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I am a child. During the next 15 years I am likely to: Question my body image. Make my first independent decision about my diet and exercise. Witness or experience bullying. Have my first sexual experience. Be offered a cigarette. Be offered my first taste of alcohol. Make my first decision about drug use. So, asks the PSHE Association, ‘Who is going to teach the knowledge and skills I will need to manage these ‘first moments’ and stay healthy and safe? (1)

  • By Marie Findlay, Policy Team, Royal Society for Public Health

Around 9% of teenagers in England are regular smokers by the age of 15 (2) and in the last month in the UK, more than half of 15-16 year-olds consumed five alcoholic drinks (3).  Teenage pregnancy rates are among the highest in Europe (4) while 31% of young men and 37% of young women aged 11-18 are overweight or obese  and only a minority do the recommended amount of physical activity (6).

Over half of mental health problems develop in teenage years (7). The significance of adolescence in forming behaviours that impact on health over a lifetime can hardly be overstated, and yet the health outcomes of young people in some of our communities are among the worst in the developed world (8).

Eight Young Health Champions recieve an award from Duncan Selbie

RSPH Chief Executive Shirley Cramer, CBE, (left) joins children from Manningtree High School. They were the first graduates to be awarded the RSPH Level 2 Certificate for Youth Health Champions (YHC) by Duncan Selbie (centre), at a ceremony attended by Jane Davis (right of Ducan Selbie), YHC Coordinator at Manningtree High School. 

Schools are unique, being one of the only agencies that have regular contact with almost all children and young people during these formative years. It is therefore essential we utilise this opportunity to properly integrate health education in order to equip everyone with the knowledge, understanding and skills to navigate a complex world of choices and lead healthy, fulfilling lives.

Personal, Social, Health and Economic education (PSHE), highlighted by the Chief Medical Officer as a ‘bridge’ between education and public health (9), not only provides this opportunity but can also drive improvements in a range of Public Health Framework Outcome indicators (10).  Young people themselves are hungry to learn, with 86% of pupils feeling they need to be taught about PSHE topics in school.  Why, then, does PSHE remain a non-statutory part of our children’s education?

Perhaps the issue is masked by the fact that most schools deliver elements of PSHE in some form. But while curriculum requirements entail coverage of some components, quality of provision is hugely variable (12) and the 2012 Ofsted Report concluded that it was not yet good enough in a sizeable proportion of schools (13). This leaves many children and young people vulnerable with gaps in knowledge and skills spanning relationships, mental health and alcohol misuse (14).

Following the latest review, Elizabeth Truss, then Parliamentary Under Secretary of State for Education and Childcare, deemed a change of status unnecessary as ‘Teachers are best placed to understand the needs of their pupils and do not need additional central prescription’ (15). But teachers suffer from the lack of emphasis placed on a non-statutory PSHE. Many simply don’t want to teach it (16) and this is unsurprising when support from schools is variable.

Research has found that only 28% of secondary school teachers find it easy to be released for PSHE CPD training and only 21% find it is easy to get funding (17).  Teachers may also feel uncomfortable talking about sensitive and controversial issues without adequate training (18) resulting in topics such as sexuality, mental health and domestic violence being dropped.

Practical, innovative input from schools is vital to improving PSHE provision and evidence points towards an integrated approach (20).  In 2012, the Royal Society for Public Health (RSPH) hosted a workshop with stakeholders across health and education who stressed the need to move away from responding to deficits by combating bullying or teaching sex education and healthy eating as isolated issues. Good practice was seen not just as providing information to pupils but building confidence and resilience, including the ability to take measured risk and make active decisions, both of which are believed to be key determinants of individual health action (21). Schools that perform well put health and development at the heart of their curriculum and ethos (22).

One way to nurture these skills is through a peer-led approach. The Youth Health Champions initiative, piloted by North East Essex Primary Care Trust, trained students as facilitators of health education and to act as signposts for their peers. This has been developed by RSPH into a movement to engage young people in their own health journeys. In schools, Youth Health Champions consult with teachers on content and work with small groups during PSHE sessions with feedback indicating messages are ‘far more relevant and easy to understand when delivered by… their contemporaries’ (23).

