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What the papers say – weekly digest (12/04/24)

Written by | 12 Apr 2024 | Male & Female Health

Your weekly digest of the top healthcare stories, covering news published from 08/04/2024 – 12/04/2024.

The Guardian

Thousands of people in England who suffer from migraines are to be offered a daily pill on the NHS that can reduce their frequency by half. In final draft guidance published today (Thursday), the National Institute for Health and Care Excellence (Nice) has given the green light to the first oral treatment that can prevent both chronic and episodic migraines. Atogepant – also called Aquipta and made by AbbVie – works by blocking the receptor of a protein found in the sensory nerves of the head and neck, known as calcitonin gene-related peptide (CGRP). CGRP makes blood vessels dilate, which can lead to inflammation and migraine. The guidance is expected to give more choice to at least 170,000 patients in England, Nice said. The regulator has recommended the drug as an option for preventing chronic and episodic migraines in adults who have had at least four migraine days a month and where at least three previous preventive treatments have failed. Chronic migraine is where a person has at least 15 headache days a month, with at least eight of those having features of migraine. Episodic migraine is where a person has fewer than 15 headache days each month. Helen Knight, the director of medicines evaluation at Nice, said: ‘’Currently, the most effective options for people with chronic migraines who have already tried three preventive treatments are drugs that need to be injected. The committee heard from patient experts that some people cannot have injectable treatments, for example because they have an allergy or phobia of needles.’’ Knight said patients with chronic migraines – that happen on more than 15 days of the month – ‘’would welcome an oral treatment’’. Affecting about 4.5 million people in England, migraines can have a significant impact on a person’s daily life, as well as placing a heavy burden on the NHS and the wider economy. Migraine charities called for ‘’swift’’ access to the drug to ensure patients with the debilitating condition ‘’can benefit from them as quickly as possible’’. The Migraine Trust CEO, Rob Music, said: ‘’A migraine attack can be incredibly debilitating. Symptoms can include intense head pain, loss of or changes to the senses, and lack of ability to carry out day-to-day life… We now need to ensure access is swift, so that migraine patients can benefit from them as quickly as possible.’’ The health minister Andrew Stephenson said: ‘’Migraines affect millions of people in this country and this new treatment will help prevent recurring migraine attacks when other medicines have failed. ‘’It will allow more people whose daily life is affected by this painful, debilitating condition to manage their migraines more effectively and to live their lives to the fullest.’’ Nice’s guidance for England comes after the pill was recommended for use in Scotland by the Scottish Medicines Consortium in October last year. Rachel Millward, the medical director of AbbVieUK, said: ‘’AbbVie has an extensive history in migraine research and is committed to addressing the unmet needs of people living with this debilitating condition.’’ The recommendation from Nice means that suitable people living with migraines will have access to an additional treatment option that has the potential to improve their quality of life, she added. Nice recommends that Aquipta should be stopped after 12 weeks if chronic migraines do not reduce by at least 30% and episodic migraines by at least 50%. If there are no appeals against its final draft guidance, Nice is expected to publish its final guidance on the drug next month.

The discovery of a gene that appears to protect against Alzheimer’s disease could lead to new treatments, scientists have said. Researchers in New York have found that a rare variant of a gene known as FN1 appears to reduce by 70 per cent the chances of developing the disease for people who would otherwise be at high risk. The protective variant seems to allow a toxic protein called amyloid to leave the brain by passing into blood vessels. An accumulation of amyloid ‘’plaques’’ between the brain’s nerve cells has long been recognised as one of the hallmarks of Alzheimer’s. Dr Caghan Kizil of New York’s Columbia University Vagelos College of Physicians and Surgeons, a co-leader of the study, published in the journal Acta Neuropathologica, said: ‘’Anything that reduces excess fibronectin should provide some protection and a drug that does this could be a significant step forward.’’ At present, the most promising treatments for Alzheimer’s are antibody drugs designed to mop up amyloid deposits. Trials have suggested that they can slow the progression of the disease, but not improve symptoms.

