2 November 2017

New data published by NHS Digital today show that smoking among 15 year olds has reached the lowest level on record at 7%. [1] The figures demonstrate that England continues to make good progress towards the government’s ambition of a smokefree generation. As outlined in the Tobacco Control Plan for England, the government has committed to reducing smoking prevalence among 15 year olds to 3% or lower by 2022. [2]

The Smoking, Drinking and Drug Use among Young People in England in 2016 survey found that in 2016 7% of 15 year olds were regular cigarette smokers [1] [3] compared to 8% at the time of the last survey in 2014. [3] This continues the longer-term decline seen since 2006, when 20% of 15 year olds were regular smokers. [5] The rate of child smoking experimentation remains almost static with 19% of 11-15 year olds having smoked at least once. This is slightly up from the 18% recorded in 2014 [4], but much lower than the 39% in 2006. [5]

These declines are the result of a long period of evidence-based tobacco policies including prohibiting advertising, promotion and sponsorship of all tobacco products and making tobacco less affordable which continues to deliver benefits.

Commenting on the findings, ASH Chief Executive Deborah Arnott said:

This report shows that England continues to head in the right direction when it comes to youth smoking. However, we need to do more to get adult smokers to quit. It is the higher rates of adult smoking in poorer communities that are the main reason for lower life expectancy.  The Tobacco Control Plan must be fully implemented and adequately funded if we are to succeed in tackling the burning injustice that those born poor die on average nine years earlier.”

This marks only the second time the survey has assessed the use of electronic cigarettes among 11-15 year olds. More children (25%) have tried e-cigarettes than regular cigarettes (17%), continuing a pattern which was already established in 2014 when 18% had tried smoking compared to 22% who had tried e-cigarettes. The vast majority of those who tried e-cigarettes had also tried smoking. Among those who had never smoked, e-cigarette experimentation remained very low at 11%, the same as in 2014. This supports the recent findings of a large scale analysis of surveys of the behaviour of 60,000 young people in the UK which gives little credence to the theory that e-cigarettes are acting as a gateway to smoking tobacco. [6]

Deborah Arnott added:

“We need to keep monitoring but it’s encouraging that since 2009 the proportion of children aged 15 smoking has fallen year on year. Reassuringly experimentation with electronic cigarettes remains low and doesn’t appear to be leading to regular use.”

ENDS

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 have an ISDN line. For more information contact ASH on 020 7404 0242 or out of hours Deborah Arnott on 07976 935 987 or Hazel Cheeseman on 07754 358 593.

References

[1] Smoking, Drinking and Drug Use among young people in England 2016. NHS Digital, September 2017. Chapter 2 tables – smoking prevalence. Table 2.3

[2] Towards a smokefree generation: tobacco control plan for England. Department of Health, July 2017. https://www.gov.uk/government/publications/towards-a-smoke-free-generation-tobacco-control-plan-for-england

[3] The study defined a regular smoker as smoking at least one cigarette per week

[4] Smoking, Drinking and Drug Use among young people in England 2014. NHS Digital, 2015 http://content.digital.nhs.uk/catalogue/PUB17879

[5] Smoking, Drinking and Drug Use among young people in England 2006. NHS Digital, 2007 http://content.digital.nhs.uk/pubs/sdd06fullreport

[6] Bauld L et al Young People’s Use of E-Cigarettes across the United Kingdom: Findings from Five Surveys 2015-2017, International Journal of Environmental Research and Public Health 2017, 14, 29 August 2017 http://www.mdpi.com/1660-4601/14/9/973/pdf

29 August 2017

UK’s largest ever analysis of data shows no evidence that e-cigarettes are leading young people into smoking

Concerns that use of e-cigarettes by young people in the UK could be leading to smoking are so far not borne out by the evidence, shows a new study published today.

