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** 18 July 2022
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** UK
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** Chinese vaping giant flouting UK advertising rules on selling to children (#1)
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** Nottinghamshire records higher than average number of pregnant smokers (#2)
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** Restriction on hip and knee ops for obese patients and smokers could be scrapped (#3)
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** International
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** Australia: Newcastle based study finds ways to help Aboriginal women quit smoking (#4)
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** US: E-cigarette maker Juul to explore options including financing (#5)
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** UK
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** Chinese vaping giant flouting UK advertising rules on selling to children
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** Leading e-cigarette brand, Elf Bar, is flouting rules to promote its products to young people in Britain, an Observer investigation has found, as experts warn that brightly coloured, sweet-flavoured vapes are being used by children as young as seven.

The Chinese-owned vaping giant that has seen the use of its products by under-18s increase in the past year, is being promoted by social influencers, who in some cases claim to be paid for the promotions and benefit from free products.

The videos – many of which show influencers vaping on camera – are not age restricted and are not always clearly marked as ads. Some have attracted hundreds of thousands of views on the short-form video app TikTok, which is used by half of eight to 11-year-olds and three-quarters of 16 to 17-year-olds.

The promotions, which appear to break rules prohibiting e-cigarette advertising on social media, are seemingly part of a push by Elf Bar to reach new customers in Britain, including campaigns on buses and billboards and giveaways of its products. TikTok this weekend removed two accounts promoting Elf Bar products after being alerted to them by the Observer.

The UK vaping market is worth more than £1bn a year, but public health experts are alarmed that disposable vapes such as those made by Elf Bar, which cost as little as £3.99 each, are leading to increased use among young people.

Selling e-cigarettes to under-18s is illegal, but they are easy to buy online and on the high street.

The Association of Directors of Public Health (ADPH) said this weekend it wanted to see tighter regulations to ban brightly coloured packaging such as that used by Elf Bar and a review of flavours likely to appeal to children.

In Britain, while the number of young people who use e-cigarettes is relatively low, research suggests the figure is growing. A survey by YouGov and ASH ([link removed]) found that the proportion of children aged 11 to 17 who vape has risen from 4% in 2020 to 7% in 2022. The percentage of children who had tried vaping has also risen, from 14% to 16%.

More than half the children who vape said disposable e-cigarettes were their preferred product – up from 7% in 2020 – and the most popular brand among them was Elf Bar.

ASH, which promotes vaping as a healthier alternative to cigarettes, said ads for Elf Bar were “problematic” and helped “drive the perception of glamour around these devices”.

Hazel Cheeseman, the charity’s deputy chief executive, said: “The value of e-cigarettes for public health is as an aid to quitting smoking, but it doesn’t seem that they’re positioning these products as an alternative to smoking cigarettes. They’re promoting them as an enjoyable experience in their own right.”

Source: The Guardian, 17 July 2022
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** Nottinghamshire records higher than average number of pregnant smokers
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** Nottinghamshire has a higher than national average number of pregnant smokers according to data from the NHS ([link removed]) which revealed that women who gave birth in Nottingham and Nottinghamshire Health and Care facilities are some of the most likely to be smokers in the East Midlands.

The data shows that from April 2021 to March 2022 there were 1,202 women across Nottinghamshire who were known to be smokers at the time of delivery, equivalent 13% of the 9,380 births in Nottingham and Nottinghamshire.

Nottingham and Nottinghamshire recorded the highest number of known pregnant smokers in the East Midlands as well as being higher than the national average of 9.1%.

There is a no smoking policy in place at all Nottingham University Hospital sites for patients, visitors and staff. In 2019, the government proposed that England should be 'smoke free' by 2030 and the NHS has an ambition for the reduction of smoking in pregnancy in its Long Term Plan.

Hazel Cheeseman, Deputy Chief Executive at ASH, said: "Smoking during pregnancy is a leading cause of stillbirth, miscarriage and birth defects. Growing up in a house with smokers also puts children at greater risk of smoking themselves.”

"Pregnant smokers should get support and medication to help them quit and this support is being stepped up through a new NHS programme.”

"While this is welcome smoking rates remain far higher than Government target of 6%. Government must implement the recommendations of a recent independent review of smoking, including providing financial incentives to help women to stop smoking in pregnancy."

