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** 18 December 2019
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** UK
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** Instagram e-cigarette posts banned by Advertising Standards Authority (#1)
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** Sir Norman Lamb to chair major London trust (#2)
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** "Cash for scrutiny" is new government’s deal for the NHS (#3)
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** Study: "Little difference" in risk of developing lung infections from vaping and smoking (#4)
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** International
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** USA: Age of sale likely to rise for cigarettes and e-cigarettes (#5)
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** Austria: Vienna's ballet academy "encouraged children to smoke to stay slim" (#6)
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** UK
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**

Four vaping companies, including British American Tobacco (BAT), have had Instagram posts promoting e-cigarettes banned by the Advertising Standards Authority (ASA). The posts showed models and celebrities such as Lily Allen holding electronic cigarettes. The advertising of these products is banned on social media. The complaint was backed by UK anti-smoking groups Action on Smoking and Health (ASH) and Stopping Tobacco Organisations and Products (STOP).

The four vaping companies under scrutiny were British American Tobacco (BAT), Ama Vape, Attitude Vapes and Global Vaping Group. The companies were accused of promoting nicotine-containing e-cigarettes and featuring models who appeared to be under 25, which is banned under the advertising code. In its response, British American Tobacco said its online communications "aimed to impart factual information regarding products but stopped short of direct or indirect promotion".

ASH chief executive Deborah Arnott said: "The law has always been clear that any advertising of e-cigarettes online is not permitted. BAT's defence that all they were doing was providing 'information' on social media not promoting their products has been blown out of the water. The ASA ruling leaves no doubt that BAT's social media tactics for Vype were both irresponsible and unlawful and must never be repeated."

The ASA ruled the posts must not appear again in their current form. It told all four companies posts promoting nicotine-containing e-cigarettes "should not be made from Instagram in future" unless steps were taken to make sure they could not be viewed by under-18s and the people featured must be 25 or older.

Source: BBC News, 18 December 2019
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Former health minister Sir Norman Lamb has been appointed chair of a major south London mental health trust. The former Liberal Democrat MP for North Norfolk will chair South London and Maudsley Foundation Trust from March 2020.

Sir Norman is well known for campaigning to improve mental health, learning disability and autism services. While health minister in 2015, he launched the government’s Future in Mind initiative, which looked at the improvement of children and adolescent mental health services. This year he received a knighthood in the Queen’s birthday honours for his public and political service, notably his contribution to mental health.

Sir Norman announced he intended to step down as an MP in August and, in a statement, said he wanted to “focus” his efforts on issues such as “the cause of equality for people with mental ill health and those with learning disability and autism”.

In 2016, Sir Norman told HSJ of his daily fight to keep mental health on the government’s agenda, which he said “did not get a look in” at performance meetings until the first waiting times for Improving Access to Psychological Therapies were introduced.

Source: HSJ, 17 December 2019
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Richard Sloggett, former special adviser to the secretary of state for health and social care, has said that the new Conservative government under Boris Johnson will put the NHS under greater scrutiny, as they provide more funding:

“This more hands on style will be seen initially through the publication of an NHS Bill. Embedding the long-term plan cash within legislation will be a primarily symbolic exercise, but good politics. New backbench Conservative MPs will stand up in the chamber and be able to promote and argue for what the plan (and other funding) will mean for their area. Labour, divided after an election, will struggle to develop a coherent response.”

“The NHS, keen to see elements of the Lansley Act reversed, will get its wish in the detail of the Bill, but with strings attached. The development of metrics for the plan presents a first test for this new world order. What will the NHS be asked to report on? How frequently and who will it be answerable to?”

“The issue of changes to waiting time targets also looms large. A path exists to make revisions on clinical advice, but the public perception and threat looms of a downgrade that is being undertaken by a system no longer able to deliver on constitutional commitments. This will require expert system and political handling to manage.”

Source: HSJ, 17 December 2019
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A new study has found “little difference" in the effect of tobacco smoke and e-cigarette vapour on bacteria often found in the lungs. Queen's University Belfast researchers found an increase in the potential of bacteria to cause harm when exposed to both. Both can lead to chronic obstructive pulmonary disease (COPD), an umbrella term which includes emphysema and bronchitis, and asthma, they said. The study’s authors are calling for "urgent" further research into the long-term effects of vaping.

