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** 5 October 2021
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** UK
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** Health funding cut said to threaten levelling up (#1)
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** GPs in England failing to urgently refer patients with “red flag” signs of cancer (#2)
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** Gove: Levelling up means empowering local government (#3)
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** International
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** US: New FDA rules for reviewing tobacco products (#4)
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** Guernsey: Tobacco, alcohol, and fuel duties to rise above inflation (#5)
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** Jersey residents encouraged to quit smoking this Stoptober (#6)
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** US: St. Paul City Council proposes stricter tobacco laws (#7)
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** UK
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**
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** New research shows that funding for healthy lifestyle support such as stop-smoking and obesity clinics has been cut by a quarter in six years in England.

The Health Foundation said councils had received £3.3 billion to run these services this year - £1 billion less than in 2015-16 once inflation is considered. The cut threatened the government’s levelling-up agenda to spread wealth and opportunity more fairly, it added. But the government said it was “absolutely committed” to the policy. A spokesperson for the government added the newly launched Office for Health Improvement and Disparities would play a crucial role in levelling up.

The research found while spending on the NHS had increased, funding given to councils for public health had been cut by 24% in the past six years. In towns like Blackpool - the most deprived area of the country - that meant £43 less per person per year was being spent on key public health services. The Health Foundation said these services were key to ensuring people remained in good health to get the most out of life. But it pointed out people in the poorest areas could expect to live nearly 20 fewer years in good health than their peers in wealthier areas - a gap likely to have been made worse during the Covid pandemic.

The Health Foundation said £1.4 billion extra would be needed by 2024-25 to reverse these cuts. The Association of Directors of Public Health supported its call, which has published a letter signed by more than 50 leading health charities and groups. ADPH interim president Prof Jim McManus said: “The public-health grant has been cut, cut and cut again, undermining the leadership and services that are essential to improving health and reducing inequalities.”

Source: BBC News, 5 October 2021

See also: ADPH Joint open letter calling for investment in local public health at the Spending Review ([link removed])
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** A new study has found that six out of 10 patients in England with key symptoms indicating possible cancer did not receive an urgent referral for specialist assessment within two weeks as recommended in clinical guidelines. Nearly 4% of these patients were subsequently diagnosed with cancer within a year.

The study was led by the University of Exeter, working with University College London, and funded by Cancer Research UK. Researchers studied almost 49,000 patients records from the Clinical Practice Research Datalink and data on hospital visits and cancer registration data between 2014 and 2015. They looked at patients who had reported cancer warning signs to their GP for the first time. The “red flag” symptoms included blood in urine, a breast lump, problems swallowing, iron-deficiency anaemia and postmenopausal or rectal bleeding. The lowest referral rate was for problems swallowing, at just 17%, and the highest was for a breast lump, at 68%.

Prof Martin Marshall, chair of the Royal College of GPs, said: “GPs follow clinical guidance to ensure that referrals are appropriate and are sensitive to the risks of over-referring patients because this would risk overloading specialist services and would not be helpful to patients or the NHS. GPs find themselves in a position where they are criticised for referring both too much and too little: what would help is better access to diagnostic tools in the community and additional training to use them and interpret the results, so that better informed referrals can be made.”

Source: The Guardian, 5 October 2021

See also: BMJ Journals - Concordance with urgent referral guidelines in patients presenting with any of six ‘alarm’ features of possible cancer: a retrospective cohort study using linked primary care records ([link removed])
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** Levelling up means “empowering local government” and “allowing communities and councillors to take back control,” the new communities secretary, Michael Gove, said yesterday (4th October) in his Conservative party conference speech.

Gove explained that levelling up means four things to the government: “We want to strengthen local leadership […]We also want to raise living standards, especially where they are lower. We want to improve public services, especially where they are weaker. And we also want to give people the resources necessary to enhance a sense of pride in the places where they live.”

Gove explained that for his department, levelling up means “investing in urban regeneration with new homes on neglected brownfield sites” as well as providing “a better deal” on social housing and home ownership.

Source: LGC, 4 October 2021
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** International
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** The US Food and Drug Administration (FDA) will announce two new rules today (5th October) in the Federal Registry for reviewing requests to sell and market new tobaccos products.

The new rules will take effect in a month. One rule applies mainly to electronic nicotine delivery systems, including e-cigarettes. The other category includes new cigarettes, smokeless tobacco, cigars, roll-your-own, and shisha tobacco products.

The regulations formalise the FDA’s current product evaluation process. The information needed includes the components, ingredients, and toxicological profile.

Source: Fort Waynes NBC, 5 October 2021
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** According to the latest States of Guernsey budget, the tax on tobacco, alcohol, fuel, and property will increase above inflation in 2022.

Tobacco duty will rise by 7.5%, while tax on real property (TRP) and alcohol and fuel duties will increase by 4% - above a 2.5% anticipated inflation rate. The 2022 budget revealed that tax revenue generated in 2021 was £46 million higher than anticipated at £508 million.

People may expect to pay roughly 47p more for a packet of 20 cigarettes, 2p more for a pint of beer, and 3p more for a litre of gasoline due to the tax rises. The increases are expected to raise around £1 million. The States said the budget showed a “strong economic bounce back” from the coronavirus pandemic, with a £22 million surplus expected in 2022.

Source: BBC News, 5 October 2021
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** Jersey residents are being encouraged to quit smoking during this year’s Stoptober campaign. This year (2021) marks the tenth anniversary of Stoptober, a campaign which encourages people to stop smoking for one month. Since 2012, 824 people in Jersey have taken up the Stoptober challenge, with 46% still not smoking after four weeks.

This year, the campaign urges smokers to consider what they could start with the money saved by not smoking. Smokers who spend around £9 per day on cigarettes could save around £3276 a year. Across Jersey, 23 pharmacies are offering stop smoking support with specialist support for people with physical or mental illness, pregnant women, and people struggling to quit.

Source: ITV News, 1 October 2021
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**
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** The St. Paul City Council is considering a slate of ordinances on cigarettes and related products. The proposed regulation would ban the use of coupons and discounts for all forms of tobacco. Other cities have banned coupons for cigarettes, but St. Paul would be the first to do so across the board.

Other changes include $10 minimum prices on packs of cigarettes and tins of chewing tobacco. In addition, the City Council is considering lowering the number of tobacco licenses for shops from 190 to 150. The ordinance change will be introduced on Wednesday (6th October) and will be discussed at a public forum later this month before being voted on.

Source: Fox 9, 5 October 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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