Doctors urge Theresa May to publish anti-smoking strategy

More than 1,000 doctors, including heads of royal colleges and public health institutions, are calling on the prime minister to publish the latest tobacco control plan without delay.

In a letter to Theresa May, the senior doctors say the plan is essential to drive down smoking rates, which are highest and most damaging to health among the least well-off. The plan was due to be published last summer.

Reminding May of her commitment to “fighting against the burning injustice that if you’re born poor, you will die on average nine years earlier than others”, they point out that half of that difference in life expectancy is caused by smoking.

The letter, which is being published in the British Medical Journal, is being sent to May by Dr Andrew Furber, president of the Association of Directors of Public Health, and Prof John Middleton, president of the Faculty of Public Health.

Furber warned that progress against smoking, which has been good in recent years, could slip. “Directors of public health in local authorities are charged with the responsibility of reducing smoking prevalence. But to succeed needs leadership at national as well as local level,” he said.

“The government must renew the tobacco strategy without further delay. Otherwise we risk losing the momentum gained from recent welcome changes such as standardised packing.”

Middleton said: “Smoking rates have declined over the years, in large part because of concerted government action. However rates are still highest amongst the poorest and if the prime minister truly wants to increase the life expectancy of the poorest in society her government needs to renew its tobacco control strategy, which expired over a year ago.”

The first tobacco strategy in the UK was the Blair government’s white paper, Smoking Kills, published in 1998. Other plans followed, including Andrew Lansley’s in 2011, then health secretary in the coalition government, which included a commitment to consult on standardised cigarette packaging.

Some anti-smoking measures have been a response to EU legislation, such as advertising and promotion bans. However, says Deborah Arnott, chief executive of Action on Smoking and Health, tobacco control strategies have reduced smoking rates in England faster than in some other European countries, particularly among children.

In 1998, 24% of 15-year-olds were smoking, but by 2014 that proportion had dropped to 8%. “France and Germany had European legislation but their rates have not gone down as fast,” she said.

There is also evidence that smoking rates can rise again if the pressure is eased. New York City’s successful Tobacco-Free Living initiative, which lowered smoking rates from 21% in 2002 to 14% by 2010, suffered funding cuts to mass media campaigns from 2009. By 2011, smoking rates rose, reaching 16.1% in 2013, but fell again after more investment in 2014.

Experts hope the new UK tobacco control plan, which has been delayed in part because of the Brexit vote and its fallout, will plot the course for driving smoking rates down to 5% by 2035, which a report from Cancer Research UK said was feasible.

“What we want is a smoke-free future,” said Dr Nicholas Hopkinson, a consultant chest physician at the Royal Brompton hospital and reader in respiratory medicine at Imperial College, who coordinated the letter.

Support for mass media campaigns is needed, he says, as well as the continuation of policies on the cigarette pricing and tobacco smuggling. Spending on media campaigns in England has dropped in the past five years from just under £25m in 2009-10 to £5.3m in 2015, although evidence shows they help people quit.

“It is absolutely clear these interventions work. It is just keeping up the momentum and making sure there is a high priority to this,” he said. “There are 9 million smokers in the UK, and smoking is increasingly associated with inequality – it is quite a bit higher in the poorer parts of society.”

Among the signatories are the heads of several medical colleges. One of them, Prof Neena Modi, president of the Royal College of Paediatrics and Child Health, said: “Most smokers become addicted as children and once addicted find it extremely difficult to quit. Since the government introduced a strategy to tackle smoking in 1998, smoking rates among 15-year-olds have fallen by two-thirds.

“We must not put that achievement at risk. The last tobacco strategy expired over a year ago, so we want to see the new plan published and enacted as a matter of urgency.”

Doctors urge Theresa May to publish anti-smoking strategy

Drug companies have to publish all information - good and poor

In February, Good announced programs to lower the “risk threshold” for statins in half, which would end result in the huge majority of males aged more than 50 and most women over 60 getting recommended to consider the medicine. Last week, as this newspaper reported, a group of nine leading doctors, like Sir Richard Thompson, the president of the Royal School of Doctors, and Prof Clare Gerada, former chair of the Royal University of Common Practitioners, wrote to Great and Jeremy Hunt, the Health Secretary, raising worries about the impartiality of the panel that produced the suggestions. They noted that eight of the 12 members who developed the suggestions had “direct economic ties” to companies that manufacture statins.

Prof Mark Baker, a senior Wonderful official, described the issues as “completely unjustified” and stated that none of the panel members stood to obtain financially from the advice. This rather misses the level, I think. The panel members can not be impartial if they have backlinks with the producers. Drug organizations devote huge amounts of funds each yr on promoting, marketing and advertising and trying to foster back links with medical doctors, scientists and viewpoint leaders exactly because they know that this will imply they are much more likely to view products favourably.

In latest many years there have been limitations placed on drugs firms: they are no longer allowed to take doctors on lavish holidays or out for high-priced meals. In reality, they are no longer permitted even to give out a pen with a drug’s identify on it. But what do these rules matter when firms can access men and women who sit on a national board that helps make selections about prescribing to millions of folks?

Two issues need to have to occur: firstly, drug organizations should be compelled to publish all their trials data, excellent and bad, so that their drugs can be independently assessed. With out all the information, we only get component of the image. Secondly, people who sit on Wonderful panels with obligation for generating guidelines need to be free from association with the pharmaceutical organizations whose medication they are assessing. We are not able to let their choices to swayed, nonetheless subtly, by companies. This is the only way that we will be ready to determine objectively on which drugs to dish out, and to whom.

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_{Farrah Fawcett campaigned towards ignorance prior to her death}

A single cancer continues to buck the trend

In recent many years, scientific and clinical advances have greatly improved the survival prices for several cancers. Deaths from a single cancer, nonetheless, have quadrupled in Britain considering that the Seventies, according to new figures from Cancer Research United kingdom. Although anal cancer stays comparatively unusual, with one,200 folks diagnosed each yr, it is responsible for close to six deaths each and every week. The rise is surprising provided the overall improvement in managing cancer in basic.

The actress Farrah Fawcett campaigned tirelessly to increase awareness of this cancer just before she died from it in 2009. Nevertheless there is nevertheless great ignorance. Number of men and women, for illustration, know that there is a vaccine that can reduce the danger of contracting it.

It is estimated that 90 per cent of anal cancer is linked with human papillomavirus (HPV), a group of viruses also linked to cervical cancer. The introduction of the HPV vaccine for women is anticipated to help, but what about for boys? In 2011, 113 men and 186 girls manufactured up the 299 deaths from anal cancer that year. The Joint Committee on Vaccination and Immunisation is taking into consideration no matter whether to lengthen the vaccine to boys. I do not see why there is even any debate.

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Sorry may be challenging for some doctors – but not this 1

In accordance to new guidelines issued final week by the General Healthcare Council, physicians should apologise to patients far more. I totally agree. It is usually baffled me why sorry is occasionally the hardest word.

I’m a excellent fan of apologising. I’m the type of particular person who apologises for everything, even when it is not my fault. A person bumps into me? I apologise. An individual stands on my foot? Sorry!

A couple of weeks ago, my secretary pointed out that, when creating to sufferers who had failed to come to their outpatients appointments, I started my letters with: “I was sorry that you did not attend…” “Why are you apologising to them for the truth they did not turn up?” she asked. “Oh, sorry,” I replied.

Max Pemberton’s most current book, ‘The Physician Will See You Now’ is published by Hodder. To purchase a copy, phone Telegraph Books on 0844 871 1515

Drug companies have to publish all information - good and poor