England: Smoking responsible for twice as many cancers in most deprived groups

Smoking is responsible for nearly twice as many cancer cases in lower income groups compared to higher income groups, according to new estimates by Cancer Research UK.

Over 11,000 cases of cancer were linked to smoking in the lowest income group, compared to around 6,000 in the highest.

Decades of glitzy packaging and marketing by the tobacco industry and targeting vulnerable groups has led us here…. [but] public health and prevention services play a vital role in tackling these health inequalities.

– Professor Linda Bauld, public health expert

Deprivation and smoking

More than 27,000 cases of cancer a year in England are associated with poverty, or deprivation, according to Cancer Research UK estimates.

People living in more deprived areas are 2.5 times more likely to smoke than those in least deprived and find it harder to quit, contributing to major health inequalities.

Experts think this is likely to be down to a mix of factors such as exposure to cigarettes, tobacco industry targeting, housing and income pressures, access to health and social care, information and education.

The study found that, of the 27,000 cases of cancer caused by deprivation, if smoking inequalities were removed and smoking rates were the same for everyone, around 5,500 of these cases could have been prevented each year in England.

Public health expert, Professor Linda Bauld, believes public health services have a vital role to play in combatting this stark inequality.

“It’s not a case of just telling people to stop smoking – going cold turkey doesn’t work for everyone. People who smoke shouldn’t be blamed but need support and the right tools to help them quit.”

She said: “Smoking has accounted for more deaths than COVID-19 in the past year. Public health and prevention services play a vital role in tackling health inequalities as well as improving health and wellbeing across England. This has come into even sharper focus since the pandemic, which has exposed where investment in these services has fallen behind.”

Achieving smoke-free

Smoking has long been the biggest preventable cause of cancer and death worldwide and is known to cause at least 15 different types of cancer, not just lung cancer.

The Government has set a goal of England becoming smoke-free by 2030, but there is a clear socio-economic divide that needs to be addressed. The most deprived groups are not on track to achieve this goal until the mid-2040s, while the least deprived are expected to achieve it in 2025.

But despite this, Stop Smoking Services, which give smokers the best chance of quitting, have continuously had their funding cut, and public health campaigns, which motivate people to stop smoking, have been axed.

Cancer Research UK’s chief executive, Michelle Mitchell believes this needs to be addressed. “Funding for tobacco control activities in England has been significantly cut in recent years, which will undermine the Government’s Smokefree 2030 goal unless this is urgently reversed.”

‘Funds without interference’

Only last week, Philip Morris International, the maker of Malboro cigarettes, announced they wanted to stop selling cigarettes in the next 10 years in the UK and expand in the health care business.

In response, Mitchell said: “We’ve heard these empty promises from the tobacco industry before and we’re concerned this move is part of an attempt by Big Tobacco to position itself as part of the solution to a smoke-free UK, all the while continuing to promote and sell lethal cigarettes here and globally.

“We know from our work supporting low and middle-income countries in the fight against tobacco industry interference, that Philip Morris’s actions globally don’t match up with their smoke-free world rhetoric.”

Mitchell called for more efforts to persuade people not to smoke, but said the tobacco industry should be made to contribute to the cost.

The charity believes one solution could be a Smokefree Fund – making tobacco companies cover the costs of the damage caused by smoking but without their involvement on how the money is spent – would be a much-needed new source of funding for tobacco control to help people stop smoking.

It would also mean more of the public health budget would be available for use in other important areas of public health and vitally reduce the cost of smoking related illnesses to the NHS in the future.

“It’s very concerning that smoking causes more cancer cases in more deprived groups. The upcoming tobacco control plan for England is a key opportunity for the Government to tackle smoking rates as well as the long-standing, unacceptable health inequalities that exist across the country,” said Mitchell.

“But this can only be achieved if there is sufficient additional investment into tobacco control. A Smokefree Fund – using tobacco industry funds, but without industry interference – could pay for the comprehensive measures needed to reduce smoking rates across all socio-economic groups.”