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** 7 January 2020
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** UK
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** Health fears could curb the flavour options in e-cigarettes (#4)
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** Philip Morris pledges to make Bristol smokefree (#1)
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** ‘Smoking doesn’t care about you' campaign launched in Sheffield (#3)
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** Scotland records rise in number of smokers (#2)
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** International
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** California vaping bill would ban all flavoured tobacco and e-cigarette sales in stores (#5)
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** Study: Dual-use of tobacco and e-cigarettes may increase stroke risk (#6)
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** UK
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**

Vaping companies could be asked to fund research into the health effects of flavoured liquids used in e-cigarettes under plans being considered by the UK’s medicines watchdog. Last week, the US announced a ban on most e-liquid flavours over fears that vaping has reached epidemic proportions among teenagers. But this ban applies only to vape “pods” – individual cartridges used in vape pens to deliver flavour popular with young people – and not to the larger “tanks”, and some experts worry that users will simply switch.

Professor John Britton, director of the UK Centre for Tobacco and Alcohol Studies at Nottingham University, who sits on the UK Medicines and Healthcare Products Regulatory Agency (MHRA)’s panel on e-cigarettes, said flavours were really important to smokers: “If you restrict the flavours, you may restrict the tolerability of vaping to people trying it for the first time, but you will also lose an awful lot of smokers.”

The US’s shift has invited scrutiny of the UK’s stance on e-liquids. An expert committee on toxicity will report to the Department of Health in the spring but it is not expected to recommend that flavours be banned. Alternatives to a ban are being explored, Britton said. “One suggestion is for vaping companies to club together to get flavours licensed. This would give these companies a marketing advantage and perhaps set their shareholders’ concerns about future litigation at rest. Most vaping companies are small, and can’t afford the time or investment in to get a flavour through the medicine licensing process.” He continued: “The only way that could happen would really be if a number of companies grouped together and applied for a common licence for a particular flavour or set of flavours. Then you would have something that would be safe to medicinal standards and at that point you can stop worrying about it.”

“If you look at the list of flavours that are available in the UK, it’s huge,” Britton said. “It would be very hard to argue that all of those are necessary but how do you then say ‘this one is OK and this one isn’t’? You could say ‘OK, no flavours’ in which case you will make vaping unacceptable to most vapers. Or you could say ‘we’ll allow a limited list of, say, half a dozen flavours’. But how do you decide what those should be? There is no way of saying that cinnamon is safer than orange. I don’t see how you draw the line.” Compared with the US, the UK heavily regulates the promotion of e-cigarettes to young people.

Source: The Observer, 5 January 2020
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**

Philip Morris has pledged to launch a new initiative to help Bristol become the first ever city in England to go smokefree. The tobacco company has pledged to help encourage smokers in the city to either give up smoking or, if they do not quit, switch to alternatives.

Philip Morris' strategy to make Bristol smokefree will include:
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** Partnering with local businesses to ensure their employee smokers understand the range of alternatives available if they do not quit;
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** Working with local retailers who are selling cigarettes to prepare for a smokefree city;
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** Campaigning locally to ensure smokers have all the facts about the full range of options to help them give up smoking.
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** Phillip Morris has already begun working with local businesses and retailers and is now working to extend this offer to every business in the city.
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**
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** Source: Bristol Live, 7 January 2020
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A new campaign and TV advert has been launched in Sheffield to encourage people to quit smoking. Smokefree Sheffield launched the campaign and advert to encourage more smokers to quit this January following a decline in the number of smokers in the city of around 4% in 2017/18.
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** The advert from Smokefree Sheffield, told from the perspective of those who have lost someone from smoking, tells the people of Sheffield that “smoking doesn’t care about you, but we do”. The campaign advert launched on ITV on demand, out-of-home and across social media channels on January 6th 2020 and provides information about local services available to help smokers quit. Smokefree Sheffield will also be holding an event on 9th January with stop smoking advisors on hand to give advice and support for those ready to quit.

Greg Fell, Director of Public Health Sheffield, said: “Tobacco kills around 16 people in Sheffield every week and every one of those people has loved ones, family, friends or colleagues who care about them [...] Tobacco is a multi-billion pound industry, it doesn’t care about smokers or their families, it just destroys lives. We’ve made positive strides towards reducing the number of people smoking in Sheffield, but we have more to do and we are working hard with partners to support people in Sheffield to quit because we do care.”

