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  • Health & Medicine

Our new report – gazing into a tobacco-free future

by Chris Woodhall | Analysis

11 July 2014

15 comments 15 comments

With your support, we’ve been campaigning hard to persuade the government to bring in plain, standardised packaging for tobacco products. So far we’ve seen encouraging signs that this will happen. But what next? How do we keep up the pressure on the tobacco industry?

Download our report here.

Download our report here.

This week, we launched a new report, Tobacco Control Endgames: Global Initiatives and Implications for the UK. Written by Ruth Malone, and colleagues from the University of California, San Francisco, the report explores what the UK can learn from the rest of the world to achieve an end to the death and disease tobacco causes.

But what are “tobacco control endgames”? And what do we mean by a society that’s ‘tobacco-free’?

A ‘tobacco-free society’ is generally taken to mean one where only five per cent (or below) of the adult population smoke – that’s one in twenty people. At the moment, around 20 per cent of UK adults still smoke – five in twenty people – so there’s a lot of work to be done to reach that goal.

So thinking about an “endgame” means working out what it would take to get to that tobacco-free future more quickly.

Our new report isn’t an instruction manual to reduce smoking rates. There’s no ‘silver bullet’. But we hope that it will fire the starting gun to raise ambition and commitment to develop the policies and provide the investment that will speed-up progress and save thousands of lives sooner.

Why are we calling for a tobacco-free UK now?

Cigarettes are no ordinary products. In the last century tobacco caused an estimated 100 million deaths worldwide and if trends continue it will kill one billion in the 21st century.

“Without an explicit engagement with the idea that an endgame for tobacco is possible, such an outcome cannot be achieved” – Tobacco Control Endgames: Global initiatives and implications for the UK

Smoking remains the single greatest avoidable risk factor for cancer. In the UK, it’s the cause of more than a quarter (28 per cent) of all deaths from cancer and has killed an estimated 6.5 million people over the last 50 years.

In the UK, smoking rates fell by six per cent between 2002 and 2012, but recently that decline has slowed. In some countries, such as France and the Czech Republic, despite long-term declines in smoking, rates have actually begun to rise again. Action on tobacco requires long-term commitment, vision, and incremental policies, such as tax rises, to drive down smoking rates – alongside investment in support to help smokers quit.

What does this report add?

The report recommends that as a community we need to start talking about ending the tobacco epidemic sooner. Which is why on Tuesday 8th July, we hosted a roundtable summit of leading tobacco control experts, to discuss tobacco-free targets and strategies for faster progress.

The meeting included participants from Ireland who have already adopted a tobacco-free Ireland target of 2025, and Scotland who have an ambition of a tobacco-free generation by 2034.

The report reviews the range of innovative measures that have been presented in academic articles, and looks at countries that are making rapid progress to reduce smoking rates such as Australia, Finland and Canada. It also analyses what’s needed to achieve a tobacco-free UK.

The report recommends building commitment to a faster end to the tobacco epidemic, and increasing constraints on the tobacco industry’s capacity to “block, amend and delay” effective measures that will save lives.

This will mean the introduction of plain, standardised packaging of tobacco products – another key recommendation in the report. Tobacco marketing continues to be a big barrier to reducing smoking rates. And growing research and independent assessments have highlighted the role standardised packaging can have in reducing the appeal of tobacco products to children. We know that eight in 10 smokers start by the age of 19 – the beginning of an addiction that kills half of all long-term users.

What next?

We’ve got bold ambitions to bring forward the day when all cancers are cured – and a big part of this involves ending death and disease caused by tobacco.

We want the UK Government to share in our vision. We hope that this report starts the conversation of how, together, we can achieve a tobacco-free UK.

Chris Woodhall is senior tobacco control officer at Cancer Research UK

The End image from Flickr

    Comments

  • Valiant
    12 July 2014

    Stop misleading the public with propaganda and ideology about Nicotine being as dangerous as smoking tobacco. Nicotine is not toxic. E-cigs only contain Nicotine and not tobacco. They don’t burn or combust. Embrace e-cigs because, “Experts recommend reclassification of Nicotine:
    http://www.ecita.org.uk/blog/index.php/how-toxic-is-e-liquid/

  • Ros C
    12 July 2014

    I find it so sad that an organisation I used to respect can produce an article about smoking reduction with so little content. It’s even more sad that Cancer Research Uk continues to ignore the role of one of the most effective proven ways of reducing smoking… VAPING. Why are CRUK ignoring the increasing evidence that vaping is a more safe and effective means of nicotine delivery? Why are they choosing to ignore something that will almost certainly have a major role in reducing the prevalence of cancer in this country?

