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E-cigarettes could be prescribed on the NHS to help people stop smoking in a world first, the Government has announced. Health Secretary Sajid Javid has backed the idea and the Medicines and Healthcare Products Regulatory Agency (MHRA) has updated its guidance and announced that it will assess applications from vape manufacturers for the prescription of their products in the UK.
E-cigarette manufacturers can now submit their products for the same regulatory approvals process as drug companies. If a product receives MHRA approval, clinicians can decide on a case-by-case basis to prescribe an e-cigarette to an NHS patient to help quit smoking. Currently doctors can advise smokers to switch to vaping but cannot prescribe a medicinally licensed product.
Sajid Javid, the Health Secretary, praised the move: “Opening the door to a licensed e-cigarette prescribed on the NHS has the potential to tackle the stark disparities in smoking rates across the country, helping people stop smoking wherever they live and whatever their background.”
Deborah Arnott, Chief Executive of ASH, said: “The MHRA guidance opens the door to a day when smokers can be prescribed e-cigarettes to improve their chances of successfully quitting. Just as the MHRA led the world in licensing vaccines for COVID-19, today it is leading the world by backing the medicinal licensing of e-cigarettes. This is entirely justified. As the Chief Medical Officer Chris Whitty has pointed out, smoking is likely to have caused more premature deaths in the UK last year than the COVID-19 pandemic. Thanks to vaccines, COVID-19 is being brought under control, but smoking will kill as many people this year as last. With nearly 7 million smokers in the UK, smoking will continue to kill people for many years to come until we make smoking obsolete.”
Arnott added: “Smokers find it hard to quit, taking on average 30 attempts to succeed, which is why we need new tools in the toolbox, such as medicinally licensed e-cigarettes. Consumer e-cigarettes bought over the counter are proven to be the most successful quitting aid, but nearly a third of smokers have never tried them, and a similar proportion believe, wrongly, that e-cigarettes are as, or more harmful, than smoking. These are the smokers who are more likely to try vaping if they had the reassurance provided by a medicines licence and products available on prescription.”
Arnott's comments were echoed by other experts. Linda Bauld, professor in public health at Edinburgh University, said: “The option of having approved devices that could be prescribed would reassure smokers about relative risks and assist in reaching those least able to afford e-cigarettes.”
Source: The Times, 29 October 2021
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Council representatives have welcomed the increase in central grant funding outlined in the Budget and spending review but have warned that it will not go far enough to cover ongoing pressures.
James Jamieson, chair of the Local Government Association (LGA), said that he LGA was “pleased that today’s spending review has provided new grant funding for councils over the next three years” but it would only “meet some – but not all – of the extra cost and demand pressures [councils] face just to provide services at today’s levels.” Sir Stephen Houghton, chair of the Special Interest Group of Municipal Authorities, similarly warned that the increase in grant funding would not make up for past cuts to local government budgets. “While a small increase in grant funding for local government is welcome, it is a drop in the ocean compared to cuts since 2010,” he said.
The new chair of the District Councils' Network (DCN), Sam Chapman-Allen, was more unequivocal, saying: “The spending review does not deliver the firm financial foundation district councils need to continue delivering frontline services and supporting local economies to grow.” Georgia Gould, chair of London Councils, likewise said of the announcement's ramifications for London councils: “The announced funding increases aren’t enough to meet the huge challenges in our communities. In particular, there remains great uncertainty over adult social care, which is the largest area of council spending and supports some of our most vulnerable residents.”
Regarding public health, Jim McManus, interim president of the Association of Directors of Public Health, said: “It is unfathomable that the government has not prioritised public health funding in the wake of the worst public health crisis of our time. If we are serious about learning the lessons of how existing health inequalities have driven and exacerbated the impact of COVID-19, we must address the socio-economic determinants of health and invest in local public health teams.”
Source: LGC, 28 October 2021
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Jessica Hill of the LGC discusses what was missing from the Budget and spending review.
The first omission, Hill identifies, was word on when the new levelling up white paper will be published. The paper, announced in July, was expected to come out around the same time as the spending review. The Government has now, however, pushed back the white paper until “later this year” with one senior source telling the LGC that they expect it to be published in December. Spending review documents hint that the paper will focus on local projects such as funding infrastructure. The government is also expected to announce which areas will receive county deals and reorganisation, but it is understood there will be no new money attached to the county deals.
The second omission Hill finds is clarity on whether the public health budget will, in actual fact, be maintained in “real terms” as the Government has pledged. Directors of public health and policy experts had called on the government to provide an extra £1.4bn per year by 2024-25 for public health and a recent Health Foundation report found that the public health budget has been cut by 24% per capita since 2015-2016. An expert source says there is scepticism about whether the grant will really be maintained in “real terms” once pay rises and extra pressures are considered.
Hill also raises questions on how councils will be funded. The fair funding review, officially scheduled for 2022-23, has been pushed back every year since 2019. Councils are also awaiting clarity on the future of business rates retention amidst mounting calls for a tax regime overhaul. The Treasury pledged earlier in 2021 to “set out the future plan for local government funding” at the spending review but there was no mention of it. It is also unclear whether local government will receive a multi-year funding settlement or rollover one-year settlements.
Source: LGC, 28 October 2021
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Efforts to end smoking in South Tyneside continue as councillors have endorsed recommendations from the latest All-Party Parliamentary Group (APPG) on Smoking and Health report and have supported the development of a local action plan led by the South Tyneside Smoke-free Alliance.
