Hiding in plain sight: Treating tobacco dependency in the NHS: A report by the Tobacco Advisory Group of the Royal College of Physicians

Royal College of Physicians, June 2018

Report from the Royal College of Physicians that addresses the harms and costs arising from smoking in patients, and argues for a new approach to treating their addiction.  It identifies giving smokers the help they need to quit smoking while in hospital will save lives, improve quality of life as well as increasing life expectancy, and help to reduce the current £1 billion per year cost to the NHS of smoking by patients and staff.

It also argues that:

  • Treating tobacco dependency is not just about preventing disease: in many cases it represents effective disease treatment. Clinicians working in all areas of medicine can improve their patients’ lives by helping them to quit.
  • Current models of delivering stop smoking services separately from mainstream NHS services, while successful in the past, may now not be the best approach because the patient has to seek help themselves
  • Most health professionals receive little or no training in treating smokers
    The NHS does not collect data on smoking treatment delivery, or have a payment tariff for treating tobacco dependency
  • Smoking treatment also tends to be squeezed out, even in the management of diseases caused by smoking, by other, less cost-effective interventions.

Click here to view the full report.

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Evidence review of e-cigarettes and heated tobacco products 2018: A report commissioned by Public Health England

Public Health England, February 2018

This report has been commissioned to summarise evidence to underpin policy and regulation of e-cigarettes/vaping devices.  It finds:

  • The addictiveness of nicotine depends on the delivery system.
  • It is possible that the addictiveness of tobacco cigarettes may be enhanced by compounds in the smoke other than nicotine.
  • As e-cigarettes have evolved, their nicotine delivery has improved. This could mean that their addiction potential has increased, but this may also make them more attractive to smokers as a replacement for smoking. It is not yet clear how addictive e-cigarettes are, or could be, relative to tobacco cigarettes.
  • While nicotine has effects on physiological systems that could theoretically lead to health harms, at systemic concentrations experienced by smokers and e-cigarette users, long-term use of nicotine by ‘snus’ (a low nitrosamine form of smokeless tobacco) users has not been found to increase the risk of serious health problems in adults, and use of nicotine replacement therapy by pregnant smokers has not been found to increase risk to the foetus.
  • Adolescent nicotine use (separate from smoking) needs more research.
  • The long-term impact of nicotine from e-cigarettes on lung tissue is not yet known and may be different from its impact systemically.

Click here to view the report.

Smoking, Drinking and Drug Use Among Young People in England – 2016

This report contains results from an annual survey of secondary school pupils in England in years 7 to 11 (mostly aged 11 to 15). 12,051 pupils in 177 schools completed questionnaires in the autumn term of 2016. The survey report presents information on the percentage of pupils who have ever smoked, tried alcohol or taken drugs and their attitudes towards these behaviours.  It also includes breakdowns by age, gender, ethnicity and region. The report observes a large increase in the number of pupils reporting that they had ever taken drugs.

Click here to view the full report.

Tobacco-free generations: protecting children from tobacco in the WHO European Region

World Health Organisation, August 2017

Several Member States in the WHO European Region are moving towards becoming tobacco-free: a smoking prevalence of 5% or less. Emphasis, in particular, is on protecting younger generations from smoking initiation and other tobacco-related harm. Protecting children from tobacco in the Region is essential, not only because smoking initiation is a key component of an important public health crisis, but also because Member States are responsible for supporting various children’s rights. This report highlights ongoing and emerging tobacco-related issues that affect children in the Region and examines the regulatory frameworks, commitments and other tools that Member States should use to protect children from tobacco. This also includes more novel approaches that could – and should – be used to pave the way towards a tobacco-free European Region.

Click here to view the full report.

Modelling foetal exposure to maternal smoking using hepatoblasts from pluripotent stem cells

Lucendo-Villarin, B., Filis, P., Swortwood, M.J. et al. Archives of Toxicology (2017). doi:10.1007/s00204-017-1983-0

This study looks at the effect of cigarette smoking on the developing liver cells of foetuses whose mothers smoke with a new approach using embryonic stem cells.  The study showed that a chemical cocktail – similar to that found in cigarettes – harmed foetal liver health more than individual components.

Click here to view the full text article.

 

POST Note: Electronic Cigarettes

Parliamentary Office of Science and Technology, August 2016

This POSTnote updates POSTnote 455 (January 2014), summarising the latest data on scale of use, safety and quality of electronic cigarettes, and their value as a stop smoking tool. It also explores the implications of the new EU Tobacco Products Directive and regulatory approaches in the UK.

Click here to view the POST note.

Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study

BMJ, 1 March 2016

This population based observational study aims to estimate how much changes in the main risk factors of cardiovascular disease (smoking prevalence, serum cholesterol, and systolic blood pressure) can explain the reduction in coronary heart disease mortality observed among working aged men and women in eastern Finland.

The study concludes that reductions in disease burden and mortality due to coronary heart disease can be achieved through the use of population based primary prevention programmes. Secondary prevention among high risk individuals and treatment of acute events of coronary heart disease could confer additional benefit.

Click here to view the full text paper.