  • Dodderer
    12 July 2014

    The latest ‘Smoking in England’ survey shows a prevalence of 18.7%(May 2014).We know from the recent ASH survey(Feb 2014) that there are 700k exclusive vapers in GB – say 600k in England which represents approx. 1.4% of the English population.

    Taking these 2 surveys together,it can be assumed that forcing vapers back to smoking would increase prevalence back to 20%.

    We’re asking you to replace idealism with a dose of realism because we’re the ones that will suffer if you don’t deviate from your current path – it’s just common humanity

  • Dodderer
    12 July 2014

    “In the UK, smoking rates fell by six per cent between 2002 and 2012, but recently that decline has slowed.”

    The ONS annual survey showed a prevalence of 26% in 2002 falling to 21% in 2007.It remained at 21% for 2008 and 2009 before falling to 20% in 2010 where it remained for 2011 and 2012.

    So your statement is disingenuous to say the least.You can’t solve the problem until you admit you have a problem.Just beating smokers harder and harder with a stick won’t work – they’re stubborn human beings just like you

  • Threthny
    12 July 2014

    Wonder why they choose the ‘tobacco free world’ goal? Its because it will never happen. Its like saying a ‘violence free world’. Tobacco control is now an industry, many jobs rely on it. People pay their mortgages, school fees, rent etc etc. It helps to have an unobtainable goal so the money comes rolling in.

    Harm reduction really fks this up for them. Wonder why Glantz/Chapman/McKee are so embroiled in a ‘scream test’ of their own making? Well this is why.

    When public health/TC is more concerned about ‘denormalisation’ than public health well you know its time for them to hang up their dancing shoes.

  • Karyyl
    12 July 2014

    Celebrating 43 years of smoking control, which would have gone much faster if it had not morphed into tobacco control and therefore hidden the snus victory for so long. But still, the tobacco control industry successfully got all the people who did NOT need nicotine, and only started because it was “cool”, off of cigarettes. Leaving the 15-20% of the population that does need nicotine, like those that used it before there ever was a Big Tobacco, as a steady-state, non-declining, smoking (and dying) population. In fact, if it were not for the massive anti-smoking education efforts, Hon Like might not have realized what killed his father, and that it would likely kill him too, and he would not have invented the e-cig. So, smoking-control people, man up and claim e-cigs as the endgame of your 50-year fight! You made Hon Lik, Hon Lik made the thing that will save over a million people worldwide every year. Celebrate! You did it!

  • Angryoldgit
    12 July 2014

    “Endgame” sounds a lot like “Final Solution” to many people. However, I will make the assumption that you have a genuine desire to reduce tobacco usage purely for health reasons. Does your endgame include supporting the e-cigarette industry, which has already shown remarkable promise in reducing the prevalence of smoking? Are you anti-tobacco or anti-anything-enjoyable. The difference could save many, many lives?

  • Tom Gleeson
    12 July 2014

    First off, tobacco is not an epidemic, look it up in the dictionary. End game? this is a game to you? Without offering an alternative your doomed to failure, old folk tail about the wind and sun trying to see who could get a man to remove his coat apply here. All stick and no carrot.
    If you think the limited marketing available to tobacco currently is so effective, why isn’t the unlimited marketing available to tobacco control more effective? Could it be because you miss the point completely, ending smoking as the means of nicotine use should be the ‘ end game’ at which point the health effect would be negligible. Embrace harm reduction as you move towards smoking elimination and you might get more people to embrace your smoke free socity vision. Yes I said smoke free not tobacco free. If cancer reduction is the goal then smoke is the target not tobacco.

  • Dominic Reedman-Flint
    11 July 2014

    We have found the solution. It just needs embracing by the likes of yourselves.

