Smoking

This issue brief relates to a developing news event. For full details of the 2008 Budget visit our in-depth Budget section.

What is smoking

In the UK, people commonly smoke cigarettes, cigars and pipes. "Smoking" in public health debates is usually used as a by-word for tobacco consumption, with cannabis treated separately as part of the drugs debate. Similarly, public health campaigns warning of the dangers of tobacco smoke occasionally outline the health risks associated with chewing tobacco.

Background

Smoking became popular because of its short-term effects, as well as a highly effective marketing campaign and little awareness of its health risks. Users claim positive effects include increased alertness, concentration and mild euphoria. However, long-term use leads to nicotine addiction, with withdrawal exposing users to confusion, restlessness, anxiety and insomnia. Smoking tobacco has been linked to a number of health problems including lung cancer, emphysema and cardiovascular disease.

Public and medical awareness of the dangers of tobacco smoking was low when cigarettes were first marketed for mass consumption. By early 1950, however, an article in the British Medical Journal found a link between smoking and lung cancer. This appeared to be confirmed by further research in 1954, prompting the government to issue its first warning of the link between lung cancer and smoking.

The Department of Health (DoH) has since made it a stated aim to reduce levels of smoking – despite few efforts from the Home Office to criminalise tobacco. The legal age to purchase cigarettes has risen progressively to 18, but for the adult population smoking remains a legal pursuit, albeit surrounded by aggressive health warnings.

Official statistics place the number of smoke-related deaths each year in the UK at 106,000. In an effort to reduce this number, the DoH has introduced a six-stranded tobacco programme.

This includes: media and education campaigns about the dangers of tobacco smoke; stop-smoking and nicotine replacement therapies, available through the NHS; a comprehensive ban on tobacco advertising and promotion; regulating the contents and labelling of tobacco products.

Controversy

As with many public health issues, the state risks taking a paternalistic approach in pushing an unashamed anti-smoking policy. Unlike with alcohol or 'junk food' the government does not set limits for a "safe" level of smoking and instead encourages smokers to give up entirely. Perhaps this is a realistic position given the addictive nature of nicotine.

The government justifies its anti-smoking policy on two grounds; firstly the cost of smoking-related health problems to the NHS and secondly the harm caused by passive smoking, for which there is now convincing evidence.

However, the government has made no effort to ban smoking outright, despite evidence nicotine is more harmful than a number of recreational drugs included on the ABC list of controlled substances.

Smokers will no doubt dispute claims the government has not tried to outlaw smoking, pointing to the ban on smoking in public places. Sales have also been restricted to minors and as of October 1st 2007 the decision whether to smoke became as important as who to vote for, as the smoking age was raised to 18.

While the government tells smokers they are a drain on the NHS, pro-smoking groups argue the taxes charged on tobacco more than compensate for the additional health needs of smokers. Tax revenue from tobacco sales contribute around £7 billion to the government, in excess of the £1.5 billion the DoH argues it costs to treat smoking-related disease.

This has been disputed by successive studies in the US – which admittedly has a differently funded health care system. There, the 'true cost' of each cigarette packet in terms of medical care and lost productivity is estimated at $7-$41 (£3.50-£20).

The government certainly has an interest in maintaining tax revenue from tobacco products. Up to 89 per cent of the cost of a packet of cigarettes is the excise duty levied by the Treasury, prompting pro-smoking group Forest to argue cigarettes are almost a fully nationalised product. The DoH justifies high taxation, arguing rising prices have been identified as a very effective way of getting smokers to quit.

The government is actively concerned by black market cigarettes, not because of any additional health risks but because of the loss in revenue. A recent Smoking and Health fact sheet estimated up to 25 per cent of cigarettes smoked in the UK avoid taxation, representing a multi-billion pound loss in funds.

The government spends a significant amount promoting the anti-smoking message and as with all public health campaigns, the success of these messages is open to debate. The DoH maintains its ongoing media and education campaigns about the dangers of tobacco smoking are one of the primary reasons smokers in the UK decide to try and quit.

In a bid to further promote the anti-smoking message, the government has enforced a comprehensive ban on tobacco advertising and promotion. The DoH predicts this will reduce smoking rates by 2.5 per cent over the long-term.

The DoH also regulates tobacco contents and labelling, giving the government remarkable influence over the design of private products. Since 2003 all cigarette products must carry large warning labels and companies are banned from describing cigarettes as low tar.
In 2007 the DoH announced it wanted to introduce pictures onto cigarette packets as a graphic illustration of the health-risks of smoking. It quotes Canadian research which found shocking images can be an effective tool for motivating smokers to quit. The first pictures of diseased and cancerous organs will appear on cigarette packets from late 2008.

Government efforts have not been without effect. Between 1998 and 2004 smoking rates among adults fell from 28 per cent to 25 per cent, which the government claims amounts to 1.2 million ex-smokers.

The greatest source of controversy has no doubt been the smoking ban. After a staggered start, a ban on smoking in public places was in force across the whole of the UK by July 1st 2007. Ministers argue this will protect members of the public from passive smoking, with specific benefits to bar and pub staff working in smoky environments.

The risks associated with passive smoking have been less readily accepted than the health-risks of cigarettes and other tobacco products, but research shows ambient smoke still contains carcinogens and toxic components. The DoH now holds the view passive smoking does present a public health risk and shows no signs of modifying this position.

2008 Budget update

In his first Budget as chancellor, Alistair Darling announced an increase in duty on tobacco. A pack of 20 cigarettes went up 11p, while a pack of five cigars is up 4p.

- Tobacco: 11p rise on pack of 20 cigarettes, 4p on pack of five cigars

Statistics

Proportion of UK adults that smoke: 25 per cent.

26 per cent of publicans believe the smoking ban was a negative move.

Number of UK deaths per year attributed to smoking: 106,000

Statistic 1 & 3(Source: Department of Health, 2005, 2007); statistic 2 (CGA Strategy survey, 2007).

Quotes

"There cannot be sane adult in the UK who isn't aware that smoking carries a health risk. On the other hand, the anti-smoking lobby's unnecessarily brutal 'quit or die' message is so demonstrably untrue that it's no wonder that so many smokers have stopped listening."

Pr-smoking campaign group Forest.

"[The smoking ban is] the single most important public health legislation for a generation. The scientific and medical evidence is clear - secondhand smoke kills. There is no safe level of exposure."

Health secretary Alan Johnson, 2007.