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** 25 November 2021
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** UK
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** Government considering single leader for local NHS and care services (#1)
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** Lung cancer experts fear extra 2,500 deaths from stay-at-home advice (#2)
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** More cigarette stubs found on Welsh beaches than ever before (#3)
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** International
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** Births, smoking and alcohol consumption all declining in Ireland, health report shows (#4)
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** Ghana completes ratification process for illicit trade in tobacco products protocol (#5)
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** Parliamentary Activity
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** Parliamentary question (#6)
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** UK
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**
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** A single person would be accountable for planning health and care services in each local area under plans being reviewed by the government, HSJ has learned. Senior sources involved in the work confirmed to HSJ that the proposal could be included in the government’s planned integration white paper, which may be published before Christmas.

HSJ’s sources said a key principle being explored at present was that each local area, referred to as “place”, would share a person who was accountable for both NHS services (reporting to the NHS integrated care board, part of the integrated care system), and for overseeing social care (for which they would be responsible to their local council). A Whitehall source said the aim was to ensure integration of health and social care services was pushed forward in all areas, rather than only in a smaller number of pioneers, and to ensure a clear understanding for each local area of accountability outcomes and delivery. Sources also stressed the plans were subject to ongoing discussions, and there would be further engagement on how they are implemented.

NHS Confederation chief executive Matthew Taylor said the prime minister has a “preference for accountability to rest in the hands of a single named person”. He added ICSs could be asked to nominate these individuals, but this should be done without undermining the “widely supported framework enacted by the Health and Care Bill.”

Another part of the white paper plan under discussion would require each area (place) to agree on a single set of measures for which it would be held responsible. Whether these would all be set locally, or some nationally is subject to an ongoing discussion. Proposals for encouraging or requiring areas to pool budgets across the NHS and local government in each place, and the extent of any national requirements, are also being debated. However, sources played down the prospect of government mandating substantial pooling of budgets.

Source: HSJ, 24 November 2021
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** A charity has warned that staying at home guidance for people with a cough during the pandemic could fuel 2,500 additional lung cancer deaths. The UK Lung Cancer Coalition (UKLCC) said improvements in survival occurring before COVID-19 are now in “jeopardy” unless urgent action is taken. In a new report, the UKLCC estimates that delays in diagnosis caused by COVID-19 lockdowns and restrictions may result in a drop of up to 5.3 % in five-year survival in England. The report calls for a national screening programme across the UK and twice-yearly national and regional public awareness campaigns linked to a dedicated lung cancer helpline.

Lung cancer is a leading cause of death in the UK, accounting for around 35,100 deaths every year. About 80% of lung cancer deaths are caused by smoking, with many others caused by exposure to second-hand smoke.

Professor Robert Rintoul, chair of the UKLCC’s clinical advisory group, said: “Prior to the pandemic, real progress was being made in raising five-year survival rates. But COVID-19 has had a devastating impact on early diagnosis of lung cancer and has compromised our target of driving up five-year UK survival to 25% by 2025. Lung cancer patients have been disproportionately affected by the pandemic. […] We need to take urgent action to get back on track.”

Source: The Telegraph, 25 November 2021

See also: The route back to 25 by 25 ([link removed])
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** The amount of waste washing up on the UK’s beaches is falling year by year, according to the results of the 2021 Great British Beach Clean, organised by the Marine Conservation Society (MCS). Volunteers found 385 pieces of litter for every 100 metres of beach on average, down from 425 in 2020 and 558 in 2019. In Wales, an average of 414 litter items was found, with figures steadily dropping over the last five years in the country. Single-use plastic bags have fallen from a high of 13 for every 100 metres in 2013 down to three in 2021. However, about 82% of litter collected from Welsh beaches this year was made of plastic or polystyrene, followed by cigarette butts.

The number of cigarette stubs on beaches more than doubled from 2020 to 2021, with this year’s average an all-time high for Welsh beaches, with 64 stubs found per 100m. In 2018, 56 stubs per 100m were discovered on average, declining to 33 in 2019 and just 9 in 2020. As a result, the MCS is working with peers at ASH Wales to call for a ban on plastic in cigarette filters and action to reduce smoking-related litter.

