MOST PEOPLE know that smoking is the most important cause of lung cancer and other lung diseases. In addition tobacco smoking is the single most preventable cause of cancer generally – nearly one third of all cancers may be attributed in some way to smoking.
Thanks to the stark warnings on today’s cigarette packs many other conditions (from impotence to heart disease) are also included on people’s lists of “reasons not to smoke”. One in two life-long smokers die early as a result of their smoking, many not living long enough to pick up their pension.
Smoking also contributes to general inequalities in health, not just through the direct effects on health, but also in the way money is spent in poor households.
Smoking rates amongst the poorest have remained unchanged for decades despite similar levels of commitment to stop. A comprehensive change in how society regards smoking is therefore needed to enable those who need the most help to make good their commitment to improving their own health.
Due to the addictive nature of nicotine – more so than heroine and cocaine according to many – smokers who wish to stop find it difficult to do so.
There is no simple solution to the death and disease that smoking unleashes on society – if there were we would have adopted it by now. However, we have known for some time what we need to do.
Indeed, in 1962 – over 40 years ago – the Royal College of Physicians published its report, Smoking and Health. The report outlined the various actions that could (and perhaps should) be taken to curb the rising consumption of tobacco. Recommendations included more education of the public; restrictions on the sale of tobacco to young people; restricting tobacco advertising; increases in tax; informing users of the contents of tobacco products; investigating the value of “anti-smoking clinics” and wider restrictions on smoking in public places. All these measures should sound familiar. They make sense.
It took longer than some would have wished, but as we enter the first part of the 21st century we are beginning to see a comprehensive strategy that includes all of the RCP recommendations emerge.
The Department of Health is working to a multi-strand approach that includes all of the actions needed to reduce smoking. On their own each one will not solve the problem. But if action is taken across all of the areas, the UK could have one of the lowest smoking rates in the western world with all the benefits that would bring to individuals, the NHS and society as a whole.
In recent years we have seen high profile education and information campaigns that inform smokers of the risks associated with tobacco and offer support to those who want to stop. Recently, the first use in the UK of “second-hand smoke” advertising has been instrumental in calls for “smoke-free homes” to protect children.
The national campaign is supported at a local level across the country. The NHS now has excellent services with dedicated staff and evidence-based treatments – including products designed to take the edge off withdrawal symptoms. The chances of smokers successfully quit-ting the habit are much higher now than ever before.
Keeping the price of cigarettes relatively high has proved difficult, but there are signs that Customs and Excise’s efforts to tackle smuggling are succeeding.
Although tobacco adverts disappeared from TV screens in the ‘60s, it was only last year that most tobacco adverts vanished for good.
It is on the control of second-hand smoke in the workplace that most controversy seems to centre.
There is little doubt that tobacco smoke is deadly. Nevertheless, there has been a long drawn-out argument over what is the best or quickest way to protect non-smokers from tobacco pollution, especially whilst at work.
Although many have seen smoke-free air for all workplaces as the preferred option, the hospitality sector, until recently, has resisted this. The experience n the Republic of Ireland of a workplace ban – apparently introduced with little problem – and numerous examples of smoke-free premises established without an adverse effect on their trade, has led to an air of inevitability about a similar law being introduced in the UK. Many prominent UK cities have said they would act to protect their citizens if they were given the powers. However, it seems that the trade would prefer the consistency of national legislation, even if this means greater restrictions. According to recent polls, such as The Big Smoke Debate and those carried out by MORI, there is over-whelming support for smoke-free offices, restaurants, cafes, transport and pubs.
Tobacco has a direct impact on public health. Smoker or not, tobacco affects us all. If we want to choose health then there seems to be no choice but to tackle the single biggest cause of health inequalities and avoidable death in the UK: tobacco.
But what can anyone do? You can:
• Support the moves towards making everyone’s workplace “smoke-free” and encourage parents and carers to
provide smoke free environments for children
• Encourage smokers to stop by directing them to the support now available through the NHS – this will put money into the local economy and create jobs
• Not tolerate smuggling and other illicit sales of cheap cigarettes that undermine the resolve of those trying to quit
• Express concern over the impact of tobacco promotion on our future generations’ health
• Use every opportunity to explain why our society would be better off if less people suffered the ill-effects of
smoking tobacco
• Use your influence to help protect those in other countries – tobacco is the second major cause of death in
the world
If everyone plays their part in the near future we might all be able to choose health by living a smoke-free life.