Green spaces may help small children avoid blue moods, a study suggests. Children aged between two and five were less likely to show signs of loneliness, anxiety and low mood if they lived within three quarters of a mile of somewhere with plenty of vegetation, such as a woodland or park, the research found. They were also less likely to be withdrawn in social situations. Nissa Towe-Goodman, a researcher from the Frank Porter Graham Child Development Institute at the University of North Carolina, said: ‘’Our research…suggests that the early childhood years are a crucial time for exposure to green spaces.’’ Parents of more than 2,000 children in America aged from two to 11 were asked to rate their child’s emotional and behavioural symptoms. The researchers then used satellite data to assess levels of vegetation around their homes. They found that higher levels of green spaces within about a 20-minute walk of a child’s home were associated with lower anxiety and depression symptoms in early childhood. This link persisted even when accounting for factors such as the socio-economic status of the neighbourhood, the parents’ education levels and their age when their children were born. A similar association was not seen in older children; the researchers speculate this may be because they spend more time away from home at school. Towe-Goodman said: ‘’In the future, researchers could look into what kinds of experiences in nature are connected to kids’ early mental health. Also, we should study how creating or preserving natural areas around homes and schools might make a difference in a child’s mental health.’’ A study of almost a million people published in the Proceedings of the National Academy of Sciences in 2019 found that children who had grown up in greener surroundings had a greatly reduced risk of mental illnesses later in life. Those raised in the lowest levels of green space were as much as 55 per cent more likely to develop disorders such as substance abuse, stress-related illnesses and schizophrenia. The link to good mental health was just as strong for those who lived in green areas of cities as for those who grew up deep in the countryside. The latest study, published in the journal Jama Network Open, and the one from 2019 were observational, which means they did offer an explanation as to why green spaces were linked to mental wellbeing. Experts have suggested that greener neighbourhoods encourage exercise and improve ‘’social coherence’’. Greenery also tends to decrease noise and air pollution.

The Telegraph

Children who believe they are transgender may actually have mental health issues, a landmark report is set to find this week. It is expected to advise that children should not be rushed on to a path to change gender, and that they receive counselling which addresses the mental health issues they may have rather than being put on drugs. Dr Hilary Cass, a paediatrician, will tomorrow (Wednesday) unveil her long-awaited review into how transgender children are supported and the medical treatment they receive. It comes amid concern that children are being allowed to change gender in school without their parents’ knowledge or consent, and after the routine prescription of puberty blockers was banned by NHS England. The Telegraph understands that the report will find that children who think they are trans disproportionately have mental issues, a difficult family situation or have suffered from abuse. They are also more likely to be neurodiverse. It is expected to suggest that these children need counselling to tackle these problems holistically, rather than them automatically being put on a path to change gender. The report is expected to warn that it is wrong to assume it is in the best interest of children who think they are trans to change gender, and urge extreme caution over the use of drugs such as puberty blockers and cross-sex hormones to facilitate this, even once someone is over 18 years old. The review is also said to express concern about a significant rise in the number of young girls wanting to become boys, and say this group needs more support. Yesterday (Monday), Downing Street said the Government would act on the basis of the report to ensure children and adolescents are kept safe. The Prime Minister’s spokesman said: ‘’We have talked about the importance of children and adolescent safety and wellbeing being paramount. That is part of previous work such as the NHS announcement to end the routine prescription of puberty blockers, it is behind our robust and clear guidance to schools, (and) it is categorical that social transitioning is not a neutral act and no one should be forced to use preferred pronouns or accept contested beliefs as fact. We’ve also said there’s more to do in this area and we will look at the review when it’s published.’’ The spokesman added: The Government has taken a number of steps in this area, recognising the effect that social transitioning can have on children and adolescents, and we’ve made clear that single sex spaces must be protected.’’ The interim Cass report in 2022 said that children being allowed to socially transition in schools – changing their name and pronouns, and being allowed to use the toilet and changing rooms of the gender they identify as – was ‘’not a neutral act’’. It also raised concerns about the NHS’s gender identity and development service at the Tavistock and Portman NHS trust in London. Dr Cass’s final report is expected to conclude that there could be many complex reasons a child may think they are in the wrong gender. It is understood to say that prepubescent children should not be put on the same ‘’pathway’’ as older adolescents who wish to identify as the opposite gender. It is expected to warn that children may experience ‘’psychological’’ repercussions as a result of being allowed to change their name and pronoun to the gender of their choice. Last month, the NHS announced an immediate ban on prescribing puberty blockers to under-18s unless they are part of a clinical trial. Ministers said the ‘’landmark decision’’ was in children’s ‘’best interests’’ and would help to ensure youngsters who feel their gender is not the same as their sex are treated using medical evidence.