The study, a collaboration between UK Centre for Tobacco and Alcohol Studies, Public Health England, Action on Smoking and Health, and the DECIPHer Centre at the University of Cardiff is an analysis of five large-scale surveys conducted in the period 2015-17 involving over 60,000 11-16 year-olds. [1]

The findings show a consistent pattern: most e-cigarette experimentation among young people does not lead to regular use, and levels of regular e-cigarette use in young people who have never smoked remain very low. [2]

Regular (at least weekly) use of e-cigarettes amongst all young people surveyed was 3% or less. This was highly concentrated in those who also smoked tobacco. Among young people who smoke regularly (at least weekly), use of electronic cigarettes ranged from 7% to 38%. [2]. However, among young people who have never smoked, regular use of e-cigarettes was negligible – between 0.1% and 0.5% across the five surveys. [2]

Most studies of e-cigarettes and young people in the UK and elsewhere have looked at experimentation – involving ever or recent use, rather than regular use. Some of these studies have suggested that trying an e-cigarette leads to young people becoming smokers, which is not justified by the evidence.

Professor Linda Bauld, Professor of Health Policy, University of Stirling:

“Recent studies have generated alarming headlines that e-cigarettes are leading to smoking. Our analysis of the latest surveys from all parts of the United Kingdom, involving thousands of teenagers shows clearly that for those teens who don’t smoke, e-cig experimentation is simply not translating into regular use.

 “Our study also shows that smoking rates in young people are continuing to decline. Future studies on this subject need to continue to monitor both experimentation and regular use of e-cigarettes and take into account trends in tobacco use if we are to provide the public with accurate information.”

Martin Dockrell, Tobacco Policy Manager, Public Health England:

 “The findings in this study suggest that in terms of protecting children we are broadly getting the balance right in the UK.  We have a regulatory system that aims to protect children and young people while ensuring adult smokers have access to safer nicotine products that can help them stop smoking. This includes a minimum age of sale, tight restrictions on marketing, and comprehensive quality and safety requirements. We will continue to monitor the trends in e-cigarette use alongside those in smoking.”

Deborah Arnott, Chief Executive, Action on Smoking and Health:

 “ASH will continue to monitor the potential impact of e-cigarettes on young people, however this study provides reassurance that to date fears that they are a gateway into smoking are just not born out by the facts on the ground. A small proportion of young people do experiment with e-cigs, but this does not appear to be leading to regular vaping or smoking in any numbers, indeed smoking rates in young people are continuing to decline.”

Graham Moore, Deputy Director, DECIPHer:

“Few people would argue that e-cigarette use in young people should be encouraged. However, these surveys consistently show that the rapid growth in experimentation with e-cigarettes among young people throughout the UK has so far not resulted in widespread regular use among non-smokers. Taken alongside our other recent analyses which suggest that among young people who use both e-cigarettes and tobacco, tobacco nearly always comes first, concerns that e-cigarettes are leading large numbers of young people into addiction and tobacco use increasingly seem to be implausible.”

ENDS

Notes

Young people are defined as aged from 11-16 in the surveys analysed.

Contributors to the research paper include: Public Health England, Action on Smoking and Health (ASH), members of the UK Centre for Tobacco and Alcohol Studies (The Institute for Social Marketing at the University of Stirling, The Addictions Department at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London) and The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement at Cardiff University.

Contributors are available for interview. Please contact Stevie Benton from Action on Smoking and Health (ASH) on 020 7404 0242

Funding

• The YTPS was supported by a grant from Cancer Research UK
• The ASH surveys were supported by grants from Cancer Research UK and the British Heart Foundation.
• The School Health Research Network in Wales is a partnership between the DECIPHer at Cardiff University, Welsh Government, Public Health Wales and Cancer Research UK, funded by Health and Care Research Wales via the National Centre for Population Health and Well-being Research.

References

[1] The five surveys are:

• The Youth Tobacco Policy Survey
• Schools Health Research Network Wales survey
• ASH Smokefree GB Youth survey 2016
• ASH Smokefree GB Youth survey 2017
• Scottish Schools Adolescent Lifestyle and Substance Use Survey

[2] Bauld L et al Young People’s Use of E-Cigarettes across the United Kingdom: Findings from Five Surveys 2015-2017, International Journal of Environmental Research and Public Health 2017, 14, 29 August 2017 http://www.mdpi.com/1660-4601/14/9/973/pdf

15 June 2017

Smoking rates in England fell to a record low last year, according to new figures from the NHS Health and Social Care Information Centre published today. [1] Across England, about one in twelve smokers quit during 2016: the percentage of people in England aged above 18 who were smokers in 2016 is 15.5% compared to 16.9% in 2015, a fall of 1.4 percentage points. This is the largest annual fall in the last 40 years. Of particular note is the large decline among young people with smoking rates falling 6.5% among 18-24 year olds since 2010.

