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** 21 June 2022
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** UK
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** Government tobacco plan must tackle link between mental health and smoking, say psychiatrists (#1)
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** All you need to know about NHS Integrated Care Systems (#2)
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** I’m an eye doctor – here’s the crucial warning I give all patients who smoke (#3)
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** Scotland: NHS Lanarkshire partners with vets to raise awareness of harmful second-hand smoke (#4)
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** Scottish independence: SNP win over Big Tobacco may send referendum up in smoke (#5)
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** International
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** Opinion: Western Australia’s misguided vaping move will be a public health disaster (#6)
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** UK
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** Government tobacco plan must tackle link between mental health and smoking, say psychiatrists.

Smoking may increase the risk of developing schizophrenia by between 53% and 127% and of developing depression by 54% to 132%, researchers from the University of Bristol have said ([link removed]) .

In an evidence review presented at the Royal College of Psychiatrists International Congress 2022 in Edinburgh on 20 June, the research team highlighted studies that have suggested smoking could have a causal effect on both depression and schizophrenia, although they stressed that there is a “high degree of bidirectionality in these relationships.”

Co-author Marcus Munafo, professor of biological psychology at the University of Bristol, said, “There is no longer any doubt that smoking is bad for mental health and this needs to be a priority in the forthcoming Tobacco Control Plan [...] Those working with people with mental health conditions need to understand and address the vicious cycle of bidirectional effects, whereby having symptoms of mental illness causes people to smoke more and to be more likely to become addicted. At the same time, smoking increases the risk of subsequent mental illness and exacerbates mental health symptoms. Lower rates of smoking will improve overall levels of good mental health as well as physical health.”

Alongside the review, the charity Action on Smoking and Health and the Royal College of Psychiatrists’ Public Mental Health Implementation Centre have published a joint report ([link removed]) calling for the government’s upcoming tobacco control plan to tackle smoking in all people with a mental health condition, through targeted investment and effective data monitoring systems.

Smoking rates are higher among people with mental health conditions than those without. In England, 13.9% of adults over 18 smoke, while 26.3% of adults with a long term mental health condition smoke.

The organisations have also called for Improving Access to Psychological Therapies services to include support for smokers to quit and for national communications campaigns on promoting positive mental health to include messages about the benefits of stopping smoking and avoiding starting. Similarly, it said national “stop smoking” communications should include the benefits to mental health.

Deborah Arnott, Chief Executive of ASH, said: “The Khan Review is called ‘Making Smoking Obsolete’ – this cannot be achieved if we ignore the more than a million smokers with mental health conditions. While the NHS has started to roll out support to quit for those with severe mental illness there is little provision for those with common mental health conditions like depression and anxiety – a plan is needed.”

Commenting on the two reports, Royal College of Psychiatrists president Adrian James said, “Smoking addiction is not a trivial matter, it causes serious harm to both body and mind. Smokers with mental health conditions can quit with the right support from healthcare professionals. It’s our duty as psychiatrists to offer them the help they need to succeed.”

Source: BMJ, 21 June 2022

See also: Smoking causes depression and schizophrenia, new report finds ([link removed])
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Marking a new era for UK healthcare, the NHS across England is being divided into 42 new NHS bodies called Integrated Care Systems (ICS). From the 1st July, these local partnerships will take responsibility for the commissioning of most NHS services, bringing the NHS together with other key partners, such as local authorities – each being overseen by an Integrated Care Board (ICB).

ICSs will take over the functions of Clinical Commissioning Groups (CCG) overseeing local primary care, establishing strategic priorities, deciding how money is spent, and tackling current challenges such as obesity. ICSs will also be given new powers, for instance taking on delegated responsibility for pharmaceutical, general ophthalmic and dental services by next April.

In the North East, existing CCGs will be replaced by the North East and North Cumbria ICS and board, which health chiefs hope will ultimately provide the best care for communities.
Overall public health in the North East is still amongst the worst in the country, despite having health and care services consistently rated amongst the best in the country. Although there have been many improvements in recent years, for example the number of people dying from cancer or heart disease has decreased, fewer people are smoking and many are living longer; healthy life expectancy remains amongst the poorest in England.
North East and North Cumbria ICS chairman, Professor Liam Donaldson, the UK’s former chief medical advisor, said: “We want to change this by working together as an Integrated Care System whereby every partner organisation is fully committed to and focused on creating a common purpose and joint determination to drive improvements in health, wealth and wellbeing.”

The ICS says most of its work will continue to be focused in places and neighbourhoods, but the new structure is a way for us to “work together on regional issues that need to be tackled at scale [...] Through closer working with our local authorities and all our partners, our ambition is to also bring together not just health and social care but also education, planning, housing, environmental health and leisure services for the benefit of local communities.”

Source: Darlington and Stockton Times, 21 June 2022

See also: Video from the King’s Fund explaining ICSs ([link removed])
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Every year thousands of these people will suffer health issues related to their smoking.

