The nanny state banned in England cigarette vending machines over the weekend.The Department of Health said the ban had been introduced to prevent under-age sales to children and to support adults who were trying to quit.

The rest of the UK is expected to implement a similar ban next year.

Some pub landlords say it is a further threat to a livelihood that has already been damaged by the smoking ban.

But Cancer Research and the British Heart Foundation have welcomed the move.

According to the Department of Health, nearly all adult smokers started smoking before they turned 18.  Of the children who regularly smoke, 11% buy their cigarettes from vending machines.

It is also estimated that 35 million cigarettes are sold illegally through vending machines to children every year.

Under the new rules, pub landlords will still be able to sell cigarettes from behind the bar but they must ensure all tobacco advertising on vending machines is removed. Any person found guilty of displaying cigarette adverts on a vending machine could face imprisonment for up to six months, a fine of £5,000, or both.

Health Secretary Andrew Lansley said smoking was “one of the biggest and most stubborn challenges in public health”, with more than eight million people in England still smoking, causing more than 80,000 deaths each year.

He said: “Cigarette vending machines are often unsupervised, making it easy for children to purchase cigarettes from them.

“The ban on cigarette sales from vending machines will protect children by making cigarettes less accessible to them – we want to do everything we can to encourage young people not to start smoking in the first place.”

Jo Butcher, the National Children’s Bureau’s programme director of health and wellbeing, welcomed the ban and said a person’s lifetime smoking or non-smoking behaviour was “heavily influenced” by decisions in their adolescence.

“Children and young people tell us that external influences make it even more difficult for them to choose healthier lifestyles.

“It’s essential that we create environments that improve health and tobacco legislation is an important part of public health protection and promotion,” she said.
Protection

Charities have also welcomed the ban.

Betty McBride, director of policy and communications at the British Heart Foundation, said thousands of children at risk of this “deadly addiction” regularly got tobacco from vending machines, “which conveniently don’t ask them to prove their age”.

“These children are often blissfully unaware of the damage smoking does to their health and, by the time they realise, they’re hooked.

“Scrapping these machines cuts off an easy source of tobacco for existing young smokers and makes it harder for a new generation to start.

“We’re encouraging landlords to remove machines completely now so they – and any left-over branding – don’t act as dusty old adverts for tobacco,” she said.

Eileen Streets, director of tobacco control at the Roy Castle Lung Cancer Foundation, said she hoped the ban would play a “significant part in stopping many children becoming the next generation of lung cancer victims”.

Jean King, of Cancer Research UK, added: “Tobacco kills half of all long-term users and is responsible for one in four cancer deaths.

“Cancer Research UK is determined to protect children from tobacco marketing and through our Out of Sight Out of Mind campaign we are continuing to work for legislation to introduce plain packaging for cigarettes.”

But the British Beer and Pub Association described the ban as “an unnecessary measure”.

A spokesman said the machines were there for the convenience of adult customers, and that the association did not believe they played a role in childhood smoking.

Although cigarettes can be sold by bar staff, the spokesman said many pubs would not opt to introduce that, as it raised issues about having a “high-value” item behind the bar and interfered with serving drinks.

Other measures to protect young people from the dangers of smoking are also on the way.

In April 2012, large retailers in England and Scotland will have to get rid of all tobacco displays. Small shops will be expected to comply from April 2015.

Wales and Northern Ireland plan to implement similar regulations.

The government is also due to begin a public consultation before the end of the year on whether to introduce plain packaging for cigarettes in order to lessen their marketing appeal to young people, help make health warnings more effective and help reduce the number of smokers.

From: http://www.bbc.co.uk/news/uk-15132529

Some women keep smoking through pregnancy just because they want to give birth to a smaller baby, according to British researchers.
Even though most women now understand there is “overwhelming evidence” that smoking during pregnancy is harmful to the developing child, they continue to do so, said Professor Nick Macklon of Southampton University.

He told the annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) in Stockholm: “It is important that people who believe that a smaller baby means an easier birth take into account the increased risk of complicated deliveries in smokers, as well as the risk of disease later in life which goes with low birth weight.”

“Smoking during pregnancy is not just bad for the mother and baby, but for the adult it ill grow into.”

He and a team at the university’s department of obstetrics and gynaecology have now produced what he called the first “hard evidence” that women who stopped smoking upon discovery they were pregnant, could protect their unborn children from harm.