Wes Streeting has criticised ‘’middle-class Lefties’’ who are opposed to Labour’s plans for NHS reform. The shadow health secretary said his party would make use of the private healthcare sector to reduce NHS waiting lists in a move he conceded would prompt cries of ‘’betrayal’’ from some quarters. Mr Streeting has previously warned the health service will go bankrupt without reform and that it would be wasteful to keep pouring money into a system that is not working. In an article for The Sun, he said: ‘’We will also use spare capacity in the private sector to cut the waiting lists. Middle-class lefties cry ‘betrayal’. The real betrayal is the two-tier system that sees people like them treated faster – while working families like mine are left waiting for longer.’’ Mr Streeting argued that the NHS must be ‘’a service, not a shrine’’ and promised it would not receive any additional funding without ‘’major surgery’’ to the way that it works under Labour. ‘It’s a 20th century service that hasn’t changed with the times and isn’t fit for the modern era,’’ he added. ‘’It catches illness too late, which means worse care for patients at greater cost to the taxpayer… This can’t go on.’’ He said the first suite of Labour’s reforms to the health service would focus on using artificial intelligence in every hospital, while expanding the NHS app to give greater choice to patients. Mr Streeting also vowed to reduce bureaucracy, noting GPs are measured by 55 targets and too much time is taken up filling in forms. Warning reform would ‘’not be easy’’ but insisting he was ‘’up for the fight’’, he concluded: ‘’The NHS saved my life when I had kidney cancer and now I’m determined to save our NHS.’’ The MP for Ilford North took time off work in 2021 after his diagnosis aged 38. He has accused Rishi Sunak of making cancer patients ‘’pay the price’’ by failing to resolve recent junior doctors’ strikes, while also blaming the Prime Minister for record NHS waiting lists and extended ambulance waiting times. During his broadcast round yesterday (Monday), Mr Street criticised Left-wingers in his own party for their ‘’howls of outrage’’ in response to his ambitions to make greater use of the private sector. He told the BBC: ‘’As the howls of outrage pour in… I kind of take it as water off a duck’s back. Because I don’t think I could look someone in the eye who is waiting for months and months, sometimes over a year, in pain and agony for treatment, I couldn’t look that person in the eye and tell them that they should wait longer because my principles trump their timely access to care.’’

