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Government says England will be smokefree by 2030. But how will it get there?

by Gabriella Beer | Analysis

23 July 2019

19 comments 19 comments

cigarette being broken in half

Smoking causes nearly 1 in 5 cancer cases and more than 1 in 4 cancer deaths each year in the UK. Decades of policy action have steadily cut the UK’s smoking rates to one of the lowest in Europe. But with around 1 in 7 people still smoking, tobacco continues to place an enormous cost on our society and our economy.

Last November, the UK Government published its vision to put “prevention at the heart of our nation’s health”, recognising the importance of preventing cancer amongst other long-term health conditions. A new ‘green paper’, published yesterday, poses some new and old ways that the Government might deliver on this. And when it comes to tackling smoking, the plan to make England smokefree by 2030 is bold.

“We want to see smoking become a thing of the past, so it’s great to see the Government pledge to make this happen,” says Kruti Shrotri, Cancer Research UK’s policy manager.

But getting there can’t just be business as usual. If the Government really intends on achieving a smokefree England by the end of the next decade, continued action on smoking is vital.

NHS and local government need support

“To make the England smokefree by 2030, we need to help people to quit smoking, particularly those who are hard to reach,” says Shrotri.

NHS England has promised that, by 2024, every hospital patient who smokes will be offered treatment to help them quit. But this isn’t enough. People also need to be offered treatment to quit by their GP. And local governments need funding to help them pay for vital services that are proven to bring smoking rates down.

“Smoking cessation services in local communities are being increasingly threatened,” says, Shrotri, referring to the impact of ongoing public health funding cuts across the country.

Slashed budgets have jeopardised vital public health services. And since 2015, the public health budget has fallen by £700 million. Funding for wider tobacco control measures and stop smoking services have been among the worst hit.

“We know stop smoking services, which offer smokers a combination of pharmacotherapy and behavioural support, are the most successful way to support smokers to stop,” says Shrotri. “However, ongoing cuts to public health funding have meant that just over half the local authorities in England have a specialist stop smoking service open to all smokers in the area.”

What about Scotland, Wales and Northern Ireland?

Each UK nation has its own government that is responsible for public health. The UK Government in Westminster is responsible for health in England, while the Scottish, Welsh and Northern Irish Governments are responsible for health in each nation. Those devolved governments have their own plans for reducing smoking. Last year, the Scottish Government committed to a tobacco-free generation by 2034. Only shorter term targets for reducing smoking rates exist in Wales and Northern Ireland. But some sources of public health funding apply to the whole of the UK. For example, money raised from a ‘polluter pays’ approach would benefit everyone. We’re working with all governments to ensure that tobacco control remains high on the agenda and that smokers are best supported to quit.

Reducing smoking rates will also help tackle health inequality. Right now, the gap in life expectancy between the richest and the poorest is widening. And because smoking rates are highest amongst the most vulnerable in society, tackling smoking is the single best thing we can do to improve that gap.

Possibility of a ‘polluter pays’ approach

Tobacco companies are responsible for the greatest and most enduring man-made public health epidemic in history, yet they continue to profit from a product that kills one in two people who use it. In its green paper, the Government recognises that charging tobacco companies in France and the USA for the damage they cause has helped to fund some tobacco control efforts, suggesting that the UK may be open to a similar approach.

“These new Government proposals mention a charge on the tobacco industry,” says Shrotri. “This is something we and others have been trying to push since 2015, so we’re really pleased they’ve acknowledged it as part of a potential solution to plug the current funding gap for tobacco control.”

More than 7 in 10 adults in England said they’d support a fee on tobacco manufacturers that could fund stop smoking services and prevent young people from taking up smoking, according to a YouGov survey commissioned by Action on Smoking and Health (ASH).

“It’s a matter of fairness,” says Shrotri, “that the tobacco industry should pay for the damage to health that they’ve caused.”

Alongside this, the green paper also suggests that an insert carrying quitting advice could be included inside cigarette packs. Canada is the only country in the world that does this, and evidence suggests this could discourage young adult smokers from continuing to smoke.

