New tools to help health professionals boost prevention impact

Public Health England | April 2019 | New tools to help health professionals boost prevention impact

E-learning tools provide quick access to information and advice to help improve approaches to preventing illness, protecting health and promoting wellbeing.

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Image source: e-lfh.org.uk

The new interactive e-learning tools, developed by PHE and Health Education England e-Learning for Healthcare, offer bite-sized information on key public health issues to help professionals prevent illness, protect health and promote wellbeing.

E-learning tools are now available for cardiovascular disease prevention, adult obesity, antimicrobial resistance, physical activity, social prescribing, giving children the best start in life and supporting those at risk of, or experiencing, homelessness (Source: Public Health England).

Access the new e-learning tools online

How many cigarettes are there in a bottle of wine? A comparison of gender-linked population cancer risks between alcohol and tobacco

ydes, T.J., Burton, R., Inskip, H., Bellis, M.A., & Sheron, N. | 2019 |A comparison of gender-linked population cancer risks between alcohol and tobacco: how many cigarettes are there in a bottle of wine? | BMC Public Health | 19| 316 | https://doi.org/10.1186/s12889-019-6576-9

A study published in the BMC Public Health  calculated ‘cigarette-equivalent of population cancer harm’ for alcohol intake as the cancer risk associated with cigarettes is much better understood, than the cancer risk associated with alcohol consumption. 

The researchers found that consumption of one bottle of wine per week is associated with an increased absolute lifetime risk of alcohol-related cancers in women, driven by breast cancer, equivalent to the increased absolute cancer risk associated with ten cigarettes per week. For men this increased absolute cancer risk was equal to smoking five cigarettes a week.

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Image source: @phe_uk

Abstract

Background

In contrast to our knowledge about the number of cancers attributed to smoking, the number of cancers attributed to alcohol is poorly understood by the public. We estimate the increase in absolute risk of cancer (number of cases per 1000) attributed to moderate levels of alcohol, and compare these to the absolute risk of cancer attributed to low levels of smoking, creating a ‘cigarette-equivalent of population cancer harm’.

 

Methods

Alcohol and tobacco attributable fractions were subtracted from lifetime general population risks of developing alcohol- and smoking-related cancers, to estimate the lifetime cancer risk in alcohol-abstaining non-smokers. This was multiplied by the relative risk of drinking ten units of alcohol or smoking ten cigarettes per week, and increasing levels of consumption.

 

Results

One bottle of wine per week is associated with an increased absolute lifetime cancer risk for non-smokers of 1.0% (men) and 1.4% (women). The overall absolute increase in cancer risk for one bottle of wine per week equals that of five (men) or ten cigarettes per week (women). Gender differences result from levels of moderate drinking leading to a 0.8% absolute risk of breast cancer in female non-smokers.

 

Conclusions

One bottle of wine per week is associated with an increased absolute lifetime risk of alcohol-related cancers in women, driven by breast cancer, equivalent to the increased absolute cancer risk associated with ten cigarettes per week. These findings can help communicate that moderate levels of drinking are an important public health risk for women. The risks for men, equivalent to five cigarettes per week, are also of note (Source:  BMC).

 

The full paper is available at Public Health BMC

Related: PHE Health Matters: tobacco and alcohol CQUIN

In the news: BBC News How many cigarettes in a bottle of wine?

BBC News Is it time to raise the smoking age to 21

Identifying and offering brief advice to tobacco and alcohol users

The latest edition of Health Matters focuses on preventing ill health caused by tobacco and alcohol use | Public Health England

This professional resource focuses on preventing ill health caused by tobacco and alcohol use and makes the case for why NHS providers should implement the Screening and brief advice for tobacco and alcohol use in inpatient settings CQUIN, published in March 2019.

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Image source: http://www.gov.uk

Smoking is the single largest cause of preventable ill health and premature death, and there are over 6 million people in England who smoke. It costs the NHS in England approximately £2.6 billion a year for treating diseases caused by smoking, but every £1 spent on smoking cessation saves £10 in future health care costs and health gains.

An estimated 1 in 4 patients in acute hospital beds in England are smokers and the prevalence of smoking in secure mental health units is even higher at 64% of patients. Therefore, a large number of smokers can be reached through health services and in particular hospitals.

Alcohol misuse contributes wholly or partially to 200 health conditions, including cancers, cardiovascular conditions, depression and liver disease. The toxic effect of alcohol misuse over time and acute alcohol intoxication lead to hospital admission.

