30 May 2018
New data published for World No Tobacco Day 31st May, by Action on Smoking Health shows that smoking costs communities in England £12.6 billion a year .
The figures show the additional pressure that smoking is putting on the NHS and social care services including annual costs of £2.5 billion to the NHS, and over £760 million to local authorities from smoking-related social care needs . Local authorities can use an easily accessible web tool to break the data down to local level so they can see the impact on their communities .
Smoking remains the largest cause of preventable death in England. However, a 2016 audit found that more than 1 in 4 hospital patients were not asked if they smoke and 50% of frontline staff are not given routine smoking cessation training .
ASH Chief Executive Deborah Arnott said:
“The Five Year Forward View calls for a ‘radical upgrade in prevention and public health’ but this has not been followed through and smokers are not getting the support they need to quit from the NHS. In some areas, Local Authority Stop Smoking Services have been reduced due to cuts in local authority funding. Cuts to public health budgets need to be reversed and the NHS needs to step-up and play a larger role in supporting smokers to quit.”
Given the enormous burden tobacco places on society, ASH argues that the tobacco industry should be forced to pay to address the harm it causes in line with the ‘polluter pays’ principle . It is estimated that tobacco companies in the UK make a collective annual profit of around £1 billion . ASH calls for the Government to place a levy on the tobacco industry with the money raised used to fund support for the recurring costs of tobacco control measures to reduce smoking prevalence, such as mass media campaigns, cessation services and local authority enforcement to prevent illicit trade and underage sales.
The theme of World No Tobacco Day this year is tobacco and heart disease. The British Heart Foundation has been award the World No Tobacco Day medal for their long standing work tackling the harm caused by tobacco.
Simon Gillespie, Chief Executive of BHF said:
“Smoking kills over 16,000 people in England every year from heart disease; a total of 20,000 across the UK. Many more people continue to live with smoking related heart problems. It is vital that tobacco control is properly funded, giving smokers the best chance to quit and preventing people from taking up smoking. A levy on tobacco companies would ensure there is sustained funding for tobacco control thus crucially help to drive down smoking rates.”
 Action on Smoking and Health (ASH). Local Costs of Tobacco Tool. 2018. http://ash.lelan.co.uk/
 Agrawal S and Mangera Z. Smoking Cessation Audit Report: Smoking cessation policy and practice in NHS hospitals. British Thoracic Society. 2016. https://www.brit-thoracic.org.uk/media/315359/BTS-Smoking-Cessation-Audit-Report-7-December-2016-final.pdf
 Smoking Still Kills, 2015 – this report produced by ASH and funded by Cancer Research UK and endorsed by 129 organisations, set out the case for making the ‘polluter pay’ and placing a levy on the tobacco industry to fund work to reduce the number of people who smoke. http://ash.org.uk/information-and-resources/reports-submissions/reports/smoking-still-kills/
 Branston JR, Gilmore AB. The extreme profitability of the UK tobacco market and the rationale for a new tobacco levy. University of Bath. 2015. http://opus.bath.ac.uk/43061/
This post was written by Deborah Arnott, Chief Executive of ASH.
Today is the WHO’s World No Tobacco Day, a day set aside as a tribute to the seven million people killed each year by tobacco and a call to action to governments to halt this deadly epidemic. An epidemic two of Britain’s largest companies, Imperial Tobacco and British American Tobacco, are busily trying to export around the world.   While the twentieth century tobacco epidemic was concentrated in high income countries like the UK and the US that is no longer the case, nearly 80% of smokers now live in low and middle income countries (known as LMICs). In the twentieth century 100 million people died from smoking, in the twenty first, on current trends, 1 billion will die, the majority in their most productive years and disproportionately concentrated in poorer countries.
