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Dr Ian Walker on Smoking: ‘An unequal burden, but a fixable problem’

Ian Walker
by Ian Walker | Opinion

31 March 2023

1 comment 1 comment

Photograph of a crushed cigarette
This entry is part 3 of 3 in the series Ian Walker on smoking

At Cancer Research UK, and right across the field of cancer research, we’re working hard to ensure that the benefits of research and innovation are available for all, irrespective of where you live, how much money you have, the colour of your skin or anything else.  

But right now, equal access to healthcare isn’t a reality across the UK. In fact, we know that health inequalities drive major differences in cancer outcomes across our country. 

Just this year, we published a report which showed that among women with some cancer types, Black women from Caribbean and African backgrounds are up to two times more likely to receive a late-stage diagnosis than White British women in England. 

Another report we published last year highlighted that there are more than 30,000 extra cases of cancer in the UK every year due to socioeconomic deprivation – that’s more than double the capacity of Wembley Arena! 

In addition to greater incidence rates, those from the most deprived backgrounds in England often struggle to access treatments and polls have shown that for people who tried to contact their GP within the last six months, those from more deprived backgrounds were less likely to be successful in booking an appointment.* 

This is one of the greatest injustices we’re facing in the UK right now, and something we, as a country really need to address. Even more frustrating, is that we estimate that over half of the cancer inequality gap in England is directly attributable to a preventable risk: smoking. 

If you’ve read my previous articles on the subject, you’ll know the devastating impact that smoking has on our health, NHS and economy. But because smoking rates vary with deprivation levels, smoking doesn’t affect everyone equally.  

In England, there are nearly twice as many cancer cases caused by smoking in the poorest areas compared to the wealthiest, and smoking accounts for half the difference in life expectancy between the lowest and highest income groups in England.      

People who smoke spend an annual average of at least £2000 on tobacco, and this dreadful, terribly addictive product very often drags people further into financial hardship. Smoking is often portrayed as a lifestyle choice, but the reality is far more complex.  

Most people who smoke started as children. And we know that some groups were specifically targeted by the tobacco industry for many years. For many, that first puff on a cigarette will pave the way to a lifetime of tobacco dependency, which, for the tobacco industry, translates into a lifetime of demand for and profit from their product.  

Around 8 in 10 people who smoke have tried to quit at some point. I have never yet heard one person who smokes that aspires for their children to follow their path; this is a habit most people regret starting.  

However, despite this alarming picture, what is most frustrating is that this is absolutely a fixable problem.  

The government commissioned Dr Javed Khan, previous chief executive of Barnardo’s, to complete an independent review into tobacco control. The findings of this review were published in July 2022 and yet there has been no action from the government on implementing the recommendations – from a review they asked for! Rather than asking our politicians to make these changes, perhaps it’s time to start asking them why they haven’t done so already. 

I believe we are at a tipping point and, with the right leadership and political bravery, we can achieve a smokefree future for the next generation. That’s why last year we launched our Smokefree UK campaign. We’re calling on the UK Government to take focus on two key aspects.  

We want to start the stop. This isn’t about vilifying people who currently smoke. Far from it – most already want to quit- and we want to empower and equip them to do so by having properly funded cessation services and making them equally accessible across the country.  

And if the government cannot pay for this, it is the tobacco industry – not the taxpayer – who should foot the bill, without being able to influence how the funds are spent.  

But this alone isn’t enough. We also need to stop the start. Over the years, the UK has successfully implemented several regulations aimed at reducing the appeal and uptake of smoking. But more needs to be done.  

Raising the age of sale of tobacco could help to prevent children and young adults from ever starting to smoke – and government should therefore consult on the best way to do so.  

Critically, the benefits of achieving a society without smoking-related illness would particularly impact those who need the help most, and in doing so, make a significant dent in the inequalities challenge we have, not just for cancer, but for a whole range of diseases linked to smoking.  

Black and white headshot of Ian WalkerWe won’t truly be smokefree until all communities are smokefree, and we need a plan which commits to reducing disparities in smoking prevalence. For example, by setting a target of reaching less than 5% smoking prevalence for all socioeconomic groups by 2040 in England at the latest. 

It really is as simple as that, and it’s something the tobacco control community has been demanding for years. But this demand is now growing, and there is a genuine opportunity to fix this problem. Real political change often comes from public mobilisation. Cancer Research UK’s campaign for a SmokeFree UK is calling for the Government to take action on tobacco control, and you can join us, by asking your MP to help end smoking-related cancers.  

Ian Walker is executive director of policy, information and communications at Cancer Research UK


*All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2365 adults. Fieldwork was undertaken between 20th September – 3rd October 2022. The survey was carried out online. The figures have been weighted and are representative of all UK adults (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. 


    Comments

  • Janette Rawlinson
    4 April 2023

    I’d like to see vaping with greater restrictions – useful as a smoking cessation tool but those who warned it could be a gateway product to smoking for younger children/people yet were waved away as if ‘naysayers’ to the latest nicotine addiction device – yet where I live, there are many young people now smoking cigarettes not just vaping. this needn’t have happened if those who market vaping products weren’t selling flavours, bright coloured packaging, in plain sight highly visible in counters in supermarkets or even our local hospital trust which opened 2 vaping shops within its hospitals and much cheaper than tobacco now cynically owned by tobacco companies – one of which now also owns the inhalers these and other patients need to support their wheezing/breathlessness when their lungs are damaged…. when will society learn? some ideas have far reaching unintended consequences… we don’t yet know what impact secondhand vaping might do to lungs but despite all the evidence, somehow smoking still seems attractive to young people starting….

    Comments

  • Janette Rawlinson
    4 April 2023

    I’d like to see vaping with greater restrictions – useful as a smoking cessation tool but those who warned it could be a gateway product to smoking for younger children/people yet were waved away as if ‘naysayers’ to the latest nicotine addiction device – yet where I live, there are many young people now smoking cigarettes not just vaping. this needn’t have happened if those who market vaping products weren’t selling flavours, bright coloured packaging, in plain sight highly visible in counters in supermarkets or even our local hospital trust which opened 2 vaping shops within its hospitals and much cheaper than tobacco now cynically owned by tobacco companies – one of which now also owns the inhalers these and other patients need to support their wheezing/breathlessness when their lungs are damaged…. when will society learn? some ideas have far reaching unintended consequences… we don’t yet know what impact secondhand vaping might do to lungs but despite all the evidence, somehow smoking still seems attractive to young people starting….