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** 12 October 2022
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** UK
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** North East health leaders urge minister to urgently clarify stop smoking plans (#1)
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** Thérèse Coffey doesn’t understand that most people are anti-smoking (#2)
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** MPs vote to scrap health and social care tax rise (#3)
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** Cuts to council services would be ‘far from easy’, warns IFS (#4)
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** International
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** Study: Thirdhand smoke can trigger skin diseases (#6)
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** Parliamentary activity
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** Debate: Health and Social Care Levy (Repeal) Bill (#7)
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** UK
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** North East health leaders urge minister to urgently clarify stop smoking plans
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**
Leading health figures in the North East have called for the Government to explain its plans to reduce smoking, following Thérèse Coffey’s noncommittal media comments yesterday when probed on publishing the awaited tobacco control plan and plans to make Britain smokefree by 2030.

Amanda Healy, director of public health in County Durham, said: "I speak on behalf of Directors of Public Health in the North East when we say we need action to reduce smoking, especially in regions like the North East where more families suffer. Despite efforts of tobacco companies to derail efforts to reduce smoking, there has been massive support for these efforts and we have made good progress to reduce smoking rates with the NHS and local communities working together [...] Smoking remains our biggest killer and is an addiction that starts in childhood. Tobacco is a driver of poverty and has a negative impact on the economy and for our businesses. Most smokers would like to stop and many deeply regret starting in the first place. The appalling fact is that millions more will die unless we take action."

Ailsa Rutter OBE, director of Fresh and Balance, the North East regional alcohol and tobacco control programme, said: “We urgently need clarity now whether it is government policy to tackle our biggest killer or hand a free licence to tobacco companies to peddle addiction for profit.”

Rutter also warned that ignoring the issue of smoking would "add more burden on the NHS and condemn more families and more children to lifelong tobacco dependency". The group has previously highlighted the connection between tobacco addiction, chronic illness and poverty in the North East.

Sue Mountain, 56, who has experienced smoking-related cancer three times urged: "Prevention saves the NHS, it helps the economy, and it helps ordinary families with their day to day finances. If money is tight then tobacco companies need to pay for the damage they do. I could have bought half a house with the money I spent on smoking instead of cancer."

Source: Chronicle Live, 12 October 2022
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Read Article ([link removed])


** Thérèse Coffey doesn’t understand that most people are anti-smoking
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The harms of smoking to the individual, to their family and to wider society are well-established and irrefutable, writes Dr Daniel Goyal, medical consultant and clinical academic in the New Statesman. So why do we face a government refusing to support a new strategy on smoking, he questions.

The Khan review, commissioned by Sajid Javid when he was health secretary, set out the route towards a smokefree country by 2030. Dr Goyal writes that implementing it would save tens of thousands of lives a year, lift around 2.6 million people out of poverty by saving them money, and have a net positive effect on the economy of around £5 billion.

The only loser seems to be the tobacco industry, Dr Goyal continues. Under this plan, the tobacco industry’s annual £1 billion in profits from UK smokers will sharply decline year on year and, under this plan, no amount of advertising or lobbying will reverse that trajectory.

Speaking on her comments to LBC in which she said: “I didn’t think it’s the right thing to be doing to be telling parents [how] to be handling the situation,” in relation to protecting children from passive smoking, Dr Goyal writes: “If Coffey does dilute plans to act on Khan's review, or simply refuses to act, it seems most likely that her argument will revolve around individual liberties [and] the tiresome “nanny state” argument will once again be rolled out.”

Dr Goyal believes the public, however, is unlikely to support such an argument. Indeed public support for further government action to support smoking cessation has risen over the past ten years. He points to a survey included in the Khan review finding only 6% of the public felt the government was doing too much to control smoking; only 30% felt the government was taking enough action.

As the public’s views on smoking reduction have long moved beyond the binary tension between individual freedom and public health, Coffey’s retreat on the previous commitment to publish the plan to reduce smoking will cost the UK billions of pounds, pass up an opportunity to save thousands of lives, and will be at odds with what the general public want. Goyal concludes saying: “If Coffey wants to argue in favour of doing even less to control smoking she will need to do a bit better than simply ‘it’s not our job’.”

Source: New Statesman, 12 October 2022

See also: Khan review - Making smoking obsolete ([link removed])
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** MPs vote to scrap health and social care tax rise
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MPs have voted in favour of scrapping a tax rise introduced to fund the NHS and social care. Treasury Minister Chris Philp defended the move, arguing that it was important to "urgently alleviate the tax burden" given the cost-of-living crisis.

Labour supported the change and criticised ministers for introducing the levy in the first place that then-Prime Minister Boris Johnson said was needed help to deal with the "catastrophic costs" towards NHS backlogs and to fund social care. However, some MPs questioned how the government would fill any shortfall left by reversing the tax rise.

Mr Philp insisted that although the National Insurance increase of 1.25p in the pound, which had been expected to raise £12bn a year, was being reversed, funding for health and social care would be "unaltered". "Not a single penny less will go to social care or the NHS," he added.