This year’s theme is “Tobacco — a threat to development”.  The UK government has already responded to this call to action by committing £15 million (around US$18 million) into supporting implementation of the WHO’s tobacco treaty (FCTC) in poorer countries between now and 2021. As the UK said in its statement launching the project, “tobacco use negatively impacts on health and development.” From civil society Cancer Research UK has invested £5 million (around $6 million)  to support treaty implementation focusing on helping build the evidence base in poorer countries. The UK government’s funding comes from the aid budget (the UK is the only G7 country to have met the UN’s target to spend 0.7 per cent of gross national income on overseas aid). The initiative is being delivered by the WHO FCTC Secretariat to directly support a number of Parties as well as supporting initiatives to promote implementation of the treaty in all low- and middle income countries. 
For this alone the UK would merit the WHO WNTD medal this year, if our public health minister had not already been awarded the WHO Director-General’s special award last year for implementing plain standardised packaging. The UK has come top of the European tobacco control country listings since 2007  and in 2015 was awarded the prestigious American Cancer Society’s Luther L Terry medal for exemplary leadership by a government ministry. These awards are due to the global leadership the UK has shown in implementing the WHO FCTC to the highest standards. The UK has everything from smoking cessation support free at the point of delivery to a complete ban on advertising promotion and sponsorship; from high taxes consistently rising above inflation year on year to comprehensive smokefree laws; from a ground breaking and highly effective anti-smuggling strategy to, most recently, being the second country in the world to pass legislation requiring standardised “plain” packaging of tobacco products.
But more remains to be done. The Prime Minister’s commitment to ‘fighting against the burning injustice that if you’re born poor, you will die on average nine years earlier than others’ is welcome and achievable. As her Government has acknowledged , half this difference in life expectancy is due to the higher rates of smoking amongst the least affluent, so major improvements can be achieved by driving down smoking rates amongst the most disadvantaged in society. 
The UK’s achievements to date are due to the strong political consensus we have in support of tobacco control. At the time plain packaging legislation was passed, with cross party support, the Health Minister shared a tweet with his opposite number saying, “Let’s hope both our children can grow up in a smokefree generation”. But the evidence, at home and abroad, is that we cannot achieve a smokefree future without a comprehensive and sustained government strategy, with tough new targets to drive down smoking prevalence. Many measures, such as the advertising ban, taxation and standardised packaging, are self-sustaining. However to succeed in reducing inequality, the Government also needs to ensure adequate funding for the recurring costs of measures that are known to be effective — mass media campaigns, smoking cessation services and tackling tobacco smuggling.  
The Tobacco Control Plan for England expired at the end of 2015 and to date there is no sign of its successor. It was promised in summer 2016 and even more recently we were told at the end of last year that it was due “shortly”. We’re only a week away from a general election — the incoming government must commit to publishing a new and challenging tobacco control plan. Since the last Tobacco Control Plan expired hundreds of children have started smoking every day. Many, if not all, of these children will go on to become lifelong smokers, half of whom will die on average 10 years prematurely after suffering from painful and unpleasant diseases such as cancer, cardiovascular disease or COPD caused by their smoking. On 1 July 2017 it will be the 10th anniversary of the implementation of smokefree legislation in England. A worthy date for publication of the next Tobacco Control Plan, with a commitment to delivering a smokefree future for our children.
 WHO press release for World No Tobacco Day 2017
Tobacco Tactics — BritishAmerican Tobacco in Afica: A Past and Present of Double Standards
 BAT’s African Footprint. ASH. 2008
UK cigarette firm criticised over Laos tobacco tax deal — The Observer, 5 October 2014
 Tobacco Atlas — Smoking’s Death Toll
 WHO World No Tobacco Day 2017 page
 Cancer Research UK policy on international tobacco legislation
 WHO — Parties to FCTC 2030 announcement
 World No Tobacco Day Awards 2016
 The Tobacco Control Scale
 American Cancer Society Luther Terry Award winners 2015
 Statement from the new Prime Minister Theresa May. 13 July 2016. Accessed online 8th December 2016.
 Hansard. Smoking: Written question — HL1194. 26 July 2016.
 Marmot M. Fair Society Healthy Lives (The Marmot Review), 2010.
 ASH. Smoking Still Kills. London 2015.
 RCP. Nicotine without smoke: Tobacco Harm reduction. A report by the Tobacco Advisory Group of the Royal College of Physicians. London. RCP. 2016.