Crucially, delivery can be approached by schools in partnership with public health authorities to target specific public health interventions in addition to meeting learning goals. The PSHE Association has, for example, supported Portsmouth City Council’s Health Improvement team to assess local public health priorities and adapt a programme of study to suit their needs – truly using the subject as a bridge between education and public health.

It is now time to strengthen this bridge with statutory underpinning. Caroline Lucas, whose bill to introduce statutory PSHE will be read in parliament for the second time in late February, has said: ‘as long as PSHE remains a non-statutory…subject…there will be virtually no coverage…in teacher training. In school, PSHE teachers are not given the curriculum time or training that they need – statutory status is key.’

We must get serious about empowering children and young people to manage their own health if we are to see changes in worrying health indicators. If we don’t do this in schools, where will we do it?

1) PSHE Association
2)  Cancer Research UK
3) RCN
4) FPH manifesto, ‘Start Well, Live Better’,
5) ‘Key Data on Adolescence for 2013’ published by the Association for Young People with the support of Public Health England
6) Chief Medical Officer’s Report, 2012
7)  RCN
8) RCN
9) Chief Medical Officer’s Report, 2012
10)  PSHE Association
11) Ofsted report on personal, social, health and economic education in English schools in 2012
12) Independent Review of the proposal to make Personal, Social, Health and Economic Education statutory, 2009
13) Ofsted 2012 report
14) Ofsted 2012 report
15) Draft Written Statement: links to a pdf
16) Kath Sanderson, ‘Health education in schools: strengths and weaknesses in relation to long-term behaviour development’, Perspectives in Public Health, DOI: 10.1177/1757913911430915
17) Formby et al, ‘ Personal, Social, Health and Economic (PSHE) Education: A mapping study of the prevalent models of delivery and their effectiveness’, January 2011
18) Ofsted report, 2012
19) Ofsted report, 2012
20) Formby et al, ‘ Personal, Social, Health and Economic (PSHE) Education: A mapping study of the prevalent models of delivery and their effectiveness’, January 2011
21) Kath Sanderson, ‘Health education in schools: strengths and weaknesses in relation to long-term behaviour development’, Perspectives in Public Health, DOI: 10.1177/1757913911430915
22) Lolc Menzies, ‘Charting a Health Literacy Journey – overview and outcomes from a Stakeholder Workshop’, Perspectives in Public Health, DOI: 10.1177/1757913911431041
23) Martin Page, ‘How to avoid ‘dad dancing’: a peer-led approach to the delivery of health education in secondary schools’, Perspectives in Public Health, DOI: 10.1177/1757913911430913

  • Amy Smullen
  • Policy Officer
  • British Heart Foundation

The nation’s oversized waistline is putting our hearts under increasing strain.

We know that obesity puts people at a greater risk of coronary heart disease and having their lives shortened by a heart attack or stroke. But this isn’t just a problem of the here and now. It’s one that’s already waiting in the wings to devastate future generations as well.

junkfood_image

Watershed? why we need to ban some food adverts before 9pm

Around 30% of children in the UK are now classed as either overweight or obese. (1) Dietary surveys show that children are also eating too much saturated fat, salt and sugar. (2) Together, these factors put too many children at risk of carrying their excess weight and poor eating habits into adulthood, putting their hearts at risk.

That is why the British Heart Foundation (BHF), alongside many other organisations, such as the Faculty of Public Health want to see advertisements for food and drink that is high in saturated fat, salt and sugar (HFSS) banned before the 9pm watershed.

The BHF are acutely aware that obesity is a complex problem that requires action on lots of fronts. We don’t pretend banning junk food adverts is a magic bullet. But the sad reality is that our children are being bombarded with clever marketing encouraging them to eat products that have little nutritional value whether it’s walking to school, surfing the internet or watching TV at home. Banning these adverts before 9pm and tightening online regulation has to be part of the solution.

