A Smokefree Future: Comprehensive Tobacco Strategy

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Last week the UK Government announced a new comprehensive tobacco control strategy for England. This document should be of interest to other countries around the world as England has been at the cutting edge of tobacco control and smoking cessation over recent years. Adult smoking prevalence fell from 28% in 1998 to 21% in 2008, and youth smoking rates fell from 11% to 6% following the previous tobacco control strategy announced in 1998. During that time frame a nationwide network of smoking cessation services was set up, comprehensive smoke-free workplace legislation was implemented (including bars and restaurants), tobacco advertising severely restricted, and large pictorial health warnings introduced on packs. In 2006 the UK ratified the World Health Organization Framework Convention on Tobacco Control.

The UK government has set ambitious targets to be reached by 2020:
1. To reduce the proportion of 11-15 year-olds to 1% (currently 6%)
2. To reduce adult smoking prevalence to 10% (currently 21%)
3. To have two-thirds of households in which parents smoke be smoke-free by 2020 (i.e. even smoking households having a policy of not smoking indoors).

One of the main components of the strategy for England is to motivate and assist every smoker to quit. Over the past 10 years the UK smoking cessation service have helped arrange over 4 million quit attempts. These services are unique in international comparisons in that they are based on a network of locally based face-to-face tobacco treatment services.

The new strategy plans to expand these services by using an expanded marketing campaign, but perhaps the most radical aspect is the plan to broaden the number of routes to cessation by encouraging smokers to (a) cut down their smoking, perhaps over a long period, by substituting cigarettes with nicotine replacement therapy (e.g. nicotine gum (b) encouraging smokers to use safer nicotine delivery products like nicotine gum in places where they are not allowed to smoke and (c) encouraging all smokers to reduce the amount of environmental smoke they emit, by replacing smoking of cigarettes to use of nicotine replacement therapy.

In order to fit in with these new pathways to cessation, the UK government plans to change the way the face-to-face smoking cessation services work, such that longer courses of behavioral and pharmacological support will become available to suit the needs of those smokers who are not yet ready to quit completely.

This last part is a fairly radical step for a government. Most countries don’t even have a government funded smoking cessation service, never mind one that also serves to help smokers reduce their smoking. Overall, so long as scarce resources are not diverted away from smokers who are seeking help to quit completely, I think the UK has broadly got it right, and many other countries should take a look at what is being achieved there and consider adopting a similar approach.
You can access the details of the strategy at:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_111749
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About the Author


MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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