Chamber and committees

You will appreciate that the Scottish Government cannot comment on the individual case that occurred in the United States of America no matter the cause of death.

In Scotland we have taken the strictest regulatory approach in Europe to e-cigarettes. The Scottish Consensus Statement on e-cigarettes is clear that these are not harmless products. Our regulatory regime aims at protecting non-smokers and children and young people from exposure to e-cigarettes because they can cause harm. Our stop smoking services are some of the first in the World to introduce support for people to quit vaping and we are already encouraging people who vape to use our services.

This information is not held centrally.

The Scottish Government does not support the use of e-cigarettes during pregnancy. Our assessment of what little research exists on the effects of e-cigarettes on pregnant women comes from evidence from adult smokers in general. This suggests that e-cigarettes are likely to be significantly less harmful to a pregnant woman and her baby than continuing to smoke. Most of the risk from smoking comes from second hand smoke, which on the basis of current evidence is not a risk factor associated with vaping. More research is required to be able to assess if using e-cigarettes during pregnancy poses specific risks.

Health Scotland has published guidance on quitting smoking in pregnancy. The guidance contains the current position on using e-cigs during pregnancy. The Health Scotland guidance is available on the following link.

http://www.healthscotland.com/uploads/documents/26973-iQuit.%20Stopping%20smoking%20when%20you%20are%20pregnant-Sept2018-English.pdf .

The Scottish Government’s advice is not to smoke or vape during pregnancy. However, for those women who feel they need to use nicotine to help quit smoking during pregnancy we would advise using nicotine replacement therapy (NRT) instead of e-cigarettes. For those pregnant women who choose to vape, on the basis of current evidence vaping will be less of a risk to the baby than smoking.

The Scottish Government recognises that all victims and survivors of domestic abuse deserve access to support. Our Equally Safe Fund provides £5.6 million (2019-2020) to support local projects and frontline services which support women and children who have experienced domestic abuse. This includes front line services for children who need support. I have asked Women’s Aid South Lanarkshire and East Renfrewshire to discuss these matters further with my officials.

More generally, we are aware of the pressures on services and are taking forward a review of how national and local specialist services for women and children experiencing gender based violence are commissioned and funded.

Barriers to attendance are regularly considered by the Scottish Cervical Screening Programme and individual NHS Boards with initiatives taking place across Scotland to look at ways of tackling inequalities of access. The Programme will review the recommendations from the Jo's Cervical Cancer Trust research and work with NHS Boards to take these forward.

The UK National Screening Committee (UK NSC) recently advised that self-sampling should not be implemented within the cervical screening programme without further research or pilots to demonstrate its value. The Scottish Government has a clear commitment to increase participation in cervical screening and a number of pieces of work are underway to ensure Scotland contributes to the emerging evidence base. While there are some potentially exciting developments for cervical screening in the pipeline, it’s imperative that the time is taken now to carefully explore the best option(s) that match our circumstances in Scotland, to avoid creating further health disparities.

The impact of local partnerships is a long term operation that is kept under constant review and development, to ensure continuous improvement. Since the publication of the ORT report in 2013, the Scottish Government has taken the following actions to specifically address this:

• We published ‘The Quality Principles: Standard Expectations of Care and Support in Drug and Alcohol Services’ in August 2014 and all ADPs were expected to implement these Quality Principles and assess local services’ compliance with the Principles. To gauge the effective implementation of the Quality Principles, the Scottish Government commissioned the Care Inspectorate to undertake a programme of validated self-evaluation across all ADPs. That work was completed in November 2016 and an individualised report mapped against the eight quality principles was made available to each of the ADPs detailing their strengths and recommendations for improvement.
• We have commissioned the Scottish Drugs Forum to work with each Alcohol and Drug Partnership (ADP) to provide support for quality improvement and development to services in their localities, in accordance with their local priorities and national drivers.
• We have published a Partnership Delivery Framework which sets out a shared ambition across Local Government and Scottish Government that local areas have specific arrangements around substance use in place. These include: clear plans to achieve local outcomes to reduce the use of and harms from alcohol and drugs; transparent financial arrangements; and assurances around effective governance and oversight of delivery.

Work has been ongoing to address this issue since the publication of the 2013 report. Actions have included:

• The Drug Strategy Delivery Group (advisory group put in place following publication of Road to Recovery strategy) along with representation from Scottish Government commissioned organisations; ADP’s; NHS; and other partners; convened an event in April 2014 which looked at all the groups in the Scottish drugs landscape, and also the governance structures in place, to ensure that institutional memory and governance were given necessary importance.
• We have worked with Scottish and UK based colleagues around the development of the updated ‘Drug misuse and dependence: UK guidelines on clinical management’, which was re-issued in 2017 and provides comprehensive clinical guidelines around the use of ORT.
• We have worked with Health Scotland around their publication of a review of literature on reducing drug related deaths. The scope of the review was to respond to the specific risks and needs identified for Scotland’s vulnerable ageing cohort of people with a drug problem.
• Going forward, we are working with Health Scotland around the development of a monitoring and evaluation framework which will sit alongside our new alcohol and drugs strategy to evaluate the proposed commitments and actions. This document will be published in the coming months.

In 2015 the Scottish Government published a ‘Scottish National Research Framework for Problem Drug Use and Recovery’. This document was compiled with the contribution of academics and stakeholders from across the country.

Following the publication of the Framework, Scottish Government officials worked with the Scottish Funding Council to create a dedicated collaborative research infrastructure for drug use research in Scotland. Established in August 2017 and funded by the Scottish Government, the Drugs Research Network for Scotland (DRNS) aims to develop collaborative research across disciplines, organisations and countries to generate high-quality evidence that will inform developments in police and practice.

DRNS is a collaboration of: academics; peer researchers; policy-makers; service planners & providers; people with lived / living experience of problem drug use; and affected family members.