The study looked at over 50,000 pregnancies in the Southampton area, analysing the birth weight of the babies and comparing this to self-reported smoking behaviour.

Those who continued to smoke through pregnancy had lower weight babies.

The more women smoked the lighter their babies were: those who smoked more than 10 a day had babies weighing some 11oz (300g) less than the average birth weight from a non-smoking mother, of about 7lb 10oz (3.45kg).

However, those who ceased smoking at about the time they conceived were just as likely to give birth to a normal weight baby as those who had never smoked.

He said: “We can now give couples hard evidence that making the effort to stop smoking in the periconceptional will be beneficial for their baby.

“Stopping smoking can ameliorate these detrimental effects.”

This could help change behaviour among smoking mothers, which he said had hardly changed in Britain over the last decade.

Prof Macklon explained that smoking during pregnancy “affects the transportation of nutrients, especially oxygen, across the placenta”.

It was also “reasonable to assume” that some of the 4,000 or so toxins in cigarettes were harmful to foetuses.

http://www.telegraph.co.uk/health/healthnews/8623267/Mothers-to-be-smoking-for-smaller-babies.html

Smokers and overweight patients in need of major operations could be thrown off hospital waiting lists under “desperate” cost-cutting plans.
Any smoker referred for ‘non-urgent’ operations will not be allowed to join the queue until they have either given up smoking, or completed a 12-week course to help them ditch the habit

Patients’ groups described the tactics as an “appalling scam” to enable NHS bosses to claim waiting times are far shorter than they are, simply by denying a place in the queue to many of those referred for surgery.

Under the plans drawn up by NHS bureaucrats in Kent, any smoker referred for “non-urgent” operations – such as hip replacements or cataract surgery – will not be allowed to join the queue until they have either given up smoking, or completed a 12-week course to help them ditch the habit.

Those who are seriously overweight will also be denied a range of operations until they have completed a three month NHS diet programme.

Although every patient has a legal right to be treated in 18 weeks of being referred for treatment by their GP, the protocols agreed mean different rules could be applied for anyone with a body mass index of more than 30, or those who smoke.

Patients groups said delays getting a place on 12-week “smoking cessation” and “weight loss” programmes could leave many patients waiting even longer than 30 weeks implied by proposals drawn up by NHS West Kent Primary Care Trust (PCT).

Katherine Murphy, from the Patients Association, said: “This is an appalling kind of scam – it is a clear device to manipulate the waiting lists simply to cut their deficit. It smacks of desperation, and it is patients who will suffer.”

The plans, seen by The Sunday Telegraph, explicitly say the rules have been introduced to save money by the end of the year.

The document says: “PCTs across the country are making decisions on prioritising treatments in order to match demand to the financial resources available to the economy as a whole and to individual trusts.

“Unfortunately this does not take us far enough: we need to take additional activity to reduce activity in this financial year if we are to be in a position to hand over a balanced budget.”

Under the proposals, smokers already on waiting lists will now be taken off until they have either been on the courses or given up smoking. New referrals will not be allowed on the lists until they have done the same.

All patients with a BMI of 30 or more who are referred for several types of surgery including hip and knee operations will also be cast off the lists until they have been on a three-month diet programme.

Many primary care trusts already try to encourage patients to stop smoking or lose weight before operations, in order to reduce the risks to them.

But patients’ groups said the use of tactics to delay even putting patients on the waiting lists was a far more draconian step.

Mrs Murphy said: “This is a clear way to keep these patients off the lists in order to cut costs, while the PCT can officially claim its waiting times have not lengthened.”

Simon Clark, director of the smokers’ lobby group Forest, accused the PCT of discriminating against smokers and creating a “two-tier” system.

He said: “Of course patients should be told that smoking could have an impact on the success or recovery from an operation, but given that they have paid huge sums in taxation on cigarettes over the years, the question of whether or not they have the surgery should be one for them, not the NHS.”

A letter sent out by the PCT tells local GPs: “There is good evidence that stopping smoking prior to surgery reduces length of stay and infection rates, and improves healing time; it is also a time when people are often highly motivated to give up.”

Kent doctors accused managers of being dishonest about the real reasons why patients were having their treatment delayed.

Dr Stephen Meech, a GP from Maidstone, said: “Patients are going to be told that they cannot have an operation because they smoke or need to lose weight, when that is not actually true – it is because the health authority can’t afford to pay for it.”

Dr John Allingham, a GP from Hawkinge, said: “The plan is extremely contentious and it is a way of extending the waiting times.