In England, 10.4 million people consume alcohol at levels above the UK CMOs’ low-risk guideline, increasing their risk of alcohol-related ill health. Alcohol identification and brief advice (IBA) can identify and influence patients who are drinking above low risk.

The national CQUIN scheme offers the chance to identify and support:

  • inpatients who smoke
  • inpatients who are drinking above low risk

It is intended to complement and reinforce existing activity to deliver interventions to smokers and those who use alcohol at increasing risk and higher risk levels.

Full resource at Public Health England

Quality In Public Health: A Shared Responsibility

This framework aims to raise quality in public health services and functions. It is the first such framework for public health, and has been developed by the Public Health System Group with support from important partners across the public health system including from local government and the NHS.

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Image source: assets.publishing.service.gov.uk

This document sets out a high-level, shared, system-wide commitment to high-quality public health functions and services.

The document:

  • Provides a framework for improving quality in the delivery of public health
    functions and services that can support sector led improvement
  • Describes what we mean by quality in public health systems, functions and
    services
  • Sets out the roles and responsibilities of key players in the public health
    system to deliver high-quality functions and services
  • Describes the process for improving quality
  • Identifies areas for priority focus and action

The main audiences for the framework are:

  • people working in public health and related areas
  • providers of public health functions and services
  • commissioners and funders
  • local authority councillors and directly elected mayors
  • national government, organisations and policy makers

Population screening: access for people with severe mental illness

Public Health England | March 2019 | Population screening: access for people with severe mental illness

Public Health England have produced guidance for commissioners and screening providers, to help improve access to screening for people with severe mental illness (SMI). NHS population screening: improving access for people with severe mental illness provides information on how to improve access to screening, for people with severe mental illness residing in mental healthcare settings.

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NHS population screening: improving access for people with severe mental illness

Appendix 1: mental health service providers

Low levels of exercise are beneficial for adults

Even low levels of leisure-time physical activities are beneficial for adults, whilst doing more vigorous exercise has additional health benefits in terms of reducing mortality.  Authors call for the promotion of any amount and intensity of physical activity, to reduce mortality risk in the general population | British Journal of Sports Medicine

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Abstract
Background:  Evidence on the role of very low or very high volumes of leisure time physical activity (PA) on the risk of all-cause and cause-specific mortality is limited. We aimed to examine the associations of different levels of leisure time PA with the risk of all-cause, cardiovascular disease (CVD) and cancer-specific mortality.

Methods:  Data were from 12 waves of the National Health Interview Surveys (1997–2008) linked to the National Death Index records through 31 December 2011. A total of 88 140 eligible participants aged 40–85 years were included.

Results:  Compared with inactive individuals, those performing 10–59 min/week of PA had 18% lower risk of all-cause mortality. Those who reported 1–2 times (150–299 min/week) the recommended level of leisure time PA had 31% reduced risk of all-cause mortality. Importantly, the continued benefits were observed among those performing leisure time PA 10 or more times the recommended minimum level. In addition, there was a larger reduction in all-cause and cause-specific mortality for vigorous vs. moderate intensity PA.

Conclusions: We found that beneficial association between leisure time PA and mortality starts from a low dose. Doing more vigorous exercise could lead to additional health benefits.

Full abstract at British Journal of Sports Medicine

Full reference: Zhao M, Veeranki SP, Li S, et al | Beneficial associations of low and large doses of leisure time physical activity with all-cause, cardiovascular disease and cancer mortality: a national cohort study of 88,140 US adults | British Journal of Sports Medicine | Published Online First: 19 March 2019

See also: Even low amounts of exercise are beneficial | OnMedica

Productive healthy ageing: interventions for quality of life

Public Health England | March 2019 | Productive healthy ageing: interventions for quality of life

Public Health England have published Productive healthy ageing: interventions for quality of life. The Menu of Interventions (MOIs) for productive health ageing is a guide that pharmacy teams working in different healthcare settings can use to support older people to improve the quality of their lives. It suggests opportunistic, evidence-based interventions that can help provide benefits for healthy ageing.  These interventions can be made by pharmacy teams, to improve quality of life for older people.

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The Menu of Interventions (MOIs) for productive health ageing is a guide that pharmacy
teams working in different healthcare settings can use to support older people to
improve the quality of their lives. It suggests opportunistic, evidence-based interventions
that can help provide benefits for healthy ageing (Source: Public Health England).

A menu of interventions for productive healthy ageing: For pharmacy teams working in different settings