    Vaping has the potential to end tobacco use completely. Nicotine addicts can still get their kicks without tobacco and much more safely.
    To not accept and back this gateway out of cigarettes is ridiculous

  • smofunking
    11 July 2014

    “How do we keep up the pressure on the tobacco industry?” That would appear to be by persecuting their customers into submission because you only see them as weak willed addicts rather than strong minded individuals who have the ability to come to their own informed decisions.
    In the unlikely event that you ever reach your oxymoronic 5% smoke free goal does that mean that your war on this legal pastime (NOT an epidemic) and its participants will have reached its conclusion? I doubt it.

  • LVD
    11 July 2014

    Nothing new since last years thinking indeed; nothing new since the strategies of a couple of decades ago that have a proven track record of only working on a limited number of smokers. Smoking rates no longer decline, that indicates the limits of the what the olden strategies can do have been reached. Just calling the recycled strategies an ‘endgame’ will not make them work by miracle. “Madness is doing the same thing over and over again and expecting a different result” (Albert Einstein). To no ones surprise CR_UK refuses to look at the world leader in smoking prevalence, Sweden, since they adopted risk reduction strategies decades ago. But when will CR_UK start to do something for those left in the cold for so many decades already? Nothing, never, not even to little to late! The remaining smokers are helping themselves with e-cigs, snus and other risk reducing products without any help from CR_UK or anybody else, just like they have grown accustomed to for all their adult lives. Now the genie that those products exist is out of the bottle, and it can not be put back. But people taking the matter into their own hands, because they have been ignored and maltreated for decades, and this without it costing one penny to the taxpayer, scares the living daylights out of them since now their heavily tax funded jobs are also on the line.

  • Dodderer
    11 July 2014

    It would be remiss of me not to mention the impact of now having a vaping but ex-smoking parent on their ‘most-at-risk’ children

  • m sowle
    11 July 2014

    When are you going to realise that ecigs are making a massive impact on smoking rates worldwide and you are still not supporting vaping, the research is out there open your eyes and look. Your support of the tpd (the sections pertaining to ecigs)and your inaction will result in more cancer deaths.

  • Dodderer
    11 July 2014

    The recent evidence shows that prevalence has plateaued since 2007(the year of the smoking ban) and would indicate that subsequent measures have not achieved their desired aim.

    Recent research from Professor West indicated that NRT purchased over-the counter is no more effective than ‘cold turkey’.

    Professor Bauld’s review of our Stop smoking Service shows a 12 month success rate of 7-9% with an estimated 35% relapse rate after one year.

    The evidence for standardised packaging is flimsy both ways – it could well encourage more uncontrolled illicit use or help reduce youth uptake – we just don’t know

    Evidence suggests ecigs are popular with smokers with 700k having used them to stop completely.Evidence to date suggests they are significantly safer than lit tobacco and are not attractive to youth and non-smokers.Reducing the choice and limiting future innovation with excessive regulation would seem a greater threat to public health than the status quo.Unusually in this instance,the wrong action will be orders of magnitude worse than no action – the precautionary principle indicates that the burden of proof is on the regulators.This proof is wholly absent.

  • Alan Beard
    11 July 2014

    This all sounds so very familiar with nothing of value added to the last years thinking.How can there be article discussing a tobacco cigarette endgame without a mention of alternative THR products like SNUS and e-cigarettes which WILL be required to achieve 5% smoking prevalence?
    Does the author genuinely believe that plain packaging and cigarette duty rises alone will achieve this “endgame”?

    Even though I share the same wish for <5% smoking prevalence, the aims will not be met by the contents of this implausible article . It needs a far more radical and importantly an inclusive series of methods to be offered to current smokers, demonization, denormalisation ,increasing taxes have been the methods adopted with a result of no change in Smoking prevalence 2007-2012 – surely now is the time for an alternative approach from tobacco control
    2.1 Million people have converted to Vaping with 700,000 sole users in the UK (Ash 2014 stats) purely by word of mouth largely (adverts a recent feature) what would that figure have been with a modicum of support instead of the scepticism from organisations like CR_UK. To totally have ignored the part that these devices could play in the whole point of the article is very revealing in my opinion -it indicates to me that CR_UK are still not understanding the psyche of smokers or vapers .