Suzanne Cass, CEO of ASH Wales, said: “... Cigarettes are not only damaging to public health, but are also harmful to the environment. It is estimated that 4.5 trillion cigarette butts are dropped across the planet each year, which ultimately leach harmful chemicals into natural habitats. More needs to be done. I would encourage decision-makers to take on board this rise in cigarette waste, and implement stronger safeguards to protect our coastline. Our longstanding campaign Smoke Free Beaches addresses this head on, calling for beaches to be smoke and cigarette butt free. If projects such as these became policy it would protect our coastline for years to come.”

Source: West Wales Chronicle, 25 November 2021
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** International
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** A new report from the Department of Health shows that those aged 15 and older drank, on average, 10 litres of alcohol last year, down from 14 litres in 2000. In the last 20 years, the amount of cigarettes consumed per person has dropped considerably, from about 2,300 to 700 cigarettes per year.

The average life expectancy of people in Ireland has also increased to 80.8 years for men and women as of 2019. This is the sixth-highest life expectancy in the EU. Ireland also has the highest self-perceived health status in the EU, with 84% of people rating their health as good or very good. The number of people reporting a chronic illness or health problem is also better than the EU average, at around 25% of the population.

Age-standardised mortality rates have also declined for all causes over the past decade by 16%, but the most notable declines were seen in suicide (-41.6%), pneumonia (-49.4%) and stroke (-44.9%). Infant mortality has also decreased by 22.2% since 2010 and remains below the EU average. The number of people seeking treatment for alcohol problems fell between 2011 and 2020, but there was an increase in the number that sought treatment for drug issues.

Source: Independent.ie, 24 November 2021
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** Ghana has joined the list of countries to have finalised ratification of the Illicit Trade in Tobacco Products Protocol, depositing the legislative instrument at the Treaty Section of the United Nations Secretariat on October 22. The Protocol, containing measures to combat illicit tobacco including prevention, enforcement, and international cooperation, will come into force on 20 January 2022.

Ghana has already taken measures to implement the Protocol with the Ghanaian Food and Drugs Authority (FDA) present at all border posts in the country and working closely with other border control agencies to intercept illegal tobacco products. The FDA oversees the registration of tobacco companies, imports, sales, and product monitoring. It has implemented various measures to easily identify illicit products including product labelling, emission statements, and health warnings.

Source: My Joy Online, 23 November 2021

See also: WHO FCTC - Protocol to Eliminate Illicit Trade in Tobacco Products ([link removed])
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** Parliamentary Activity
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**
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** House of Lords: Smoke-free Pavements

Yesterday (24 November), Baroness Merron, Shadow spokesperson for Health and Social Care, tabled an oral question to ask, “Her Majesty’s Government what plans they have to introduce rules on smoke-free pavements outside pubs and restaurants.”

In response, Lord Greenhalgh, Minister of State, Home Office and Department for Levelling Up, Housing & Communities, said:
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** The temporary pavement licence provisions introduced in the Business and Planning Act 2020 and subsequently extended have a national smoke-free condition requiring businesses to provide seating where smoking is not permitted.
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** Local authorities can attach their own conditions, including those that prohibit smoking entirely.
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** The Government has committed in principle to making the pavement licensing permanent and will provide further details in due course.
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** He is working closely with the Minister and colleagues at the Department of Health.
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** The Government has not committed to how they plan to proceed with this legislation, but it is important to reduce smoking while reviving the economy.
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** Lord Faulkner of Worcester, who passed his motion to regret the Government’s failure to require COVID-19 related seating outside cafes, pubs, and restaurants to be smokefree, asked the Government to investigate the experiences of the ten local authorities that have chosen to pursue 100% smokefree pavement licenses to see if they have encountered any problems and, more importantly, if the hospitality industry has suffered economically.

Lord Greenhalgh, in response, admitted that lessons needed to be learnt from areas that had pursued 100% smokefree pavement licenses and that the Government would look at their experience carefully.

Source: Hansard, 24 November 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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