Over 58% of smokers still try to quit without using an aid and going ‘cold turkey’ despite this being the least effective way. A Public Health England (PHE) report highlights that public misunderstanding of the harmfulness of nicotine containing products, such as nicotine replacement therapy (NRT) and e-cigarettes, may be linked to inaccurate and confused perception of the risks of nicotine.

The risks of nicotine use are likely to be very low or negligible. NRT is safe and licenced for use in pregnancy and for people with cardiovascular disease. And there is now wide international consensus that e-cigarettes are far less harmful than smoking. It is the cocktail of deadly chemicals in cigarette smoke, including tar and carbon monoxide, which causes almost all of the harm of smoking.

Four in 10 smokers and ex-smokers incorrectly think that nicotine in cigarettes is the cause of most of the smoking-related cancer. Understanding of the harms of nicotine among the general population is similarly poor. In 2017:

• only 7.5% thought that none or a very small part of the risk of smoking comes from nicotine
• 14% thought that it was nearly all the risk
• almost a quarter (24.2%) of the population didn’t know

The use of quit aids can greatly increase your chances of quitting successfully. Research shows that:

• using NRT as a quit aid, such as patches and gums, or e-cigarettes makes it one and a half times as likely you’ll succeed
• your chances of quitting are doubled if using a stop smoking medicine prescribed by a GP, pharmacist or other health professional
• expert support from a local stop smoking service gives you the best chance of quitting successfully
• combining quit aids with expert support makes it four times as likely you’ll stop smoking successfully

Professor John Newton, Director of Health Improvement at PHE said:

Misunderstanding about the risks from nicotine may be deterring smokers from using quit aids such as e-cigarettes or nicotine replacement therapies like patches and gums.

Nicotine is addictive but it’s the many thousands of chemicals in tobacco smoke that are responsible for almost all of the harm caused by smoking. Using nicotine quit aids helps manage cravings and can be one of the solutions to helping you stop for good. Going ‘cold turkey’ is not recommended as it’s the least successful way.

To get the most benefit, make sure you use as much nicotine replacement as you need, and for as long as you need, as this will help you stop smoking and stay smokefree. Combining quit aids with support from a stop smoking service gives the best success rates. With the wide range of aids now available, there’s never been a better time to stop.

PHE has been supporting all NHS trusts across the country to do all they can to become truly smokefree. The government and NHS England have both made commitments to a smokefree NHS, in the latest tobacco control plan and the NHS five year forward view.

Professor Newton comments:

For a truly smokefree NHS to become a reality, our emphasis is to support hospitals shift their efforts away from simply ‘enforcing’ no smoking towards offering on-going support to help smokers stop for good, including encouraging them to use quit aids.

Smoking rates are at their lowest ever level (15.5% of the adult population), but there are still nearly 7 million smokers in England. Smoking kills 79,000 people in England every year and for every death another 20 smokers are suffering from a smoking-related disease.

Background

For further information or interview bids contact:

NHS Smokefree

Visit the NHS Smokefree site for support and advice on quitting smoking.

PHE’s e-cigarette evidence review

Read the annual update of PHE’s e-cigarette evidence review by leading independent tobacco experts.

Smoking prevalence figures

In 2016, 15.5% of adults aged 18 and over in England currently smoke, down from 19.9% in 2010. In 2000, 26.8% of adults aged 16 and over were smokers. Prevalence since 2010 has fallen most in younger age groups according to Statistics on Smoking, England 2017.

PHE’s Tobacco Control Profiles

For local smoking prevalence figures and additional local data see Local Tobacco Control Profiles.

Costs of smoking

The total cost from smoking to society in England is approximately £14.7 billion a year. This includes the cost to the NHS of treating diseases caused by smoking which is approximately £2.5 billion a year.

Source: ASH: The Local Cost of Tobacco – ASH Ready Reckoner and Towards a Smokefree Generation: A Tobacco Control Plan for England.

Tobacco Control Plan for England

The government’s new Tobacco Control Plan sets a series of challenging ambitions:

• reduce adult smoking rates from 15.5% to 12% or less
• reduce the prevalence of 15 year olds who regularly smoke from 8% to 3% or less
• reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less

Public Health England

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

A Llanelli man has been sentenced today for illegally supplying prescription drugs. Lee Daniels received a 40-month sentence for selling unauthorised versions of anti-cancer drugs such as Tamoxifen and Letrozole as well as steroids and pain killers across the EU.