    Comments

  • Valiant
    12 July 2014

    Stop misleading the public with propaganda and ideology about Nicotine being as dangerous as smoking tobacco. Nicotine is not toxic. E-cigs only contain Nicotine and not tobacco. They don’t burn or combust. Embrace e-cigs because, “Experts recommend reclassification of Nicotine:
    http://www.ecita.org.uk/blog/index.php/how-toxic-is-e-liquid/

  • Ros C
    12 July 2014

    I find it so sad that an organisation I used to respect can produce an article about smoking reduction with so little content. It’s even more sad that Cancer Research Uk continues to ignore the role of one of the most effective proven ways of reducing smoking… VAPING. Why are CRUK ignoring the increasing evidence that vaping is a more safe and effective means of nicotine delivery? Why are they choosing to ignore something that will almost certainly have a major role in reducing the prevalence of cancer in this country?

  • Dodderer
    12 July 2014

    The latest ‘Smoking in England’ survey shows a prevalence of 18.7%(May 2014).We know from the recent ASH survey(Feb 2014) that there are 700k exclusive vapers in GB – say 600k in England which represents approx. 1.4% of the English population.

    Taking these 2 surveys together,it can be assumed that forcing vapers back to smoking would increase prevalence back to 20%.

    We’re asking you to replace idealism with a dose of realism because we’re the ones that will suffer if you don’t deviate from your current path – it’s just common humanity

  • Dodderer
    12 July 2014

    “In the UK, smoking rates fell by six per cent between 2002 and 2012, but recently that decline has slowed.”

    The ONS annual survey showed a prevalence of 26% in 2002 falling to 21% in 2007.It remained at 21% for 2008 and 2009 before falling to 20% in 2010 where it remained for 2011 and 2012.

    So your statement is disingenuous to say the least.You can’t solve the problem until you admit you have a problem.Just beating smokers harder and harder with a stick won’t work – they’re stubborn human beings just like you

  • Threthny
    12 July 2014

    Wonder why they choose the ‘tobacco free world’ goal? Its because it will never happen. Its like saying a ‘violence free world’. Tobacco control is now an industry, many jobs rely on it. People pay their mortgages, school fees, rent etc etc. It helps to have an unobtainable goal so the money comes rolling in.

    Harm reduction really fks this up for them. Wonder why Glantz/Chapman/McKee are so embroiled in a ‘scream test’ of their own making? Well this is why.

    When public health/TC is more concerned about ‘denormalisation’ than public health well you know its time for them to hang up their dancing shoes.

  • Karyyl
    12 July 2014

    Celebrating 43 years of smoking control, which would have gone much faster if it had not morphed into tobacco control and therefore hidden the snus victory for so long. But still, the tobacco control industry successfully got all the people who did NOT need nicotine, and only started because it was “cool”, off of cigarettes. Leaving the 15-20% of the population that does need nicotine, like those that used it before there ever was a Big Tobacco, as a steady-state, non-declining, smoking (and dying) population. In fact, if it were not for the massive anti-smoking education efforts, Hon Like might not have realized what killed his father, and that it would likely kill him too, and he would not have invented the e-cig. So, smoking-control people, man up and claim e-cigs as the endgame of your 50-year fight! You made Hon Lik, Hon Lik made the thing that will save over a million people worldwide every year. Celebrate! You did it!

  • Angryoldgit
    12 July 2014

    “Endgame” sounds a lot like “Final Solution” to many people. However, I will make the assumption that you have a genuine desire to reduce tobacco usage purely for health reasons. Does your endgame include supporting the e-cigarette industry, which has already shown remarkable promise in reducing the prevalence of smoking? Are you anti-tobacco or anti-anything-enjoyable. The difference could save many, many lives?

  • Tom Gleeson
    12 July 2014

    First off, tobacco is not an epidemic, look it up in the dictionary. End game? this is a game to you? Without offering an alternative your doomed to failure, old folk tail about the wind and sun trying to see who could get a man to remove his coat apply here. All stick and no carrot.
    If you think the limited marketing available to tobacco currently is so effective, why isn’t the unlimited marketing available to tobacco control more effective? Could it be because you miss the point completely, ending smoking as the means of nicotine use should be the ‘ end game’ at which point the health effect would be negligible. Embrace harm reduction as you move towards smoking elimination and you might get more people to embrace your smoke free socity vision. Yes I said smoke free not tobacco free. If cancer reduction is the goal then smoke is the target not tobacco.

  • Dominic Reedman-Flint
    11 July 2014

    We have found the solution. It just needs embracing by the likes of yourselves.