“If you’ve got to do a 12-week smoking cessation course before you can have your hernia fixed, or before you’ve even gone on the waiting list to have your hernia fixed, it immediately makes those waiting lists another 12 weeks longer.”

The PCT said it was in talks with local doctors over the proposals. Marion Dinwoodie, its chief executive, said she regretted the need “to take measures in the short term that may have an impact on local people”.

She said no one with a compelling clinical need for treatment this year would miss out.

From: http://www.telegraph.co.uk/Smokers-and-fat-patients-thrown-off-NHS-waiting-lists

Eating five portions of fresh fruit and vegetables every day will not protect you from cancer as they have little effect compared with smoking, alcohol and obesity, a study finds.
Official guidelines recommend at least five portions of fruit and vegetables a day in order to be healthy but new research has found that this may not have a substantial effect on cancer.

The science suggests that people should be told that cancer risk is much more related to how much you smoke, eat and drink rather than what you eat.

The review, published in the British Journal of Cancer, looks at a decade of evidence on the links between fruit and vegetables and the development of cancer, but it concludes that the evidence is still not convincing.

The only diet-related factors that definitely affect cancer risk are obesity and alcohol, they discovered.

Tobacco is still the single biggest cause of cancer.

While smoking increases the risk of cancer by as much as 50 fold, even large consumptions of fruit and veg will only reduce the risk by a maximum of 10 per cent.

Professor Tim Key, an epidemiologist from Oxford University, said that while there are undoubted benefits in eating fruit and vegetables there is little hard evidence that they protect against cancer.

But the evidence is indisputable that cancer is strongly linked to being overweight or obese, and drinking more alcohol than the recommended daily limits.

He said: “Fruit and vegetables are an important part of a healthy diet and a good source of nutrients.

“But so far the data does not prove that eating increased amounts of fruit and vegetables offers much protection against cancer.

“But there’s strong scientific evidence to show that, after smoking, being overweight and alcohol are two of the biggest cancer risks.”

Overweight people produce higher levels of certain hormones than people of a healthy weight and this can contribute to an increased risk of breast cancer.

Being overweight can increase your risk of other common cancers like bowel and also hard-to-treat forms of the disease like pancreatic, oesophageal and kidney cancer.

When alcohol is broken down by the body it produces a chemical which can damage cells increasing the risk of mouth, throat, breast, bowel and liver cancers.

In the UK 15,000 cases of cancer are caused by alcohol, it is believed, and 19,000 cases of cancer are caused by being overweight or obese.

Sara Hiom, director of health information at Cancer Research UK, said: “Too few people know about the significant cancer risks associated with obesity and drinking too much alcohol.

“While stopping smoking remains the best way to cut your chances of developing cancer, the importance of keeping a healthy weight and cutting down on alcohol shouldn’t be overlooked.

“Keeping alcohol intake to a maximum of one small drink a day for women and two small drinks per day for men and keeping weight within the healthy limits can have an enormous impact.”

The British research mirrors the findings of an American study published in April.

For every extra two portions consumed the risk of cancer reduced by just three per cent, the research conducted by a team at Mount Sinai School of Medicine, in New York suggested.

From: http://www.telegraph.co.uk/Five-a-day-will-not-stop-cancer

NICE the killer quango wants to waste taxpayers money by suggesting that the NHS should bribe fat people to lose weight and smokers to quit, and give children toys for eating their fruit and vegetables.The Killer Quango- the National Institute for Curbing Expenditure (NICE) was set up in early 1999 by the labour Secretary of State for Health Frank Dobson and has since condemned hundreds of cancer sufferers to early deaths and blighted thousands to painful existences by restricting payments- creating postcode lotteries for health care.

Now during the credit crunch nice want to waste millions of taxpayers pounds bribing people when earlier pilot studies showed that there were high drop out rates and up to 80% failed to reach their targets.

The advice, which will be published by the National Institute for Curbing Expenditure, has been greeted with anger by critics who claimed such “bribes” were draining the public purse of money which could be better spent elsewhere.

The study examined a series of schemes, including one in Kent which pays dieters up to £425 for losing weight and another in Scotland which gives pregnant women shopping vouchers worth up to £650 for quitting the habit.

It also looked at programmes in Oxford, Manchester, London and Bangor in Wales, where schools have been given toys such as juggling balls, stickers and pencils to children who have eaten their fruit and vegetables.