Exasperated mothers often warn that their children ‘’will be the death of them’’, and a new study suggests that there may be some truth in the admonishment. Pregnancy accelerates biological ageing with each baby causing women to grow older by up to 2.8 months, scientists have discovered. Carrying a child is known to have long-term health impacts, but previous studies have found that they are largely beneficial, such as lowering the risk of cancer and dementia. Now new research by Columbia University in New York has shown that pregnancy takes such a toll on the body that it causes a woman to age internally. The research, which was carried out on 1,735 young people in the Philippines, looked at alterations to DNA to calculate the biological age of mothers compared with their actual age. Throughout life, as a person ages, small molecules get added to their DNA, giving updated instructions about how to function. These ‘’tags’’ accumulate at a steady rate and can be used as a kind of clock that reveals age. Each additional pregnancy was associated with between 2.4 and 2.8 months of accelerated biological ageing. The team found that men were not impacted in the same way, with their DNA unaffected by fatherhood. This implies that it is something about pregnancy, or breastfeeding specifically, that accelerates biological ageing, the researchers said. ‘’Our findings suggest that pregnancy speeds up biological ageing and that these effects are apparent in young, high-fertility women,’’ said Dr Calen Ryan, the lead author of the study and an associate research scientist at the Columbia Aging Center. ‘’Our results are also the first to follow the same women through time, linking changes in each woman’s pregnancy number to changes in her biological age. Ultimately I think our findings highlight the potential long-term impacts of pregnancy on women’s health, and the importance of taking care of new parents, especially young mothers.’’ The bodies of women who reported having been pregnant appeared biologically older than those who had never been pregnant. Women who had been pregnant more often were biologically older again than those who reported fewer pregnancies. The relationship between pregnancy history and biological age remained even after taking into account other factors tied to biological ageing, such as socioeconomic status, smoking and genetic variation. Dr Ryan added: ‘’We still have a lot to learn about the role of pregnancy and other aspects of reproduction in the ageing process.’’ The research was published in the journal PNAS.

Long Covid symptoms may be driven by the reactivation of dormant viruses such as herpes, scientists have suggested, after finding evidence of inflammation in the blood of sufferers. At the last count by the Office of National Statistics last year, some 1.9 million people reported symptoms of long Covid, which can include fatigue, brain fog and muscle aches. Now Imperial College and the University of Leicester, have found in long Covid sufferers, the immune system is still active long after a Covid infection has cleared up, with tell-tale signs of inflammatory proteins detectable in the blood. Experts said this inflammation may be caused by trace amounts of Covid-19 lingering in the body; autoimmunity, when the immune system attacks the body’s own tissues; or even the reactivation of other viruses. Imperial’s Dr Felicity Liew said: ‘’Even though the acute phase of illness resolves, there may be virus persisting in the body that could continually trigger the immune system and cause the ongoing inflammation that we found. It can also cause reactivation of herpes viruses or people that previously had glandular fever caused by Epstein-Barr virus, and it can cause that to reactivate and cause ongoing symptoms. Or it can result in auto-immunity, and all of those scenarios result in the types of inflammation that we see, and could result in chronic and on-going abnormal inflammation represented by these proteins highlighted here.’’ The analysis looked at blood plasma from 426 people treated in hospital with Covid who had experienced long-term symptoms  and compared them with blood from people with no ongoing problems. The study is published in the journal Nature Immunology.

