The World Heart Federation calls on all countries to set a target year to end tobacco use

At the Tobacco End Game Conference in New Delhi, India this week the World Heart Federation (WHF) signalled to all countries worldwide to set a target year to end tobacco use in their country. Ending tobacco use implies reducing population smoking levels to five percent or below.

Some countries have already taken the lead and have announced their “target year” to reduce tobacco consumption. These include Finland (2030), Scotland (2034), New Zealand (2025) as well as a few Pacific Island States (2025).  

The Risks

Previous Blogs, “Raising Awareness for Lung Cancer” and “Smoking – a big turn off”  have highlighted the negative impacts of smoking on health, and the evidence continues to affirm that tobacco use is one of the main risk factors for heart disease and is the cause of millions of premature deaths each year worldwide.

Smoking is estimated to cause nearly ten percent of cardiovascular disease (CVD) and is also the second leading cause of CVD after high blood pressure. Further more, it is not just smokers who bear the consequences of tobacco smoke, passive smokers are also placed under unnecessary risk.

Figures indicate that nearly six million people die from tobacco use or exposure to second hand smoke worldwide, every year. By 2030 is it believed that tobacco-related deaths will increase to over eight million deaths a year.

With strong evidence available to the public on the adverse effects of smoking and the efforts to promote these facts, the statistics on tobacco related deaths remain shocking!  

Thus, important questions arise about what else we need to be doing to reduce smoking in adults and prevent children from starting.

Could further changes in marketing be the answer?

Over the past decades the UK has witnessed some significant changes to how tobacco is advertised and this began in the early 1990’s but took greater affect after the millennium.  The 1990 and 1996 Broadcasting Acts prohibited tobacco marketing on broadcast media (television and radio). However, it was the Tobacco Advertising and Promotion Act 2002 (TAPA) that banned most forms of tobacco advertising. This included a ban on print media and billboard advertising (2003) and advertising at the point of sale (2004).

As the UK is a Party of the Framework Convention for Tobacco Control (FCTC) they were bound by agreement to implement the framework into national policy.  The drive to improve population health coupled with the requirement to integrate further restrictions on tobacco advertising, saw a new national tobacco control strategy emerge in 2008 by the Labour Government and later reinforced by the Coalition Government in 2011. The consultation included a ban on the display of tobacco in shops and a ban on tobacco vending machines (2011) both of which were included in the Health Bill.

Since April 2012 it has become illegal to display tobacco products at the point of sale in large stores and this ban will come into force in smaller stores from 2015. Although in 2010 the Coalition government agreed to review the evidence for plain packaging as part of its national strategy, this has still not come into affect, despite pressing evidence that branding of tobacco packets and higher consumption rates exists. Read the RSPH press release here on our disappointment of not introducing standardised packaging on tobacco products.

“Research shows that Point of Sale (PoS) display has a direct impact on young people’s smoking. In 2006, almost half (46%) of UK teenagers were aware of tobacco display at PoS and those professing an intention to smoke were more likely to recall brands that they had seen at the point of sale.”

Tobacco companies invest large amounts of resources in branding their products and making them appear as attractive as possible. They know that brand imagery is much more important to younger age groups, thus standardised packaging would reduce brand appeal and reduce the inclination to smoke.

Next Steps

Clearly, measures have been made to reduce smoking in the UK, tighter restrictions on tobacco advertisement and the implementation of the smoking ban in public spaces 2007/2008 have sought to reduce appeal for smoking. However, there remains more to be done to ensure we are able to align ourselves with the World Heart Federations’ aim to reduce tobacco use below 5% and prevent thousands of avoidable deaths a year (in England the current ambition is to reduce smoking prevalence to 18.5% or less by 2015; to 12% or less among 15 year olds by 2015). 

The World Heart Federation President Professor K Srinath Reddy said: "There is no hiding from the deadly effects of tobacco on heart health....There are many countries across all incomes making great strides in tobacco control and it should be possible for each of these nations to further bolster their tobacco control efforts by setting themselves a target year for reducing tobacco use below 5%. So the World Heart Federation would hope to see these countries, followed by those around the world, following the brave lead set by the countries that have announced target dates."

Visit RSPH Training Solutions to see programmes and courses that can give you the confidence and skills to help people make key lifestyle choices to improve their health.

For further information on UK regulations click here to read the ASH Briefing: UK Tobacco Control Policy and Expenditure.

For more information on the negative effects of tobacco use and how to quit please click here and NHS Choices website. 

The Seven Golden Rules for a Healthy Life

If we follow these simple steps, can we really reduce our risk of heart disease?