However, despite this decline, smoking remains the leading cause of preventable death [1] and every day since the last tobacco control plan expired on 31st December 2015, hundreds of under 16s have started smoking [2]. Smoking is also responsible for half the difference in life expectancy between rich and poor [3] and worryingly 1 in 4 of people in routine and manual occupations continue to smoke compared to around 1 in 10 people in managerial occupations.

There is also a concerning trend in other data published today on the rates of women smoking while pregnant. These have remained almost unchanged in 2016/17 at 10.5% compared to 10.6% in 2015/16 [4] this is despite good progress reducing rates over previous years. To tackle this public health epidemic ASH is calling on the Government to publish the new Tobacco Control Plan with tough new targets and a commitment to reducing inequalities without further delay.

ASH Chief Executive Deborah Arnott said:

“One in two lifetime smokers will die from smoking related disease, so a fall in smoking rates of this scale will save many thousands of lives in years to come. This proves that tobacco control policies work, when they are part of a comprehensive strategy and are properly funded.

 “But we must not stop now. Every day since the last tobacco control plan expired on 31st December 2015, hundreds of under 16s have started smoking. On 1 July 2007 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.”

 The fall in smoking rates follows the implementation of a well-funded and comprehensive strategy, which ranked the UK top in Europe this year for implementation of tobacco control policies, according to criteria set by the World Bank. [5] Policies which helped put the UK at the top and have supported declines in prevalence include:

• Annual increases in tobacco taxes above inflation to reduce affordability (there has been a commitment to an annual increase of 2% above inflation since 2011)
• The continuing impact of the ban on smoking in enclosed public places; the complete ban on advertising, promotion and sponsorship; and the requirement to put tobacco out of sight in shops
• The availability of stop smoking services for smokers, with nicotine replacement products available on prescription (although these are now facing significant cuts following the devolution of public health to local government and austerity grant settlements for local councils [6])
• A shift to the use of electronic cigarettes by current smokers; survey figures released by ASH last month estimated that there are now 2.9 million vapers across the UK, of whom 1.5 million no longer smoke at all [7]
• The introduction of standardised packaging for tobacco products (the figures published today for 2016 include the period since May 2016 in which standardized packs were gradually being introduced by retailers). 

ENDS

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 ASH on 020 7404 0242 or out of hours Hazel Cheeseman on 07754 358 593.

References

[1]        Statistics on smoking in England: NHS Digital

[2]        Hopkinson, NS., Lester-George, A., Ormiston-Smith, N., Cox, A. & Arnott, D. Child uptake of smoking by area across the UK. Thorax 2013. doi:10.1136/thoraxjnl-2013-204379

[3]        See ASH Briefing on Health Inequalities

[4]        Women smoking at time of delivery:

2016/17                10.5%

2015/16:               10.6%

2014/15:               11.4%

2013/14:               12.0%

2012/13:               12.7%

[5]        The Tobacco Control Scale website was launched at the 7th European Conference on Tobacco or Health 2017 as a joint initiative of the Association of European Cancer Leagues and the Tobacco Control Unit of the Catalan Institute of Oncology, a WHO Collaborating Center for Tobacco Control.

[6]        Report on local tobacco control published by ASH November 2016

[7]        Large national survey finds 2.9 million people now vape in Britain: For the first time over half don’t smoke: ASH media release 8 May 2017

20 September 2016

In advance of the annual Stoptober stop smoking campaign, ASH is calling on the Government to increase the frequency and the amount of money spent on stop smoking campaigns.

Deborah Arnott Chief Executive of ASH said,

“ASH strongly supports Stoptober which provides the support and encouragement that we know most smokers need to help them stop.  However, we are very concerned about the recent announcement by the Health Minister in the Lords that funding for mass campaigns like Stoptober has been cut again this year. The evidence is clear, to be successful mass media campaigns need to run throughout the year; Stoptober alone is not enough.”