More than 25,000 doses of unlicensed, prescription-only medicines and class C drugs were seized by Medicines and Healthcare Products Regulatory Agency investigators including addictive benzodiazepines. Daniels conducted his illegal trade in medicines whilst also running a business selling vinyl records.

Investigators believe that Daniels made more than £270K from his illegal medicines business between 2013 and 2016. The profits were deposited into accounts held under variations of his own name and in to accounts in the name of his wife and a friend who it is believed were completely unaware of his illegal business.

Daniels worked full-time as a welder before branching out in to selling discs and diazepam. He was eventually uncovered when a raid at an associate’s warehouse resulted in hand-written notes being seized which led investigators to his address.

Daniels sold powerful medicines with potentially dangerous side effects directly to the public. He often sold cheap, untested, unlicensed versions of these medicines and did so without any form of medical supervision or prescribing. His customers were put at serious risk by his activities.

Alastair Jeffrey, MHRA Head of Enforcement said:

Selling medicines outside of the regulated supply chain is a serious criminal offence. These criminals are motivated by greed and have no concern about your safety or welfare.

Always seek professional help and visit your GP if you are ill. If you buy medicines online, you are trusting a criminal to look after your health.

MHRA is currently running the #FakeMeds campaign to warn people against buying potentially dangerous or useless unlicensed medicines sold by illegal online suppliers.
Visit www.gov.uk/fakemeds for tips on buying medicines safely online and how to avoid unscrupulous sites.

As part of this year’s British Science Week, 1,800 pupils from 10 schools across England are being given the opportunity to take part in interactive science workshops hosted by Public Health England (PHE) scientists.

From pupils extracting DNA from their own cells using household products, to a science and health-related game of Pictionary and quizzes on air pollution, the aim of these workshops is to inspire the young people to consider a career in science and showcase the variety of areas within science they could pursue.

British Science Week is an annual 10-day event, with this year being its 24th year running. It encourages organisations, professionals in the science sector, science communicators and the general public to hold events that get people involved in scientific activities.

This year, PHE is expanding its reach to 10 schools across 3 regions: the North (Manchester, Salford), South West (Bristol, Cheltenham and Torquay) and South East (Harlow). During the week, there will be 25 PHE scientists leading interactive science workshops for pupils aged 13 to 14 years old.

The scientists taking part specialise in a range of disciplines, including toxicology, microbiology, environmental public health, microscopy, vaccine research and epidemiology.

Duncan Selbie, Chief Executive of PHE said:

It’s important that the current generation of scientists informs and inspires the next generation, and shows young people the range of routes and opportunities they can pursue within world-leading UK science. We are thankful for the scientists taking part in British Science Week workshops across the country, and hope that their efforts encourage the pupils to consider a career in science as a viable and exciting option.

Sarah Robertson, Senior Environmental Health Scientist at PHE said:

I speak for all of the scientists involved when I say that we are excited to take part in British Science Week and showcase just a few of the many disciplines within science to the students. Although a large proportion of our time is dedicated to research, outreach work such as these interactive workshops is also our responsibility, particularly to highlight the breadth of our roles to young people. Science and research are imperative in our world and we must ensure that the future workforce continues to be made up of talented and passionate individuals.

PHE is in the process of creating a world-leading centre of excellence for public health research, improvement and protection, and a new headquarters, at the vacant GlaxoSmithKline site in Harlow. This will involve relocating facilities from Porton in Wiltshire and Colindale in north London, as well as the current central London headquarters. PHE Harlow is expected to be fully operational by 2024.

Background

1. British Science Week is an annual event and in 2018 takes place between 9 to 18 March.
2. Schools attending the sessions are:
   • Burnt Mill Academy
   • Forest Hall School
   • Mark Hall Academy
   • Stewards Academy
   • Passmores Academy
   • Torquay Academy
   • Fairfield School
   • All Saints’ Academy
   • All Hallows R.C. High School
   • Walkden High School
3. Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

Almost three-quarters of women start breastfeeding when their child is born, however by 6 to 8 weeks this drops to just 44%. This makes breastfeeding rates in England among the lowest in the world.

