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** 03 August 2021
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** UK
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** Smoking-related cancer twice as prevalent among poor in England (#1)
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** BBC Radio 4 Today Programme: Interview with Professor Linda Bauld (#2)
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** Named: the first 25 integrated care board chairs (#3)
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** Opinion: Levelling up must recognise existence of functioning economic geographies (#4)
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** International
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** Opinion: Philip Morris International says it wants to stop selling cigarettes in the UK. Could it ever happen in the US? (#5)
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** Philip Morris International bids for new cigarette factory license in Egypt (#6)
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** UK
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**
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** New estimates published by Cancer Research UK (CRUK) have found that smoking causes twice as many cancers amongst the poor as it does the well-off. The estimates found that about 11, 247 cases of cancer caused by smoking are diagnosed amongst the poorest 20% of people in England each year compared to 6,200 amongst those in the top 20% income bracket.

In total, 21% of the 53,227 cancers diagnosed every year amongst the poorest 20% of people in England are caused by smoking. Although more cancer cases occur in the wealthiest 20% of people, an estimated 63, 828, only 10% are the result of someone smoking.

Deborah Arnott, chief executive of ASH, said: “This stark differential in cancer rates exists because of the iron chain linking smoking and disadvantage. Around a quarter of those who are unemployed or in routine and manual occupations smoke, compared with fewer than one in 10 working in management or the professions.”

Arnott joined CRUK chief executive Michelle Mitchell in calling for the Government to introduce a polluter pays levy on tobacco firms to help fund the cost of ending smoking. “Tobacco manufacturers make extreme profits off the backs of the poor. The time has come to make them pay to end the epidemic that they and they alone have caused,” Arnott said.

Mitchell pointed out that without action like this the Government would not achieve its target of England becoming smokefree by 2030. The number of people smoking would need to fall from 15.5% to just 5% for that ambition to be achieved but smoking rates remain persistently high amongst poorer groups, with people in the most deprived communities two and a half times more likely to smoke than the top fifth of people by income.


Source: The Guardian, 3 August 2021
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** BBC Radio 4’s Today Programme discusses the findings from Cancer Research UK’s research with Bruce and John Usher Professor of Public Health at the University of Edinburgh, Linda Bauld.

Professor Bauld: ''The gap [in smoking rates] between the most and least affluent really has not narrowed and in some communities has widened. These are preventable cases of death, preventable cases of cancer, and as we move out of the Covid crisis the Government needs to be thinking about these other priority areas for public health’’.

‘’We know there’s about 27,000 cases of cancer caused by deprivation and one of the reasons is smoking. If you take that out and smoking rates were the same for everyone, around 5,500 of these cases could have been prevented each year’’.

‘’There was an All Party Parliamentary Group report which reported recently just setting out a range of measures looking ahead at what we could do and also how we could raise money from the profits made by the tobacco industry to fund really vital services that smokers actually want access to’’.

Source: BBC Radio 4 (52:55- 57:25), 3 August 2021

See also: ASH - Delivering a Smokefree 2030: The All Party Parliamentary Group on Smoking and Health recommendations for the Tobacco Control Plan 2021 ([link removed])
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** The chairs have been chosen for 25 of the 42 NHS integrated care boards (ICBs) which will plan health services from April 2022. ICBs will lead the integrated care systems which are due to be put on a statutory footing by the Government’s Health and Social Care Bill, currently making its way through Parliament.

Of the 25 ICB chairs selected, 11 are women (26% of the total) and five are known to have an ethnic minority background. Job adverts have been published for the remaining 17 posts with a salary range of £55,000 - £80,000. ICB chairs are not allowed to be councillors or MPs, or to work for any of their ICS’s constituent organisations, which has ruled out several current ICS chairs from applying for the roles.

ICBs will work with local authorities to create an “integrated care partnership” (ICP) board for each system which will develop the area’s health and care strategy. ICBs chairs are allowed to chair the ICP board but it is not clear how many will want to undertake this joint role and/or be acceptable to local government partners who might want to put forward their own candidates.

In cases where current ICS chairs wanted to lead the relevant ICB, NHS England had to decide whether they could be selected without an open competition. It is understood that NHSE considered whether the chairs had been selected previously by an open process and/or had been appointed in the past 18 months. They also considered the views of others in the system, including that of the NHSE regional director. The appointments had to be approved by the health and social care secretary.

A process for selecting ICS chief executives is expected to begin in the coming weeks. It is not known how many existing ICS executive leads will be directly transferred and how many posts will be advertised. It is likely to be a more contentious process than for chairs and will affect the redundancy rights of clinical commissioning group directors whose posts will be abolished.

Source: HSJ, 29 July 2021
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** If levelling up is to succeed it must first recognise the existence of functioning economic geographies, argues the principal research consultant at ResPublica Mark Morrin.

Morrin argues that levelling-up is predominantly an economic agenda. However, prioritizing the local economy means that local authorities will have to be flexible about the scale at which levelling-up occurs. Morris argues that ‘functioning economic geographies’ at a local level do not correlate neatly with administrative boundaries.

Instead, such geographies are best understood, according to Morrin, as the places ‘where people travel to and from work’. Even though these geographies will have shrunk over the last 18 months amidst COVID-19 home-working, the need to think in terms of travel-to-work areas means that local authorities will have to collaborate across boundaries with neighbours to maximise the benefits of levelling-up. Morrin argues that places that do so should be rewarded by national government.

Source: LGC, 30 July 2021
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** International
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** NBC reporter Ben Popken argues that whilst they may claim that they want to stop selling cigarettes in the UK, Philip Morris International (PMI) has no such intentions in the US.

Popken points out that ''when it comes to ending smoking in America, [PMI’s] tone is a little softer’’. Critics note that PMI is not taking the action required to end smoking in the USA. Eric Lindblom, a law professor at Georgetown University, says: “If PMI were serious about banning combustible cigarettes within 10 years, it would strongly support strong new government action now to make cigarettes (and all similarly smoked tobacco products) less attractive, less addictive, more expensive, and otherwise less readily available to both smokers and nonsmokers, especially youth. But they have not done that.”

PMI has been transitioning to a business model more centred on so-called ‘reduced-risk products’ but last week Philip Morris USA disclosed in its second quarter earnings that it had "delayed further expansion of [its] IQOS and Marlboro heatsticks" due to legal uncertainty following an unfavourable ruling by the US International Trade Commission when it reviewed a judge's findings in a patent infringement case brought by British American Tobacco against its rival PMI.

Popken notes that there is another factor in the likely continued prevalence of cigarette smoking in the US: the American desire to maintain the ‘freedom’ to smoke. “Smokers in the US may be more resolute in their desire to maintain the ‘freedom’ to smoke, a slightly unique American disposition that is not nearly as strong in other countries,” said Kathleen Hoke, a law professor and Director for the Center for Tobacco Regulation at the University of Maryland School of Law.

Source: NBC News, 2 August 2021
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** The local representative of Philip Morris International in Egypt has presented a technical offer to the Egyptian Industrial Development Authority (IDA) applying for a new cigarette factory license. British American Tobacco, Al-Mansour Group (the distributor of Imperial Tobacco products in Egypt), and Japan Tobacco International (JTI), each did not submit offers and asked for a delay in the process.

The latter three companies are said to have reservations regarding the amended bidding terms and one has asked for separate licenses for conventional cigarettes and heated tobacco products, according to Ibrahim Embaby, head of the tobacco division at the IDA. The request for a delay will be presented to the Egyptian Prime Minister Moustafa Madbouly.

Source: Zawya, 2 August 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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