During a parliamentary debate, the Health Minister, Lord Prior said that the expenditure allocated for this financial year was £4 million.*  Last year it was £5.3 million and it has declined significantly in the last 6 years; in 2008-09 it was nearly £25 million.

ASH is also calling on the Government to publish without delay its new Tobacco Control Plan, replacing the previous one which expired at the end of 2015.  The new plan needs to clearly set out how the Government intends to fund tobacco control including mass media campaigns and Stop Smoking Services.

ENDS

Contact:   Deborah Arnott 020 7404 0242 (w) or 07976 935 987 (m)

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 core funding from Cancer Research UK and the British Heart Foundation.

* Hansard. HoL Debate.  Lord Prior of Brampton:  “£4 million has been allocated for tobacco-specific marketing activities, £1 million of which is for the Stoptober campaign launching next month.”

https://hansard.parliament.uk/lords/2016-09-14/debates/16091442000095/Smoking-RelatedDiseases

Effectiveness of Mass media campaigns

1. Research has shown that mass media campaigns are highly effective and cost-effective in motivating quit attempts and discouraging uptake of smoking.[i] However, the UK is currently falling far below best practice spending on mass media campaigns.

2. In 2009 funding for anti-smoking mass media campaigns in England was just under £25 million: by 2015 this figure had been cut to only £5.3 million, with further cuts expected this year. If England were to fund mass media campaigns at levels recommended by the US Centers for Disease Control and Prevention, it should have been spending around £60 million; more than ten times the amount spent in 2015.[ii]

3. Studies carried out in England in the past few years have found that mass media campaigns have been effective in triggering quit attempts and have been responsible for a significant proportion of the reduction in smoking prevalence,[iii] and that the freeze on mass media campaigns at the time of the 2010 election was associated with a reduction in quitting activity.[iv] A systematic review of economic evaluations of mass media campaigns noted that all of these found mass media campaigns to be cost effective[v], but these campaigns need to have sufficient intensity and be sustained in order to have a meaningful effect.[vi]

4. A 2016 regional mass media campaign conducted by Fresh North East and Smokefree Yorkshire and Humber illustrates the value of mass media in promoting quit attempts. The campaign which focused on 16 cancers caused by smoking, reached approximately 333,000 people via TV, radio, print and online. Of those who saw the campaign 16% (around 55,300 people) cut down on their smoking. A further 8.4% (around 28,000 people) made a quit attempt as a result of the campaign while 4% switched to electronic cigarettes. This shows the clear impact mass media campaigns have on triggering quit attempts and changes in behaviour.

[i] ^{Langley T. et al. The impact of media campaigns on smoking cessation activity: a structural vector autoregression analysis, Addiction 2012, 107(11):2043-50.} 

[ii] ^{Hopkinson NS, Millett C, Glantz S, Arnott D, and McNeill A (2016) UK government should fund stop smoking media campaigns not give tax breaks to films with smoking imagery. Addiction. doi: 10.1111/add.13511}

[iii] ^{Sims M, Salway R, Langley T. et al.. Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study Addiction. 2014 109 (6): 986-94}

[iv] ^{Langley T, Szatkowski L, Lewis S et al. The freeze on mass media campaigns in England: a natural experiment of the impact of tobacco control campaigns on quitting behaviour.  Addiction 2014: 109: 995-1002}

[v] ^{Atusingwize E, Lewis S, Langley T. Economic evaluations of tobacco control mass media campaigns: a systematic review  Tobacco Control 2015: 24: 320-327}

[vi] ^{Durkin S & Wakefield M.  Commentary on Sims et al. (2014) and Langley et al. (2014) Mass media campaigns require adequate and sustained funding to change population health behaviours.  Addiction 2014: 109: 1003-1004.}

This fact sheet summarises tobacco control policy formulated by the European Union.  Aug. 2016.

ASH response to a consultation on the future of the Health Survey for England

ASH response to a consultation on the future of various Office for National Statistics information products.