Smartphones will be given to diabetic children to track their blood sugar under Labour’s plans for the NHS. Sir Keir Starmer has pledged to give a mobile phone to all 32,000 children with type 1 diabetes so that they can take advantage of new glucose monitoring devices. The Labour leader said he had reached a deal with Virgin Media O2 to supply the phones in a move that shows his government would ‘’work hand-in-glove with business’’ to improve the NHS. Yesterday (Monday), Wes Streeting the shadow health secretary, and Sir Keir unveiled plans to give children mobile phones that are compatible with continuous glucose monitors (CGMs), making them available on the NHS. They announced the measures during a visit to King’s Mill Hospital in Sutton-in-Ashfield, Notts. The partnership between Virgin and the NHS would build on work by the charity Supporting Children with Diabetes (SCD), which has already given out about 500 donated phones to children. The CGMs allow anyone with diabetes to monitor their glucose levels by checking their smartphone and receiving notifications if it is dropping too low or going too high so they can adjust what they eat and drink – and when. Sir Keir said: ‘’It’s a travesty that hundreds of children with type 1 diabetes can’t afford smartphones to take advantage of new monitors which check and monitor glucose levels. This new technological breakthrough should be available to all children who need it. We need an innovative and collaborative approach to tackle this head on. That’s why my Labour government will work hand-in-glove with leading businesses to break down the barriers to access.’’ He said a 10-year plan to modernise the NHS would bring it into the digital age and ‘’give all children the best possible start in life’’. About 32,000 children in the UK are currently living with the condition. Carolyn Goldhill, the chief executive of SCD, said many of those affected cannot afford a new smartphone and are forced to finger prick to test levels. Labour said that the NHS would identify children who are in need of a smartphone and direct them to the charity. It has also said it would digitise the ‘’red book’’ given to parents to track their newborn’s medical records as they grow. Mr Streeting said: ‘’There is a revolution in medical technology taking place before our eyes. Under the Tories, the NHS is failing to secure the advantages of AI and new treatments for its patients, but private health care won’t. If this continues, the two-tier healthcare system that is emerging in our country today will grow, the gap between public and private will widen, and the NHS will become the poor man’s service. That is the future we must avoid. Labour will reform the NHS so it takes full advantage of modern technology to deliver better care for all patients.’’ Nicola Green, the corporate affairs director of Virgin Media O2, said: ‘’As someone with type 1 diabetes, I have first-hand experience of how smartphone technology can help manage the condition. The recycled devices that Virgin Media O2 is donating will reduce the hassle and stress for those families affected by diabetes.’’

The Times

More than 150,000 patients waited more than 24 hours in A&E before getting a hospital bed last year, a tenfold increase on 2019. Elderly and frail patients made up the bulk of those who had to spend a full day in an emergency unit before a bed could be found for them. Medical leaders said that hospitals were too full to give people the care they needed. Senior doctors said that such long waits were likely to lead to the deaths of patients, after years in which NHS delays have been steadily lengthening. NHS chiefs have acknowledged the problem, which they said was caused by rising demand as they tried to find alternative ways of treating people that avoided the need for admissions to hospital. Official figures show that almost 40,000 patients a month now wait 12 hours in accident and emergency departments for a bed, a 50-fold increase on numbers before the pandemic and a 600-fold increase on 2015, the last time the NHS met its target of seeing 95 per cent of patients within four hours. Now freedom of information data compiled by the Liberal Democrats shows that a significant proportion of those patients are waiting a full day in emergency units. Responses from 73 hospital trusts, about half the total, show that 153,000 patients waited more than 24 hours in A&E before a bed could be found for them. That figure includes only patients who were ill enough to need a hospital bed, not those who could be treated and sent home. It is up 17 per cent in a year after a seven-fold increase from 2021 to 2022. In 2019, the equivalent figure for 24-hour waits was less than 15,000. About two thirds of the patients affected are older than 65. ‘’It is appalling that so many elderly and vulnerable people are being forced to put up with these terrifying waits as our health service teeters on the brink,’’ Sir Ed Davey, the Liberal Democrat leader, said. ‘’Behind each one of these figures is a story of someone waiting in pain, worried sick about getting the care they need,’’. Blaming the government for ‘’neglect of the NHS and care’’, Davey added; ‘’We desperately need more hospital beds and a long-term solution to the social care crisis to end these devastating A&E delays.’’ Adrian Boyle, president of the Royal College of Emergency Medicine, said that the patients behind the statistics were ‘’always people who are sick who need to be admitted to hospital. The majority are those who have general medical problems and are elderly with multiple conditions. Quite a lot also have mental health problems.’’ The college has estimated that more than 250 patients a week died last year because of A&E delays. ‘’We know that staying 12 hours is harmful for people, so staying longer certainly won’t be good for people,’’ Boyle said. ‘’For every 72 stays of 12 hours (in A&E), there will be one excess death. There was also a study in France showing that if people over 75 spend more than 12 hours in the emergency department they had a 5 per cent increased risk of death in the subsequent admission.’’ He estimated that the NHS was short of 10,000 beds, saying: ‘’This is a deep-seated lack of capacity in our hospitals. We still have the least number of beds per head of any European country apart from Sweden. The pandemic disrupted things, but the problems were set in stone beforehand.’’ Failure to improve social care means that hospitals struggled to discharge frail elderly patients, Boyle added. ‘’If you go back to 2015, all the graphs show a steady downward curve. It’s just become much more noticeable.’’ East Kent Hospitals had the worst record of the trusts that submitted figures, with 14,400 patients waiting more than a day – almost one in ten of the total, and up from 1,300 in 2019. Ten of the 73 hospitals said that they had fewer than 100 24-hour waits and some, including Northumbria Healthcare, reported none. Boyle said that there was a ‘’lot of unwarranted variation – we know some hospitals are much better at this’’, for example with more efficient discharge processes. An NHS spokeswoman said: ‘’Last year NHS staff contended with significant demand – 393,000 more A&E attendances and 217,000 more emergency admissions compared with 2022. – on top of unprecedented industrial action, high bed occupancy and the usual pressure caused by seasonal illness including Covid and flu.’’ She added that there had been ‘’significant progress for patients – alongside increasing capacity, including extra beds and ambulances, the NHS has expanded the use of innovative measures like same-day emergency care… and treating people closer to home.’’ A spokeswoman for the Department of Health said: ‘’A&E four-hour performance improved in February compared to January, despite the highest number of A&E attendances on record and the impact of industrial action. Out Urgent Care Recovery Plan, backed by £1 billion in 2023-24, has added 5,000 hospital beds and rolled out 10,000 hospital at home wards.’’