So why have we focused in on junk food adverts?

Firstly; because children aren’t like us adults. They cannot distinguish between what is harmless entertainment and what is persuasive advertising (3) and are they are therefore classed as a vulnerable group when it comes to advertising. Industry regulator Ofcom (4) states that ‘media literacy develops with age and … it isn’t until after 11 or 12 years of age that children can articulate a critical understanding of advertising.’

Second, research shows that food promotion, such as TV ads, can influence children’s food preferences and consumption. (5) Adverts also encourage general consumption, meaning that an advert for a specific chocolate bar won’t make you more likely to buy just that specific brand but any chocolate bar in general. (6)

And thirdly, on average our children are spending 27 hours either online or watching TV every week. That averages out at just under 4 hours per day. And it’s not just a few children skewing the average. Over 80% of children aged 5-15 watch the TV almost every day (7).

In 2007, the Government acknowledged that HFSS advertising was a problem, and banned any HFSS adverts during children’s programming. (8) But, while reducing the number they saw, this hasn’t stopped children seeing them.

That’s because adverts which are banned during children’s shows can be shown during family programming. Shows such as The Simpsons, X-Factor, and Britain’s Got Talent are technically classed as ‘family programmes’ despite high child audience levels. (The last two programmes made it into the top 20 programmes most watched by children in 2013.) (9) As such, marketeers are allowed to advertise any product they want. An audit by the University of Liverpool in 2013 showed that  almost one in four TV adverts shown between 8-9pm, when children’s viewing peaks, were for food products. (10)

Online, it’s even worse. It’s no secret that our children are online more than ever. Worryingly many of the techniques used to promote food and drinks online blur the lines between persuasion and entertainment, making it difficult for children to identify online marketing. (11)

Take, for example, advergames. These are online games that have a brand or marketing message integrated into them. Where a TV advert may only last for 30 seconds, research has shown that children spend longer engaging with the product message and engage with the brand at a deeper subconscious level. (12)

Adding to this the Committee of Advertising Practice Code, which governs marketing on advertisers own websites and their social media channels, doesn’t distinguish between healthy and unhealthy food.

The code states that “marketing communications should not condone or encourage poor nutritional habits or an unhealthy lifestyle in children’ – but what constitutes ‘condoning and encouraging’ or ‘poor habits’ is not defined.

But isn’t it all down to the parents? Shouldn’t they be policing their children more?

While we agree that parents are responsible for helping children eat a healthy balanced diet, these adverts undermine their efforts to do that. When we asked parents for their views, 70% of them told us that they had been pestered to buy HFSS products that their children had seen advertised on TV and 39% of parents said that these adverts were making it difficult for them to help their children eat a healthy diet. (13)

Over 30,000 people have already signed our petition, which calls on the Government to ban HFSS adverts before the 9pm watershed. Alongside the BHF and Faculty of Public Health the Academy of Medical Royal Colleges, the Royal College of Paediatrics and Child Health, Children’s Food Campaign, UK Health Forum, The Heart of Mersey, the British Dental Association, Family and Childcare Trust, the Association for the study of Obesity and the University of Liverpool also call for a 9pm watershed ban.

The demand for action is getting stronger and louder.

Help us stop these adverts by signing our petition to send a clear message to the Government that they must stop our children from being bombarded with HFSS adverts to protect their health.

