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** 17 October 2022
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** UK
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** Liz Truss's chief of staff recuses himself from government smoking strategy due to "Big Tobacco" links (#1)
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** NHS investment boosts wider UK economy, study shows (#2)
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** The Observer view on the dangers of assuming vaping is a safe alternative to smoking (#3)
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** International
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** China bans fruity vapes – but not their export to the UK (#4)
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** Voters to decide on California ban on flavoured tobacco (#5)
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** UK
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** Liz Truss's chief of staff recuses himself from government smoking strategy due to "Big Tobacco" links

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** Liz Truss's chief of staff has recused himself from discussions about changes to the government's smoking strategy due to his past work as a tobacco industry lobbyist. Mark Fullbrook, the prime minister's most senior adviser, has worked on behalf of British American Tobacco and Philip Morris, the maker of Marlboro cigarettes.

The government is considering shelving an action plan on tackling smoking, according to media reports. On Tuesday, Health Secretary Therese Coffey was unable to confirm if she was scrapping the plan. The Department of Health insists "no decisions have been taken".

Mr Fullbrook told Sky News he will have "no involvement whatsoever" in government smoking policy.

Labour's Wes Streeting, the shadow health secretary, said: "Number 10 has questions to answer about the involvement of Mark Fullbrook and any other former lobbyists for Big Tobacco in the decision to drop plans to tackle smoking. The health secretary must also be clear about her own tobacco industry connections." In 2011, Ms Coffey received £1,132 in gifts and hospitality from tobacco company Gallaher Ltd. In 2015 she voted against banning smoking in cars with children.

Last week, Labour called for an investigation into the appointment of Mr Fullbrook, after it was revealed he was questioned as a witness in an FBI bribery inquiry and was initially being paid by Number 10 via his lobbying company. Mr Fullbrook refused to answer questions by Sky News about the FBI investigation, but he has not been accused of any offence and there is no suggestion he was aware of the alleged bribery plot.

Source: Sky News, 16 October 2022

See also: The Guardian - No 10 chief of staff’s position untenable amid lobbying claims, says Labour ([link removed]) | Tobacco Tactics - Crosby Textor [Fullbrook] Group ([link removed])
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** NHS investment boosts wider UK economy, study shows

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** The NHS is a major contributor to the UK economy, with every £1 spent on health generating £4 of economic growth, according to a study that makes the case for investment as a driver of productivity.

The research, carried out by the consultancy Carnall Farrar, comes as the health service battles rising inflation, high energy costs and the prospect of further spending reductions with the government enforcing “fiscal discipline” in the wake of its “mini” Budget. However, achieving this would require greater investment in the NHS to reduce the treatment backlog, which this week reached a record high, and the number of those living with conditions that left them unable to work, it concluded.

Against a backdrop of high sickness absence levels, the study, which was commissioned by the NHS Confederation, showed that reducing the number of Britons not in employment due to ill-health by 1 per cent could increase the number able to work by 180,000 — “equivalent to the working-age population of Bolton”.

Matthew Taylor, chief executive of the NHS Confederation said the analysis “debunks the myth that the NHS is a drain on public resources — in fact, it’s a key driver of labour productivity and wider economic activity”. With a staff of about 1.4mn people, the NHS is one of the UK’s largest employers, providing the main source of employment in many areas, Taylor pointed out.

Carnall Farrar drew on economic and health data from 2015-2020, concluding that spending on the NHS delivered a fourfold boost to “gross value added” in individual localities. It said that “the link between an effective healthcare system and a high performing economy” was underscored by the fact that “those who were not currently working are far more likely to report poor health than those who are still in work”.

Source: Financial Times, 16 October 2022

See also: Carnall Farrar - Health spending and economic growth: cost or investment? ([link removed])
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** The Observer view on the dangers of assuming vaping is a safe alternative to smoking

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** The Observer on Sunday published an editorial piece outlining some of the key arguments for and against e-cigarettes (vapes). The piece highlights on the one hand key proponents of vapes, citing Public Health England saying that, to some extent, PHE argues that “vaping is a much safer alternative to smoking and that it helps smokers give up”, while on the other key critics “point to its dangers, for children and young people in particular”.

The piece notes that, “while the proportion of people smoking has fallen significantly in recent decades, it remains the single biggest cause of preventable illness and disease in the UK. Cigarettes are the one legal consumer product that if used as recommended by the manufacturer will kill most of their users. So anything that helps reduce levels of smoking and overall levels of harm is to be welcomed.”

The Observer argues there are mixed clinical findings on e-cigarettes’ safety and efficacy and highlights the role of social media platforms such as TikTok in encouraging young people to take of vaping, despite, UK regulations prohibiting the sale of vapes to anyone under the age of 18.

