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** 26 July 2022
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** UK
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** Alcohol deaths from pandemic drinking are predicted to rise (#1)
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** Public spending in the north falls behind rest of England despite government's Levelling Up agenda (#2)
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** Jersey banning branding on cigarette packaging (#3)
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** Nottinghamshire County Council to improve support for the homeless (#4)
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** NHSE director accuses Sunak and Truss of ‘silence’ on mental health waits (#5)
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** International
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** US study: Scientists say raising taxes on vaping devices by just $1 will see a rise in people smoking (#6)
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** UK
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** Alcohol deaths from pandemic drinking are predicted to rise
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Heavy home drinking during the pandemic may lead to rises in alcohol-related deaths and illness in England, forecasters warn. The work, commissioned for the NHS, suggests even under the best-case scenario of people cutting back to pre-pandemic drinking levels, there could be 1,830 extra deaths within two decades. At worst it could be 25,000, along with a million extra hospital admissions.

The NHS-funded findings prompted fresh calls from health experts for more determined government action to reduce alcohol-related harm by tackling its price, availability, and promotion. The warnings come from two separate modelling studies - one by the Institute of Alcohol Studies and another by University of Sheffield. Both agree there could be a high toll of alcohol-related disease, premature deaths and hospital admissions, costing the NHS billions.

The studies also highlight that the impacts are not evenly distributed across the population, with heavier drinkers and those in the most deprived areas - who already suffer the highest rates of alcohol harm - expected to be disproportionately affected.

People who already drank moderately when the UK went into its first lockdown in March 2020 generally reduced their intake of alcohol while government-ordered restrictions on social mixing were in place. However, many of those who already drank heavily consumed even more at a time when pubs, restaurants and other places that sell alcohol were closed, leading to a sudden spike in deaths.

Colin Angus, who led the University of Sheffield study, said: "These figures highlight that the pandemic's impact on our drinking behaviour is likely to cast a long shadow on our health, and paint a worrying picture at a time when NHS services are already under huge pressure due to treatment backlogs."

Dr Sadie Boniface, from the Institute of Alcohol Studies, said: "Changes in alcohol use during the pandemic led to a 20% rise in alcohol-specific deaths in England in 2020, and the worrying trends continue. Our study projects that if alcohol consumption stays at current levels … inequalities in deaths from alcohol will also grow wider than they already are [...] This research should act as a 'wake-up call' to take alcohol harm seriously as part of recovery planning from the pandemic."

Source: BBC News, 26 July 2022

See also: Guardian - Lockdown drinking increase could cause 25,000 excess deaths in England ([link removed])
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** Public spending in the north falls behind rest of England despite government's Levelling Up agenda
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Public spending in the North has fallen behind the England average despite the Government's flagship "levelling up" policy, think tank IPPR North, a branch of the Institute for Public Policy Research, has said. IPPR North fellows state that despite the Government's rhetoric, the levelling-up agenda has in many ways been "business as usual".

According to the analysis, per-person public spending was higher in real terms in northern England in 2019 than the England average, but by 2021, the latest year of available data, it had fallen behind. Although public spending has increased in every region of England, the think tank said its research shows that in 2021 total public spending on the North was £16,223 per person, an increase of 17% on 2019, compared with the England average of £16,309 in 2021, which was an increase of 20%. That means per-person public spending in the North went from being £246 higher than the England average in 2019, to £86 under the average in 2021.

IPPR North said London saw the highest total per-person public spending and the highest increase, up 25% to £19,231. The spending gap between the North and the capital doubled during that period, it said, from a difference of £1,513 per person to £3,008. Yorkshire and the Humber received the lowest total per-person public spending in England in 2021, according to the analysis, at £15,540, and the lowest percentage increase compared with 2019 was in the North East, at 16%.

IPPR North said it also examined the data while excluding the spending on health and COVID-19 support to allow for the impact of the pandemic, but that it found the same trend, with £11,505 per person public spending in 2021 in the North, up 2% on 2019, compared to the England average of a 3% increase to £11,524.

Marcus Johns, a research fellow at IPPR North, said: "On public spending, the money simply didn't follow the levelling-up rhetoric. Although an increase in public spending on 2019 was welcome, and absolutely essential, spending is lower - and grew slower in the North - than in other parts of the country. At the same time, the country became more centralised and inequalities widened. This is because power is not distributed fairly in this country."

A Government spokesperson said: "We do not recognise these figures and are pressing full steam ahead with levelling up the North."

Source: Bloomberg, 26 July 2022

See also: IPPR North - Full press release ([link removed])
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** Jersey banning branding on cigarette packaging
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Packaging on cigarettes will be standardised in local shops in Jersey from Monday 1st August to try to reduce. New and bigger picture warnings will be added along with information on the island’s Help2Quit service, a spokesperson said.

Jersey's Director of Public Health, Prof Peter Bradley said: "It is hoped that this move will help islanders and deter young islanders from taking up the habit. Quitting smoking is one of the most important things people can do to improve their health [...] We have ongoing support for smokers to stop through the island's Help2Quit service and we are hopeful that all these actions together will work towards a generation of non-smokers."