Fiona McEvoy, from the TaxPayers’ Alliance, said state funds should not be used to pay people to change their lifestyles,

She said: “Bribing people to lose weight or quit smoking is nothing but a quick fix which patronises the individuals in question and drains much-needed money away from the public purse. At a time when cancer drugs are being denied to sufferers due to lack of funds, many will be disgusted to learn that NICE are considering such a costly approach.”

Other schemes examined in the report include a pilot in Manchester which rewards overweight parents for walking their children to school.

As part of a £30m project, supermarket points are given to unfit people who attend keep-fit classes, weight loss clubs or go for a run in the park.

Overweight people gain credit points they can cash in for groceries just for turning up, with extra rewards depending on how much weight they lose.

In Newcastle, Bristol, Torbay, Manchester and Bury St Edmunds, those aged 16 to 22 are given subsidised gym membership if they visit at least once a week.

However, the report found limited evidence about whether the schemes make a difference.

In the Scottish antismoking project, for instance, the study acknowledged that four fifths of the women in the £43,000 scheme were smoking again within three months of giving birth.

The recommendations from NICE’s independent citizens council do not constitute its official advice to the NHS. Its board will launch a public consultation on the matter before considering the paper, which would inform future guidance.

However, the rationing body has already supported financial rewards for heroin addicts.

Originally NICE recommended that addicts who attended treatment programmes should be given the chance to win prizes, such as televisions and MP3 players.

The body dropped the idea following a public outcry but instead recommended that shopping vouchers worth up to £10 could be awarded to those who completed programmes, or showed they were clear of drugs.

NICE has been widely criticised for refusing to pay for dozens of cancer drugs on the grounds of cost. Medicines rejected include the drugs Avastin for advanced bowel cancer and Nexavar for advanced liver cancer.

Last year the institute fuelled controversy when it ruled marriage guidance counselling should be funded by the NHS, and supported the use of acupuncture for back pain, despite finding there was no good evidence it worked.

The report follows a three day meeting of NICE’s citizens council, where members were asked to vote about the use of incentives.

“More than 60 per cent said they were in favour of such schemes, as long as they were only used as a “last resort” and were not exchangeable for tobacco or alcohol.

Sir Michael Rawlins, the chairman of NICE said: “We clearly face several public health challenges in today’s society, some more obvious than others, and we must seek to improve these in ways that are likely to achieve the best outcomes to those affected.

“The majority of the council has voted in favour of the use of incentives under certain circumstances, but this clearly remains a divisive issue”.

Public consultation on the report starts today.

From:

http://www.telegraph.co.uk/NICE killer quango taxpayers-bribes-for-obese-and-smokers.html

Health Direct finds this new waste of taxpayers money a disgrace. Research in pilot studies has clearly showed that bribing people to lose weight and stop smoking DOES NOT WORK in the vast majority of cases.

On June 10, 2010 Health Direct published research :Nanny state cash bribes for good health fail three quarters of patients at http://www.healthdirect.co.uk/2010/06/nanny-state-cash-bribes-for-good-health-fail-three-quarters-of-patients.html

A Department of Health spokesman has already described them as an undesirable use of money and should only be adopted as a “last resort”.

If you would like to tell the killer quango NICE what you think of this scheme, comments should be sent to Clifford Middleton, Research and Development Project Manager at clifford.middleton@nice.org.uk by 5pm on Friday, 26 November 2010.

If email is a problem for you, please send your comments in a letter to Clifford Middleton at:

NICE,
MidCity Place,
71 High Holborn,
London WC1V 6NA.

Britain’s top GP has launched a scathing attack on widespread reckless public behaviour towards food, alcohol and cigarettes, which he claims is causing growing levels of disease and early death.
In a dramatic intervention in the public health debate, Professor Steve Field criticises parents, mothers-to-be, the very overweight, smokers and drinkers for damaging their own health, or their children’s, through irresponsible actions.

Writing in the Observer, Field, chairman of the Royal College of General Practitioners, backs the controversial call by Andrew Lansley, the health secretary, for Britons to take more responsibility for protecting their health.

“The truth is that too many of us neglect our health, and this is leading to increasing levels of illness and early death,” Field writes. Soaring levels of diabetes, much of it caused by obesity, and the medical consequences of heavy drinking, which are affecting ever-younger people, illustrate this widespread failure, he adds.

