Media Briefing: No Smoking Day: Ditch or Switch – Give Yourself a Pay Rise!
Wednesday 8th March is No Smoking Day.  It’s also Budget day and tobacco taxes will rise by at least 2% above inflation.  ASH wants smokers in England to use the day as their chance to quit – smokers are being encouraged to ‘Ditch or Switch’.
A 10 a day smoker who decides to quit completely could save themselves about £23.50 a week, or more than £1,200 a year. Average pay in the UK is now slightly over £500 a week (roughly £20,000 a year after tax), so someone on average earnings who successfully quits has effectively given themselves a 6% pay rise. [3,4] A “savings calculator”, showing how much money individuals could save by quitting, and other information on the benefits of quitting can be found at www.nhsinform.scot/nosmokingday.
Only about one in twenty unaided attempts to quit smoking result in smokers stopping for good. The best chance for quitting smoking in England is to use a local Stop Smoking Service, which should offer behavioural support and coaching, and prescriptions for a stop smoking medicine such as varenicline and/or nicotine replacement therapy. That can improve a smoker’s chance of quitting by up to four times. But the Government has cut funding for public health, and local authority budgets generally are contracting sharply. The ASH latest annual survey of English local authorities, commissioned by Cancer Research UK and covering 2016/17, shows that smoking cessation budgets have been cut in almost three in five authorities surveyed, and 45% had cut budgets for other tobacco control work, including trading standards enforcement and action on illicit trade.
By May 20th this year, all cigarettes must be sold in standardised (“plain”) packs, which will include on the front the message “get help to stop smoking at www.nhs.uk/quit”. But if you use the site to try to find a stop smoking service near you, you may not get what you need. For example, Worcestershire Council now only funds stop smoking services for pregnant women. Wyre Forest NHS Clinical Commissioning Group (CCG), South Worcestershire CCG and Redditch and Bromsgrove CCG have jointly decided not to fund stop smoking medication for prescription by GPs. The NHS site directs Worcester smokers to a stop smoking service in Solihull, which is about 35 miles away and does not offer a service to people from Worcester.
Guidance developed by NICE states that patients should be encouraged and supported to stop smoking by their GP, but in some parts of England the GP will not be able to prescribe medication to help quitting, and there will be no Stop Smoking Service to use.[8,9,10] There are particular risks for smokers needing operations as it is not always safe for surgery to take place when a patient continues to smoke and, as a result, some surgeons will not carry out procedures until a patient is able to abstain from smoking (“Stop before the Op”). Smokers are 38% more likely to die after surgery than non-smokers. Following surgery smokers have: higher risks of lung and heart complications; higher risks of post-operative infection; impaired wound healing; require longer hospital stays and higher drug doses; are more likely to be admitted to an intensive care unit; and have increased risk of emergency re-admission. Not providing help on the NHS for such patients is likely to harm their health and cost the NHS more in the long run. 
While quitting using nicotine completely is best for both your pocket and your health, switching from smoking to using electronic cigarettes can also help smokers to quit.  Although the nicotine in cigarettes is what keeps smokers dependent, the smoke from cigarettes is what causes the vast majority of the health damage. That’s why the Royal College of Physicians has estimated that electronic cigarettes are likely to cause at most 5% of the harm caused by smoking.  However, ASH surveys show that more than half of adults in Great Britain either think that electronic cigarettes are as harmful or more harmful than cigarettes, or do not know.
Use of electronic cigarettes can also save smokers money: for example the Leicester Stop Smoking Service report that smokers who switch to vaping tell them they save up to 90% of the money they used to spend on smoking. Electronic cigarettes are now the most commonly used aid to quitting,  and ASH surveys find that the most common reasons ex-smokers give for using electronic cigarettes are to help them stop smoking, to save money and to help keep them from starting smoking again. A short film put together by the National Centre for Smoking Cessation and Training which can be found at http://bit.ly/2lbTBUD is designed to help smokers considering switching to vaping. 
ASH wants the Government to do more to help smokers to quit, by:
- Publishing a new tobacco control plan for England without further delay.
- Funding effective and continuing mass media campaigns to encourage smokers to quit.
- Reconsidering its decision not to proceed with a levy on tobacco manufacturers to pay for measures to help smokers quit and discourage young people from taking up smoking.
Smoking rates have declined rapidly in England, among both adults and children, since Governments began to implement comprehensive tobacco strategies from 1998 onwards. The latest figures show adult smoking prevalence in England has declined by more than a third from 27% in 1998 to 16.9% in 2015. However, as smoking is uniquely lethal, it remains the leading cause of preventable premature death across the UK. Previous reductions in smoking prevalence have been driven by co-ordinated Government action set out in successive tobacco control plans. The last plan expired in December 2015, and despite assurances that the new Plan would be published “shortly”, the Government has yet to give a publication date. 