What happens next?

This latest Government document is only a series of suggestions. The proposals are now out in the public domain and open for debate.

Organisations and companies with an interest in the proposed measures – whether they prioritise public health or not – are now free to weigh in and attempt to influence how these proposals are taken forward.

What about obesity?

Overweight and obesity is the second biggest preventable cause of cancer after smoking. Some plans are already underway to tackle this, and the green paper updated on some others:

  • The Government will look at whether the tax on sugary drinks should be extended to milk-based drinks
  • We’re still waiting for the Government to publish its plans on the mandatory calorie labelling of food items, restricting junk food bargain buys and a introducing a 9pm watershed on junk food advertising promotions.

“Clearly our NHS is overburdened,” says Shrotri. “We know that there are things that the Government can do to reduce people’s chance of getting cancer.” These proposals are a positive start. But clear plans are now needed so that by the time we reach 2030, the UK is happier, healthier and completely smokefree.

Gabi

    Comments

  • Peter Parker
    23 August 2019

    The best treatise and concise manual on how to stop smoking is Alan Carr’s ‘The Easy Way to Stop smoking’. Although it is a slight misnomer to call it the ‘easy’, ( it should be called the ‘easiest’ way), it looks at all aspects concerning the habit, the pitfalls to look out for, and leads the reader to a climax whereby you stop and never want to smoke again. Basically, he gets you back to where you were before the first cigarette. He also clearly shows that one is not really enjoying a cigarette, but rather one is rationalising to justify what is essentially an addiction. I feel indebted to him for the book which led me to one of the most important decisions of my life. One thing I would say though, it’s best to read the book with a prior desire to quit.Finally, it should be made publically known that the tobacco industries have perpitrated the biggest lie ever known.

  • K.Russell
    10 August 2019

    Phase out packs of 20 and sell only 10 and possibly 5 per pack.

  • PB
    9 August 2019

    What about adverts targeted at the young that emphasises that getting cancer is not cool and making a very clear link between smoking, cancer and death.

  • TG
    8 August 2019

    A smoke free country would be great. What about reducing how many cigarettes are in a pack to start, then only selling one pack at a time like paracetamol for example. Until you can only buy a pack of 10 or even 5 in any one transaction. It’s easy for me to say though as I’m not addicted to smoking (I’m not a smoker) but I am obese. I live on roughly 1300 calories most days and when you see what that is you’d know that’s not excessive. I do reduce this some days but can’t seem to lose any weight so I know it’s not easy to do and I for one would not want to be discriminated against because of my weight. I’ve worked all my adult life, paying tax and NI and I’ve been lucky enough not to have to claim any benefits but who knows what tomorrow may bring. We are so lucky in this country to have the NHS. What we could do without is people wasting Doctors time with colds and sore throats and calling ambulances for anything other than a life threatening medical problem that they need to get to hospital quickly for and not something they could get a taxi to the hospital for or wait to see their GP.

  • David Willett
    8 August 2019

    I have thought for many years that a smoke free country would be really good. I hate smelling smoke Frome those who do smoke. I even cross to the other side of the road to avoid it.

  • Lucy Parkin
    8 August 2019

    I think smoking has become less acceptable but it’s still getting support in work places with smoking areas and smoke breaks. Hospital grounds a day all public places should an smoking. Parents smore outside my daughter’s school. People smoke outside the main entrance to my hospital, others walk along the street shamelessly smoking. It should be banned everywhere that is public and retailers should stop selling tobacco and cigarettes. We.need a complete unashamedly proactive approach in telling people of any age that smoking is unacceptable. So man up and give up!!!!

  • Colette Codling
    8 August 2019

    I read it further down the comments but why not just stop selling tobacco products? I have never smoked so don’t know but is going cold turkey from tobacco so bad? If people insist on causing damage to their bodies (whether it be food, tobacco, drugs or alcohol) despite all the information maybe they should have to pay for treatment?? But I mean actually pay what it costs the NHS to fix them not a token donation. I know a statement like that always gets the response “what about people who take part in dangerous sports or just driving a car?” But those are calculated risks in comparison to smoking or obesity surely?