Source: The Star, 7 January 2020
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** See also: Smokefree Sheffield - Smoking doesn’t care about you. But we do. ([link removed])
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**

The number of smokers in Scotland is on the rise for the first time in seven years, prompting fears over the prospect of achieving a smokefree Scotland by 2034. However, the Scottish Government has said that the increase is explained by population growth in Scotland rather than an increase in smoking prevalence. The number of people smoking in Scotland increased from 806,817 in 2017/18 to 808,829 in 2018/19, official health service figures show.
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** The number of smokers trying to quit has also declined and spending on cessation campaigns has fallen dramatically. Figures reveal spending on smoking cessation campaigns fell to £55,223 in 2018/19 – down from £552,975 the year before. The number of people in Scotland seeking to quit smoking declined to 50,962 last year, down from 55,322 the year before.

Sheila Duffy, chief executive of ASH Scotland, said: “It’s disappointing that the overall smoking prevalence rate across Scotland has stagnated. However, what I find particularly alarming about these new figures is the reported increase in the number of smokers in Scotland’s most deprived communities – up 5% since last year. This means that people living in the most difficult circumstances are increasingly burdened by the health and financial harms caused by tobacco [...] This must be a priority for the new Public Health body. As part of this, we’d like to see more funding for mass media campaigns and smoking cessation services, which have been proven to help people quit.”
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** A Scottish Government spokesperson said: “Taken in isolation these figures present a misleading picture on smoking rates, as smoking prevalence in Scotland continues to fall. As Scotland’s population size is increasing it is critical to compare figures alongside this in order to gain an accurate picture.”
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**
Source: The Scotsman, 7 January 2020
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** International
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**
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** Days after concerns over youth vaping led the Trump administration to announce a partial ban on many e-cigarette pods, California lawmakers on Monday 6th January introduced a much stronger measure to outlaw store sales of all flavoured tobacco and e-cigarette products in the state.

The proposal would go beyond the federal government’s plan for a temporary ban on many candy and fruit-flavoured e-cigarette products that could be lifted if companies can convince the US Food and Drug Administration that the pods are safe. The Bill would prohibit flavoured products not covered by the federal ban, including menthol-flavoured cartridges and refillable, tank-based vaping systems that can be filled with flavoured liquids. It would also outlaw flavours for traditional combustible cigarettes and cigars, as well as for chewing tobacco and water pipes.

The measure does not apply to products available on the Internet, including those sold by out-of-state businesses. It is supported by health and youth advocacy groups. The legislation was announced by a bipartisan group and 30 lawmakers. Other states are considering additional restrictions on flavoured products, but California could become the second state to adopt a full ban should the bill become law, following Massachusetts which will permanently prohibit flavoured tobacco and e-cigarette sales starting in June 2020.
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**
Source: Los Angeles Times, 6 January 2020
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**
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** Vapers who currently smoke or have previously smoked tobacco may be at greater risk of stroke compared to people who only smoke cigarettes, new research suggests.

Those who used both at the time of the study were almost two times more likely to have a stroke, compared to those who only smoked cigarettes at the time, experts say. And they were nearly three times more likely than non-smokers to have a stroke, the research published in the American Journal of Preventive Medicine suggests.

Compared with non-smokers, sole e-cigarette use was not linked to significantly different odds of stroke. If participants had former or current cigarette use, odds of stroke were significantly increased even when compared to current sole cigarette use, scientists say.

But Dr Lion Shahab, senior lecturer in epidemiology and public health at University College London, cautioned that it was not clear whether dual use of e-cigarettes, or switching to e-cigarettes from cigarettes, was a result of stroke or preceded it. Dr Shahab said: "It is entirely possible that the group of current or former smokers took up e-cigarettes precisely because they had a health scare, which would result in the observed association. It is entirely possible that dual users chose to use e-cigarettes in addition to cigarettes because they are more dependent, as has been found in other studies, which would suggest that over their lifetime this group of people may have been exposed to more harmful substances from cigarette smoking, increasing their risk of stroke. While this paper highlights the need to continue studying the potential health effects of e-cigarette use, the results should be interpreted with caution as the observed associations may be simply due to unmeasured
confounding and reverse causality."

Source:The Sun, 7 January 2020
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** American Journal of Preventive Medicine: Risk of stroke with e-cigarette and combustible cigarette use in young adults ([link removed](19)30468-4/fulltext)

See also: Independent - Vaping and smoking together doubles likelihood of stroke, new study warns ([link removed])
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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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