1) British Heart Foundation (2013) ‘Children and Young People Statistics’ http://www.bhf.org.uk/publications/view-publication.aspx?ps=1002326
2) Department of Health (2014) ‘National Diet and Nutrition Survey: Headline Results from Years 1, 2 and 3 (combined) of the Rolling Programme 2008/09 – 2011/12.
3)  E.g. Young B (2003) ‘Does food advertising influence children’s food choices?’ International journal of Advertising 22: 441-459. Hastings et al (2003) ‘Review of the research on the effects of food promotion to children.’ Food Standards Agency
4)  Livingstone S (2004) Childhood Obesity – Food Advertising in Context.
5)  Ofcom (March 2006) ‘Television Advertising of Food and Drink products to Children: Options for new restrictions: A consultation’ (para 1.8).
6) Hastings et al (2003) ‘Review of the research on the effects of food promotion to children.’ Food Standards Agency.
7)  Ofcom (2014)
8) Ofcom (2007) ‘Television advertising of food and drink products to children – final statement.’
9) Ofcom (2014)
10) Boyland, E and Whalen E (2014) ‘Analysis of food adverts shown during a sample of primetime television.’
11)  A.Nairn (2009) ‘Changing the rules of the game: implicit persuasion and interactive children’s marketing.’ Berkley Media Studies Group
12) Nairn, A. (2012) ‘Advergames: It’s not child’s play.
13)  British Heart Foundation (2015) survey.

2014 in review

The WordPress.com team prepared a 2014 annual report for this blog:

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 12,000 times in 2014. If it were a concert at Sydney Opera House, it would take about 4 sold-out performances for that many people to see it.

Click here to see the complete report.

  • by Jim Pollard
  • Websites Editor
  • Men’s Health Forum

Men don’t go and see their GP as often as women. Now let’s not kid ourselves, as some men doubtless do, that men don’t have as much cause to go as women: at every age group bar one men are more likely to die than women. True, there are more deaths among women over 85 than among men but this is for the simple reason that there are very few men left at this age (1).

The most pronounced difference in GP attendance is in the age group 20-40 when women attend twice as much as men. Can this all be down to child-rearing? The fact that after retirement men tend to visit a GP as often as women suggests that work may well be a factor too.

We know from the most recent Skills and Employment survey that job insecurity in 2012 was higher than at any time in the previous two decades. Job insecurity is implicated in increased mental and physical health problems. For example, it increases the risk of asthma by 60%.

Two years on, it’s unlikely that insecurity has decreased. Given that in the last year the number of UK workers in the UK earning less than £7.69 an hour has increased by 250,000 to over 5 million – one fifth of the workforce, it has probably got a lot worse. Is this a job market in which you would risk asking for time off work to go to the GP? With 87% of men working full-time, perhaps what’s most remarkable is that so many men still do find time to get to the GP!
Image of four figures in descending height order. Text reads Men's health manifesto: in the UK one man in five dies before the age of 65. We can change that.

Men’s Health Forum manifesto cover

Paying the living wage and reducing insecure forms of employment would help but the need for health services that reflect the reality of male lives is also clear. The Men’s Health Forum, in its recently published Manifesto, is calling on local health systems and Public Health England to collect and analyse gender-disaggregated data and to act on it to ensure that services are appropriate for and targeted at men.

For example, NHS Health Checks are primarily about reducing heart disease. Now, men make up 75% of those dying prematurely from heart disease yet only 35% of local authority NHS Health Check providers even know how many men they are reaching with the programme. The evidence from those who do know is that men are far less likely to attend with only 44% of participants male. Similarly, the Forum has just published How to Make Weight-Loss Services Work For Men to help service-providers address the absence of men on such programmes. Two thirds of men are overweight or obese yet only 10-30% of participants on weight-management programmes are male.

Of course, it will always need to be a joint approach which is why the Forum works both with service-providers to make services more male-friendly and with men to enable them to be better informed about their own health and the importance of holding on to it. In its manifesto, the Forum is also calling for improved symptom-awareness and knowledge of the health system – especially how to seek help – starting with boys in school. If boys understand the importance of watching their health before they start work, they may be better empowered to do something about it once in the workplace – and that includes going to the GP.

Reference:

(1) ONS (2014) Mortality Statistics: Death registered in England and Wales, 2013

john middleton

  • Dr John Middleton
  • Vice President
  • UK Faculty of Public Health

By necessities, I understand not only commodities which are indispensably necessary for the support of life, but whatever the custom of the country renders it indecent for creditable people even of the lowest order, to be without

Adam Smith

The UK Faculty of Public Health manifesto calls on all political parties to commit to a living wage strategy over the next five years.

