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** 4 August 2022
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** UK
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** Renewed summer appeal to tackle illegal tobacco sellers (#1)
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** Liverpool NHS: Hundreds not offered second cancer consultation (#2)
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** Millions of counterfeit cigarettes and tobacco found in van during £1.3m motorway raid (#3)
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** Nottingham City Hospital goes live with the UK’s first advanced radiotherapy CT scanner (#4)
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** International
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** US Study: Lung cancer risk is 10-fold higher in smokers who are not recommended for annual screening (#6)
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** Australia Study: Smoking in pregnancy most significant risk factor for Developmental Language Disorder (#6)
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** UK
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** Renewed summer appeal to tackle illegal tobacco sellers
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Enforcement teams are appealing for new information from the public as the latest ‘Keep It Out’ campaign has launched in Northumberland, County Durham and Tyne and Wear.

Trading standards teams have been active across these areas – seizing 1,030,900 illegal cigarettes and nearly 340kg of illegal hand rolling tobacco in 2021/22 through Operation CeCe, a partnership between National Trading Standards and HMRC to tackle illegal tobacco. Illicit tobacco is estimated to make up around 11% of the total tobacco market in the North East.

Since 2017, the campaign has resulted in more than 2,000 tip offs from within the region. This information has led to trading standards seizing illicit tobacco, taking sellers to court, closing down shops, issuing fines and removing alcohol licences.

Ailsa Rutter, director of Fresh (the North East regional programme for tobacco control), said: “We know that two thirds of long-term smokers will die from smoking, regardless of where they buy their tobacco, how much they pay for it or whether they smoke cigarettes or roll-ups. But cheap, illegal tobacco keeps smokers smoking, gets kids hooked and makes health inequalities even worse, which is the last thing we need right now. Dealers in illegal tobacco are linked to all kinds of criminal activity and they really don’t care if local children buy it.”

Source: Northumberland Gazette, 3 August 2022
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** Liverpool NHS: Hundreds not offered second cancer consultation
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Hundreds of patients with potential cancer symptoms were not offered a second appointment by an NHS trust, it has emerged. About 1,800 people were not contacted for a second consultation if they did not attend the first date by Liverpool University Hospitals NHS Foundation Trust between May 2021 and May 2022.

National guidance states a second booking should happen automatically and the trust said it had reported the issue as a serious incident. Patients involved were on the two-week referral pathway - which is a request from a GP for an urgent hospital appointment as they have symptoms that might indicate cancer. The matter was made public after minutes were published from a board meeting of the trust, the Local Democracy Reporting Service said.

Dr Jim Gardner, the trust's executive medical director, said the trust had now reviewed 1,200 patients out of the original 1,800 who may not have been offered a second appointment due to an administrative error. He said the trust was confident that 950 of those cases needed no further action. The initial analysis of the 600 remaining cases is expected to be completed within the next two weeks.

"We will contact all patients and their GPs who require a follow-up appointment directly," he assured, adding that "we take all safety incidents seriously and we are extremely sorry for the concern this may cause our patients and their families. We have reported this as a serious incident with the Care Quality Commission and NHS England and Improvement and will be working closely with them to ensure oversight of our investigations."

Source: BBC News, 3 August 2022
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** Millions of counterfeit cigarettes and tobacco found in van during £1.3m motorway raid
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A huge haul of around 1.4 million counterfeit cigarettes and 75kg of hand-rolling tobacco with a combined street value of £1.3m has been seized by Lancashire Police. Three men have been arrested on suspicion of theft and counterfeit offences, with Trading Standards and HM Revenue and Customs also now investigating.

The stash of cigarettes and tobacco was found inside a van stopped on a motorway on Tuesday. Put together, the cigarettes and tobacco would have resulted in a loss of £600,000 in excise duty, the force said as it revealed details of the operation and images of the haul. The seizure followed a report to police of 'suspicious activity' in Blackburn after a large group of men were seen loading boxes filled with cigarettes into a van.

