From Action on Smoking and Health <[email protected]>
Subject ASH Daily News for 11 October 2021
Date October 11, 2021 12:36 PM
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** 11 October 2021
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** UK
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** Northern Ireland: Health Minister outlines plan to ban smoking in cars with more than one person (#1)
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** Former Cabinet minister urges UK to express support for e-cigarettes (#2)
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** Life expectancy gap in England 'a growing chasm' exacerbated by Covid (#3)
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** Sajid Javid working on radical plan to merge social care with health in England (#4)
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** International
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** Research into US vape fluid finds six chemicals which are possibly harmful (#5)
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** Opinion: Vectura's inhaler sales may suffer over Philip Morris backlash (#6)
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** UK
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** Northern Ireland’s health minister Robin Swann is outlining plans to ban smoking in cars when there is more than one person present. Under the proposal, "failing to prevent smoking in a smoke-free private vehicle" would become an offence and those found in breach of the proposed regulations could face a £50 fixed penalty notice. Swann said that the aim of the plans was to protect people, "particularly children, from the effects of second-hand smoke".

Swann also outlined plans to ban the sale of nicotine inhaling products, such as e-cigarettes, to anyone under the age of 18. The minister said that the number of young people taking up smoking in Northern Ireland has been "steadily decreasing in recent years" but said that he did not want to see the number of young smokers simply replaced by young vapers, citing WHO research on the health harms of e-cigarettes for young people and expressing concern that vaping may act as a gateway into smoking.

If the new regulations are supported by Northern Ireland Assembly members, they could come into force in early 2022. It is already illegal to smoke on public transport or to smoke in work vehicles used by more than one person in Northern Ireland. A ban on smoking in vehicles carrying children has been in force in England and Wales since October 2015 and took effect in 2016 in the Republic of Ireland.
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** Source: BBC News, 11 October 2021

See also: ASH Factsheet - Use of e-cigarettes among young people in Great Britain ([link removed])
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** David Jones MP, the former Welsh Secretary and Brexit Minister, has said that Britain should express its support for e-cigarettes during the next summit on tobacco organised by the World Health Organisation, countering the WHO which has called for a ban on e-cigarettes.

Concerns have been raised by some that the WHO may not recognise the UK as an independent voice at its upcoming COP9 summit on tobacco products and smoking next month and will instead defer to the EU, whose stance on e-cigarettes is more sceptical than the UK’s, as a voice for the Europe region.

Mr Jones insisted that the UK must use its newly won independent voice to explain the benefits of using e-cigarettes as a way of saving lives by getting people to switch from traditional tobacco products. Around 8 million people a year die worldwide from tobacco-related health issues, but the UK is one of the few countries to successfully use e-cigarettes and vaping to save lives.

Jones said: “The WHO has launched an anti-scientific crusade against vaping, which has been shown time and time again to help smokers quit. The organisation consistently praises nations who undertake ever more draconian measures against vaping. These decisions cost lives, and the UK must take a stand. Unlike previous COPs, the UK does not have to join the EU’s position. We are independent and free to back the science, back Public Health England, and back our own health experts.’’
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Source: Express, 10 October 2021
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New research from the King’s Fund has shown that England’s richest people are living for a decade longer than the poorest whilst the life expectancy gap between rich and poor has widened to “a growing chasm”. The analysis of official data found that the difference in expected lifespan between some of the wealthiest and poorest areas has more than doubled since the early 2000s.

Whilst life expectancy has steadily increased in wealthier areas, the analysis found that life expectancy had stagnated in poorer areas to the degree that the gap in life expectancy between the richest and poorest parts of the UK has grown by almost two-and-a-half years over the last two decades. For example, between 2001-03 and 2018-20 male life expectancy rose in Westminster from 77.3 to 84.7 years whilst men in Blackpool saw their expected longevity rise only 2.1 years from 72 to 74.1 years.

The research found that COVID-19 has exacerbated the north-south divide and the “deprivation divide” in life expectancy. London is experiencing significant rises in life expectancy, despite having high deprivation, large minority ethnic populations, and reeling from the impact of COVID-19. King’s Fund researcher Veena Raleigh said that this could be because London has a younger population with healthier lifestyles, better access to and quality of NHS care.

The analysis underlines the scale of the challenge facing the health secretary Sajid Javid, who in a recent keynote speech in Blackpool on “levelling-up” in health pledged to tackle “the disease of disparity” – dramatic differences in outcomes based on geography, ethnicity, and income.

