Delivering the vision of a ‘Smokefree Generation’ The APPG on Smoking and Health submission to the Prevention Green Paper
New recommendations for central government significantly strengthen tobacco regulation in order to deliver the vision for prevention  and achieve the ‘smokefree generation’ envisaged in the 2017 Tobacco Control Plan for England.
When the Secretary of State for Health and Social Care launched his vision for prevention, he asked for ideas for the Green Paper on Prevention, currently in development, saying “We will not meet our mission with ‘business as usual’.”. The Chairman of the All Party Parliamentary Group (APPG) on Smoking and Health has risen to the challenge, backed by cross-party support. 
Bob Blackman MP (Chairman of the APPG, Harrow West, Conservative) said:
“Smoking remains the leading cause of premature death and health inequalities. Ratcheting up tobacco regulation further and faster is essential to achieve the Government’s vision for prevention, to increase healthy life expectancy by five years by 2035 while reducing inequalities between the richest and poorest in society.”
The APPG believes that while commitments in the NHS Long Term Plan to provide dedicated funding to help smokers quit are welcome, treatment is only part of the solution. Furthermore that as local authority public health funding has declined year on year, the reliance on local action in the 2017 Tobacco Control Plan is unrealistic. The APPG report concludes, therefore, that additional sources of funding and central government regulations are essential if declines in smoking prevalence are to be maintained and increased. The report recommendations are summarised below:
- Making the polluter pay: a charge on the tobacco transnationals designed to deliver a fixed sum annually to the Government to fund high impact, evidence-based measures to encourage smokers to quit, and discourage youth uptake.
- Reducing the affordability of tobacco: by increasing the annual tobacco tax escalator with an added uplift for hand-rolled tobacco (currently much more lightly taxed) to prevent down-trading detrimental to public revenues and public health.
- Retail licensing: to support enforcement activity against underage sales and illicit tobacco, by banning the sale of tobacco from unlicensed retailers or those who break the law.
- Collection and publication of tobacco manufacturers’ sales and marketing data: to monitor the evolving behaviour of the industry and inform better regulation.
- Increased funding for education campaigns: using the charge on the industry to fund targeted campaigns to increase attempts to quit, and discourage uptake, using social and mass media.
- Support for innovative regional collaboration: to motivate quitting, enforce age of sale regulations and reduce illicit trade.
- Raising the age of sale of tobacco from 18 to 21: to discourage uptake by those most at risk and reinforce the message that smoking is uniquely dangerous.
- Government mandated pack inserts to support quitting: a cheap and effective means of supplementing on-pack warnings with messaging encouraging smokers to quit.
- Enhanced guidelines on smoking on screen (film and TV): to reduce the exposure of young people to images of smoking which have been proven to increase uptake of smoking.
Alex Cunningham MP (Vice Chair of the APPG, Labour) said:
“Our recommendations, if implemented, will reinvigorate the tobacco control strategy and deliver the vision for prevention. They range from a new ‘polluter pays’ charge on the tobacco manufacturers to provide essential additional funding, to licensing of all retailers, reducing the exposure of young people to smoking on screen and increasing the age of sale from 18 to 21. These measures operate as an integrated package, not a pick and mix set of options.”
Baroness Finlay (Vice Chair of the APPG, crossbencher) said:
“Public education campaigns using social and mass media are highly cost-effective at discouraging uptake and encouraging quitting, but government funding for such campaigns has fallen by 90% in the last decade. Over the same time period the proportion of smokers trying to quit each year has fallen by a quarter, smoking rates among young people have now started to flatline and the inequalities gap is widening. To quote the Secretary of State for Health “We will not meet our mission with ‘business as usual’.”.”
Lord Rennard (Vice Chair of the APPG, Liberal Democrat) said:
“Tobacco manufacturing is by far and away the most profitable consumer industry in the world, and Big Tobacco can certainly afford to pay more to clear up the devastating damage its products cause. There is no more obvious example of the principle that the polluter should be made to pay.”
Professor John Britton, Director of the UK Centre for Tobacco and Alcohol Studies (which was commissioned to research and write the report for the APPG) said:
“The evidence is clear, not just from the UK but globally, that smoking rates only continue to decline when tobacco control policies are comprehensive and in line with the international tobacco treaty the WHO FCTC. That is why the APPG recommendations are endorsed by doctors, health charities, academics and public health professionals.”
Deborah Arnott, Chief Executive of Action on Smoking and Health (ASH) said:
“Legislation to strictly regulate smoking used to be considered controversial and extreme by all mainstream political parties. Thanks to the dedication of the All Party Group, working closely with civil society, that’s no longer the case. Governments now have confidence that tough tobacco regulation both delivers results, and, crucially, has widespread cross-party and public support.”
Notes and Links
The All Party Parliamentary Group on Smoking and Health is chaired by Bob Blackman MP. The secretariat is provided by ASH. The purpose of the APPG is to monitor and discuss the health and social effects of smoking; to review potential changes in existing legislation to reduce levels of smoking; to assess the latest medical techniques to assist in smoking cessation; and to act as a resource for the group’s members on all issues relating to smoking and public health. For more information see:
 All Party Parliamentary Group on Smoking and Health. Delivering the vision of a ‘Smokefree Generation’. The APPG response to ‘Prevention is better than cure’. February 2019. (Commissioned by the Chairman of the APPG from ASH and the UK Centre for Tobacco and Alcohol Studies, which researched and wrote the report for the APPG). https://ash.org.uk/wp-content/uploads/2019/02/2019-APPG-report.pdf
 Department of Health & Social Care. Prevention is better than cure: Our vision to help you live well for longer. 5 November 2018.
 Department of Health. Towards a smokefree generation: tobacco control plan for England, 18 July 2017.
Deborah Arnott MBA FRCP (Hon)
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