This new bill could wipe out smoking and vaping – the only losers would be those who profit from it
Addiction to smoking traps then slowly disables and kills thousands of our fellow citizens, especially the most vulnerable. The great majority of smokers wish they had never started, but their choice was taken away at a young age by marketing that deliberately promoted addiction to nicotine.
About 80,000 people a year die in the UK as a result and many more are harmed. The burden of smoking-related diseases is very heavily weighted towards people living in areas of deprivation, with about one-third of smokers in England living in the most deprived two deciles. Smoking is one of the most important modifiable drivers of the substantial inequalities in health we see across the country.
If the tobacco and vapes bill, which gets its second reading in parliament today, is passed it will have a major effect on preventing disease. No child or young person turning 15 from this year on will ever legally be sold a cigarette or other forms of tobacco, leading over time to a smoke-free generation. Stopping smoking is backed by the overwhelming majority of doctors, nurses and health charities, who see the effects of the habit on vulnerable people. It is also backed by a substantial majority of the public according to polling, and by the governments of all four UK nations. In addition, the bill will substantially reduce the ability of vape companies to market to children, an utterly unacceptable practice.Some of the effects of a smoke-free generation will take decades to fully have an effect, but many will be rapid. About 70% of lung cancer cases, the UK’s largest cause of cancer deaths, are caused by tobacco, along with premature smoking-related strokes, heart disease and dementia.
These major diseases do not usually come on before late middle age, so the effects of a smoke-free generation will not be felt for more than three decades – but will then be substantial. Some benefits will be immediate, like reducing asthma attacks in children exposed to secondhand smoke. Some of the earliest effects of a smoke-free generation will be on smoking in pregnancy. All mothers want the best for their newborn, but addiction to nicotine means many find it very hard to stop. Smoking in pregnancy is heavily weighted to pregnancies in the youngest mothers, and to the most deprived communities. Smoking leads to problems including significantly increased rates of stillbirth and premature babies. Disparities in poor birth outcomes between the most affluent and the most deprived areas are deeply depressing – smoking is one driver of them that we can and should prevent.
The tobacco industry, which is very wealthy, is the one gainer from the death and disease induced by its products. Its talking points, usually introduced by paid lobbyists, need to be addressed head on. It tries to link its products to “choice”, despite the fact sales are based on addiction (taking choice away). It always claims illegal cigarette sales will go up with new control measures, despite evidence that they actually go down (due to reduced demand). It makes a big thing about age cutoffs for its products, but public health measures have always been based on various age cutoffs, including screening and vaccination. It tries to pass off new tobacco products as “safe”, as it did with “low tar cigarettes” and cigarette filters – but no tobacco products are safe.If passed, the smoke-free generation this bill proposes would be a major step forward in public health, with a substantial positive effect on preventing disease, disability and death long into the future. This generation of children should not have to endure the damage caused by tobacco seen in adults in wards and GP surgeries across the country. MPs today have a major opportunity to reduce health inequalities for children now and in the future.
Prof Chris Whitty is the chief medical officer for England