Smoking: A pleasure or a killer? Smoking and social class

Wednesday 09 June 2004

Media Briefing from ASH

Immediate Use: Wednesday 9 June 2004


Smoking and Social Class


1.   Health Secretary John Reid has described smoking as “one of the few pleasures left for the poor on sink estates and in working men’s clubs”. According to the Guardian, he also described smoking as “an obsession of the learned middle class”.


2.   In fact:

·     Smoking kills a disproportionate number of people from social classes D and E

·     Smoking is the biggest single contributor to health inequality – and differences in life expectancy – between social classes

·     Exposure to secondhand smoke in the workplace is a major health and safety risk, particularly for people in low-paid and insecure work

·     Support for a new law to end smoking in the workplace is strong across all social classes, In particular support is high among social classes C2 and DE, and higher than might be expected given relative smoking prevalence rates.


3.   “Smoking Related Behaviour and Attitudes” (Office of National Statistics, 2002) showed that in 2002, 17% of men and 16% of women in “managerial and professional occupations” smoked, compared with 34% of men and 30% of women in “routine and manual occupations”.


4.   Opinion poll figures show a high degree of support for restrictions among social classes C2 and D/E – higher than might be expected given differences in smoking prevalence rates. A March 2003 national poll by MORI gave the following % results by social class for two propositions:


1.   “all employees should be able to work in a smoke-free environment”

2.   “waiters and waitresses in cafés and restaurants should be able to work in a smoke-free environment”

AB                    C1                    C2                    DE


Agree to 1                                 87                     80                     74                     70

Agree to 2                                 84                     76                     75                     70


5.   Smoking is the greatest single factor in the different life expectancy between social classes. The Wanless Report gave the following table (5.1):


Proportion of Males Dying Under Age 70


  Social Class I Social Class V Difference
Actual proportion 22% 48% 26%
Actual proportion predicted if all population were non smokers  






Estimate proportion attributed to smoking  






Source: Department of Health analysis


6.   Most smokers want to quit; this is true for all socio-economic classifications. The ONS 2002 survey gave the following results for smokers wanting to quit:


Managerial &     Intermediate      Routine &          Never worked

Professional                              Manual              & Unemployed

Would like to give up (%):

  • Very much indeed        25                     26                     25                     30
  • Quite a lot                     28                     18                     23                     21
  • A fair amount                12                     13                     13                     10
  • A little                             8                       6                      6                     14


TOTALS                              71                    73                     68                     76


7.   It is known that ending smoking in workplaces is a simple and cost-effective way to encourage smokers to quit. Derek Wanless in his recent report to the UK Government on public health (“Securing Good Health for the Whole Population”). stated that: “the voluntary approach to smoking in the workplace has had limited success” and that “A number of other countries have now implemented a workplace smoking ban via legislation. Some of this experience has been shown to be successful in reducing the prevalence of smoking. Public support for smoking restrictions has also been found, in surveys, to be high…” (para 4.21). “Some studies estimate that a workplace smoking ban in England might reduce smoking prevalence by around 4 percentage points – equivalent to a reduction from the present 27 per cent prevalence rate to 23 per cent if a comprehensive workplace ban were introduced in this country.” (Box 4.2).


8.   Estimates of the number of premature deaths from exposure to secondhand smoke were presented by Professor Konrad Jamrozik of Imperial College in London to a conference of the Royal College of Physicians on 11th May. Professor Jamrozik estimates that exposure to secondhand smoke in the workplace:

·        causes 49 premature deaths each year among hospitality industry employees – or one a week, and

·        causes about 700 deaths each year across the UK.

For comparison, the total number of fatal accidents at work from all causes in the    UK in 2002/3 was reported by the Health and Safety Executive as 226 (see


9.   Deborah Arnott, Director of Action on Smoking and Health said:


“Any Government that cares about improving public health must act to protect workers from secondhand smoke, and to encourage more smokers to quit.Secondhand smoke kills more poor people than any other group in society. Smoking is also the single greatest cause of the large difference in life expectancy between the rich and the poor.


If Dr Reid’s contribution to the White Paper on smoking is to say ‘let the poor smoke’, then his policy on obesity will presumably be ‘let them eat cake’. Fortunately Mr Blair has shown more concern for the damage that smoking does to every section of society – and poorer communities in particular.”


CONTACT:          Ian Willmore (ASH)     020 7739 5902 (w) 07887 641344 (m)