Wanless Report gives powerful backing to case for smokefree law

Wednesday 25 February 2004

ASH MEDIA RELEASE: Wednesday 25th February 2004


For Immediate Release


Today’s report on public health from Derek Wanless provides “powerful backing” to the case for a new law ending smoking in the workplace, according to tobacco control pressure group Action on Smoking and Health. The Wanless Report (‘Securing Good Health for the Whole Population’) also calls for the Government to consider a new independent regulatory body for nicotine products, a call strongly backed by ASH and the Royal College of Physicians.


The report identifies smoking as “the single greatest cause of preventable illness and premature death in the UK”. It also states “there is a strong socio-economic gradient … half the difference in survival to 70 years of age between social class 1 and V is due to smoking.” (Para 1.38). “It is estimated to kill 120,000 people per year in the UK (one fifth of all deaths) … It is estimated to cost the NHS up to £1.7 billion each year … as well as having wider costs in productivity losses from ill health, absenteeism and accidents” (Para 4.4). “In England, an estimated 27 per cent of adults were smokers in 2001 … Although there has been a large decline in smoking since the 1970s … smoking prevalence remained fairly stable at around 27 per cent during the 1990s”. (Para 4.6). Cutting smoking levels further will be “a key determinant of success” in meeting the Government’s public health targets (Para 4.11).


The report finally refutes the tobacco lobby’s attempts to deny that secondhand smoke is dangerous to the health of non-smokers. “Secondhand smoking … increases the risk of lung cancer for 20-30% for people who live with smokers, equivalent to several hundred deaths a year. Secondhand smoke also causes heart disease… Children are particularly vulnerable to passive smoking because they have less developed immune systems and smaller lungs. It has been observed that the children of smokers have a doubling of the risk of sudden infant death syndrome and a 50 per cent increase in the risk of asthma” (Para 4.5).


The report says that the “voluntary approach to smoking in the workplace has had limited success”. “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)


The report also gives some backing to the Government’s Big Conversation proposal to allow local authorities to introduce workplace smoking restrictions in their areas. “If national restrictions are not introduced, an equivalent city or town in England [to New York] could act as a champion for smoke-free public places across the country and make a real impact on the health of their population, whilst piloting a ban on smoking in public places in England” (Box 4.2)


The report is critical of existing Government smoking targets, particularly the four week quit target set for smoking cessation services (i.e. numbers using the service still not smoking after four weeks). “The ideal would be organisational level data [i.e. for each Primary Care Trust or Strategic Health Authority] which gave the full picture of progress towards smoking reduction” (Para 3.44).


A number of key principles are given to guide future Government action. Two in particular provide clear backing for action on secondhand smoke:

“2. Interventions should be evidence based, though the lack of conclusive evidence should not, where there is a serious risk to the nation’s health, block action proportionate to that risk…

5. The rights of the individual to choose their own lifestyle must be balanced against any adverse impacts those choices have on the quality of life of others”. (Chapter 7 summary).


The report calls for “the forthcoming consultation period, ahead of the White Paper, should be used, inter alia, to seek the public’s views about the acceptability of different of different ways of tackling smoking. There are number of major areas for consideration; a workplace/public place ban, the need to take firmer action over smuggling and counterfeiting cigarettes and the possibility of allowing nicotine substitutes to be more widely available. It is evidence from our recent lack of reasonable progress in reducing smoking … that the benefits which success from these firmer actions might produce would be expensive to achieve by more conventional techniques of education and advice.” (Summary page 7)


The report also supports other key tobacco control objectives including a new single body to regulate all nicotine products (at present nicotine replacement products are far more heavily regulated than cigarettes, preventing such products from developing a market). “Some arguments can be made for one organisation to take on this regulatory role. It is recommended that the Department of Health’s review of arm’s length bodies consider this proposal.” (Para 4.26).


ASH Director Deborah Arnott commented:


“The first Wanless Report was a milestone for health policy in Britain. It spelled out in clear terms that we can only achieve the healthy population we all want if we do far more to pursue key public health objectives: cutting smoking, increasing exercise and tackling obesity and excessive drinking.


This second Report is just as important. It shows how smoking remains the number one cause of preventable deaths in Britain. It confirms that action to end smoking in the workplace would cut the risk to non-smokers and save the lives of smokers as well. It calls for clear targets to cut smoking and supports the case for a new regulatory system for all nicotine products.


This Report must be acted on by Government without delay. Action to end smoking in the workplace will be a key early test of the Government’s seriousness in improving public health”.



The new Wanless report ‘Securing Good Health for the Whole Population’ is available online from the treasury website:



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ASH experts are available for advice, briefing and comment on the Wanless Report.




Deborah Arnott     020 7739 5902 (w) 079 7693 5987 (m)

Ian Willmore         020 7739 5902 (w) 07887 641344 (m)