Source: Guardian, 10 October 2021
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** Senior Conservative and Whitehall sources have told The Observer that the government is actively considering radical plans to deliver health and social care together under a new national care service and could include such plans in a white paper to be published next month.

At present, local authorities have responsibility for running social care services in their own areas, but critics say that this leaves little incentive for cash-strapped councils to develop better care for people in their homes or in the community as it is actually cheaper for them if those who need care go into hospital where the cost is met by a separate NHS budget. This leaves many who could be cared for at home or in the community occupying much-needed hospital beds.

There are different options for the plans. Under the most radical option, local authorities would lose any involvement in social care which would come entirely under the NHS, but Observer sources say that this would likely involve too great an upheaval and prove hugely unpopular with councils. Sally Warren, director of policy at the King’s Fund, says that integration could mean the NHS delivering services or could just mean shared accountability for health and social care services working together. Tory MP and former health under-secretary Dr Dan Poulter said that the key was to pool budgets.

The Scottish Government is currently holding a consultation on similar proposals for a National Care Service. Under the plans for England, it is understood thar there would be national standards for care and conditions for carers. The Observer has learnt that prime minister Boris Johnson was keen to announce the plans last month when he revealed the rise in National Insurance contributions to raise funds for the NHS and social care but pushed back an announcement as Downing Street remained unclear about how an integrated system could best work.

Source: Guardian, 10 October 2021
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** International
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** Scientists from John Hopkins University in Baltimore in the US have analysed four popular tobacco flavoured liquids on sale in the US, including Mi-Salt, Vuse, Juul and Blu, finding that six chemicals were possibly harmful, including three never previously found in e-cigs.

The research team applied an advanced technique used to check organic compounds in food, wastewater, and blood. They identified the unique 'fingerprints' of almost 2,000 chemicals using a state-of-the-art scanning technique. The vast majority of the chemicals analysed were unidentified.

Lead author Dr Mina Tehrani was particularly surprised to find caffeine in two of the four products. The stimulant has previously only been found in e-cig liquid flavours like coffee and chocolate. Dr Tehrani said: "That might be giving smokers an extra kick that is not disclosed. We wonder if they are adding it intentionally."

Three industrial chemicals, a pesticide, and two flavourings linked with possible toxic effects and respiratory irritation were also found. However, senior author Dr Prasse noted: "Existing research that compared e-cigarettes with normal cigarettes found cigarette contaminants are much lower in e-cigarettes."

Source: Staffordshire Live, 10 October

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** Editorial note:
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** Products on sale in the US do not meet UK standards. In the UK, caffeine and other stimulants are banned in e-liquid, as are vitamins, colourings and any additives that, in unburnt form, meet the criteria for classification as a carcinogen, mutagen, or reprotoxin. See regulation 15 in the Tobacco and Related Products Regulations 2016. ([link removed])
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** Bloomberg reporter Corrine Gretler argues that Vectura’s inhaler sales may suffer as a result of outcry over Philip Morris International’s (PMI) acquisition of the respiratory health company.

Gretler says that some doctors and patients have already signaled that they may switch to treatments made by Vectura’s rivals such as AstraZeneca and Teva Pharmaceutical Industries. Respiratory organizations plan to issue guidance within the coming weeks on how health-care providers should handle PMI’s purchase of the U.K. company that makes treatments for lung illnesses.

Vectura’s intellectual property is used in 13 approved inhaled products used by more than 10 million patients around the world last year. Nicholas Hopkinson, professor of respiratory medicine at Imperial College London and chair of ASH, has written a paper showing the range of alternatives for people currently using Vectura products that would not carry significant risk to patient outcomes. Gretler notes that doctors considering switching patients from Vectura products would have to ensure that the alternatives were equally effective and suitable for the individual patient and should not share their private moral views with patients unless explicitly invited to do so.

UK Inhaler Group is among dozens of health organizations currently drafting guidance for patients and health-care practitioners. The European Lung Foundation and its sister organizations are considering whether an international coalition is needed to discuss the long-term goals for respiratory health under the changed conditions, with a potentially stronger advocacy role with policymakers and legislators to try and prevent more such acquisitions in the future on an international level.

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** Source: Bloomberg, 11 October 2021

See also: Authorea - Adapting inhaled medication practice in COPD and asthma to avoid funding the tobacco industry ([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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