Major Online Mapping Project Shows ‘Iron Chain’ Between Smoking and Deprivation
Monday 09 October 2006
|ASH news release: Embargo: 00:01hrs Monday 9th October 2006|
|A major new mapping project which shows smoking rates and deprivation in every ward in England has been published online by Action on Smoking and Health. The project, intended for use by policy makers, health professionals and media, clearly shows the “iron chain” that links smoking and deprivation. Smoking remains the single biggest factor behind the difference in life expectancy between social classes in England.
The maps, produced for ASH by cartographers Lovell Johns , can be searched by region and district, or by entering a specific postcode. They link data from a study of smoking rates across England conducted for the Health Development Agency by the Institute for the Geography of Health at the University of Portsmouth , with the deprivation index for each ward produced by the Department of Communities and Local Government . The spreadsheets, with both sets of underlying data, can be downloaded from the site. There is a help file on the site, with easy to follow instructions on how to use the maps. The maps can also be downloaded and printed for use in publications, policy papers and other documents.
The maps illustrate the key point that men and women in deprived social groups are much more likely to smoke. Only 20% of men and 17% of women in the professional and managerial groups smoke compared with 34% of men and 30% of women in routine and manual groups. In his report for the Government on public health (“Securing Good Health for the Whole Population”) , Derek Wanless reported that 48% of men in social class V (the poorest) died before the age of 70, compared to 22% of men in social class 1. He estimated that half of this difference was accounted for by higher smoking rates among men in social class V. While the national smoking prevalence rate at the time the data for the mapping project was collected was 26%, the rate in the most deprived ward in England (Princess ward in Knowsley) was estimated to be 52% while for the least deprived (Keyworth North ward in Rushcliffe) it was 12%.
A smoking habit of 20 cigarettes per day costs between £1,600 and £1,800 per year. Poorer smokers spend a disproportionately large share of their income on cigarettes compared with more affluent smokers. In 2003 the poorest 10 per cent of households spent 2.43% of income on cigarettes per week, whilst the richest 10 per cent of households spent 0.52%. Among the most deprived groups – including lone parents in receipt of state benefits – three out of four families smoke and spend a seventh of their disposable income on cigarettes .
The smokefree provisions of the Health Act 2006, which will end smoking in virtually every enclosed public place in England by Summer 2007, are expected to have an effect in reducing the gap in smoking rates between social classes. But ASH is calling on all Councils to work with their Primary Care Trusts to put cutting smoking rates at the top of the local policy agenda.
ASH is also calling on the Government to ensure that funding for stop smoking services and other work on public health and smoking does not suffer because of the cash crisis in the NHS.
Deborah Arnott, Director of ASH said:
“This important new project shows the iron chain that links smoking and deprivation. Smoking is the biggest killer in England, and it kills more people in poorer communities than in richer ones.
These easy to use maps give policy makers, media professionals and interested members of the public the chance to see exactly how smoking and deprivation are linked across every ward in England. We hope that local Councils, NHS Primary Care Trusts, MPs and decision makers will use these maps as part of their work on tobacco control. This project shows once again why smoking must be top of the list of concerns for everyone who cares about tackling poverty and social exclusion.”
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The map is available online at www.ash.org.uk/current-policy-issues/health-inequalities/smoking-and-health-inequalities(click on the “more” tab.
 A ward history database was used to identify the ward list as 2003 Standard Table (ST) Wards. From the Office of the Deputy Prime Minister, Lovell Johns obtained Index of Multiple Deprivation (IMD) 2004 data by Lower layer Super Output Area (LSOA). Each ST Ward area comprises a whole number of LSOAs, so an accurate IMD score could be calculated for each ST ward. LSOAs are small, statistically-consistent areas, with an average population of 1500 and a minimum of 1000. Each ST ward consists of a set of entire LSOAs.
Please note that because it was necessary to create an average deprivation score for each ward, using the LSOA data, the resulting deprivation ranking may not be exactly the same as that used by some local Councils and others. Also please note that the underlying data relates to 2004. The maps are shaded by quintiles – prevalence and deprivation data are both divided into fifths of the population.
 Twigg L., Moon G and Walker S (2004) The Smoking Epidemic in England. Health Development Agency: London. Estimates of current smoking are what would be expected in each ward given the age, sex and marital status composition of the resident population. The estimates also take account of characteristics of the local area and regional effects. These figures are not based on local survey information. Instead they have been generated via a combination of statistical modelling techniques and synthetic estimation. For more information on the methodology used to generate these estimates, please refer to the above publication, produced by the HDA, now part of NICE, which is available at www.nice.org.uk/page.aspx?o=502811.
At all times, these figures must be regarded as estimates.
 For further information about how the Index of Multiple Deprivation was produced please visit: www.imd.communities.gov.uk
 Securing Good Health for the Whole Population, HM Treasury, 2004
 Marsh A and McKay S (1994) Poor Smokers. London: Policy Studies Institute and ONS (2004) Family Spending. A report of the 2002/03 Expenditure and Food Survey
 The mapping project was part-funded by Cancer Research UK.