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** 12 April 2022
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** UK
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** No new licence applications for e-cigarettes since UK medicines regulator changed its guidance (#1)
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** Underage vaping in Essex now a “contemporary issue” (#2)
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** Sheila Oxtoby: Partnerships should understand communities before defining structures (#3)
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** International
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** USA: Is Joe Biden Banning Vapes? Nicotine Products Could Be Removed Under Law (#4)
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** Deaths from noncommunicable diseases on the rise in Africa (#5)
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** UK
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** The Medicines and Healthcare products Regulatory Agency (MHRA) has not received any applications from companies to licence e-cigarettes as medicines to aid smoking cessation, since regulatory guidance was updated six months ago.

In October 2021, MHRA published updated guidance for licensing electronic cigarettes and other inhaled nicotine-containing products as medicines to support smoking cessation.

At the time, the Department of Health and Social Care said that the update “paves the way” for medicinally licensed e-cigarette products to be prescribed on the NHS, in what would be a “world first”.

The MHRA said the guidance, which was first published in December 2017, related to “quality standards for dose uniformity, non-clinical toxicological data requirements, and the design of the clinical pharmacokinetic studies”.

However, in a statement made to The Pharmaceutical Journal on 5 April 2022, the MHRA said that it was yet to receive any licensing applications from manufacturers since the update.

Deborah Arnott, chief executive of ASH, said: “Making an application for a medicinal license requires the pulling together of a very detailed dossier which can take significantly longer than six months.”

“That no applications have yet been made is no reflection on consumer e-cigarettes currently on the market, which already meet safety standards which are set and overseen by the MHRA.”

“Around 3.6 million people use e-cigarettes in Great Britain, so if there were serious safety concerns about e-cigarettes currently on the market we would have expected the MHRA’s yellow card monitoring system to have picked them up by now.”

Source: The Pharmaceutical Journal, 7 April 2022
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** Speaking with the Basildon, Canvey and Southend Echo, a headteacher from Colchester, has reported that “Vaping among students is becoming more of a problem.” With some anecdotal evidence suggesting they are being bought by school students - even those still wearing their uniforms – without being asked for proof of age.

A previous study by ASH found the most common way of accessing e-cigarettes among 11 to 17-year-olds was through shop purchase. The study found 42 per cent bought e-cigarettes over the counter while 20 per cent of 11 to17-year-olds purchased the vapes and the juices online.

And while vaping is used as a tool in giving up smoking, the practice is not without risk.

The headteacher said: “The student bulletin has identified a number of shops in town where vapes are cheap and easy to get, with no ID required.”

Hazel Cheeseman, deputy chief executive of ASH, said: “Underage vaping is a cause of concern though it is unlikely to cause the damage that underage smoking does.”

Source: Basildon, Canvey and Southend Echo, 9 April 2022
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Chief executive of Great Yarmouth borough council, Sheila Oxtoby, shares the experiences of Norfolk and Great Yarmouth’s councils as part of a new Integrated Care System (ICS) and advice for other councils building new partnerships.

Oxtoby highlights the importance of working at ‘place’ level, prioritising “understanding people and communities” and agreeing upon a shared purpose at the outset. She argues that identifying common aims between trusts and community boards “allows partnerships to be built on an ethos of equality across sectors, organisations, professionals and communities.”

Oxtoby also highlights Norfolk’s already close connection with its community as a key strength for the new ICS to build upon at both neighbourhood and ‘place’ level. She concludes by arguing that building on these pre-existing strengths and relaitonships with communities will “[...]allow the power and funding – and more importantly the improvements on the ground – to follow”.

Source: LGC, 12 April 2022

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** International
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** A new law is set to take effect this month that will see some vaping products that use synthetic nicotine pulled from the shelves if they fail to receive authorization from the Food and Drug Administration (FDA).

The spending bill amended the Federal Food, Drug, and Cosmetic Act (FDCA) to define a tobacco product as "any product made or derived from tobacco, or containing nicotine from any source, that is intended for human consumption."

This change is not a ban on vaping or vaping products generally but it could have major consequences for producers and consumers of e-cigarettes and potentially see popular products withdrawn.

Previously, some producers of e-cigarettes had turned to synthetic tobacco in their products after a new rule was introduced in 2016 requiring e-cigarette companies to prove to the FDA that their products did more good to public health than harm.

Synthetic nicotine products on the market as of 14^th April can continue to be sold until 14^th May but if companies want their products to remain on the market after that date, they must make a premarket tobacco product application (PMTA) to the FDA by 14^th May.

Source: Newsweek, 12 April 2022
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** Noncommunicable diseases such as cancer, cardiovascular diseases and diabetes are increasingly becoming the main cause of mortality in sub-Saharan Africa, where the diseases were responsible for 37% of deaths in 2019, rising from 24% in 2000 largely due to weaknesses in the implementation of critical control measures including prevention, diagnosis and care. This comes on the eve of a high-level heads of state and health leaders meeting in Ghana to find ways of accelerating progress against noncommunicable diseases.

In Africa, between 50% and 88% of deaths in seven countries, mostly small island nations, are due to noncommunicable disease, according to the 2022 World Health Organization (WHO) Noncommunicable Disease Progress Monitor. The report also finds that in seven other countries – the majority of them being Africa’s most populous – the diseases claimed between 100 000 and 450 000 lives annually.

The rising burden of noncommunicable diseases will exert pressure on treatment and care services. In the African region, the number of people living with diabetes, for example, is expected to reach 47 million by 2045 up from 19 million in 2019.

“The growing burden of noncommunicable diseases poses a grave threat to the health and lives of millions of people in Africa: over a third of deaths in the region are due to these illnesses. What is particularly concerning is that that premature deaths from noncommunicable diseases are rising among people younger than 70 years,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

The heads of state and health leaders meeting for the inaugural International Strategic Dialogue on Noncommunicable Disease and the Strategic Development Goals on 12 April are expected to agree on an initiative to boost progress towards the key Sustainable Development Goals of reducing mortality from noncommunicable diseases by 30% by 2030. The meeting will also agree on ways to speed up the efforts to achieving the key targets of universal health coverage that include access to quality, safe, effective and affordable health care.

Source: WHO Africa, 11 April 2022
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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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