  • Kay
    8 August 2019

    Smoking should be banned in outdoor areas of pubs and cafes. We cannot enjoy sitting in sunshine enjoying a coffee or drink without being surrounded by smokers. The indoor policy should be extended to outside eating and drinking premises for all to enjoy.

  • George
    8 August 2019

    Why not just stop producing and selling cigarettes. People will have little choice but to give up. Goverment wont do that though because they are making masses of money in revenue. But if they did Then there wont be all the trouble of people failing to quit, they would have to. And that is
    Coming from myself who smokes.

  • Jenny Carter
    8 August 2019

    Smoking needs to be stopped and folks need help to quit, to save them from Cancer, and to help the non-smokers from breathing in their pollution. My father died from cancer through smoking at the age of 52! Obesity is a problem as folks are not getting enough exercise and junk food is everywhere!

  • Meg Bell
    8 August 2019

    Bring in on the spot fines for people smoking on hospital premises & follow it through.
    Refuse to treat patients who refuse to stop smoking.
    Double the price of cigarettes & halve the price of nicotine replacement products & vaping etc.

  • Mark Avery
    8 August 2019

    An excellent article, and one with my whole hearted support! One of the best actions any government took, was to ban smoking in public places, in particular pubs and restaurants!! I remember all the negativity surrounding that, “it won’t work.” Well it has, splendidly!! And the idea of placing an advice slip on giving up, in every packet is brilliant. Giving people, especially youngsters, time to reflect on the issue in their own privacy and time. The fact that Canada is the lead on this doesn’t surprise me, with their innovation and liberalism. Credit to them, and great if we follow their need!

  • Anthony Scott
    8 August 2019

    AS an ex-smoker,now free for some 30 years,but with a wife who will not stop,I hate the smell.She is obstinate,knows it is wrong,but will not stop.
    Double the price of tobacco,then double it again.Make them aware they will have pay to see a doctor each and every time they need help?
    Or just leave them to die early with no help??

  • Robert Giles
    8 August 2019

    Sugar is not the problem with obesity it’s a lack of proper exercise. The sugar tax is the nanny state at its worst and the only thing it will be effective at is increasing a persons intake of artificial chemical sweeteners which might cause cancers. Are you proposing a sugar tax on apples? They contain sugar. It is just plain wrong to point out sugar as the problem the problem is eating to much combined with not enough physical exercise. Judging on all the overweight people there are it does not look like the the sugar tax is working. Hopefully the Government will abolish this crazy tax.

  • Graham Robinson
    8 August 2019

    Tobacco in various forms/uses has been with us for centuries. With the considerable reduction in smoking over the last few decades , it is clear that much money and effort has gone into bringing about this change. I don’t think,given the powerful vested interests in the smoking habit, it will be realistic to set the date/total ban target- remember the sauerkraut legend. Being human, we may wellcome back smoking big-time, or worse still, drugs will be seen as a ‘healthier’, more acceptable habit.Fag-ash out of the car window is unpleasant but ‘stoned’ driving is a nightmare scenario. Monitor the situation carefully -‘make haste slowly’ as someone once said.Smoking eventually killed my father, so rest assured I’m on your side!

  • Cathy Ball
    8 August 2019

    Both second hand smoke and second hand vapour or aerosol as its proper term cause me to get asthma attacks, last time resulted in being at hospital half the night. Both need restricting in public places for a start, as in USA both are banned for several feet outside shops, etc., and some cities have areas in the centres that are smoke and vape free, why can UK not do the same?

  • Angela harper to be withheld not for public!
    7 August 2019

    Basically a good idea however it is going too be hard to get it implicated, you can always tell a smoker in a crowd, the smell of nicotine just does go away! Also vapping s not nice either, and they haven’t been around long enough for research to give a firm results as too whether they could potentially caused lung damage or other health issues including people being in the same room where vap smoking is taking place! I have never been a smoker so I’m not going one those preaching on my high horse, just concerned about smokers and effect it could have on people in public places, streets, parks etc! They need to include Vaps too! Nothing like enjoying a walk along the hush to be choked by viper smoke release!