Cardiovascular disease (CVD) still remains the biggest killer in the UK.  In 2010, around 180,000 people died from CVD and 80,000 of these deaths were from coronary heart disease (CHD).  Although over the past decade, there has been a decline in death rates from heart disease in England, there still remains regional and socioeconomic differences in both incidence and case fatality, along with behaviour inequalities.

In 2010, the American Heart Association (AHA) proposed seven factors to help people understand the most effective ways of avoiding CVD and lowering the risk of developing cancer. 

The findings came from a long term study carried out by researchers from Northwestern University (Chicago), the University of Minnesota, and a number of other US research institutions; their findings were published in the peer-reviewed journal Circulation.  The cohort study followed 13,253 white and African American participants for between 17 and 19 years, to establish if maintaining ideal levels of the seven health factors could reduce heart disease and lower the risk of cancer. 

The Seven Simple Steps

• 1      Not smoking (never smoking or quitting more than 12 months ago
• 2      Maintaining a healthy body weight (that is a healthy Body Max Index (BMI)
• 3      Eating Healthily (diets rich in nutrition, fruits and vegetables)
• 4      Physical Activity (at least 75 minutes per week of vigorous physical activity, or 150 minutes per week of moderate or moderate plus vigorous activity
• 5      Having low cholesterol levels
• 6      Healthy blood sugar rates
• 7      Healthy blood pressure

The Findings

From the study, researchers found that the health benefits were higher among people who met the ideal levels for each of the seven factors.  For example, people who achieved ideal levels for six of more factors had a 51% reduced cancer risk and those who met the ideal levels of four factors had a 33% reduced rate of developing cancer.

While the findings have been welcomed, it is worth noting that smoking appeared responsible for the majority of the associations seen between the seven factors and cancer risk. This once again exemplifies how smoking has a direct correlation with your heart, blood pressure, circulation and individual risk of lung cancer.

What more can be done?

As highlighted above, CVD and CHD continues to be a major health concern in the UK, with health issues being more prevalent among low income earners. Those from lower socioeconomic groups are more likely to have poorer diets, lead sedentary lifestyles, suffer from mental health issues and partake in health risk behaviour, including smoking and alcohol abuse. These factors have a major impact on heart disease.

Type 2 diabetes and obesity are also some of the main contributors leading to CVD.  In England alone, a quarter of adults are obese and the prevalence of diabetes in the UK is around 5% for women and 6% for men.  The financial cost to society can also be detrimental.  The statistics reveal that in 2009, CVD cost the UK economy £19 billion – putting further strain on the health care system.

Although the AHA’s seven steps to improving health helps people to understand where to make the changes in their life (healthy eating, exercising), the problem is how to make these changes?  For most people, breaking old habits and changing behaviour can seem like an impossible task, and for some, change is not always welcomed. How do we engage with people and offer advice on sensitive issues that could potentially save their lives?

The RSPH, having recognised the fundamental importance of behaviour change to improve health, has developed a qualification in Understanding Behaviour Change, Level 2 Award, to provide an understanding of communication styles and practical skills to help individuals implement lifestyle changes. The one day programme will also aim to give learners knowledge and confidence to offer brief advice and engage in brief interventions.  Sometimes, having the right conversation with someone can have far reaching positive affects.   For further information on the qualification please click here or contact Gina Mohajer.

For further information on heart disease visit the British Heart Foundation here

Smoking – A Big Turn Off

A recent survey, conducted by the Department of Health (DoH), shows that people who smoke could potentially be limiting their romantic chances of meeting someone, because the majority of the population find smoking off putting.


The DoH says to boost your chances of dating success this Valentine’s Day (February 14^th) quit smoking!

The poll surveyed 1,700 people, of which, half claimed that they would think twice about starting a serious relationship with a smoker.   Three-quarters of people aged between 18 and 24 said they would not kiss someone who had just smoked and agreed that smoking makes people less attractive.

The BBC news also pointed out that anecdotal reports from dating agencies appear to support the evidence reported by the DoH that people, in search of a partner, really did prefer non-smokers.

Popular relationship websites such as eHarmony.co.uk states that eighty-one percent of its members would not partner with a heavy smoker.  Similarly, at Match.com seventy-two percent of male members and seventy-three percent of female members, specified that they wanted a “non-smoking” partner.  At Mysinglefriend.com over half of its members (sixty-seven percent) said that smoking would put them off dating someone.

Sarah Beeny, founder of Mysinglefriend.com said; "It's particularly obvious that non-smokers find it harder to live with a smoker, so by giving up you not only increase your dating market, but protect the years you have together when you do settle down."