 Source: Estimate by CRUK based on data from the national survey on Smoking, drinking and drug use among young people in England in 2014. The NHS Information Centre for Health and Social Care.
Friday 26 May 2017
Wednesday 31st May is World No Tobacco Day (WNTD),  a day set aside by the World Health Organisation as a tribute to the six million people killed each year by tobacco and a call to action to governments to halt this deadly epidemic. 
This year the theme of World No Tobacco Day is “Tobacco – a threat to development”, a threat the UK government has acknowledged by providing £15 million over the next five years to help poorer countries implement the comprehensive tobacco control policies set out in the international tobacco treaty, the WHO Framework Convention on Tobacco Control (FCTC). 
The UK has also taken a leadership role in implementing the WHO FCTC domestically, and will celebrate a decade of smokefree legislation in England on 1st July. ASH will be covering some of these achievements in more detail leading up to the anniversary, but other highlights in the last decade, which have been achieved with strong public and cross party political support include:
These achievements have been matched by significant declines in smoking prevalence in recent years, with smoking amongst adults and children in England now the lowest in recorded history, at 16.9% for adults  and only 3% for 11-15 year olds.  However, despite this smoking remains the leading cause of preventable premature death killing 78,000 people a year in England, and is also the major cause of health inequalities, responsible for half the difference in life expectancy between the richest and poorest in society.
It has been estimated by Cancer Research UK that every day since the last tobacco control plan expired on 31st December 2015, hundreds of under 16s have started smoking.  Between a third and a half of young people who try smoking will go on to become lifelong smokers, up to two thirds of whom will die prematurely after years of suffering from painful and unpleasant diseases such as cancer, cardiovascular disease or COPD. Tackling smoking remains the single biggest public health challenge facing the incoming government, killing more people than the next six causes of preventable premature death put together, including obesity, alcohol and illegal drugs.  ASH calls on the incoming government to publish a new tobacco strategy with tough new targets and a commitment to reducing inequalities without delay.
Deborah Arnott, Chief Executive of ASH, said: “The UK has made great progress in the last ten years but we cannot rest on our laurels. We’re only a week away from a general election – the incoming government must publish a new and challenging Tobacco Control Plan as soon as possible or we risk much of the progress we have made.”
Deborah continued: “On 1 July 2017 we will be celebrating the 10th anniversary of the implementation of smokefree legislation in England. How fitting it would be if our government were to choose this day to show their commitment to a smokefree future for our children by publishing the new Tobacco Control Plan.”
The UK’s achievements in tobacco control to date are due to the strong public and political consensus in support of tobacco control. At the time plain packaging legislation was passed, with cross party support, the Health Minister shared a tweet with his opposite number saying, “Let’s hope both our children can grow up in a smoke-free generation”.  But the evidence, at home and abroad, is that to achieve a smokefree future will require a comprehensive and sustained government strategy, with tough targets to drive down smoking prevalence. Many measures already in place, such as the advertising ban, taxation and standardised packaging, are self-sustaining. However to succeed in reducing inequality, the Government also needs to ensure adequate funding for the recurring costs of measures that are known to be effective – mass media campaigns, smoking cessation services and tackling tobacco smuggling.  
See also this blog post from ASH Chief Executive, Deborah Arnott, for her personal take on World No Tobacco Day (please note the blog is under embargo until 9am on Wednesday 31st May).
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.
ASH staff are available for interview and for more information. Please contact Deborah Arnott on 020 7404 0242 or 07976 935 987.
 Estimate by CRUK based on data from the national survey on Smoking, drinking and drug use among young people in England in 2014. The NHS Information Centre for Health and Social Care.
 Banks E et al. Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Medicine 2015]
 RCP. Nicotine without smoke: Tobacco Harm reduction. A report by the Tobacco Advisory Group of the Royal College of Physicians. London. RCP. 2016.
ASH Briefing – Illicit Tobacco: What is the tobacco industry trying to do? Produced for World No Tobacco Day, May 2015, the briefing reports on the tobacco industry’s conflicting positions on the illicit trade.Illicit_tobacco_industry_action.pdf