A new survey of 1,000 mothers of young children commissioned by Public Health England (PHE) revealed that in hindsight, mothers wished they had been better prepared for breastfeeding. Before the birth of their first child, mums’ biggest priorities were:

• buying baby equipment (66%)
• preparing for labour (49%)
• buying baby clothes (40%)

However, post birth, nearly a quarter (24%) wished they had read about and were more prepared for breastfeeding and 1 in 4 (26%) of those who had given breast milk to their first child wished they had known that asking for help can make a real difference.

Evidence shows the right support helps mothers to breastfeed for longer. PHE’s programme Start4Life has created the Breastfeeding Friend to encourage parents to adopt healthy behaviours. It is available for free on a range of platforms, including Facebook Messenger, and now for the first time it will also be available as a skill for Amazon Alexa’s voice service.

Mothers can ask Alexa a variety of questions about breastfeeding and the answers will be provided tailored to the age of the baby. This means that they can get helpful advice even when their hands are full.

The survey also highlighted that almost a third (31%) of mothers also felt embarrassed about asking for help with breastfeeding from healthcare professionals. Many mothers can find breastfeeding challenging and often this may cause them to give up.

It also found that almost two thirds (64%) felt that access to 24 hours a day, 7 days a week breastfeeding support, such as a phoneline, website or chatbot, would make new mothers:

• more likely to have a positive experience of breastfeeding
• more likely to decide to try breastfeeding (59%)
• breastfeed for longer (58%)

PHE recommends exclusive breastfeeding for around the first 6 months. Breastfeeding boosts a baby’s ability to fight illness and infection, and babies who are not breastfed are more likely to get diarrhoea and chest infections. Breastfeeding also lowers a mother’s risk of breast cancer and may reduce the risk of ovarian cancer.

Viv Bennett, Chief Nurse at Public Health England said:

Breastfeeding, whilst natural, is something that mothers and babies learn together, and whilst learning, women may have questions and setbacks. PHE is working with health professionals to make sure women are not embarrassed and receive timely help. Health professionals do an excellent job of caring for new mothers, but they cannot be available 24 hours a day, 7 days a week, which is where our Breastfeeding Friend from Start4Life is designed to help. This tool, together with the range of support materials from Start4Life, can provide breastfeeding advice at any time of night or day and support mothers and their partners and families through challenges they may face.

These digital offerings will help guide new parents through their first weeks of breastfeeding and beyond, providing help at any time of the day or night, and aim to complement support and advice from health care professionals and breastfeeding specialists. The information provided by all the Start4Life services is NHS approved and both services are independent of Amazon and Facebook.

Dr Cheryll Adams CBE, Executive Director Institute of Health Visiting, says:

This innovative new service will enhance those already provided by health professionals. Whether a mother manages to establish breastfeeding is largely determinant on the support she receives in the first few days after birth. However, with such short hospital stays, professional support is not as widely available as it once was. To have this back up, which can be accessed from anywhere, will be hugely helpful and we expect health visitors to want to promote the service.

Justine Roberts, CEO and Founder of Mumsnet, says:

Breastfeeding is a hard-won skill for many women, and most mothers will experience a setback along the way, particularly in the first few weeks. We see from conversations on Mumsnet that mothers are looking for breastfeeding support 24 hours a day, 7 days a week, and in fact middle of the night crises when face-to-face help isn’t available can be the most profoundly lonely and difficult. These new round-the-clock digital services could provide help when mothers need it most.

More information, advice and tips on breastfeeding is available on the Start4Life website.

Background

1 – Once Breastfeeding Friend from Start4Life is enabled from the Alexa app, users can activate the skill on their Alexa by using the wake word ‘Alexa’ and asking for the ‘Breastfeeding Friend’. A ‘card’ will be sent to the user’s Alexa app showing some of the most common questions the Breastfeeding Friend can answer. Users can access quick tips or advice, and ask Alexa a variety of questions about breastfeeding. The answers will be provided tailored to the age of the baby. The 24 hours a day, 7 days a week Breastfeeding Friend from Start4Life aims to make it simple and easy for breastfeeding mums to ask for help if they are facing any breastfeeding difficulties.