Researchers compared the effects of smoke extracted from Marlboro Red cigarettes to the vapour from a best-selling device. The paper read: "Exposure of respiratory pathogens to e-cigarette vapour induced changes in phenotype and virulence, which may increase bacterial persistence and inflammatory potential. These changes were similar, and in some cases exceeded, those observed following bacterial exposure to cigarette smoke and suggest that there is little difference between the effect of (cigarette smoke and e-cigarette vapour). There is therefore an urgent need for further robust clinical studies investigating and clarifying the long-term effect of e-cigarette use on both airway cells and respiratory pathogens, to enable a better-informed judgment to be made regarding their safety."

Dr Deirdre Gilpin, researcher from the School of Pharmacy at Queen's University and lead author, added: "This study shows us that vaping may carry the same risk as cigarette smoke in increasing the susceptibility to bacterial infection."

Experts generally agree that vaping is safer than smoking. The authors of the current study say that to fully assess the changes, tests on mammal models need to be undertaken.

They also say they may have underestimated the exposure of the bacteria to e-cigarettes because they used similar delivery methods for the vapour and tobacco smoke. In practical terms, research has found that e-cigarette users typically take larger and longer puffs compared with traditional smokers.

Source: Evening Standard, 18 December 2019

See also:
Res
piratory Research. Electronic cigarette vapour increases virulence and inflammatory potential of respiratory pathogens. ([link removed]) December 2019
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** International
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US Congress is moving to pass the biggest new sales restrictions on tobacco products in more than a decade, with support from two unlikely backers: the Marlboro cigarette maker, Altria, and the vaping giant Juul. The legislation would raise the minimum age to purchase all tobacco products, including electronic cigarettes, from 18 to 21 nationwide. Juul and Altria, the vaping company’s biggest investor, threw their support behind the effort this year amid a backlash against e-cigarettes at the local, state and national levels.

Altria, the nation’s largest tobacco company, said it supports a “clean” Tobacco 21 bill focused exclusively on raising the age limit because it is the “quickest and most effective” way to address the recent surge in youth vaping. For decades previously, Altria and other tobacco companies aggressively defended the 18-year-old minimum purchase age. Juul has similarly supported legislation that raises the purchase age without affecting vaping flavours. The companies’ support sapped attention away from other proposals that would have gone much further. For example, a bill from the New Jersey Democratic congressman Frank Pallone would have banned flavours from all vaping and tobacco products, including menthol cigarettes, and prohibited online sales.

The logic for hiking the purchase age for traditional cigarettes is clear: most underage users obtain them from older friends. An estimated 90% of smokers start before age 18. Delaying access to cigarettes is expected to produce major downstream health benefits, with one government-funded report estimating nearly 250,000 fewer deaths due to tobacco over several decades.

Still, anti-tobacco experts say age restrictions are only effective when they are vigorously enforced, and tobacco sales can fall through the cracks amid a patchwork of local, state and federal law enforcement. They point to underage drinking as an example of the limited impact of age-based restrictions.

State laws banning tobacco sales to those under 18 evolved over several decades and were reinforced by a federal law in 2009. The same law banned all flavours from traditional cigarettes except menthol, which received a special exception at the behest of tobacco lobbyists. More than a third of US states including California, Illinois, New York and Texas and the District of Columbia have already raised their minimum purchase age to 21. Anti-smoking groups have tracked the trend with measured support, noting the role of Juul and Altria lobbyists behind many of the efforts.

Source: The Guardian, 17 December 2019
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Vienna’s prestigious ballet academy is endangering children’s wellbeing including by encouraging them to smoke to stay slim, an Austrian commission investigating abuse claims has concluded. The scandal broke in April when a media report accused the academy at Vienna’s renowned State Opera of inflicting serious physical and mental abuse on its students as well as of sexual assault.

The weekly Falter newspaper published a detailed investigation exposing “19th-century” methods, alleging young dancers were hit, scratched until they bled, pulled by their hair and humiliated over their physiques, with some developing anorexia. Created in 1771, the academy is one of Europe’s most prestigious and attracts applicants from across the world. A government-backed special commission confirmed on Tuesday that students received insufficient medical care, and also found a general “disregard” for child welfare.

Commission head Susanne Reindl-Krauskopf said that students were advised to start smoking to stay slim and addressed with their first names and clothes sizes.
“It is clear that children and adolescents are not sufficiently protected from discrimination, neglect and negative medical effects,” the report stated. It also warned that students’ training loads were insufficiently controlled, “endangering their wellbeing”.

The academy boasts alumni who dance for some of the world’s most famous companies, including London’s Royal Ballet, St Petersburg’s Mariinsky and New York’s American Ballet Theatre.

Source: The Guardian, 17 December 2019
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For more information call 020 7404 0242, email [email protected] (mailto:[email protected]) or visit www.ash.org.uk

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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