08 July 2021

UK

CQC to get new powers through Health and Care Bill amendment

Study: Smokers at increased risk of recurring pneumonia

BBC Radio 4: Today

International

US Study: Menthol cigarettes linked to greater difficulty in quitting smoking

Parliamentary Activity

Parliamentary questions

UK

CQC to get new powers through Health and Care Bill amendment


An amendment will be made to the government’s Health and Care Bill to give “new powers” to the Care Quality Commission (CQC), health secretary Sajid Javid has confirmed. The pledge is made in a letter from the health secretary to Health and Social Care Committee chair Jeremy Hunt.  Currently, the CQC can only review systems with permission from the health secretary and does not have the power to rate them.
 
The letter said: “The committee proposed that [integrated care systems] should be held accountable for the quality and safety of care through transparent CQC assessments. My officials have been working closely with the CQC and NHS England to develop detailed proposals to include in the bill as an amendment. These new powers for the CQC are an opportunity not only to inform the public about the quality of health and care in their area but also a way to review progress against our aspirations for delivering better, more joined-up care across ICSs.”
 
Mr Javid also seemed to suggest he is willing to listen to wide-ranging concerns about the new powers to intervene in any local reconfiguration proposal at any time the health secretary deems fit. On the power to direct NHS England, Mr Javid said it was needed to “ensure is NHSE is working effectively with other parts of the system, including social care and public health, to support integration and tackle broader priorities such as health inequalities.”
 
He added that the power could be used, “for example”, to request to see guidance developed by NHSE before it is published to ensure effective working.
 
Mr Javid knocked back proposals by the committee to include duty in the bill that would require Health Education England to publish independent annual reports on workforce shortages. He said: “We do not agree that a requirement in primary legislation to publish long-term workforce projections is needed in order to continue to invest [in the workforce].”
 
Instead, he confirmed a new duty would be introduced in the upcoming bill that would provide “clarity on the purpose and role of each organisation in the system on workforce planning”, which would be set out in “one document… to provide… accountability for actions.” He also said the Department of Health and Social Care are working [with] NHS England to “develop a set of criteria for… appointments [to the Integrated care boards].
 
Source: HSJ, 8 July 2021

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Study: Smokers at increased risk of recurring pneumonia
 

A new study led by experts at the University of Nottingham has shown that people who smoke are at a higher risk of being hospitalised repeatedly with pneumonia.
 
The study authors investigated the occurrence of recurrent pneumonia after hospitalisation from an episode of pneumonia. Within 90 days and one year of follow-up, they found that approximately 3% and 9% of patients developed recurrent pneumonia. They also looked at the risk factors for recurrent hospitalisation for pneumonia. 
 
The researchers found that smokers are at increased risk of recurring pneumonia. Findings from the study revealed that smokers had a 42% higher risk of recurring pneumonia than non-smokers during a year of follow-up after hospitalisation for pneumonia. The risk halved in ex-smokers by 24%. Other factors that increased hospitalisation risk included increasing age, being male, being from a low-income background, and other medical conditions.
 
Dr Vadsala Baskaran, the study lead, said: “Effective interventions to help people stop smoking should be implemented as a key component of pneumonia management. These include evidence-based stop-smoking interventions such as providing brief advice on smoking cessation, offering behavioural support, alongside medications such as nicotine replacement therapy. Our research also showed that ex-smokers reassuringly had a lower risk of recurrent pneumonia. Future research is warranted to establish why, and for how long are ex-smokers continue to be at higher risk of developing pneumonia.”
 
Source: Hippocratic Post, 7 July 2021
 
See also: BMJ - Effects of tobacco smoking on recurrent hospitalisation with pneumonia: a population-based cohort study

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BBC Radio 4: Today

 

Listen to Dame Clare Gerada, a Londoner-based GP, as she answers questions on the state of covid.
 
Listen from: 2.49.55 “In January this year covid was the leading cause of death it is now may number 26 and those preventable causes that we bang on about all the time smoking in particular is the leading cause of about the first 12 causes of deaths: lung cancer, respiratory diseases. …[cut from 2.50.16 to 2.50.49]
 
“ and if you want to do anything for your health anything at all it’s give up smoking which is the boring advice I’ve been giving for the last forty years”
 
Source: BBC Radio 4, 6 July 2021.

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International

US Study: Menthol cigarettes linked to greater difficulty in quitting smoking

 

A new study finds that smoking menthol cigarettes versus unflavoured cigarettes are associated with reduced success in quitting among people who smoke nearly every day.
 
The study authors used data from the Food and Drug Administration (FDA) funded nationwide survey called Population Assessment of Tobacco and Health to examine the probability of people abstaining from smoking for 30 days and 12 months. The study participants in the nationally representative sample — 17% of whom were Black Americans — were surveyed four times between 2013 and 2018, allowing researchers to track smoking habits in specific individuals.
 
Researchers at the University of California, San Diego found that menthol cigarette smokers — who made up nearly 40% of those in the study — had a significantly harder time quitting than non-menthol smokers. Use of menthol cigarettes before attempting to quit decreased the probability of a smoker being able to abstain for more than one month by 28%, and for more than one year by 53%, compared to those who did not smoke menthol cigarettes.
 
The study revealed that individuals who switched from menthol cigarettes to unflavoured cigarettes had a higher likelihood of quitting than those who maintained menthol use. The study also found that the association between menthol use, and difficulty quitting was more pronounced in non-Hispanic Black smokers.
 
Geoffrey Fong, the chief principal investigator of the International Tobacco Control Policy Evaluation Project, said this finding “indicates the continued threat that menthol poses for the health of Black Americans.”
 
The new study “would be another reason why the FDA should go ahead with their plan in the next year and go through regulations to ban menthol cigarettes.”
 
Source: STAT, 6 July 2021
  
See also: BMJ - Effects of menthol use and transitions in use on short-term and long-term cessation from cigarettes among US smokers

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Parliamentary Activity

Parliamentary questions

 

PQ1: WHO Framework Convention on Tobacco Control

Asked by Sir Charles Walker, Broxbourne


To ask the Secretary of State for Health and Social Care, what criterion his Department will use when deciding on the selection of UK Government accredited observers for the WHO Framework Convention on Tobacco Control (COP9); and if he will make a statement.

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

The criteria for accredited observers is determined by the World Health Organization’s Framework Convention on Tobacco Control.

Source: Hansard, 7 July 2021

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PQ2:Electronic Cigarettes

Asked by Sir Mark Hendrick, Preston


To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of banning vaping in (a) public and (b) indoor spaces.

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

The ban on smoking in enclosed public places is based on strong evidence of harm from exposure to second-hand smoke, and the health benefits of preventing that exposure. No evidence of comparable harm from exposure or benefit from protection exists in relation to exposure to electronic cigarette aerosol in public or indoor spaces.

Source: Hansard, 7 July 2021

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