  • Brian Hewson
    7 August 2019

    I think it’s a good idea but who will police it? At the moment we can’t stop people who drink, take drugs and driving on mobile phones as we have not got personal to deal with it.

  • Teresa O'connell
    7 August 2019

    As a palliative care nurse I think the idea of including quitting advice in cigarette packets is a great idea to reach the tobacco smokers at source. Informing and educating is the way forward!

    Comments

  • Peter Parker
    23 August 2019

    The best treatise and concise manual on how to stop smoking is Alan Carr’s ‘The Easy Way to Stop smoking’. Although it is a slight misnomer to call it the ‘easy’, ( it should be called the ‘easiest’ way), it looks at all aspects concerning the habit, the pitfalls to look out for, and leads the reader to a climax whereby you stop and never want to smoke again. Basically, he gets you back to where you were before the first cigarette. He also clearly shows that one is not really enjoying a cigarette, but rather one is rationalising to justify what is essentially an addiction. I feel indebted to him for the book which led me to one of the most important decisions of my life. One thing I would say though, it’s best to read the book with a prior desire to quit.Finally, it should be made publically known that the tobacco industries have perpitrated the biggest lie ever known.

  • K.Russell
    10 August 2019

    Phase out packs of 20 and sell only 10 and possibly 5 per pack.

  • PB
    9 August 2019

    What about adverts targeted at the young that emphasises that getting cancer is not cool and making a very clear link between smoking, cancer and death.

  • TG
    8 August 2019

    A smoke free country would be great. What about reducing how many cigarettes are in a pack to start, then only selling one pack at a time like paracetamol for example. Until you can only buy a pack of 10 or even 5 in any one transaction. It’s easy for me to say though as I’m not addicted to smoking (I’m not a smoker) but I am obese. I live on roughly 1300 calories most days and when you see what that is you’d know that’s not excessive. I do reduce this some days but can’t seem to lose any weight so I know it’s not easy to do and I for one would not want to be discriminated against because of my weight. I’ve worked all my adult life, paying tax and NI and I’ve been lucky enough not to have to claim any benefits but who knows what tomorrow may bring. We are so lucky in this country to have the NHS. What we could do without is people wasting Doctors time with colds and sore throats and calling ambulances for anything other than a life threatening medical problem that they need to get to hospital quickly for and not something they could get a taxi to the hospital for or wait to see their GP.

  • David Willett
    8 August 2019

    I have thought for many years that a smoke free country would be really good. I hate smelling smoke Frome those who do smoke. I even cross to the other side of the road to avoid it.

  • Lucy Parkin
    8 August 2019

    I think smoking has become less acceptable but it’s still getting support in work places with smoking areas and smoke breaks. Hospital grounds a day all public places should an smoking. Parents smore outside my daughter’s school. People smoke outside the main entrance to my hospital, others walk along the street shamelessly smoking. It should be banned everywhere that is public and retailers should stop selling tobacco and cigarettes. We.need a complete unashamedly proactive approach in telling people of any age that smoking is unacceptable. So man up and give up!!!!

  • Colette Codling
    8 August 2019

    I read it further down the comments but why not just stop selling tobacco products? I have never smoked so don’t know but is going cold turkey from tobacco so bad? If people insist on causing damage to their bodies (whether it be food, tobacco, drugs or alcohol) despite all the information maybe they should have to pay for treatment?? But I mean actually pay what it costs the NHS to fix them not a token donation. I know a statement like that always gets the response “what about people who take part in dangerous sports or just driving a car?” But those are calculated risks in comparison to smoking or obesity surely?

  • Kay
    8 August 2019

    Smoking should be banned in outdoor areas of pubs and cafes. We cannot enjoy sitting in sunshine enjoying a coffee or drink without being surrounded by smokers. The indoor policy should be extended to outside eating and drinking premises for all to enjoy.

  • George
    8 August 2019

    Why not just stop producing and selling cigarettes. People will have little choice but to give up. Goverment wont do that though because they are making masses of money in revenue. But if they did Then there wont be all the trouble of people failing to quit, they would have to. And that is
    Coming from myself who smokes.