Rishi Sunak said he was dissatisfied by his failure to cut NHS waiting lists, acknowledging that he had made less progress on that than on his other priorities – but insisted there were signs that ‘’the plan is working’’. The prime minister urged junior doctors to accept a pay offer that he said was ‘’most generous for anyone in the public sector anywhere’’, blaming a campaign of strikes for the failure to bring down the queues. The waiting list for routine treatment and operations stands at 7.6 million, down slightly on a peak of almost 7.8 million but still almost 400,000 higher than January last year, when Sunak promised to reduce it. Cutting waits was one of the five priorities he set out – the others being to bring down inflation, expand the economy, reduce debt and stop small boat crossings. While halving inflations is the only pledge to have been unambiguously met, Sunak told LBC: ‘’Of all the areas that I set out, when it comes to the NHS, that’s the place where we’ve not made as much progress as I would have liked.’’ He acknowledged that ‘’the waiting list today is higher than it was when I took office’’, but argued: ‘’Obviously it was impacted by the strikes, and we were actually seeing progress before then.’’ Last week NHS consultants accepted a pay deal that will raise some doctors’ pay rise by 19 per cent, and Sunak used this to increase pressure on junior doctors still threatening strikes in the push for a 35 per cent pay rise. ‘’We’ve just now reached a settlement with the consultants which is very positive, so now it’s just the junior doctors who are the ones that remain out on strike. I’d say come back around the table,’’ he said. ‘’We’ve resolved this with everybody else and we’ve put very fair offers on the table. The offer for the junior doctors is the most generous for anyone in the public sector anywhere and I would urge them to do it.’’ Sunal said he was ‘’heartened’’ by recent falls in waiting lists, saying: ‘’The waiting lists have now fallen for four months in a row. We haven’t been suffering as much industrial action over that time.’’ He insisted: ‘’The plan is working. The last four months show that the numbers are all now starting to come down, and if we stick with it, I can make sure that we can get everyone the help that they need.’’ According to some estimates, the strikes have increased waiting lists by about 200,000.