    Vaping has the potential to end tobacco use completely. Nicotine addicts can still get their kicks without tobacco and much more safely.
    To not accept and back this gateway out of cigarettes is ridiculous

  • smofunking
    11 July 2014

    “How do we keep up the pressure on the tobacco industry?” That would appear to be by persecuting their customers into submission because you only see them as weak willed addicts rather than strong minded individuals who have the ability to come to their own informed decisions.
    In the unlikely event that you ever reach your oxymoronic 5% smoke free goal does that mean that your war on this legal pastime (NOT an epidemic) and its participants will have reached its conclusion? I doubt it.

  • LVD
    11 July 2014

    Nothing new since last years thinking indeed; nothing new since the strategies of a couple of decades ago that have a proven track record of only working on a limited number of smokers. Smoking rates no longer decline, that indicates the limits of the what the olden strategies can do have been reached. Just calling the recycled strategies an ‘endgame’ will not make them work by miracle. “Madness is doing the same thing over and over again and expecting a different result” (Albert Einstein). To no ones surprise CR_UK refuses to look at the world leader in smoking prevalence, Sweden, since they adopted risk reduction strategies decades ago. But when will CR_UK start to do something for those left in the cold for so many decades already? Nothing, never, not even to little to late! The remaining smokers are helping themselves with e-cigs, snus and other risk reducing products without any help from CR_UK or anybody else, just like they have grown accustomed to for all their adult lives. Now the genie that those products exist is out of the bottle, and it can not be put back. But people taking the matter into their own hands, because they have been ignored and maltreated for decades, and this without it costing one penny to the taxpayer, scares the living daylights out of them since now their heavily tax funded jobs are also on the line.

  • Dodderer
    11 July 2014

    It would be remiss of me not to mention the impact of now having a vaping but ex-smoking parent on their ‘most-at-risk’ children

  • m sowle
    11 July 2014

    When are you going to realise that ecigs are making a massive impact on smoking rates worldwide and you are still not supporting vaping, the research is out there open your eyes and look. Your support of the tpd (the sections pertaining to ecigs)and your inaction will result in more cancer deaths.

  • Dodderer
    11 July 2014

    The recent evidence shows that prevalence has plateaued since 2007(the year of the smoking ban) and would indicate that subsequent measures have not achieved their desired aim.

    Recent research from Professor West indicated that NRT purchased over-the counter is no more effective than ‘cold turkey’.

    Professor Bauld’s review of our Stop smoking Service shows a 12 month success rate of 7-9% with an estimated 35% relapse rate after one year.

    The evidence for standardised packaging is flimsy both ways – it could well encourage more uncontrolled illicit use or help reduce youth uptake – we just don’t know

    Evidence suggests ecigs are popular with smokers with 700k having used them to stop completely.Evidence to date suggests they are significantly safer than lit tobacco and are not attractive to youth and non-smokers.Reducing the choice and limiting future innovation with excessive regulation would seem a greater threat to public health than the status quo.Unusually in this instance,the wrong action will be orders of magnitude worse than no action – the precautionary principle indicates that the burden of proof is on the regulators.This proof is wholly absent.

  • Alan Beard
    11 July 2014

    This all sounds so very familiar with nothing of value added to the last years thinking.How can there be article discussing a tobacco cigarette endgame without a mention of alternative THR products like SNUS and e-cigarettes which WILL be required to achieve 5% smoking prevalence?
    Does the author genuinely believe that plain packaging and cigarette duty rises alone will achieve this “endgame”?

    Even though I share the same wish for <5% smoking prevalence, the aims will not be met by the contents of this implausible article . It needs a far more radical and importantly an inclusive series of methods to be offered to current smokers, demonization, denormalisation ,increasing taxes have been the methods adopted with a result of no change in Smoking prevalence 2007-2012 – surely now is the time for an alternative approach from tobacco control
    2.1 Million people have converted to Vaping with 700,000 sole users in the UK (Ash 2014 stats) purely by word of mouth largely (adverts a recent feature) what would that figure have been with a modicum of support instead of the scepticism from organisations like CR_UK. To totally have ignored the part that these devices could play in the whole point of the article is very revealing in my opinion -it indicates to me that CR_UK are still not understanding the psyche of smokers or vapers .