  • Jenny Carter
    8 August 2019

    Smoking needs to be stopped and folks need help to quit, to save them from Cancer, and to help the non-smokers from breathing in their pollution. My father died from cancer through smoking at the age of 52! Obesity is a problem as folks are not getting enough exercise and junk food is everywhere!

  • Meg Bell
    8 August 2019

    Bring in on the spot fines for people smoking on hospital premises & follow it through.
    Refuse to treat patients who refuse to stop smoking.
    Double the price of cigarettes & halve the price of nicotine replacement products & vaping etc.

  • Mark Avery
    8 August 2019

    An excellent article, and one with my whole hearted support! One of the best actions any government took, was to ban smoking in public places, in particular pubs and restaurants!! I remember all the negativity surrounding that, “it won’t work.” Well it has, splendidly!! And the idea of placing an advice slip on giving up, in every packet is brilliant. Giving people, especially youngsters, time to reflect on the issue in their own privacy and time. The fact that Canada is the lead on this doesn’t surprise me, with their innovation and liberalism. Credit to them, and great if we follow their need!

  • Anthony Scott
    8 August 2019

    AS an ex-smoker,now free for some 30 years,but with a wife who will not stop,I hate the smell.She is obstinate,knows it is wrong,but will not stop.
    Double the price of tobacco,then double it again.Make them aware they will have pay to see a doctor each and every time they need help?
    Or just leave them to die early with no help??

  • Robert Giles
    8 August 2019

    Sugar is not the problem with obesity it’s a lack of proper exercise. The sugar tax is the nanny state at its worst and the only thing it will be effective at is increasing a persons intake of artificial chemical sweeteners which might cause cancers. Are you proposing a sugar tax on apples? They contain sugar. It is just plain wrong to point out sugar as the problem the problem is eating to much combined with not enough physical exercise. Judging on all the overweight people there are it does not look like the the sugar tax is working. Hopefully the Government will abolish this crazy tax.

  • Graham Robinson
    8 August 2019

    Tobacco in various forms/uses has been with us for centuries. With the considerable reduction in smoking over the last few decades , it is clear that much money and effort has gone into bringing about this change. I don’t think,given the powerful vested interests in the smoking habit, it will be realistic to set the date/total ban target- remember the sauerkraut legend. Being human, we may wellcome back smoking big-time, or worse still, drugs will be seen as a ‘healthier’, more acceptable habit.Fag-ash out of the car window is unpleasant but ‘stoned’ driving is a nightmare scenario. Monitor the situation carefully -‘make haste slowly’ as someone once said.Smoking eventually killed my father, so rest assured I’m on your side!

  • Cathy Ball
    8 August 2019

    Both second hand smoke and second hand vapour or aerosol as its proper term cause me to get asthma attacks, last time resulted in being at hospital half the night. Both need restricting in public places for a start, as in USA both are banned for several feet outside shops, etc., and some cities have areas in the centres that are smoke and vape free, why can UK not do the same?

  • Angela harper to be withheld not for public!
    7 August 2019

    Basically a good idea however it is going too be hard to get it implicated, you can always tell a smoker in a crowd, the smell of nicotine just does go away! Also vapping s not nice either, and they haven’t been around long enough for research to give a firm results as too whether they could potentially caused lung damage or other health issues including people being in the same room where vap smoking is taking place! I have never been a smoker so I’m not going one those preaching on my high horse, just concerned about smokers and effect it could have on people in public places, streets, parks etc! They need to include Vaps too! Nothing like enjoying a walk along the hush to be choked by viper smoke release!

  • Brian Hewson
    7 August 2019

    I think it’s a good idea but who will police it? At the moment we can’t stop people who drink, take drugs and driving on mobile phones as we have not got personal to deal with it.

  • Teresa O'connell
    7 August 2019

    As a palliative care nurse I think the idea of including quitting advice in cigarette packets is a great idea to reach the tobacco smokers at source. Informing and educating is the way forward!