The piece concludes by arguing, “[…] Vapes should be available as part of smoking cessation programmes, but outside these programmes sales should be tightly regulated, with no advertising, plain packaging, health warnings and a ban in public spaces. […]”

Source: The Guardian, 16 October 2022

Editorial note: The most recent independent review of vaping, commissioned by Public Health England and published by its successor the Office for Health Improvement and Disparities stated that vaping is substantially less harmful ([link removed]) than smoking and the framing is clearly in terms of reduced risk not increased safety. ASH supports stricter regulation of the marketing of tobacco, and there are already health warnings on e-cigarettes and the evidence does not justify a legislative ban on vaping in public places. For more information see the Office for Health Improvement and Disparities recent review Nicotine vaping in England: 2022 evidence update summary ([link removed]) . The Observer also describes UK regulation of e-cigarettes as,
“very lightly regulated”; however, Great Britain and Northern Ireland, in line with EU laws, have a comprehensive set of regulatory guidelines for the importation, sale and distribution of e-cigarettes, as outlined here ([link removed]) and here ([link removed]) . The UK also imposed an age of sale of 18 and ban on proxy purchase of e-cigarettes in 2015, in advance of many other countries and 84% of UK 11-17 year olds have never tried vaping ([link removed]) . Finally, the article states that smoking-cessation “programmes” are more effective at supporting smokers to quit than e-cigarettes. Current research shows cessation programmes are even more effective when e-cigarettes are used in a stop smoking service setting as they are the
most effective method for helping smokers to quit ([link removed]) and that their safety for use in pregnancy is similar to that of nicotine patches ([link removed]) .
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** International
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** China bans fruity vapes – but not their export to the UK

China has banned the sale of flavoured e-cigarettes as part of a wide-ranging crackdown on the industry. The new rules mean vapes that have flavourings other than tobacco – such as those that taste fruity or sweet – cannot be sold on the domestic market, but they can still be manufactured in China to be shipped around the world, including to the UK, where Chinese-made brands such as Elfbar, known for its range of flavoured disposable vapes, are popular.

The ban, which comes into effect this month, follows a tightening of other rules relating to e-cigarettes, including a ban on selling them online and an order for packaging to include warning labels that say they are harmful to health and must not be used by schoolchildren.

It comes in response to concerns about underage vaping in China and is likely to severely affect its domestic e-cigarette market, which had been growing rapidly. While the number of young people who use e-cigarettes in the UK is relatively low, research suggests it has increased over the last two years. A survey by YouGov and ASH found that the proportion of children aged 11 to 17 who vape had risen from 4% in 2020 to 7% in 2022. The percentage of children who had tried vaping had also risen, from 14% to 16%.

More than half of the children who vaped said disposable e-cigarettes were their preferred product – up from 7% in 2020 – and the most popular brand was Elfbar.

In July, an Observer investigation found that Elfbar was advertising its products in videos on TikTok by influencers who in some cases claimed to be paid for the promotions and benefit from free products. The videos – many of which showed influencers vaping on camera –were not age-restricted and were not always clearly marked as ads. In response to the findings, Elfbar said it was “very aware of the UK regulations” and would conduct “internal investigations” into the allegations.

The UK vaping market is worth more than £1bn a year. The Association of Directors of Public Health has called for tighter regulations to ban brightly coloured packaging and a review of flavours likely to appeal to children.

Source: The Guardian, 16 October 2022
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** Voters to decide on California ban on flavoured tobacco

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** Two years ago, California banned flavoured tobacco products such as menthol cigarettes and cotton candy vaping juice, arguing that they mostly attracted children.

However, the law never took effect. Tobacco giants, including R.J. Reynolds Tobacco Co. and Philip Morris USA, spent $20 million on a campaign that gathered enough signatures to put the issue to the voters. Californians will now decide on the 8 November in a state-wide ballot, whether to abandon the law or keep it.

Tobacco companies are pushing hard to keep from being shut out of a large portion of California’s vast market. Meanwhile, supporters of the ban, who include doctors, child welfare advocates and the state’s dominant Democratic Party, say the law is necessary to put a stop to the staggering rise in teen smoking. However, the California Republican Party wants to repeal the law, saying it would cause a giant loss in tax revenue.

The tobacco industry’s campaign has painted the ban as being especially bad for Black and Latino people, who use menthol at higher rates than other communities. But the ads drew a backlash from some Black leaders who call the campaign offensive: “I am insulted that the tobacco industry would make an effort to make us believe that mentholated cigarettes are part of African American culture, and that this is a discriminatory piece of legislation against Black people,” said then-Assemblywoman Shirley Weber before the Legislature voted on the ban. Weber, a San Diego Democrat who chaired the California Legislative Black Caucus, is now California's secretary of state.
If voters approve, California would become the second state in the nation to enact such a ban after Massachusetts. A number of cities, including Los Angeles and San Diego, have already enacted their own bans.

Source: The Independent, 16 October 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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