Former Conservative minister James Cartlidge asked if the gap would be filled by borrowing "or some other change". Mr Philp replied that this would be set out by Chancellor Kwasi Kwarteng on 31 October when he delivers his economic plan to MPs.

Labour shadow Treasury minister James Murray said his party welcomed the government "finally admitting they were wrong to raise national insurance on working people and businesses in the middle of a cost-of-living crisis".

Following a debate, the bill cleared the Commons after receiving an unopposed third reading. Before it comes into effect, the reversal also needs to be approved in the House of Lords - this is expected to happen on 17 October.

The Treasury has said dropping the tax rise would save nearly 28 million people an average of £330 per year, while 920,000 firms would get a tax reduction of nearly £10,000.

Source: BBC News, 11 October 2022
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** Cuts to council services would be ‘far from easy’, warns IFS
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It would be “far from easy” to find more savings from public services including those provided by local government, the Institute for Fiscal Studies (IFS) warned this morning.

The Green Budget 2022, the IFS’s in-depth look at fiscal challenges facing the chancellor, warns that the chancellor would need to announce a fiscal tightening of more than £60bn just to stabilise debt as a fraction of national income in 2026–27. The Green Budget project is funded by the Nuffield Foundation and produced in association with Citi.

Implementing a 10% cut in day-to-day public services spending, exempting NHS and Defence budgets, could save the government £23bn the IFS said. But it would be difficult to find these cuts.

The report states: “Many of these public services saw big cuts to their budgets during the ‘austerity’ years of 2010 to 2019: in particular, spending in areas such as prisons, policing and services provided by local government saw deep real-terms cuts of in excess of 20% over this period.” Further efficiencies would be “harder still” because of the savings that have recently been implemented during austerity. The IFS said: “This is not impossible, but like claims that economic growth will be increased, it is easier said than done.”

In response to the IFS’s report the Local Government Association urged the government to protect council services. James Jamieson, chairman of the LGA, said: “In the past decade, councils have done more than their fair share of the heavy lifting when it came to putting public finances on a more sustainable footing, having faced a £15bn real terms reduction to core government funding between 2010 and 2020 [...] The government needs to ensure councils have the funding to meet ongoing pressures and protect the services that will be vital to achieve its ambitions for growth and to produce a more balanced economy, level up communities and help residents through this cost-of-living crisis.”

He added that councils need clarity about funding for “next year and beyond”, otherwise they will “implement significant cuts to services including to those for the most vulnerable in our societies”.

Source: Local Government Chronicle, 11 October 2022

See also: Institute for Fiscal Studies - Green Budget 2022 ([link removed])
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Read article ([link removed])


** International
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** Study: Thirdhand smoke can trigger skin diseases
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Researchers at the University of California found exposure of human skin to thirdhand smoke (THS), residual pollutants from tobacco smoke that remain on surfaces and in dust after tobacco has been smoked, could contribute to inflammatory skin disease, and other diseases, such as cancer, heart disease, and atherosclerosis.

Researchers found biomarkers of harmful toxicants were higher among those exposed to THS, with elevation in biomarkers mimicking the pattern found among cigarette smokers.
Prue Talbot, the paper's corresponding author, emphasised the study’s importance given the general lack of knowledge of human health responses to THS exposure.

Source: Medical Xpress, 11 October 2022
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Read article ([link removed])


** Parliamentary activity
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** Debate: Health and Social Care Levy (Repeal) Bill
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**
On Tuesday 11th October, MPs debated and voted on the repeal of the Health and Social Care Levy.

During the debate Alex Cunningham, Labour MP for Stockton North, pressed on the relevance of tobacco control to the issue, arguing that ([link removed](Repeal)Bill#contribution-E602A78A-D63C-4E2B-BBE6-14D677967C0E ) :

“The Minister seems to have mentioned everything except the need for a healthy workforce. Local authorities spend £1.2 billion every year on social care needs caused by smoking, and that will get more expensive if the Government fail to address the issue of tobacco. This morning the Health and Social Care Secretary hinted that she will do less, not more, to tackle the dangers of smoking. Will the Minister join me and press her to bring forward the tobacco control plan, to help protect the health of the nation and save health and social care costs?”

Steve Brine, Conservative MP for Winchester, emphasised this point, saying that ([link removed](Repeal)Bill#contribution-BA209C83-744F-493B-846C-8C00D678045A) :

That takes me to my second point, which is on cancer. Around four in 10 cancers today are preventable. Smoking causes at least 15 different types of cancer. It is the biggest cause of cancer in the world today. Earlier, the hon. Member for Stockton North (Alex Cunningham) mentioned the smoking cessation plan, which I published when I was in office, and subsequently updated. We are still waiting for its revision. Press reports say that it is to be dropped as well. I gently suggest that that would be a massive own goal for our Government, and for the NHS, which we argue about how to fund.

MPs voted to repeal the Levy, as covered in the news story above.

A full transcript of the debate is available here ([link removed](Repeal)Bill#contribution-E602A78A-D63C-4E2B-BBE6-14D677967C0E) .


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