Care bill have shed light on how the new bill will end compulsory competition in the NHS and give the Health Secretary new powers.

The notes confirm that the bill proposes removing Section 75 of the Health and Social Care Act 2012, which requires clinical commissioning groups to tender any contracts over a certain value. The note also reveals that the bill proposes removing competition duties from NHS Improvement, removing the Competition and Markets Authority’s (CMA) powers to review foundation trust mergers, and NHS Improvement’s ability to refer contested license conditions and tariff prices to the CMA. The note however reassures that patient choice ''will continue to be protected’’ in the procurement process.

The explanatory note also reveals how the health secretary’s new powers over the NHS will work. The language used in the note appears to give the health secretary significant scope to intervene in NHS functions as the health secretary can ''set direction and intervene in relation to NHS England’s functions … on specific matters or on a standing basis’’. Such powers cannot however be used on staff appointments or on the provision of a particular drug, treatment, or diagnostic technique.

The bill also gives the health secretary powers to transfer functions between the health system’s different arm’s length bodies, though this will not apply to independent regulators such as the Care Quality Commission, the National Institute for Health and Care Excellence, and the Health Safety Investigation Branch.

Source: HSJ, 7 July 2021

See also: HSJ - How health secretary's new powers over the NHS will work ([link removed])
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** The new Health and Care Bill will allow Integrated Care Systems to set their own constitution, determine staff pay, and raise ‘additional income’, but the health secretary will have the power to approve ICS chairs.

The legislation also confirms that ICSs will have two boards which will take on the ‘’commissioning function’’ of clinical commissioning groups with accountability for NHS spend and performance. There will be the statutory integrated care board, previously known as an NHS ICS board, and a statutory integrated care partnership, previously known as a health and care partnership board. The explanatory note accompanying the legislation states how each board will be able to exercise these functions through new place-based committees, generally seen as the size of a local authority.

The legislation also states that ICSs must publish their own constitution, with NHSE to issue a “model constitution” to help areas develop their own. The constitution must set out how much board members will be paid, length of tenure, and eligibility for reappointment. ICSs will also be allowed to “raise additional income for improving the health service, provided that this does not significantly interfere with the integrated care board’s ability to perform its function”. However, the legislation says that each ICS chair will be “appointed by NHS England, with the approval of the secretary of state”, and only NHSE can remove the chair from office, subject to approval by the health secretary.

Source: HSJ, 7 July 2021
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** Lesbian, gay, and bisexual people are more than twice as likely as heterosexual people to have a long-term mental health condition, and to drink heavily and smoke, an analysis of NHS data suggests.

Of the adults surveyed over the eight years in the 2011-18 Health Survey for England, 1,132 or 2%, identified as lesbian, gay, or bisexual. Of these, about 16% reported having a long-term mental or behavioural disorder, compared with 6% of heterosexual adults. LGB people reported lower average mental well-being scores than heterosexual people, with LGB women having the lowest score of all.

LGB respondents were also more likely to smoke and drink. One in three LGB women reported smoking, compared with one in six heterosexual women. One third of LGB respondents reported drinking more than 14 units of alcohol a week, compared with a quarter of heterosexual people. However, LGB respondents were less likely to be overweight, with nearly two-thirds of heterosexual adults reporting being either overweight or obese, compared with half of the LGB population.

Source: BBC News, 14 July 2021

See also: NHS Digital - Health and health-related behaviours of lesbian, gay and bisexual adults ([link removed])
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** Martin Dockrell and Mark Cook from Public Health England explain how an updated methodology has led to statistics on the deaths and hospital admissions caused by smoking going down by around 15%.

Dockrell and Cook explain that smokers are much more likely than non-smokers to get a wide range of diseases including respiratory and cardiovascular diseases as well as a wide range of cancers and that it’s possible to calculate the risk of them occurring in smokers compared to smokers. This is called ‘relative risk’ and is specific to each disease, age group and sex. They explain that PHE has updated the data for relative risks, from data from between 1982 and 1988 to the latest scientific evidence from the RCP report Hiding in Plain Sight which covers 17 cancers, 8 respiratory conditions, and 7 mental health conditions.

Using the updated and more accurate methodology, the estimated number of deaths and hospital admissions in England caused by smoking are 15% lower than previous estimates. This new estimate doesn’t change what we know about the deadliness of smoking – it is still true that around 2 in 3 lifelong smokers will die of smoking related deaths
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Source: Public Health Matters, 6 July 2021
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Read Blog Post ([link removed])


** Parliamentary Activity
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**
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** PQs 1-2: WHO Framework Convention on Tobacco Control (Grouped questions)

1. Asked by Sir Charles Walker, Broxbourne

To ask the Secretary of State for Health and Social Care, with reference to the WHO Framework Convention on Tobacco Control, what the distinguishing criteria are between the categories of (a) the Government delegation and (b) observers accredited by the UK Government ahead of the Ninth Session of the Conference of the Parties (COP9).

2. Asked by Sir Charles Walker, Broxbourne

To ask the Secretary of State for Health and Social Care, what the timeline is for selecting the UK Government accredited observers for the WHO Framework Convention on Tobacco Control (COP9); and how his Department will notify interested parties of that process.

Answered by Jo Churchill, the Parliamentary Under-Secretary for Health and Social Care

The United Kingdom delegation for Conference of the Parties (COP9) will be comprised of officials from the Department of Health and Social Care and the Foreign, Commonwealth and Development Office, as has been the case for previous COPs. No registration details, agenda or papers for the November COP ninth session are available at present.

The process for the accreditation of other interested parties such as international inter-governmental organizations and non-governmental organizations for the COP is set out by the Secretariat of the World Health Organization’s Framework Convention on Tobacco Control, which is available at the following link:

[link removed] ([link removed])

Source: Hansard, 29 June 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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