In her first speech as Prime Minister, the Rt Hon Theresa May MP committed to “fighting against the burning injustice that, if you’re born poor, you will die on average 9 years earlier than others.” 
Half the difference in life expectancy between the richest and the poorest social groups is due to differences in smoking prevalence. To tackle this, the Government needs to ensure adequate funding for key tobacco control measures – particularly mass media campaigns, smoking cessation services and tackling illicit tobacco. In 2009-10, funding for mass media campaigns was nearly £25 million,  but by 2015/16 it had been reduced to £5.3 million,  with further cuts in 2016/17.
Louise Ross of Leicester Stop Smoking Service said: “Good stop smoking services, including medication and nicotine replacement products on prescription, are the best way to help a smoker who wants to quit. Electronic cigarettes can help people go smokefree too, and can be important for preventing relapse to smoking. Many of our service users have done well with a combination of electronic cigarettes and traditional stop smoking products, along with the coaching we provide.”
Deborah Arnott, Chief Executive of Action on Smoking and Health said: “This year No Smoking Day takes place on the same day as the Budget statement. This would be an excellent moment for smokers to save themselves thousands of pounds and improve their health by quitting. People who stop smoking start to feel the benefits within days. Using a Stop Smoking Service gives you the best chance of success, but using electronic cigarettes can also be helpful.
“But the Government can’t leave it to individual smokers to try to quit on their own. We urgently need a new tobacco control plan for England, and proper funding for public health and for mass media campaigns. That’s essential if Theresa May’s Government is to live up to her promise to tackle health and social inequality.”
 No Smoking Day is an annual health awareness day in the United Kingdom which is intended to help smokers who want to quit smoking. The first No Smoking Day was on Ash Wednesday in 1984, and it now takes place each year on the second Wednesday in March. Spending on No Smoking Day activities has been shown to be cost effective in helping smokers to quit. (How cost-effective is ‘No Smoking Day’? D Kotz, J A Stapleton, L Owen, R West. Tobacco Control 2011;20:302e304. doi:10.1136/tc.2009.034397)
 HM Treasury. Budget. HC1104. March 2014. 2.142 Tobacco duty rates beyond 2014-15 – Annual duty increases of 2% above RPI will continue until the end of the next Parliament to help improve public health.
 Assuming a price per pack of 20 of £6.70 (the cost of 20 Sterling cigarettes, the most popular UK brand, in a supermarket). In practice, many smokers will be spending more, for example the price of 20 Marlboro in a supermarket is currently around £9.60. Average daily consumption of cigarettes in England is now about 11 a day. Statistics on smoking: England, 2016. The Health and Social Care Information Centre, May 2016
 Average weekly earnings Office for National Statistics. Release date 15 February 2017
 Public health functions were transferred to local authorities under the Health and Social Care Act 2012, supported by a ring fenced grant, originally of £2.8 billion in 2015/16. In June 2015, the Chancellor announced an in year cut to this grant of £200 million, in the 2016 Autumn Statement it was announced that the grant would be reduced by a further £84 million in 2017/18 and by an average of 3.9% each year until 2020.
 ASH/CRUK report. Cutting down the reality of budget cuts to local tobacco control. November 2016
 Medicines Commissioning News. Wyre Forest CCG, South Worcestershire CCG and Redditch and Bromsgrove CCG. March 2016
 NICE Guidelines (PH1) Smoking: brief interventions and referrals. 2006
 NICE Guidelines (PH1) Stop smoking services. 2008
 NICE Guidelines (PH48) Smoking: acute, maternity and mental health services. 2013.
 Smoking and Surgery Joint briefing by ASH in partnership with the Royal College of Surgeons of Edinburgh, the Royal College of Anaesthetists and the Faculty of Public Health, and endorsed by the Royal College of Surgeons, Royal College of Physicians and the Royal College of General Practitioners.
 ‘The Switch’. A video produced by NCSCT in which former smokers talk about the benefits of switching to vaping
 Nicotine without smoke: tobacco harm reduction. Royal College of Physicians 28 April 2016
 Use of electronic cigarettes (vapourisers) among adults in Great Britain. May 2016
 E-cigarettes may have helped 18,000 people quit smoking in 2015: web page of UCL Health Behaviour Research Centre, published 14 September 2016
 Use of electronic cigarettes (vapourisers) among adults in Great Britain. May 2016
 Annual Population Survey, 2015. ONS, 2016
 Statement from the new Prime Minister Theresa May. 13 July 2016.
 Smoking: Written question – HL1194. House of Lords Hansard 26 July 2016