Wordle: FPH Start Well, Live Better

 A Wordle illustration of FPH’s manifesto, Start Well, Live Better

From Adam Smith through to Peter Townsend, the Joseph Rowntree foundation and the Living Wage Foundation of the present day, social commentators have recognized the notion of relative poverty. There are some you cannot do without and still function in the culture of modern society.

I call it the brown bread line. The white breadline represents absolute poverty  – just enough to survive on. The Food Banks charity, Trussell trust, in its, latest publication, suggests we have gone below the breadline. Acute hunger has returned to Britain for the first time in the welfare state.

In our open letter to the Prime Minister published by the Lancet in May, the Faculty of Public Health highlighted three key and catastrophic changes which have combined for a perfect storm of food poverty. Food prices up 12% over five years, double figure price rises in energy costs and a fall in wages by over 7% in five years.  The result has been that some of the poorest people in our society must pay over one fifth of their disposable income to feed themselves.

Poverty kills. In global terms the difference between rich and poor is obvious. In the UK, the sixth wealthiest nation in the world, the gap in income between rich and poor has been getting bigger at least since the mid-seventies and it has accelerated in our latest period of austerity.

The gap in life expectancy between rich and poor has also grown.  The gap in life expectancy between rich and poor grew throughout the 1980s. Large studies from Glasgow and the North of England showed the extent to which poverty and unemployment contributed to the gap. The national Office of Population Censuses and Surveys’ longitudinal study reported in 1984 that unemployment was associated with a 20% higher than national death rates. Whilst the overall life expectancy has improved  for rich and for poor  to the present day, it has not  improved  as much for the poor.

A succession of reports from Black, Whitehead, Acheson and Marmot has highlighted the difference in health between rich and poor. It a cradle to grave story, a life course, as Marmot has described it. The babies of poor are more likely to be born small and more likely to be still born or die in the first year of life.  They are less likely to be breast-fed, grow up shorter and nowadays, fatter, and loose their teeth earlier.

They will perform less well at school – though not through lack of intellect or ability, They will grow up in overcrowded housing and suffer more infectious illnesses. They are more likely to be victims of accidents or violence. Their chances of a university education are very much less and their chances of satisfying, financially rewarding work are slim. They will drift through short-term, unskilled jobs on the edge of the labour market, in more dirty, dangerous, or boring work.

They will develop diabetes, heart disease, cancers and other long-term conditions at an earlier age. Many will die prematurely; those that are propped up with the techno-fixes of modern medicine simply live more years with a disability and the dependency of long-term medical conditions.

Adam Smith’s realization of the idea of relative poverty has been revived. Creditable people, even of the lowest order, according to the Office of National Statistics, face severe material poverty if they cannot afford to:

  • Pay their rent, mortgage, utility bills or loan repayments.
  • Keep their home adequately warm,
  • Face unexpected financial expenses,
  • Eat meat or protein regularly,
  • Go on holiday for a week once a year,
  • A television set,
  • A washing machine,
  • A car,
  • A telephone.

Poverty contributes materially to the burden of ill health in a number of ways. It is easy to see that poor people cannot afford high quality, energy-efficient, safe household appliances, and safety devices, brown bread is more expensive than white, people who are ill carry a large burden of costs for transport to health facilities.

A recent study of the cost of a healthy diet showed that across a basket of 94 foodstuffs cheaper calories came from cheaper more highly processed foods. When you are poor, it’s calories you are thinking about to survive. Fresh foods and foods higher in nutrients minerals and vitamins were more expensive.  When you are making decisions to feed the meter, or feed a family, processed foods are cheaper to cook, but come with the high fat, high transfat, high salt, high sugar cocktail condemning people to early obesity and disease.