2 – In addition to the Breastfeeding Friend from Start4Life there are many other ways that mothers can get breastfeeding support. The Start4Life website has a range of advice and resources which can help mothers continue breastfeeding. Mothers can also call a national helpline (0300 100 0212) provided by the Breastfeeding Network 365 days a year. Mothers can also get help through:

• friends and family
• their Midwifery team
• their health visitor
• local breastfeeding drop-in services

3 – The survey was conducted by Kantar Public from 26 January to 7 February 2018 with a nationally representative sample of 1005 mothers in England with children under the age of 4, on behalf of PHE. The data were weighted to population statistics based on age of mum, region and socio-economic group. Findings show:

• of those who ever gave breastmilk to their first child, younger mums were more likely than older mums to use online sources (42% of 18 to 34 years compared to 30% of 35 to 50 years) when researching or starting to breastfeed
• of mums who breastfed their first child, a quarter wished they’d known it can take a long time, but it’s quality time to spend with their baby (25%) and there is lots of help and support available from breastfeeding groups, other parents and online (24%)
• 1 in 4 (26%) mums felt using more online/digital tools and information would have helped them to be more prepared for becoming a mum
• in hindsight, mums wished their main priorities before the birth of their first child had been preparing for labour (33%), spending time with friends and family (26%), reading about and preparing for breastfeeding (24%) and preparing for night feeds (22%)

4 – Sometimes breastfeeding isn’t possible for a range of reasons. If this is the case, in terms of liquids babies should only be given infant formula milk for the first 12 months and no other types of milk.

5 – Start4Life’s Information Service for Parents and Start4Life website offers NHS information and advice for parents-to-be and parents of 0 to 5 year olds providing them with the advice they need to help get their child off to the best start in life.

6 – The Department of Health is also supporting Unicef UK to develop a neonatal infant feeding network to support sick and preterm babies.

7 – PHE exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services.

The Medicines and Healthcare products Regulatory Agency is warning people who may have purchased a “natural” Chinese herbal medicine, Yiganerjing Cream, as a treatment for skin conditions to stop using it immediately as it has been found to contain an undisclosed steroid and two antifungal ingredients.

MHRA officials have been acting to stop the sale of this cream and have had it withdrawn from many websites and on-line market places but people may have purchased it in the past and still be using it.

Yiganerjing Cream is not a licensed medicine and has been marketed in the UK as a “natural” Chinese herbal medicine for the treatment of a range of skin conditions, most commonly eczema, psoriasis and rosacea.

Our analysis found the presence of the steroid clobetasol propionate. This steroid is the active ingredient in Prescription-Only Medicines used for the treatment of a range skin conditions such as psoriasis and eczema. Creams containing steroids should be used sparingly and as directed by the prescriber. It is contraindicated in children under 1 year of age.

We are also aware of the use, via a herbal clinic, of a product called Penny Orange Cream which has also been found to contain clobetasol propionate. While this product is no longer available, and we are not aware of its widespread use, it did contain an undisclosed steroid and should not be used.

If you are unsure about the safety of a medicine claiming to be “natural” or “herbal” you should check for a Marketing Authorisation (MA) or Product Licence (PL) number or Traditional Herbal Registration (THR) number / the THR logo. This means the product has been assessed by MHRA for safety and has been manufactured correctly. For more information, visit NHS Choices.

Dr Chris Jones, Manager of the Medicines Borderline Section at MHRA said:

The sale of potent steroid creams directly to the public is illegal for good reason. If used without medical supervision these medicines can be dangerous.

Steroids must be prescribed by healthcare professionals who follow strict criteria when prescribing them and monitoring patients using them. They can suppress the skin’s response to infection, can cause long-term thinning of the skin, and if applied long term over a wide area, particularly in babies and children, can cause other medical problems.

Our advice to anyone who is using Yiganerjing Cream, particularly on young children and babies, is to discontinue use immediately. If you have any questions, please contact your healthcare professional.

If you are aware of Yiganerjing cream being sold, please report it to MHRA at Borderline_medicine@mhra.gov.uk.