Statistics complied by Action on Smoking and Health (ASH.org.uk) shows that currently in the United Kingdom, more than ten million people smoke and it is estimated that half of these are likely to die from smoking-related diseases if they do not stop.  Every year, over 100,000 smokers die from smoking related diseases.

The DoH suggests that by quitting smoking, people could increase their life expectancy by 16 years.

We are all aware of the harmful affects of smoking to our health, and although the evidence suggests that in our quest for love, people do prefer partners who are non-smokers, the bottom line is that people need to make positive health changes for themselves. 

For advice on stopping smoking visit the NHS Choices website and see the benefits you can make to your help

Ask your Pharmacist Week

This week is “Ask your Pharmacist Week” whereby the National Pharmacy Association aims to promote the health services provided by community pharmacists, which may not be familiar to everybody.

People generally use pharmacies to collect prescriptions and pills,  seldom realising the wider role that pharmacies can play in their local communities.  Pharmacies offer more than just a place to pick up prescriptions, the pharmacist can advise, support and offer guidance on a number of common health problems and minor ailments.  These range from obesity, diabetes, sexual health, skin conditions, coronary heart disease and airway conditions.

Pharmacists are also able to provide help on dieting and exercise, as well as alcohol consumption and stopping smoking.  

“Pharmacies are there to help you stay well, not just to treat you when you are sick”

Healthy Living Pharmacies

Some pharmacies are known as Health Living Pharmacies, because they have a healthy living champion who, as well as delivering services themselves and advising people on health issues,  also keeps up to date with health services and are able to signpost people to receive further help.

For further information on the services that Pharmacies provide, please click on the Ask Your Pharmacy website. 

The RSPH supports the work carried out in pharmacies and sees their role as integral to helping to reduce health inequalities and ensuring that everyone can access health services as well as getting the right advice.

RSPH Training Solutions currently offer the Level Two Award in Understanding Health Improvement to health trainers and champions and continue to develop tailored programmes for people working in pharmacies.. 

For more information on this please contact Gina Mohajer gmohajer@rsph.org.uk or 0207 265 7327.

  

Positive Pharmacy

-       There are currently 12,000 pharmacies across the UK, therefore for the majority of us, they are easy to access and tend to be close by.

-       To visit a pharmacy you do not need to make an appointment.

-       There is always a fully qualified healthcare professional and support team who can answer queries and offer knowledgeable advice.

-       Most pharmacies have a consultation room, whereby you can talk with your pharmacist without being overheard.

-       Health checks and vaccinations can also take place in the consultation room

British Women - Unhealthy Lifestyles Have Led to Higher Rates of Cancer!

Data from the World Health Organisation, found that Britain has higher rates of potential fatal disease than the USA, Australia, Germany and Spain.  The statistics reveal that British women are more likely to be diagnosed with breast cancer because of their unhealthy lifestyles.  Cause for concern for?   

A project called GLOBOCAN, set up by the WHO, collects figures on the incidence of and deaths from the most common types of cancer for countries across the world.  The data which was used and analysed for a recent study by the World Cancer Research Fund, found that Britain is the 12th worst of the 50 countries in terms of rates of all cancers among women, and is rated 11th worst for breast cancer.  The figures show that although Belgium is the worse with 109.2 cases per 100,000 women in 2008 with breast cancer, Britain is not far behind with 89.1 cases per 100,000.  There are around 46,000 breast cancer cases per year in the UK, of which a quarter die.

Although high levels of breast cancer rates may be attributed to better detection methods such as new technological advancements and increased awareness, experts claim that lifestyle choices also plays a significant factor.
Meg McArthur, Senior Policy and Information Officer for Breakthrough Breast Cancer, says that “Breast cancer is thought to be due to a combination of lifestyle, genetic and environmental factors and although some risk factors cannot be changed, women can reduce their risk by drinking less, maintaining a healthy weight and exercising regularly.”

Currently international studies demonstrates that Britons now eat and drink more than their counterparts in many other countries.  Recent figures from the Office for National Statistics shows that 56 percent of women over the age of 16 drinks more than double the recommended daily allowance of alcohol every week, while 24 per cent of women in England are classified obese.

Therefore, experts claim that the high number of women diagnosed with breast cancer in the UK could be avoided if women adopted healthier lifestyles, including drinking less alcohol, eating better and doing more exercise.
Sarah Woolnough, director of policy for Cancer Research UK said "We do know that up to half of all cancers could be prevented by changes to lifestyle such as giving up smoking, keeping a healthy weight and cutting down on alcohol"

The National Cancer Director, Professor Sir Mike Richards, said "We want to vastly improve cancer outcomes - that’s why we will shortly be launching the first ever Government awareness campaign for cancer, to promote earlier diagnosis and to save more lives.”

