ASH Welcomes New Tobacco Control Plan for England: Funding needed for it to succeed

Action on Smoking and Health has welcomed the Government’s new Tobacco Control Plan for England, “Towards a Smokefree Generation”, published today. [1] The previous Plan expired at the end of 2015, and pressure has been growing from parliament and the public health community for the Government to renew its commitment to tackling smoking. There is also strong public support, with 76% supporting continued government action to limit smoking. [2]

ASH particularly welcomes the Government’s vision of a “smokefree generation”, defined as a smoking prevalence rate of 5% or less. Since the introduction of the last Tobacco Control Plan smoking rates have fallen from 20.2% [3] to 15.5% [4] and if this rate of decline can be sustained a smokefree generation could be achieved by 2030.

Over the next five years until the end of 2022 the targets are to:

• ·      Reduce smoking prevalence among adults from 15.5% to 12% or less
• ·      Reduce the proportion of 15 year olds who regularly smoke from 8% to 3% or less
• ·      Reduce the prevalence of smoking in pregnancy from 10.7%  to 6% or less

Deborah Arnott ASH Chief Executive said:

“ASH congratulates Steve Brine for showing his commitment to tobacco control by getting the new Plan published only weeks after taking over as Public Health Minister. The vision of a “smokefree generation” it sets out is a welcome step change in ambition from the last Tobacco Control Plan for England and should be achievable by 2030.”

The Plan calls for a shift in emphasis from national to local action in order to achieve the vision of a “smokefree generation”. But this comes at a time of severe government cuts in public health funding which threaten successful implementation of the Plan.

Commenting on this Deborah Arnott said:

“Funding must be found if the Government is to achieve its vision of a “smokefree generation”. The tobacco industry should be made to pay a through a licence fee on the ‘polluter pays’ principle. Tobacco manufacturers are some of the most profitable companies on earth; they can easily afford the costs of radical action to drive down smoking rates.”  

The Plan sets out specific commitments including to:

• ·      Continue to use mass media campaigns to promote smoking cessation and raise awareness of the harms of smoking.
• ·      Reduce the inequality gap in smoking prevalence between those in routine and manual occupations and the general population
• ·      Provide access to training for all health professionals on how to help patients quit smoking.
• ·      Promote links to “stop smoking” services across the health and care system and full implementation of all relevant NICE guidelines by 2022.
• ·      Implement comprehensive smokefree policies, including integrated tobacco dependence treatment pathways, in all mental health services by 2018; and improve data on smoking and mental health; in order to better support people with mental health conditions to quit smoking.
• ·      Maximise the availability of safer alternatives to smoking.
• ·      Maintain high duty rates for tobacco products to make tobacco less affordable.
• ·      Continue to uphold its obligations under the WHO FCTC.

The Plan highlights the challenges: 

• There are still 7.3 million smokers in England, and more than 200 people a day die from smoking related illness that could have been prevented.
• The difference in life expectancy between people in the poorest and richest social groups in England is about 9 years on average, and the difference in smoking rates accounts for about half this difference.
• Smoking costs our economy in excess of £11 billion a year, including £2.5 billion to the NHS, £5.3 billion to employers (because of lost output due to sickness and smoking breaks), £4.1 billion to the wider society due to lost output. There are further costs including around £760 million from increased social care costs to local councils. 

The last Spending Review in 2015 announced cuts in public health funding of 3.9% a year amounting to a real terms reduction of at least £600 million a year by 2020/21, on top of the £200 million in year cut to the 2015/16 budget.[5]  A November 2016 survey of local authority tobacco control leads in England [6] found significant budget cuts for smoking cessation services and that in a growing number of authorities there is no longer a specialist stop smoking service accessible to all smokers.  A recent analysis by the King’s Fund found that in 2017/18 local authority funding for wider tobacco control faces cuts of more than 30% and that stop smoking services is one of the top four services in absolute planned cuts (£16 million). [7]

Collective action by local authorities working together on tobacco control, as encouraged by the Plan, has been very effective in the North East [8] and can deliver economies of scale. However, local authorities facing such severe cuts cannot deliver public health improvement without support from the NHS. The Plan sets out a clear role set out for the NHS in supporting smokers to quit. The NHS must now live up to the commitment set out in the Five Year Forward View to a “radical upgrade in prevention and public health”. [9] 

Furthermore ASH urges the government to introduce licensing of the tobacco industry at all levels from manufacturers to wholesalers and retail outlets. [10] Opinion poll results show 76% of the public support the licensing of tobacco retailers, and 71% support requiring tobacco manufacturers to pay for the costs of regulation of the industry. [2] The four major tobacco companies are some of the most profitable businesses [11] in the world, and could easily afford to pay more, through a licence system, to mitigate the damage their products cause, on the “polluter pays” principle.

ENDS

Notes and Links: 

Action on Smoking and Health is a health charity working to eliminate the harm caused by tobacco use. For more information see:www.ash.org.uk/about-ash

ASH receives funding for its programme of work from Cancer Research UK and the British Heart Foundation.

References 

[1] Towards a smoke-free generation: tobacco control plan for England. Department of Health. July 2017

[2] Smokefree: The First Ten Years. ASH. June 2017. Opinion research carried out by YouGov for ASH. Total sample size was 12696 adults. Fieldwork was undertaken between 16^th February 2017 and 19^th March 2017

[3] HM Government. Healthy Lives Healthy Futures: A Tobacco Control Plan for England. March 2011.

[4] Statistics on smoking in England: NHS Digital 2017

[5] Impact of the 2015 Spending Review on health and social care. Joint submission to the Health Select Committee by the Nuffield Trust, Health Foundation and the King’s Fund. 17 December 2015

[6] A survey of local authority tobacco control leads in England November 2016, conducted by ASH, funded by Cancer Research UK

[7] David Buck. Chickens Coming Home to Roost: local government public health budgets for 2017/18.  King’s Fund 12 July 2017.

[8] Fresh North East. Achievements. 

[9] NHS England. Five Year Forward View. October 2014. 

[10] ASH response to HMRC Consultation on Tobacco Illicit Trade Protocol – licensing of equipment and the supply chain. May 2016.

[11] Branston, JR. and Gilmore, A. The extreme profitability of the UK tobacco market and the rationale for a new tobacco levy. University of Bath, 2015.