Source: Nottinghamshire Live, 17 July 2022
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** Restriction on hip and knee ops for obese patients and smokers could be scrapped
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** Controversial restrictions blocking obese patients and smokers from routine surgery for up to a year are being reviewed by NHS bosses amid concerns over postcode lotteries for treatment.

Thousands of people from Yorkshire are believed to have been affected by delays imposed by health officials for patients to lose weight or quit smoking ahead of surgery.

The measures have led to significant variations in access to treatment for planned operations including routine hip and knee replacements and hernia repairs depending on where people live in the region.

The Yorkshire Post reports delays in referrals for treatment for six or 12 months have been imposed in Rotherham, Barnsley, the East Riding, York and North Yorkshire, excluding Craven but not in other parts of the region including Hull, Sheffield and West Yorkshire.

Health chiefs have ordered the reviews following the latest NHS reorganisation which saw 15 clinical commissioning groups (CCGs) serving the region abolished and replaced by three integrated care systems at the beginning of July.

The review decision has been welcomed by surgeons’ leaders who called for the “unfair” thresholds to be abandoned.

Prof Neil Mortensen, president of the Royal College of Surgeons, said: “Rationing surgery on the basis of BMI or smoking was an unhelpful tactic of some CCGs so it’s vital that the new integrated care systems review this approach […]”.

Source: The Yorkshire Post, 18 July 2022
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Read Article ([link removed])


** International
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** Australia: Newcastle based study finds ways to help Aboriginal women quit smoking
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**
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** A new study by researchers at the University of Newcastle and Hunter Medical Research Institute is set to help Aboriginal and Torres Strait Islander women quit smoking.

The “Which Way?” findings, published today in the Medical Journal of Australia, is the first Indigenous-led study developed for, and by Aboriginal and Torres Strait Islander women to develop ways to quit smoking.

University of Newcastle research fellow Michelle Kennedy who led the three-year study to find culturally effective quitting methods, said: "A lot of evidence that we use when we are developing or implementing services to quit smoking are drawn from the general population or even overseas and implemented in an Aboriginal community and what we find is that they are usually not successful".

The project specifically looked at what is of interest to women of reproductive age to try and stop them from smoking before or during their first pregnancy, or ahead of subsequent pregnancies.

Dr Kennedy continued: "We know that [smoking in pregnancy] impacts our low birth weight babies which is a real concern because that hasn't changed much over the years of the campaign but we have never found that thing that is going to help empower Aboriginal women to quit smoking in pregnancy."

A survey as part of the research involved more than 400 Aboriginal and Torres Strait Islander women and found that most have made, and are continuing to make, attempts to quit smoking.

Data involved smokers and ex-smokers, assessed the differences in age and geographic location and looked at the systemic embedding of tobacco-use on First Nations peoples and how those factors impacted quitting attempts. The women involved in the survey said they were interested in non-pharmacological support to quit smoking such as meditation practices and cultural practices that will bring the community together to help each other quit.

Dr Kennedy said now that the study is complete, they must find ways to implement the findings into the community, and get rid of the "one-size fits all quitting approach."

Source: Newcastle Herald, 18 July 2022
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See also - The Medical Journal of Australia - Smoking and quitting characteristics of Aboriginal and Torres Strait Islander women of reproductive age: findings from the Which Way? study ([link removed] )
Read Article ([link removed] )


** US: E-cigarette maker Juul to explore options including financing
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** Juul Labs Inc said on Friday it is in the early stages of exploring several options including financing alternatives, as the company deals with lawsuits and a probable ban on sales of its e-cigarettes the FDA.

Bloomberg News earlier reported that Juul's bankers at Centerview Partners are sounding out investors for a possible $400 million first-lien term loan due August 2023.

The proceeds would help refinance an existing term loan, which has around $394 million outstanding and matures on the same date, the report added.

Centerview Partners declined to comment when contacted by Reuters.

Bloomberg News in its report said Juul was also considering a new $150 million second-lien term loan, which may have an August 2024 maturity, to help pay down some of the first-lien term loan and to increase liquidity.

Financing proposals for either loan are due 21 July, according to the report.

Source: Daily Mail, 15 July 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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