Since 2017, tobacco control measures in Jersey have included increasing the cost of tobacco by 5% over inflation year on year and increasing the cost of rolling tobacco by 10%. Other actions to deter islanders from smoking include legislation in workplace and hospitality venues, restrictions on advertising, and smoke free cars for under 18s, the government said.

Source: BBC News, 26 July 2022
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** Nottinghamshire County Council to improve support for the homeless
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More support is planned for homeless people in Nottinghamshire suffering health problems to try to reduce the number of people sleeping rough repeatedly. The county council will renew and improve an existing contract, drawn up in 2018, to address new concerns and better support people out of homelessness, with plans revealed to significantly increase the help and guidance it offers to people.

In 2021, the existing provider supported 393 people across short-term hostels and a further 271 people in its ‘move-on’ longer-term programmes. When people use the service, existing providers create support plans, offer help with debts, refer residents to services to help quit smoking and deal with any addiction problems, and ensure their eventual exit is done in a planned way. A recent review found about 80% of people using the service have a mental health support need, while also identifying more than 60% need support applying for housing.

Major changes, coming into effect in April 2023, will see people experiencing homelessness offered further support with housing, accessing benefits as well as skills and employment support. The new contract will also offer access to healthcare, mental health services and social care assessments if needed, as well as help to identify issues with their health, exercise, diet and smoking. The service will continue to offer access to substance misuse services and provide further follow-up support for people exiting temporary accommodation

In a report, Jonathan Gribbin, director for public health in Nottinghamshire, said: “The service supports the needs of a vulnerable population that experience significant disparities in health, as well as other types of disadvantages that require additional input from a range of professionals. The intention is to be able to identify health and care needs of those that are experiencing homelessness earlier. [This] will require close liaison with health services including primary care services, mental health care, substance misuse services and social care assessment.”

Source: Newark Advertiser, 25 July 2022
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** NHSE director accuses Sunak and Truss of ‘silence’ on mental health waits
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NHS England’s national director for mental health has warned the “silence is deafening” from Conservative leadership candidates over the treatment backlog for mental healthcare. Claire Murdoch made the intervention on Twitter after former chancellor and contender to be the next prime minister Rishi Sunak outlined an emergency package to force down NHS waiting lists, which featured no mention of mental health.

The CEO of Central and North West London Foundation Trust wrote yesterday: “I repeat … will the mental health treatment backlog be treated with the same urgency [to physical elective care]? Or in other words, parity?” In a follow-up message this morning, she added: “The silence is deafening. And worrying.”

Over the weekend, Mr Sunak announced that if he was prime minister he would seek to eliminate 52-week referral-to-treatment waits by September 2024 after dubbing the elective recovery the “biggest public services emergency”. But there was no mention of measures to tackle the mental health backlog, which, according to latest estimates, stands at 1.6 million waiting for treatment, and does not feature in RTT figures. An additional 8 million people cannot get specialist help as they are not considered sick enough, according to NHS Providers.

There have been signs of sharply growing demand for some mental healthcare since the pandemic, with 1.6 million people in contact with services at the end of April 2022, according to figures published by NHS Digital in July. An additional £2.3bn a year is being invested to increase access to mental health services by 2023-24, as part of the NHS long-term plan. But as NHS England board papers from May make clear, “there is a historical treatment gap in mental health” which the body says the long-term plan is “seeking to reduce, but will not eradicate”.

Source: HSJ, 25 July 2022
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** International
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** US study: Scientists say raising taxes on vaping devices by just $1 will see a rise in people smoking
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**
Researchers at Georgia State University monitored 38,000 people aged 18 to 25 years and found raising the price of e-cigarettes by $1 per millilitre triggered a rise in the number smoking by 3.7% once the increase was implemented and a 2.5% drop in e-cigarette use.

In the study, published in the journal Addiction, scientists analysed data from the Current Population Survey — a monthly survey of households in the U.S. conducted by census officials. They looked at the number of youngsters aged 18 to 25 years old who said they smoked or vaped in each state from 2010 to 2019.

In the study, they also found people aged 18 to 25 were three times more responsive to price changes than older adults making them more likely to switch between them, and suggested taxes should be raised on both cigarettes and e-cigarettes at the same time to avoid youngsters switching to 'more lethal' cigarettes. They also pointed out the early 20s is a period when many switch from 'experimental' to 'daily' nicotine use.

A federal tax of $1 per pack is levied on cigarettes at present, with all states imposing their own additional charges. Chicago, Illinois, has the highest at $6 per pack. A total of 30 states apply their own tax rates on e-cigarettes at present, but there is no nationwide tax and these are on either the wholesale price or that per container. Minnesota has the highest wholesale tax rate at 95%, while the highest per container is in Kentucky at $1.50 each.

Dr Abigail Friedman, an associate professor of public health at Yale School of Public Health who led the study, warned some youngsters were changing how they consumed nicotine due to prices. She said: “People are substituting between products, and if you raise the price of one, some subset is going to switch to a less expensive option, even if they don't like that product as much [...] From a public health perspective, it is important that that less expensive option is also less harmful.”

Source: Daily Mail, 25 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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