Nearly one in three NHS staff have taken time off work with mental health issues in the past year, a survey by Unison, the trade union, suggests. Panic attacks, high blood pressure, chest pains and headaches were among the physical signs of stress reported by some of the 12,200 nurses, porters, 999 call handlers and other NHS staff who completed the survey. The union said the results showed the impact of a staffing crisis and said many workers were suffering ‘’burn-out’’ as they tried to tackle waiting lists. The survey also suggested that staff had been shown pornographic images, offered money for sex and assaulted at work. Before the union’s health conference in Brighton, Helga Pile, its head of health, said: ‘’Many NHS staff are clearly at their limit. Burnout is a reality in every part of the health service, from hospital wards to ambulance stations. As more staff quit, the pressures increase for those still working in the NHS, and many are struggling to cope. No one should suffer stress-related issues such as panic attacks and chest pains because of their job. Employers must do more to recognise the overwhelming pressures on all NHS staff, including healthcare assistants, cleaners and paramedics. The range of support available to workers experiencing mental health issues needs to be reviewed too. Managers must also ensure staffing levels are safe and that employees have regular breaks.’’ According to the survey, 31 per cent of staff had taken time off work with mental health problems in the past year. Of those who did, one in five said they had not given the real reason for their absence because they did not feel their manager would be supportive. Of those who asked for support, 48 per cent said they did not feel supported. Unison said staff felt undervalued and frustrated, and that many left for a less stressful job or a better-paid job. The survey suggested that one in ten workers had been the victim in incidents including being touched or kissed, or had been asked for sex or verbally abused. Sexual assault was reported by almost a third of respondents, and half said they had been leered at or had been the target of suggestive gestures. One in four said they had suffered unwelcome sexual advances, propositions or demands for sexual favours. Half of staff said they had not reported sexual harassment to their bosses, mostly for fear of being thought as ‘’over-sensitive’’ or because they believed nothing would be done. A 111 call handler reported being harassed by anonymous callers and said she was told by her managers that it was part of the job. Christina McAnea, Unison’s general secretary, said: ‘’No one should ever have to endure such despicable behaviour and certainly not in their place of work.’’ A spokesman for the Department of Health and Social Care said: ‘’We have a zero-tolerance approach and will continue to work with the NHS to ensure that they are taking measures to stop sexual assaults… and to ensure staff feel comfortable raising concerns. We encourage any member of staff who have faced these issues to report it within the NHS, and to the police.’’ Professor Nicola Ranger, the Royal College of Nursing’s director of nursing, said: ‘’These figures paint an incredibly disturbing picture… We also need more data, otherwise we simply cannot know the scale of the problem and what needs to be done. Data should be collected, publicly reported and reviewed in terms of the protected characteristics of staff who have experienced abuse.’’

Almost £11 billion a year that is going up in smoke could benefit communities instead if people gave up cigarettes, research has found. The study found that poorer regions of England stood to benefit the most. A team from the University of Sheffield’s addictions research group found that spending on tobacco – minus the 7 per cent kept by retailers as profit – added up to £10.9 billion for the tobacco industry and the Treasury, which could be spent locally instead. Dr Damon Morris, the study’s author, said: ‘’The total economic benefit of going completely smoke-free would be greater than £10.9 billion. As well as the local area benefits, there would be savings made by the NHS with fewer ill smokers, and benefits to the wider economy through fewer people being unable to work due to smoking-related illness.’’ The Tobacco and Vapes Bill will restrict the sale of tobacco so that anyone turning 15 this year, and anyone younger, will never legally be sold cigarettes. Government figures suggest that smoking costs the economy about £17 billion a year, dwarfing the £10 billion raised through taxes on tobacco. The Sheffield study, published in the journal Tobacco Control, included data from the Smoking Toolkit Study, made up of 18,721 adult smokers who estimated how much they spent on their habit. This data was compared with figures from government tax receipts and estimates of illegal tobacco use. It concluded: ‘’The total dividend in England is estimated to be £10.9 billion each year, which equates to £1,776 per person who smokes, or £246 per adult regardless of smoking status.’’

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