Scotland could regain 'UK public health leader' crown says new charity head

Research shows the number of heart attacks fell by 74% from 1990 and 2014 in Scotland. Reductions in the numbers smoking along with increased uptake of cholesterol testing and statin drugs were cited as major contributory factors.

David McColgan, the new leader of British Heart Foundation Scotland, said he believes there is "an appetite" with the SNP administration to push smoking laws further.

In July New Zealand legislators vowed to break the “disgusting and bizarre” hold of cigarette companies, introducing world-first legislation that will stop the next generation from ever being able to legally buy cigarettes.

The government has introduced its new laws to try to create a smoke-free generation, installing a steadily rising purchasing age so that teenagers will never be able to legally purchase cigarettes.

READ MORE: Smoking ban credited for 74% drop in heart attacks in Scotland 

The rules target only tobacco products, and vaping will remain legal.

Coronary heart disease is still the number one killer in Scotland. Cigarette smokers are 2 to 4 times more likely to get heart disease than non-smokers.

While overall smoking rates have declined in Scotland, differences by deprivation have increased, with rates highest in the most deprived areas, highlighting that smoking remains an ongoing health inequality challenge.

Mr McColgan said Maree Todd, Minister for Public Health, was "really passionate" about the issue.

Earlier his year her husband John, a previously fit and healthy 48-year-old, had a heart attack and was given clot-busting drugs in the back of an ambulance en route to Raigmore hospital in Inverness.

"If we could get everyone to stop smoking today, heart disease rates would plummet, so would cancer and a whole range of things," said Mr McColgan, who is also the chair of ASH Scotland.

"There is new tobacco strategy being developed at the minute. 
"We've seen a lot of exciting developments around tobacco and New Zealand is leading the way.

"The three measures they are looking at are taking nicotine out of cigarettes and they want to go from something like 5000  tobacco retailers to 900.

"They are also looking at incremental age so every year they are going to increase the age of sale so theoretically people born on a certain date will never be able to buy cigarettes."

READ MORE: £400 incentive doubled smoking quit rate in Scotland 

Asked if Scotland could follow their lead he said: "I think the Scottish Government has got a strong record in tobacco control and I think there is an appetite there to be that public health nation again.

"Maree Todd is really passionate about this. There is great work out there that can evolve in Scotland."

The Irish government introduced the first national comprehensive legislation banning smoking in all workplaces, including bars and restaurants in on March 29, 2004.

Mr McColgan said Scotland was already a step ahead of England in driving forward legislation to ban junk food price promotions such as two-for-one offers by Spring next year.

"Boris Johnson committed to price promotion legislation which has been silently pushed to the side," he said.

"I kind of feel that we in a really positive place with a minister like Maree Todd."

A major piece of work by the government to establish which areas of Scotland are under-performing in heart disease diagnostics and treatments will publish its findings in the New Year.

READ MORE: Five myths about quitting smoking as research shows 40% of cancers could be prevented

"In Scotland, data collection is standard but there is no national picture of heart disease," said Mr McColgan, who will take over the role as head of the charity on November 14.

"We can't tell you whether the service is better in one health board versus another. It's very patchy.

"We know from speaking to patients that some are waiting longer for procedures or diagnostics but across the board we don't have that data and that's probably the biggest concern in Scotland.

"If we have that data picture we would be much better able to direct cash.

"They did an exercise like this in cancer and it was instrumental in helping tackle health boards that were under-performing and pull funding into those areas."

National funding for a heart disease action plan remains a concern, he says.

"They invested £2.2million in the initial stages of the plan which doesn't buy you much. Much of that has gone on the data collection project, which is vital and needed to be done.

"Coronary heart disease is still the biggest killer in Scotland yet the funding received to provide a world-class service is massively shadowed by cancer.

"There is a mature conversation to be had about the burden of disease."

Emergency care for heart attacks in Scotland is good, he says, despite the challenges facing the NHS.

He said: "By and large we are doing a pretty good job. The biggest challenge is discharge at the other side."

He said that while patients had not been able to get in front of clinicians so much during Covid, in some ways the shift to digital care had been positive.

"There's been a lot of innovation. BHF launched a cardiac rehab at home programme.

"The big challenge in that though is if you are not confident in digital technology or you don't have access to it.

"The most important thing in this is not to compound inequalities"