Discussion of the harmful medical consequences of ill-advised personal behaviour is curtailed because of its sensitivity, Field argues.

“Too many people do not face up to the hard facts, as they perceive them to be an attack aimed, in particular, at the poorer members of society. But it is impossible to argue on medical or ethical grounds that such behaviour is acceptable.”

While arguing for health prevention to become an individual duty and start at home, Field makes it clear that he does not want people to be left to make lifestyle changes on their own or to see personal responsibility as a total solution. Those who seek to alter their behaviour need continuing NHS and government help, he adds.

“So please don’t take offence if we [GPs] tell you to lose weight or stop smoking or drinking. You need to face facts and take responsibility. Support is out there and it could save your life – and save the NHS a fortune.”

Anne Milton, the public health minister, said greater personal responsibility was vital. Many senior doctors also agreed, but stressed that government action was needed to help create a climate in which people could swap healthy for unhealthy behaviour, such as by monitoring big food companies.

Lansley has alarmed senior doctors by saying the coalition will use much less regulation than Labour did to tackle problems such as obesity and smoking.

GPs seek to help people live healthy lives “but every day we are confronted by the harm caused by smoking, excessive alcohol consumption and the ‘tsunami’ of obesity”, adds Field, the leader of the country’s 40,000 GPs.

Irresponsible parents are damaging their children’s health by smoking around them, feeding them unhealthy food and failing to act as good role models, he says. Mothers and fathers who smoke in cars carrying their offspring – who Field says “are committing a form of child abuse” – and at home in front of their children kill more young people than do accidental injuries.

Parents who give their children unhealthy food, or serve them large portions are storing up huge problems for them, says Field. “Unless parents exert more control over their children’s diets, they are risking a lifetime of health problems, and even premature death – death before their parents, which is almost too sad to contemplate,” he adds.

Parents’ failure to safeguard their children from sunburn and using sunbeds can also lead to them developing skin cancer, he argues. Mothers who smoke while pregnant risk causing their child’s death through cot death syndrome, asthma, lung infections or house fires. Would-be mothers and women who are already expecting need to control their weight because maternal obesity can harm the mother or her baby.

Instead of becoming obese and then asking the NHS to provide liposuction or gastric bands, “it would be better if people didn’t become fat in the first place”, by eating better and exercising more.

Agreeing with Field, Milton said: “We need a new public health movement, owned by everyone, for everyone’s benefit. A movement that transforms the way in which the public’s health is improved, but also revolutionises the way we think about it. As Field points out, personal responsibility is a key part of this.”

However, Milton added: “The government recognises that it cannot force people into behaving in a certain way. But we can help people make informed decisions and ensure that they are enabled and supported to make healthy choices.”

Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, agreed some parents let down their children. “Of course paediatricians agree that people should take responsibility for their own lives. But young children cannot do that. What they eat and the environment they live in are determined by their parents. There is a role for society to protect young children from promotion of unhealthy foods and passive smoking. Would all parents strap young children into a car seat if it was left to choice rather than law?”

He urged a twin-track approach of exhorting parents to care for children well but society also intervening to help by, for example, limiting advertising of unhealthy foods.

Dr John Middleton, vice-president of the UK Faculty of Public Health, said: “A significant amount of ill-health is due to people’s lack of personal responsibility. The NHS would have fewer burdens on it if people were more physically active, cut their alcohol consumption and ate a lower-fat, lower-sugar diet. The government and the NHS cannot do everything. But someone trying to give up smoking will find it easier if they get counselling and nicotine replacement therapy on the NHS, for instance.”

The government had a key role to play in promoting health, as shown by its crackdown on smoking and its fluoridisation of water supplies, said Professor Dinesh Bhugra, president of the Royal College of Psychiatrists. People who insisted on smoking despite all the warnings about it should retain their freedom to do so, he added.

But Tam Fry, National Obesity Forum spokesman, suggested Field was being naïve. “If Professor Field wants a world where everyone assumes personal responsibility, he is living a dream. He appears to have forgotten the 35-40% of our population who live in the same obesogenic environment as he does but simply can’t cope with it or have long since given up the unequal struggle. They are the people who are quite unequipped to resist the 24/24 battering of junk food promotion and are easy prey for the marketing men.”

However, “certainly the 40% of women entering pregnancy either overweight or obese do so simply because they have never had role model lessons in parenting from either their own mothers or health professionals”, Fry added.

From: http://www.guardian.co.uk/public-health-attitudes-leading-gp