This piece was written by Chloe Watson, Policy Manager for Research and Prevention at the British Heart Foundation.
This weekend marks 10 years since smoke free legislation was introduced in England. Its introduction has transformed our pubs and restaurants, making smoke-filled meals and drinks out with friends a thing of the past. But smoke isn’t the only thing that has disappeared from our local pubs over the last 10 years. Tobacco vending machines used to be a regular feature, providing young people with an easy way to buy cigarettes without the risk of being asked for ID.
We know that smoking is a major risk factor for cardiovascular disease — compared with non-smokers, smokers have a 2 to 4 times increased risk of heart disease and stroke. 
Two-thirds of smokers start before the age of 18, and until 2011 , vending machines made it easy for them to do so.
Although legislation already stated that it was an offence to allow tobacco to be purchased by children and teenagers from vending machines, a number of studies found that it was surprisingly easy for a teenager to purchase cigarettes unchallenged, as so many of the vending machines were unsupervised. In fact, it is estimated that in 2006, a staggering 45 million cigarettes were sold to 11–15 year olds through cigarette vending machines. So, in the same year that smoke free legislation was introduced in England, the British Heart Foundation and others began working to secure a complete ban of tobacco vending machines.
What did we do?
The task ahead was not straightforward. We knew that there was public support for a ban — a survey commissioned by ASH found that 65% of respondents in England were in favour of a ban, with only 16% against the measure — but that the Government would take some convincing. At BHF, we set to work gathering our evidence — commissioning a survey of pub landlords, looking to examples from elsewhere in Europe, and even creating our own undercover video designed to show how easy it is for children to buy cigarettes.
Then, in mid-2008, the Department of Health launched a consultation on the future of tobacco control, giving us a real opportunity to influence. We began to build support, from our network of supporters right through to MPs and government officials. In total, 6000 members of the public signed our petition calling for the ban, 100 letters were published in local newspapers and 100 MPs signed an Early Day Motion tabled by supportive MPs. We had meetings with the Department for Business, spoke to Ministers at party conferences and much more besides. We weren’t the only ones working to build support — in total the Government’s consultation received more than 100,000 (mostly positive) responses! By 2009, it seems the Government had been convinced and the ban was introduced as part of the 2009 Health Act, which came into effect on 01 October 2011.
Have we seen an impact?
The last decade of tobacco control — from the introduction of smoke free legislation to the ban on vending machines — has been instrumental in protecting people from smoking-related heart attacks and stroke.
The number of 11 to 15 years olds who have tried smoking is now at its lowest level since 1982 (when the Government’s survey began) , and deaths from smoking-related cardiovascular events have fallen by over 20% since 2007 .
This is a fantastic achievement but we cannot afford to be complacent — there are still up to 20,000 deaths a year in the UK from smoking-related heart attacks and stroke.  When we look back over the next 10 years, let’s make sure we have just as much to celebrate.
 October 2016, ASH Fact Sheet, Smoking, the heart and circulation
 March 2017, ASH Fact Sheet, Smoking Statistics
 November 2011, ASH Fact Sheet, Smoking and vending machines
 July 2015, Smoking, Drinking and Drug Use by Young People in England Survey, NHS Digital
 NHS Digital, Statistics on Smoking
 BHF UK estimate based on NHS Digital, Statistics on Smoking, 2017
While most forms of tobacco advertising and promotion in the UK are banned, the tobacco industry has continued to promote its products through packaging and “below the line” marketing.