This entry is part 2 of 3 in the series Ian Walker on smoking
Smoking is linked to at least 15 different types of cancer, as I outlined in this article.
As if this wasn’t alarming enough, we also know that smoking is the single largest driver of health inequalities in England.
Around 30,000 extra cases of cancer in the UKeach year can be attributed to economic deprivation, and sadly, more deprived groups are less likely to survive their cancer.
Lung cancer has by far the largest number of excess cases attributable to deprivation, with over 14,000 excess cases each year in England alone. In fact, there could have been 61% fewer cases of cancer linked to deprivation in England if nobody smoked.
I am, and always have been a proud Yorkshireman – I grew up in Barnsley and most of my family still live there. But my upbringing there made me very much aware of the impact that socioeconomic deprivation can have on the health outcomes within communities, and importantly how this translates into families, including my own.
It is totally unacceptable that in this day and age, in a wealthy, developed country, where you live is still linked with your life chances and your health outcomes.
We already know that 1 in 2 of us will get cancer in our lifetime, and in the UK around 375,000 cases of cancer are diagnosed every year.
And this number is growing. Part of the reason for this is that we’re living longer, and cancer is strongly linked to ageing – the older we get, the higher our risk of developing cancer.
But there are preventable factors that can also affect our risk of developing cancer. These risk factors come in many forms, but by far and away the biggest risk factor for cancer is smoking tobacco. And it is most closely associated with lung cancer.
Smoking causes 72% of lung cancer cases in the UK and lung cancer accounts for 21% of all cancer deaths in the UK.
Lung cancer is of course a terrible disease whatever stage you’re diagnosed at. But at present, most patients present with late-stage disease, meaning that the average survival statistics in England are 44% for 1 year survival and only 20% for 5-year survival.
This is a pretty depressing picture in many ways, but there is a sliver of light. With bold, brave and evidence-led political leadership, this is absolutely a problem that can be fixed.
The Government made a request in 2021 for an independent tobacco review, to be chaired by Dr Javed Khan. This expertly delivered review sought the opinions and evidence of specialists from across the world.
Importantly, the review provided 15 recommendations that would seek to make smoking obsolete in the UK. If implemented, we could realistically see our children grow up without the burden of smoking addiction. We could also drive positive change in reducing cancer inequalities and shifting the balance to ensure that the benefits of cancer research are available for everyone, no matter where you live or how much money you have.
Alongside this report we also saw the recent evidence review from the UK National Screening Committee which, based upon the best evidence, has recommended that UK governments implement a targeted lung screening programme for those who smoke or used to.
This new intervention has the potential to be game-changing in finding lung cancers at a stage when they can be more effectively treated. Importantly, it could also seek to reduce some of those inequalities, by ensuring the new service is effectively implemented in those areas with the greatest need.
But targeted action is required to ensure those most at risk of smoking related harm can access these services.
As I write this, it feels strange to me that I would need to justify these changes. Simple political decisions could cut cancer cases, tackle health inequalities within the system and reduce human suffering for this generation and for every generation thereafter.
But there are other motivators.
In England, smoking-related illnesses cost the NHS approximately £2.2bn every year. These illnesses caused by this poisonous product are all preventable and now, more than ever, we need to be finding ways to use our precious resources within the NHS as effectively as we can.
What’s more, for a government that places such a focus on the growth agenda, they should be aware that smoking has a financial cost to society in terms of productivity, estimated at £30.7 billion a year.
So now we know that smoking has an impact on cancer, health inequalities, the NHS and the economy.
We also know that we have public support – in a recent Cancer Research UK poll, 70% of people surveyed in England supported the Government investing more money to help England to become smokefree*. Most smokers want to quit this habit! I’m genuinely now struggling to think what more I’d need to convince the Government to act.
But maybe the final nail in the coffin for smoking is one of the starkest estimations in the Khan review: to do nothing will ultimately see more lives lost as a result of smoking-induced illness.
But more than that, to do nothing is simply unacceptable, to do nothing is immoral and to do nothing is ignorant of the swathes of evidence we have which proves the destructive nature of smoking. We should learn from the lessons of the past and act on evidence now.
For the political powers that be, take note. This responsibility is not one you can shirk. There are lives at stake and inactivity is not an option. You have an opportunity to revolutionise public health for this generation and for all future generations. You have an opportunity to leave behind a legacy with long-lasting impact. Most importantly, you have an opportunity to save lives and help us beat cancer.
I can explain just how in the next article in this series.
Ian Walker is executive director of policy, information and communications at Cancer Research UK
*An independent review has suggested the government needs to urgently invest a minimum additional £125 million per year, to help England become smokefree (where less than 5% of the adult population smoke). Most of this investment will go to help the services that support people to stop smoking. There are multiple ways of raising this amount of money. Which ONE, if any, of the following do you prefer to raise this additional investment through? (If you don’t think more money should be invested to help England become smokefree, please select the ‘Not Applicable’ option). All figures are from YouGov Plc. Total sample size was 1780 adults. Fieldwork was undertaken between 13th – 14th October 2022. The survey was carried out online. The figures have been weighted and are representative of all adults in England (aged 18+).
Cancer Research UK analysis earlier this month showed that ending smoking could free up 75,000 GP appointments each month and save the NHS £2.2bn each year. Since then, we’ve been pleased to hear Government ministers and politicians re-committing to achieve a Smokefree UK by 2030. We wait with anticipation for these plans to be unveiled.
- Dr Ian Walker on Smoking: ‘The killer behind the counter’
- Dr Ian Walker on Smoking: ‘A political no-brainer’
- Dr Ian Walker on Smoking: ‘An unequal burden, but a fixable problem’
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Peter Smith March 27, 2023
Cancer Research UK’s article on smoking being a political no-brainer is both informative and encouraging. It’s refreshing to see policymakers taking steps to reduce smoking rates, especially among disadvantaged communities. The article’s emphasis on the importance of prevention and early intervention is crucial in reducing the burden of cancer on society. Keep up the good work, Cancer Research UK!