set out plans to target illegal activity at all stages of the supply chain to stamp out opportunities for criminals in light of the new rules

The estimated size of the illicit market was 17.7% of all tobacco trade in 2021 to 2022. The government has acted in recent years to deter illicit trade of tobacco products through publishing its national strategy, introducing harsher penalties to deter and punish those selling illicit tobacco and launching the Tobacco Operational Intelligence Coordination Centre (TOICC), a multi-disciplinary and multi-agency team which identifies tactical opportunities to counter organised criminal groups’ activities.It’s important to note that smoking paper can still be harmful even if you take these precautions. Therefore, it’s always best to avoid smoking paper altogether and use rolling papers or other smoking devices. Risks of Smoking Paper So, the government is considering bringing forward legislation on point of sale displays to keep them away from children. Context As with other health risk behaviours, experimentation and prevalence is higher among older children. According to NHS Digital’s report Smoking, drinking and drug use among younger people in England 2021, 1% of 11 year olds were current vape users, compared with 18% of 15 year olds. This lower rate in younger children has been the case since data collection began in 2014. However, in 2021, there were larger increases in current use for those aged 14 and 15 compared to younger age groups. Rolling papers come in a variety of widths and lengths. The most commonly used is the 'regular' size - the basic normal 'roll your own cigarette' size. We propose that products in scope of the new legislation will mirror the existing age of sale legislation which would mean that all tobacco products, cigarette papers, waterpipe tobacco (such as shisha) and herbal smoking products would be subject to the new law.

In the UK, a 2023 survey by ASH shows that the most frequently used vape flavouring for children is ‘fruit flavour’ with 60% of current children using them. 17% of children who vape choose sweet flavours such as chocolate or candy and 4.8% choose to vape energy or soft drink flavours. Figure 11 shows the most frequent flavours chosen by young people. Funding will be used to help bring all services in line with quality standards that are set out by National Centre for Smoking Cessation and Training guidance. It will support a core specialist team of advisors into local SSS, and a range of other trained professionals (for example, nurses and pharmacy staff) to engage with specific smoking populations that typically do not access SSS without being targeted and directed to stop smoking support. This will also support delivery of the ‘Swap to Stop’ scheme as detailed later in the chapter. In our consultation later this month, the government will explore whether further regulatory measures are needed for other nicotine consumer products such as nicotine pouches. Preventing industry giving out free samples of vapes to children Primary and secondary school children are already educated on the harms of tobacco. In May 2023, the Prime Minister announced that the government will do more to teach children about the risks of vaping. The Department for Education has brought forward the review of the relationships, sex, and health education statutory guidance, and will include the risks of vapes in it.The inherited EU regulations do not support the government’s objective to promote vapes as a quit aid for adult smokers. Instead, the regulations have enabled a system where vapes are all too often promoted and marketed to children. This needs to change, which is why the government will look to introduce measures to reduce the appeal and availability of vapes to children. In the absence of an approved medicinal vape, the government is rolling out a new national vaping ‘Swap to Stop’ scheme to support a million smokers to quit. When the BPRF suggests that the average exposure of smoking increases the risk of a health outcome by 50–85% (that is, ROS > 0.41–0.62), smoking is categorized as having a 4-star association with that outcome. We identified three outcomes with a 4-star association with smoking: COPD (72% increase in risk based on the BPRF, 0.54 ROS), lower respiratory tract infection (54%, 0.43) and pancreatic cancer (52%, 0.42). By contrast, tobacco point of sale restrictions in England reduced the exposure of cigarettes in shops to children. The likelihood of noticing cigarettes decreased from 81% in 2018 to 66% in 2022 for small shops and from 67% to 59% in supermarkets. This also coincided with a decrease in buying cigarettes in shops. There is evidence that previous legislation on tobacco has reduced smoking-related pressures on the NHS: the smokefree (ban in public places) legislation in 2007 led to a reduction in emergency admissions in England, including a reduction in the incidence of acute coronary events and reduced admissions for childhood asthma. The economic cost of smoking When the most conservative interpretation of the evidence, that is, the BPRF, suggests that the average exposure (15th–85th percentiles of exposure) of smoking increases the risk of a health outcome by >85% (that is, ROS > 0.62), smoking and that outcome are categorized as a 5-star pair. Among the 36 outcomes, there are 5 that have a 5-star association with current smoking: laryngeal cancer (375% increase in risk based on the BPRF, 1.56 ROS), aortic aneurysm (150%, 0.92), peripheral artery disease (137%, 0.86), lung cancer (107%, 0.73) and other pharynx cancer (excluding nasopharynx cancer) (92%, 0.65).

Hemp rolling papers - these are made from dried cannabis sativa pulp. They are regarded as the organic and ultra-sustainable option and they have a fine texture, mild taste, and burn at a moderate rate. They have a medium rolling difficulty.

Abstract

The government must also invest in new research and data, including commissioning further research on smoking related health disparities. The relationship between smoking and prostate cancer is nonlinear, particularly for middle-to-high exposure levels where the mean risk curve becomes flat (Fig. 4a). We did not adjust for any bias covariate because no significant bias covariates were selected by the algorithm (Supplementary Table 7). The RRs reported across studies were very heterogeneous, but our meta-analytic method fit the data and covered the estimated residuals well (Fig. 4b,c). The ROS associated with the BPRF is −0.05, suggesting that the most conservative interpretation of all evidence, after accounting for between-study heterogeneity, indicates an inconclusive relationship between smoking exposure and the risk of prostate cancer. After trimming 10% of outliers, we still detected publication bias in the results for prostate cancer, which warrants further studies using sample populations. See Supplementary Tables 4 and 7 for study bias characteristics and selected bias covariates, Supplementary Fig. 5 for results without 10% trimming and Supplementary Table 8 for observed RR data and alternative exposures across studies for the remaining 1-star pairs. Age-specific dose–response risk for CVD outcomes