New independent tobacco review sets roadmap for a smokefree England for all

A new independent review into tobacco control, commissioned by the Health Secretary Sajid Javid, has just been published. The review, led by Dr Javed Khan OBE, sets out a roadmap the UK Government should follow to close the health inequality gap and end smoking in England.  

We are urging the Government to take these measures on board and implement a comprehensive and properly-funded Tobacco Control Plan. With bold action and strong leadership, we could avoid thousands of deaths from tobacco each year. 

The size of the prize  

A tobacco-free future could mean around 54,000 fewer cases of cancer each year in the UK, save the English economy £17 billion per year, level up the health of the nation and put money back into the pockets of those who need it the most.   

The unequal burden of smoking 

Smoking is the biggest cause of cancer in the UK, responsible for 3 in 20 (15%) cases; and an estimated 1 in 4 deaths from all cancers. But we also know that huge differences in smoking rates between the country’s most and least deprived means the burden of smoking is not felt equally by all.  

Our modelling estimated that smoking is responsible for almost twice as many cancer cases in the most deprived group compared to the least deprived. This means that tackling smoking – and amongst the most deprived groups in particular – could have a huge impact on reducing health inequalities. As Javed Khan put it in their review “reducing smoking is one of, if not the most, effective ways to “level up” health and wealth”. 

Bold ambitions 

The UK Government has made bold commitments on making England smokefree by 2030, extending life expectancy by 5 years by 2035, and delivering a 10 year “war on cancer”.  

If achieved, these commitments would save countless lives and lead to a healthier nation for all. However, to make this a reality, it would require significant progress to put an end to smoking.   

However, our modelling suggests that, if current trends continue, England is off track to reach the smokefree 2030 target by 7 years for the population as a whole, and almost double that for the most deprived communities. Javed Khan recommends that the UK Government sets a specific smokefree targets for every community, including the most deprived, and drives a new ambition of making smoking obsolete by 2040. As we have also argued, England won’t truly be smokefree until all groups are.  

The need for more funding 

We know that the budgets for many essential tobacco control services and measures have been severely reduced in recent years. For example, largely as a result of funding cuts, only 67% of local authorities in England commissioned a specialist stop smoking service open to all local people who smoke in 2021, despite these services giving people who smoke the best chance of quitting.  

Javed Khan is unequivocal: “The bold action that the government states is needed to reach Smokefree 2030 is not possible without investment”. That’s why he calls for an urgent additional investment of £125m per year, with the bulk of that going to the services that empower and support people to stop smoking.  

Javed argues, if Government is not able to find the funds for these services, then it should introduce a ‘polluter pays levy’: “why should taxpayers have to pay for the health and other consequences of the tobacco industry’s lethal products?” 

Amidst the current cost of living crisis, smoking continues to drag those that can least afford it further into financial hardship. All the while, Big Tobacco is profiting off our nation’s health. “It is high time the industry foots the bill and pays for the damage it causes.

Michelle Mitchell, our chief executive 

Stop the start

We have a duty to protect young people from suffering a lifetime of addiction, ill-health and even premature death – and Javed Khan’s review suggests a number of measures to help prevent people, and young people in particular, from taking up smoking.  

He recommends raising the age of sale of tobacco by one year, every year – a measure already committed to by New Zealand – as a way to prevent a new generation of people who smoke. He also suggests other important measures, including introducing licenses for tobacco retailers, increasing taxes on tobacco, and reducing the appeal of cigarettes. 

We call on the UK Government to consider his recommendations – including by setting out a timetable for a consultation on raising the age of sale and the best way to do this.  

Helping people quit for good

Smoking isn’t a personal choice, it’s an addiction. And whilst the majority of people who smoke want to stop, they need support to do so. That’s why it’s essential that we give people who smoke access to the tools and services they will need to help them quit. Beyond calling for funding to ensure that stop smoking services are available to all people who want to quit smoking, and that mass media campaigns encourage them to do so, Javed also makes recommendations on the role that vaping should play.  

As he highlights, whilst not risk-free, e-cigarettes are far less harmful than smoking and can help people who smoke to stop. He therefore recommends that accurate information on vaping is provided to healthcare professionals, and that vapes should be offered to people who smoke as an alternative to smoking, but at the same time, that the Government must take action to prevent young people from starting to use these products.  

Improving prevention in the NHS 

Javed also highlights the key role the NHS plays in helping people who smoke to stop before they have developed tobacco-related diseases, and the benefit of ensuring this happens. As he says: “Investing now will save the NHS billions in care for patients who could have lived healthier lives for longer”. 

As our own research –  cited in the review – shows, by 2039, improving stop smoking treatment in primary care could help prevent over 430,000 cases of smoking related disease and save £9.4 billion in costs to the UK health service. 

Making smoking obsolete 

Taking bold action on smoking, as Javed Khan suggests, isn’t just right, it’s also popular. Polling shows that the public supports the Government doing more on tobacco control. Now Government must turn Javed Khan’s bold and important recommendations into concrete action – starting with the upcoming Health Disparities White Paper and the Tobacco Control Plan for England. There’s no time to waste, with assertive  leadership, we can save lives. 

Alizee Froguel is a policy manager specialising in prevention at Cancer Research UK.