The endorsements were made at a full meeting of South Tyneside Council on October 21 2021 in which councillors were shown a report on tobacco control in the borough. The report showed that there were 882 smoking-attributable deaths in the over 35s in South Tyneside between 2017 and 2019. Smoking prevalence in the area has reduced from 18.8% in 2018 to 16.3% in 2019 to bring it close to the England average. Smoking in pregnancy has dropped from 25.9% in 2014/15 to 13.9% in 2019/20, thanks partly to the Council’s successful smoking in pregnancy financial incentive scheme. South Tyneside’s stop smoking services have been amongst the most successful in the region with the highest rate of confirmed four-week quits in the region in 2019/20.
The APPG report endorsed by the councillors outlines the actions needed in the next Tobacco Control Plan to secure the Government’s goal to make England smokefree by 2030, defined as a 5% smoking prevalence across the population. Councillor Anne Hetherington, cabinet member for independence and wellbeing, said: “Endorsement of the [APPG] recommendations is the first step in the journey which will involve local action to implement the National Tobacco Control Plan. Such leadership sends a clear message to the government that if it is to achieve its ambition for a smoke-free 2030 and a levelling up of society, it will require bold action.”
Though councillors unanimously backed the report and its recommendations, Green Group leader councillor David Francis said that the council could do more, such as reassessing existing “indirect investments in the tobacco industry” in the council’s pension fund via “pooled funds it invests in.”
Source: Shields Gazette, 28 October 2021
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The latest results from the Tobacco Statistics 2020 survey published on Thursday 28 October by Finland’s National Institute for Health and Welfare show that daily smoking by people living in Finland continues to decline but the use of snus tobacco has increased amongst men.
The statistics show that about 12% of people living in Finland aged 20–64 smoked daily in 2020, 14% of men and 11% of women. Among men, smoking has declined since 2019, while for women the numbers are showing a slight uptick. Long-term, smoking in both sexes has declined significantly. At the turn of the millennium, nearly 30% of men and about 20% of women smoked regularly. Daily smoking among young people, 14–20 years-old, has also continued to decline, with 7% of boys and 5% of girls continuing to smoke daily in 2021. An estimated 7% of retirees (aged 65-84) smoke daily; consisting of 8% of men and 5% of women.
Regarding snus tobacco, about 7% of Finnish men aged 20–64 used snus daily in 2020, two percent higher than in 2019, whilst only one percent of women used snus daily in 2020. Snus was most common in the 20-34 age group, where 12% used the substance daily. The daily use of snus in young people aged 14 to 20 appears to be declining overall as in 2021 snus was only used daily by 5% of 14- to 20-year-olds, one percentage point less than in 2019. Turning to e-cigarettes, the data found that e-cigarettes were used daily by 1% of men aged 20-64 and fewer than 1% of women in 2020. Regular e-cigarette use is also generally low among young people.
Source: yle, 28 October 2021
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PQ1: Smoking
Asked by Sir George Howarth, Knowsley
To ask the Secretary of State for Health and Social Care, what plans he has to bring forward proposals for regulatory or legislative amendments as a result of the contents of the forthcoming Tobacco Control Plan for England.
Answered by Maggie Throup, The Parliamentary Under-Secretary for Health and Social Care
As part of the development of the new Tobacco Control Plan we are exploring a broad range of policies and regulatory measures to support our bold ambition to be smoke-free by 2030. These will be set out at a later date.
Source: Hansard, 27 October 2021
PQ2: Smoking
Asked by Virenda Sharma, Ealing, Southall
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to set a delivery plan and timetable for the forthcoming Tobacco Control Plan for England; and if he will make a statement.
Answered by Maggie Throup, The Parliamentary Under-Secretary for Health and Social Care
The Department is currently in the process of drafting a new Tobacco Control Plan. Once the Plan has been published, we will set out a delivery plan and timetable to monitor its progress, and to make sure we deliver our ambition to be smoke-free by 2030.
Source: Hansard, 27 October 2021
PQ3: Smoking and Young People
Asked by Dan Jarvis, Barnsley Central
To ask the Secretary of State for Health and Social Care, what assessment he has made of recent trends in smoking among young people in England; and what steps he is taking to reduce smoking prevalence in young people.
Answered by Maggie Throup, The Parliamentary Under-Secretary for Health and Social Care
Updated figures for the under 15 years old age range will be published in 2022.
The new Tobacco Control Plan will outline plans to protect young people from the harms of smoking in support of our ambition to be smoke-free by 2030.
Source: Hansard, 28 October 2021
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Yesterday (28 October), the Health and Care Bill committee debated several amendments on tobacco and related products tabled by Mary Foy MP. Responding for the Government, the Minister for Health Edward Argar reaffirmed the Government’s commitment to a Smokefree 2030 and said that the Government would consider all the policies proposed as part of the development of the upcoming Tobacco Control Plan, but opposed their inclusion in the Health and Care Bill. Two of the amendments – banning free distribution of e-cigarettes to under 18s and removing child friendly branding on e-cigarette packaging – were moved to a vote and defeated by the Government.
You can watch the debate here and read the transcript here.
If accepted, the amendments would have given the Secretary of State powers to:
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Introduce health warnings on cigarettes and cigarette papers.
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Introduce cigarette pack inserts with health information messaging.
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Introduce a 'polluter pays' levy to raise funding for tobacco control.
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Raise the age of sale for tobacco to 21.
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Close loopholes in existing regulations by:
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removing child-friendly branding from e-cigarette packaging.
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Ban free distribution of e-cigarettes to children under 18.
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Extend the tobacco flavour ban to all flavourings, not just those defined as 'characterising'.
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The MHRA has published new guidance on the licensing of e-cigarettes for prescription by the NHS. You can read the guidance here.
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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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