THE UK government introduced its Tobacco and Vapes Bill in Parliament today, aiming to create a “smoke-free generation” by prohibiting anyone born after 1 January 2009 from legally purchasing cigarettes for the rest of their lives. The Bill also proposes strict new restrictions on nicotine products, including vapes, heat-not-burn products, and nicotine pouches.

Public health experts in Wales are largely supportive of the new legislation, seeing it as a potential driver in reducing the strain on the NHS in Wales. Smoking-related illnesses are a major contributor to healthcare costs, and advocates argue that curbing smoking among future generations will yield long-term health and economic benefits. This could be especially impactful in Welsh regions where smoking rates are persistently high.

However, there is also concern about how restrictions on safer nicotine alternatives, such as vapes and heat-not-burn products, could impact Welsh individuals trying to quit smoking. The Welsh NHS has invested in smoking cessation programs that promote these alternatives, and some fear that restrictions on these products may reduce access to effective cessation tools, ultimately affecting health outcomes.

Mike Salem, UK Country Associate for the Consumer Choice Center (CCC), reacted to the news: “Whilst it is predictable that the prohibition was going to be introduced, I am extremely concerned and disappointed with how little regard the government has had for consumers’ voices, particularly the young voices.”

The Bill revives an initiative initially proposed by the previous Conservative government before the election, though Labour’s version brings in tougher regulations. The proposal has sparked debates across various groups, with health advocates supporting the measures and others, like the CCC, voicing concerns about potential unintended consequences.

Illicit market worries

The CCC has highlighted fears that prohibitions may fuel an already significant black market for tobacco products in the UK. According to Salem, 2023 saw the highest number of illicit cigarettes consumed in the country, with one in five cigarettes sold illegally. He warns that restrictions risk expanding this underground market.

“It is no surprise that gangs and illegal suppliers are already positioning themselves in this market in anticipation of the prohibition,” Salem said. He cited experiences from other regions, such as the state of Victoria in Australia, where similar prohibitions have led to gang-related violence and exposed children to criminal activities, including arson.

Impact on young people

Critics of the Bill argue that the Labour Party’s approach may negatively impact young people, whom they claim are already disadvantaged by recent policies. “The Labour Party has shown that it is the Party of Boomers, and is letting young people down,” Salem said. He added that recent increases in tuition fees and levies on alcohol and soft drinks, along with tougher employment markets, restrict young people’s lifestyle choices and increase their exposure to illegal markets.

Public health debate

Supporters of the Bill believe these measures are necessary to protect public health. They argue that strict controls on tobacco and nicotine products are crucial steps towards reducing smoking rates, improving long-term health outcomes, and reducing the burden on the NHS. Advocates also believe that limiting youth exposure to nicotine will reduce future smoking rates.

However, Salem argues that the Bill may have the opposite effect. “Not everyone can quit cold turkey,” he said, noting that many people have found success using alternative products like vapes, heat-not-burn devices, and nicotine pouches. “Restricting safer methods of consuming nicotine makes it extremely difficult for those who are trying hard to quit smoking to do so permanently and positively.”

Alternative solutions proposed

The CCC says it is calling on the government to ensure existing laws are enforced first, such as banning nicotine sales to under-18s, before introducing a total prohibition. They argue that failing to do so will lead to worse public health outcomes and put consumers and children in a vulnerable position. The Bill now moves forward for further debate, with both sides urging careful consideration of the potential impacts on public health, youth, and the illicit market.

BMA Cymru Wales’ GP committee has voted unanimously to reject the Welsh Government’s offer for the 2024/2025 GMS (General Medical services) contract, as it fails to provide a credible and sustainable future for general practice.

GPs in Wales will now vote on whether to accept or reject the contract in a referendum which will open later this month.*

Dr Gareth Oelmann, chair of the BMA’s Welsh GP committee said:

“The decision to disregard the serious concerns and valuable contribution of general practice once again in Wales is beyond insulting, it is dangerous, leaving more surgeries and their patients in peril.

“We are deeply concerned that this offer will leave more practices with no option but to close their doors. GP practices are being denied the resources they need to deliver vital services to the population.

“For years, the service has been starved of adequate funding which has led to the closure of 100 surgeries since 2012. This is having a devastating impact on general practice.

“A recent survey** of our members showed that 91% of GPs are routinely unable to meet patient demand due to unsustainably high workloads.

“With 100 fewer surgeries for patients to turn to, GPs are now seeing up to 35% more patients each, causing unsustainably high workloads and burnout with doctors being expected to do more with less, risking patient safety. How long can this continue?”

Dr Oelmann continued: “General Practice is the foundation of a high-quality, cost-effective health system, but successive governments have insisted on ignoring the vital role general practice plays in the national health service.

“Welsh Government had an opportunity to change the current trajectory but has failed to do so. It is now up to GPs to decide what happens next.”

A NURSE has been suspended for 12 months after striking an elderly patient during a challenging incident at Withybush Hospital.

The suspension followed an incident in May 2022 on the trauma and orthopaedic ward, where nurse Primrose James, described as experienced and respected, was assisting an 80-year-old man known as Patient D. The patient, who had been recovering from a broken hip for six months, had a history of lashing out at staff.

A healthcare assistant who witnessed the event reported that James had struck the patient across his face and tapped his cheek after he had hit her. Recalling the incident, the assistant told the panel: “Primrose was standing beside the bed when she struck him across the face and then tapped him on the cheek, telling him off for hitting out.”

Reflecting on the incident, Ms. James expressed regret, noting her intention was never to harm patients. “This was a difficult encounter in a fast-moving situation,” she stated. “Knowing his history of aggression, I should have anticipated he might strike out, but I reacted instinctively in the moment.”

ALLEGATIONS REVIEWED

At the Nursing and Midwifery Council hearing, Ms. James faced multiple allegations. Two were substantiated: that she struck the patient and tapped his cheek. Allegations that she had acted further aggressively by pressing on his forehead and making unprofessional comments were dismissed as unproven.

The panel acknowledged Ms. James’s previously unblemished 16-year career, her extensive experience with dementia patients, and her immediate remorse following the incident. It was noted that Patient D’s aggressive behaviour was a recurring issue on the ward, and despite staff regularly facing his outbursts, no measures had been implemented by senior staff to manage the situation.

NEED FOR SUPPORT

In its decision, the panel criticised the lack of support for managing Patient D’s behaviour, stating: “Staff had reported ongoing assaults, yet action to address the patient’s aggression was lacking.”

While the panel determined that Patient D suffered no physical harm, they raised concerns about the potential for psychological distress to the patient and his family.

12-MONTH SUSPENSION

The panel ultimately ruled that a 12-month suspension was necessary to reflect the seriousness of the misconduct, despite Ms. James’s previously clean record and her remorse over the incident. The panel remarked: “This was an isolated incident involving a challenging patient, but a suspension order is warranted to underline the gravity of the incident.”

Ms. James’s suspension is subject to review at the end of the 12 months.