Tobacco control plan for England published

The Department of Health has published its long-awaited Tobacco Control Plan for England.

The plan aims to create a “smokefree generation” by reducing smoking rates through prevention and helping smokers to quit. 

While welcoming the plan’s publication and aims, campaigners were quick to point out a lack of clear targets and issues around funding.

“Cuts to public health budgets have left local authorities in a very difficult position and struggling to deliver the necessary stop smoking services,” said Alison Cox, Cancer Research UK’s director of prevention. “It is worrying that this was not addressed at all in the plan.

“We want to see the government commit to a timeline for getting smokers down to just five per cent of the population, and to ensure every socioeconomic group is targeted to achieve this aim.” 

While no date is set, the plan’s ambition is to reduce smoking prevalence to below 5 in 100 people. If this was achieved by 2035, the NHS could save £67million per year, avoiding 97,500 new cases of smoking-related disease, including 35,900 cancers over 20 years.

“The sustainability of the NHS is at stake if demand – caused by preventable factors like smoking – isn’t reduced,” Cox added. 

The plan includes aims to reduce smoking by 2022 among certain groups, from today’s figure of 16 in 100 adults to 12 in 100, and from 8 in 100 young people who smoke to 3 in 100.

Cox also welcomed the government’s commitment to tackle the health inequalities caused by smoking.

The plan aims to reduce smoking levels in pregnant women to 6 in 100 from around 11 in 100. For the first time the government has also set out priorities for reducing smoking in people with mental health conditions. 

Four in 10 adults with a serious mental health condition are smokers and it is estimated that around 1 in 3 cigarettes are smoked by someone with a mental health condition. 

The plan addresses the potential for e-cigarettes to help smokers quit, saying “the evidence is increasingly clear that e-cigarettes are significantly less harmful to health than smoking tobacco.” The plan pledges to monitor the impact of regulation and policy, assess the latest research, and provide clear public guidance. 

“There are great gains to be made if we can continue to drive down smoking rates,” said Cox. “Fewer smokers mean fewer cancers, and fewer lives devastated by tobacco. Improving the health of the nation will benefit everyone, including smokers and their families, as well as our health service.”

The plan describes Stop Smoking Services as “highly cost-effective” saying they offer smokers “the best chance of quitting”. But funding for public health has been drastically cut in recent years, and figures from Cancer Research UK show that as a result, Stop Smoking Service budgets are being cut in almost 60% of local authorities and shut entirely in many places. 

Also mentioned is the positive effect of mass media campaigns in promoting public health messages, though funding promised for this is around 10 times lower than recommended by the US-based Centres for Disease Control and Prevention.

Local authorities have had large cuts to budgets in recent years and their central government-funded public health grant will be withdrawn in 2021. It is unclear what funding will replace the public health grant, as a proposal to use local business taxes has not been reintroduced under the new government and no funding mechanism has been announced in the plan. 

As implementation of much of the plan will fall to local services, Cox called for more backing to help them.

“Cuts to the public health grant must be halted and councils given the funding they need to deliver vital support to help more smokers quit,” she said