Contact lens optician Sujata Paul has highlighted the often overlooked health effect of smoking, its negative impact on our sight. Paul explained that smoking can increase your risk of serious eye conditions that in some cases may lead to permanent vision loss, including age related macular degeneration (AMD), cataracts and glaucoma.

"On a short-term perspective, tobacco smoke can also cause dry eye syndrome, leading to irritated and painful eyes."

Paul recommends booking an eye exam should you notice changes in your sight, often the most effective method to spotting any eye disease early. In order to improve the health of your eyes, Paul stresses quitting smoking will help prevent any long term damage to your eye health.

Source: The Sun, 20 June 2022
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The Lanarkshire health board is running a campaign with vet surgeries to protect pets and children from second-hand smoke.

Quit Your Way, the health board's team is hoping to emphasise the harmful effects exposure to smoke has on pets of all kinds including dogs, cats, birds, guinea pigs and even fish, amongst others. They also provide free support and information as well as free Nicotine Replacement Products should their clients wish to quit smoking altogether.

Health improvement senior in NHS Lanarkshire, Queensley Ajuyakpe, said: “We want to give our family the best and healthiest lives we can, and this includes our pets [...] Many Lanarkshire residents love their pets like additional family members and may not be aware that their pets are at risk of health issues from exposure to second-hand smoke. Sharing this important information with local vets will hopefully lead to more residents making their homes and car smoke-free.”

Veterinary surgeon, David Gardner-Roberts, said: “Smoking tobacco is harmful to pets in the same way it’s harmful to other people in our home. Although the smoke we see disappears quickly, the particles are so small that 85% of them are invisible and odourless. The levels of invisible but harmful toxins in the air can linger for up to five hours afterwards and pose a threat to pets of all kinds [...] Encouraging a smoke-free environment for children, families and pets can help protect them from inhaling the same toxic chemicals found in tobacco smoke, as there is no safe level of second-hand smoke.”

Source: Glasgow Evening Times, 20 June 2022
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A 2012 Scottish Government decision to take on Big Tobacco over cigarette vending machines may have inadvertently damaged the Scottish National Party’s (SNP) hopes of holding a second independence referendum, legal experts have claimed.

A decade ago Imperial Tobacco argued against Scottish legislation to scrap cigarette vending machines, claiming the law was illegal as it related to the sale of goods and product safety laws, which are reserved to Westminster. However, Scottish ministers argued successfully that the law was a health measure and devolved to Holyrood.

While the Scottish Government won the battle, they may have lost the constitutional war as the case featured a lengthy legal debate on the nature of the Scotland Act, as it was the first time Holyrood’s competence was tested in this way.

The Supreme Court weighed up whether the act was like a constitution — open to wide interpretation — or like any other Westminster law and subject to strict enforcement. Judges ruled that the Scotland Act created Holyrood as an extension of the UK legislature, and it was therefore bound by it. The Imperial Tobacco case has been cited in cases since, including the SNP’s efforts to keep the Scottish parliament aligned with EU law after Brexit.

Torrance cites legal experts who say any act which enables a Scottish independence referendum, even if it is advisory or consultative and is not legally binding, would “relate to a reserved matter”, as the constitution of the UK is reserved to Westminster.

Source: The Times, 21 June 2022
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** International
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The West Australian (WA) government is threatening to destroy the retail vape industry in Western Australia with massive fines for selling vaping products and nicotine-free liquids, Dr Colin Mendelsohn, Australian Tobacco Harm Reduction Association Founder writes in WA Today. He warns these measures ensure “that only the black market and tobacco companies will ultimately benefit.” Rather than address increases in youth vaping, the move will instead harm current adult smokers and ex-smokers who have successfully quit smoking by vaping.

Vape stores were informed of the crackdown by letter last month and were told they could face up to $80,000 (£45,000) in penalties [...] Cracking down on small businesses who help tens of thousands of adult West Australians remain smoke-free will be a “public health disaster” according to Mendelsohn.

Mendelsohn explains: “The current legislation in WA, the Tobacco Product Control Act 2006, bans the sale of devices that look like cigarettes. This has always been the case, but if it does begin these enforcement activities by cracking down on vaping-related goods, including individual components of vaping devices, batteries, and nicotine-free liquids, this would shut down vape stores across the state, leaving only the black market in operation.”

He continues that the campaign, based on the New South Wales (NSW) Health ‘Do you know what you’re vaping?’ campaign, is ripe with misinformation. The new proposal he warns “leaves the black market free to expand and continue selling unregulated, high-nicotine disposable vapes to young people [...] The state government should address illicit sales to youth by policing and enforcing the laws to prevent the sale of illicit, dodgy vaping products.”

Mendelsohn states that WA government should adopt an approach to vaping products similar to New Zealand and the United Kingdom, to “include mandated ingredients lists, ensure chemical additives are safe, and enforce strict minimum age-of-sale laws like those which apply to combustible cigarettes and alcohol” so that smokers can quit with vaping as an aid, and be able to do so safely.

Source: WA Today, 21 June 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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