Even fast food takeaways are competitive in the fight not to feed the meter. There are also the stress-related aspects of working in a low span of control job, for next to no money.  Employees may benefit from a higher income fit to live on, but employers have also benefitted from a more reliable, content, satisfied and efficient workforce when they have implemented the living wage, as a recent publication by Marmot’s team shows.

The Labour government in 1997 addressed poverty through the minimum wage, working families tax credit, Surestart maternity grant and commitment to eradicate child poverty.  Most of these have been scrapped or reduced in their scope and ambition. The minimum wage is now so far behind what people need to live creditably, that now rightly there is the call for the living wage.

The problems of poverty have been over-complicated through well meaning campaigns from different pressure groups  – food poverty, fuel poverty, housing and other poverty.  All are characterised by the poor needing to spend a greater proportion of their disposable income than the rich on each household item. The living wage campaign begins to address this, being based on a complex set of assessments of household makeup and budget items which came from the minimum income standard (MIS) devised by Joseph Rowntree and Loughborough University.

It is always possible to contest those items  – people are always free to spend their money in other less ‘sensible ways’ but evidence suggests that as people do get better off they will take decisions for more long-term benefit.

It is said that there is all party support for the move. The prime minister and the mayor of London and the other main political parties support it. The living wage this week has been revised to  £9.15 an hour in London and £7.85 an hour in the rest of the UK.  It is a measure, which could vastly improve the health of our workforce and their families and improve our workforce efficiency and economy. For all these reasons the FPH manifesto calls on all political parties to commit to a living wage strategy over the next five years.

  • By Deborah Arnott
  • Chief Executive
  • Action on Smoking and Health (ASH)

In the UK, smoking kills around 100,000 people a year (1). To replace those who quit or die, the tobacco industry has to continually recruit new smokers. As most people start smoking before they’re 18 it is children and young people who the industry must recruit (2). Advertising and marketing has been shown to increase the appeal of cigarettes to children and tobacco manufacturers design their packs to be glitzy and glamorous with often novel designs resembling such things as perfume packaging.

This is a tactic that works: around 207,000 young people start smoking annually in the UK (3) and exposure to tobacco marketing has been shown to increase this risk (4). Children from the most deprived backgrounds, where smoking prevalence is highest, are most likely to be exposed to tobacco packaging (5). Of those who become lifetime smokers, 1 in 2 of will die of a smoking-related disease (6).

Standardised packaging is the best way to protect children from the lure of sophisticated tobacco industry marketing and the FPH’s new manifesto for public health in the next parliament rightly identifies standardised packaging as vital in giving children the best possible chance of achieving a healthy future (7). However, to maximise the public health gains possible from standardised packaging we need to act now to make sure legislation is voted on by this Parliament.

As part of The Children and Families Act, which became law in February 2014, MPs voted in favour of powers enabling the Government to introduce regulations requiring standardised packaging for tobacco products (8). Since then, the Government has published and consulted on draft regulations. To bring the legislation into effect, these regulations need to be put before Parliament for a further vote. The revised Tobacco Products Directive from the European Parliament, which contains a series of measures intended to deter young smokers including larger health warnings, will be implemented in the UK by May 2016 (9). Because measures have a cumulative effect, implementing standardised packaging at the same time will maximise the public health gain; for this to happen Parliament must be given the chance to vote on the regulations to introduce standardised packaging before the next General Election.

The tobacco industry is running a well-resourced and highly misleading campaign against the introduction of standardised packaging in the UK, but the evidence base for the measure’s effectiveness is now well-established. In April this year, Sir Cyril Chantler’s government-commissioned independent and comprehensive review of evidence reported that there is a strong public health case for the policy, concluding that “the body of evidence shows that standardised packaging… is very likely to lead to a modest but important reduction over time on the uptake and prevalence of smoking and thus have a positive impact on public health” (10).

Moreover, despite claims from the tobacco industry that standardised packs will lead to an increase in tobacco smuggling, the proposed packs would contain the same security markings as existing packs and would be no easier to counterfeit. Sir Cyril Chantler stated in his review that he was “not convinced by the tobacco industry’s argument that standardised packaging would increase the illicit market, especially in counterfeit cigarettes” (10).