Raise awareness for women's health! 
In aid of International Women’s Day this year, the Royal Society for Public Health will be running a programme on the 8^th March on "Women’s Health and Well-being".  The event will raise awareness of interrelationship between lifestyle and health, while educating participants about the steps they can take to empower women to improve their physical and mental health.  For further information or to attend the programme please contact Nicolette Smith or by phone 020 3177 1625. 

Smoking - The Main Reason Why Men Die Sooner Than Women

In a report published by Tobacco Control "Contribution of smoking-related and alcohol related deaths to the gender gap in mortality: Evidence from 30 European countries" found that smoking continues to be the most important cause for gender differences in mortality across Europe.  

Since the 1990's emerging evidence has revealed that women outlive men in all countries of the world.  Historical records demonstrate that in England, Wales and some of the Nordic countries, the life expectancy of women has exceeded that of men since the mid to late 18th Century.  Currently in the UK women are estimated to live four years longer than men.  There has been a great deal of speculation as to why this appears to be the case.  Many expects claim that simple biology or the fact that women seek medical help more readily than men are the reasons for the disparity in life expectancy.

However, as the report discovers, smoking is the main cause followed by alcohol, which accounts for 20 percent of the difference. 

The report which studied the data extracted from the World Health Organization database, looked at thirty European countries.  It found that in all countries death from all causes were higher for men than for women.  However, the report also noted that there continues to be a considerable variation in the extent of gender difference in contemporary Europe.  The gender gap in all-cause death rates varied from 188 excess deaths per 100,000 in Iceland and the UK, to over 800 in Ukraine and Lithuania.    

Despite the variations, the researchers discovered that smoking-related deaths alone contributed to around 40 to 60 percent of the gender gap in all countries, excluding Denmark, France and Portugal where it is considerably lower, and Malta where it is higher at over 70 percent. 
The data demonstrated that in the UK, smoking-related diseases such as lung cancer and heart disease caused 60 percent of the excess male deaths. 

The researchers highlighted that, "It is no surprise that two of the most important health behaviours, smoking and hazardous drinking continue to account for substantial proportions of the gender gap in mortality because health behaviours have long been a powerful way of portraying gendered identities." 

Thus the report makes clear that there is an "ongoing need for public health measures to reduce health damaging behaviours". 

Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: "It is never too late to give up smoking so it's important we invest in support services to help people quit the habit as well as ensuring our young people don't start smoking in the first place.”

Men's Health Week 13 - 19 June
-To Raise awareness of preventable health problems among men and boys -

In light of Men's Health Week this year, the RSPH will be hosting a one day Men's Health course on May 13th.  The purpose of the event is to facilitate men’s access to information, empower them to be more aware and access health leisure services, in order to improve key lifestyle behaviours.
For further information or to book onto the course please contact Nicolette Smith.

Quitting Smoking Can Make You Feel Happier

The notion that smoking helps relieves emotions such as anxiety and depression is a myth, say researchers at Brown University.  People are known to smoke when they are feeling stressed in an attempt to relieve tension.  However a study published in the Nicotine & Tobacco Research, indicates that people who are in the process of giving up smoking have never felt happier!

Christopher Kahler, corresponding author of "Time-Varying Smoking Abstinence Predicts Lower Depressive Symptoms Following Smoking Cessation Treatment" says smokers thinking of quitting should be encouraged by the double benefit - both physical and mental.  Not only will giving up smoking improve your physical health but evidence suggests that your mental health is also likely to improve.  Therefore, stopping smoking is far from a psychological nightmare done to live longer, Kahler added.

Kahler noted that "The assumption has often been that people might smoke because it has anti-depressant properties and that if they quit it might unmask a depressive episode.  What's surprising is that at the time when you measure smokers' mood, even if they've only succeeded for a little while, they are already reporting less symptoms of depression."

Scientists at the Peninsula Medical School in the UK, in a study called the English Longitudinal Study of Aging, assessed the wellbeing of nearly 10,000 people over the age of 50.  It was found that smokers in that group reported lower average levels of pleasure and less satisfaction with their lives than the non smokers.   The lead researcher on the team, Iain Lang, reported that smokers feel pleasure when they initially light up.  But that's because they're feeding their addiction.  Overall they're not any happier than non smokers.  In fact, they're less so.

For more information on ways to quit smoking click here.