Speaking on the implications incidences like these have for both public health and organised crime, Sergeant Pete Fyans, of Lancashire Police said: "We hope this shows that we will not tolerate items like this being circulated on the streets of Lancashire and we will always act on information which disrupts the supply of counterfeit goods in the county."

Source: Manchester Evening News, 3 August 2022
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** Nottingham City Hospital goes live with the UK’s first advanced radiotherapy CT scanner
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In a bid to enhance the standard of cancer care delivered to its local population, especially with the increased momentum of proactive lung cancer screening programmes, Nottingham University Hospitals NHS Trust has invested in two newly launched AI-assisted CT scanners, which were developed specifically for advanced radiation oncology.

The scanners are the first of their kind in the UK and are able to deliver quicker patient scans with better image quality and reconstruction times at a lower dose of radiation. One scanner is now operational at City Hospital in Nottingham with a second due to be commissioned by autumn 2022.

Lee Beresford, Radiotherapy Service Manager at Nottingham University Hospitals NHS Trust, anticipates the need for these highly specialised CT scanners will grow, as the NHS Targeted Lung Health Check programme focuses this year on past and current smokers aged 55 to 74 in the Nottingham area. He said: “With one of the highest mortality rates for lung cancer in England, it is estimated that over 300 new cases of lung cancer will be identified earlier in Nottingham by the proactive health screening initiative.”

Source: Hospital Times, 3 August 2022
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** International
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** US Study: Lung cancer risk is 10-fold higher in smokers who are not recommended for annual screening
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Current ‘light’ and ‘former heavy’ smokers appear to have a 10-fold higher lung cancer risk than never smokers, a US study published in Journal of the American Medical Association (JAMA) Oncology has found. Despite their higher risk, these smokers and former smokers are not currently recommended to have a CT scan by clinical guidance in the US.

The researchers used patient data from the Cardiovascular Health Study. A total of 4279 participants with a mean age of 72.8 years (57.3% female) were included and followed for a median of 13.3 years. There were 861 current non-heavy smokers and 615 former heavy smokers and 1,973 never smokers who were used as the reference point.

During follow-up, lung cancer occurred in 0.5% of never smokers, 5% of current non-heavy smokers and 5% of former heavy smokers. The mortality risk for current, non-heavy smokers was 53% higher and 18% higher for former heavy smokers.

Current US recommendations suggest annual screening for adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening, however, is not advocated for former smokers with a 20 pack-year or greater smoking history who quit 15 or more years ago (former heavy smokers) or for current smokers with a smoking history of 20 pack-years or less (current non-heavy smokers).

The authors concluded that there appears to be a very high lung cancer risk among those who are excluded from the recommendations for CT screening and called for future studies to examine whether annual screening could reduce lung cancer mortality in these populations.

Source: Hospital Healthcare, 4 August 2022

See also: Study - Assessment of lung cancer risk among smokers for whom annual cancer screening is not recommended ([link removed])
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** Australia Study: Smoking in pregnancy most significant risk factor for Developmental Language Disorder
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Published today in the Journal of Paediatrics and Child Health, researchers found the most significant predictor of a child being diagnosed with Developmental Language Disorder (DLD) was being exposed to smoking during pregnancy, with the odds of meeting the criteria of DLD 2.56 times greater than mothers who did not smoke at 18 weeks gestation.

The language skills of more than 1,600 children aged 10 years were examined as part of the Raine Study, the nation's longest-running public health study.

Co-author Dr. Liz Hill emphasised "It is critical that we identify and support these children early in order to promote the best possible outcomes. This includes raising awareness of the potential impact of smoking during pregnancy on a child's life-long language and communication skills."

The same study also identified "referral bias" present in DLD, with young girls equally likely to be living with language difficulties despite more boys being referred for support services. Lead author Dr. Sam Calder, from the Curtin School of Allied Health, said he was concerned more young girls were not being diagnosed with DLD given the potentially life-long consequences of not receiving the appropriate care and support.

Source: Medical Xpresss, 3 August 2022

See also: Study - The prevalence of and potential risk factors for Developmental Language Disorder at 10 years in the Raine Study ([link removed])
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.

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