An industry-commissioned report using sales data from Australia to claim that there has been an increase in tobacco sales since the introduction of standardised packaging has been widely dismissed. Although the industry reported a small (0.28%) increase in sales year on year, they did not report the increase in the Australian population between 2012 and 2013. Adjusted for population, tobacco sales per person have in fact fallen (11).

Tobacco industry efforts have also failed to dent the popularity of standardised packaging, which currently has strong support from the public, politicians across the political spectrum and the public health community (12). A YouGov poll in March 2014 found that overall 64% of adults in Great Britain support or strongly support plain standardised packaging with only 11% opposed to the measure (13) and when Parliament voted to give the Government the power to introduce standard packs through regulations, 453 MPs voted in favour and just 24 against.

Evidence from Australia, the first country to introduce standardised packaging in December 2012, has been encouraging. Soon after standardised packs began to appear in shops, smokers reported that they found cigarettes in these packs less appealing or satisfying (14). Research has also shown that smokers consuming cigarettes from standard packs were 81% more likely to have thought about quitting at least once a day during the previous week and to rate quitting as a higher priority than smokers using branded packs (14).

Every day since the publication of Sir Cyril Chantler’s review in Spring 2014 hundreds of children have started smoking and the public health community has a responsibility to ensure this number stops growing. You can help make the case for standardised packaging by writing to your MP and urging them to encourage the Government to bring regulations to Parliament as soon as possible.

References and notes
(1) ASH Fact Sheet, Smoking Statistics: Illness and death, 2014
(2) Office for National Statistics. General Lifestyle Survey Overview: A report on the 2011 General Lifestyle Survey. 2013.
(3) ASH Fact Sheet, Young People and Smoking, 2014
(4) The packaging of tobacco products. March 2012. The Centre for Tobacco Control Research. Core funded by Cancer Research UK.
(5) Marmot, M. et al. (2010) Fair Society, Healthy Lives: Strategic review of health inequalities in England post-2010 Marmot review secretariat, London
(6) Doll, R. et al. (2004) Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328: 1519
(7) Faculty of Public Health, (2014) Start Well, Live Better – a manifesto
(8) Children and Families Act 2014
(9) Tobacco Products Directive 2014
(10) Standardised packaging of tobacco. Report of the independent review undertaken by Sir Cyril Chantler. Kings College London, April 2014
(11) Is smoking increasing in Australia? The Guardian, June 2014
(12) The Smokefree Action Coalition an alliance of over 250 health organisations including medical royal colleges, the BMA, the Trading Standards Institute, the Chartered Institute of Environmental Health, the Faculty of Public Health, the Association of Directors of Public Health and ASH, all support the introduction of standard packs.
(13) The poll total sample size was 12,269 adults. Fieldwork was undertaken by YouGov between 5th and 14th March 2014. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+). Respondents were shown what a standard pack could look like, including larger health warnings as in Australia.
(14) Wakefield M et al (2013); Introduction effects of the Australia plain packaging policy on adult smokers: a cross-sectional study; BMJ Open 2013

Originally posted on CyclingWorks:

fph-logoThe Faculty of Public Health is the standard-setting body for specialists in public health in the United Kingdom. It is a joint faculty of the three Royal Colleges of Physicians in the UK, and is the home of 3,000 professionals working in public health. For more than 40 years they have been at the forefront of the transformation of the public health profession.

The Faculty sent this letter to TfL outlining the strong public health benefits of the scheme and urging its adoption. The letter points out TfL’s commitments under the Transport Action Plan from February of this year to increase active travel and make streets safe and inviting for all users.

We welcome Transport for London’s proposals for the creation of East-West and North-South cycle superhighways.

The National Institute for Health and Care Excellence (NICE) recommends the facilitation of active travel through improvements to infrastructure. The creation of cycle superhighways incorporates…

View original 543 more words

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