A recent independent report by Dr Javed Khan OBE is urging the implementation of drastic new strategies to make England ‘smoke-free’ by 2030. The research, published by the UK Government on the 9th June 2022, finds that without taking these bold, and possibly controversial, new moves, the government will miss its smoke-free target by at least seven years, with the poorest communities lagging behind this by at least fourteen. This is compounded by the potential failure of the government’s adjacent ‘10 Year Cancer Plan’ strategy.

Khan references the 2007 introduction of the ban on smoking in pubs and clubs in England, suggesting that while these current moves may prove divisive, previous government strategies to cut down on smoking have been widely accepted. But is the government really willing to put their support behind these new recommendations?

Where does England currently stand on smoking?

If sources are to be believed, it seems unlikely. While the government has said it will ‘consider’ the proposed strategies, with Health Secretary Savid Javid reportedly backing the plans, the BBC reports that ministers are currently unlikely to support them, with Prime Minister Boris Johnson said to be opposed to raising the legal smoking limit above 18. Taking a brief look at the statistics on smoking in England, this seems like an absurd attitude to take, given the monumental toll smoking takes on the nation’s health yearly.

Smoking remains the biggest cause of preventable deaths in England. It has been reported around 280 children take up smoking a day in England, which is 298,300 minors (and counting) since the government introduced its 2030 Smokefree strategies. While smoking rates have been steadily falling over the past decades, England makes up for the 6 million current smokers out of the UK’s overall 7 million, and Dr Khan has warned this decline has been reduced to a ‘small trickle’. He observes that without a more radical approach, smoking will contribute to more than half a million deaths in England by 2030. The BBC reports that in 2019, smoking was a factor in over 75, 000 deaths in England, which is 15% of the total number and around a quarter of all cancer deaths.

While the government may be unenthusiastic, polls show that a general majority of the population supports stricter rules on tobacco products. A survey by Techne UK found that around 54% of those polled are in favour of phasing out regular cigarettes for other smoking methods, such as vaping. A poll presented by Dr Khan shows that 52% of 18 to 24-year-olds – an age cohort in which the ONS states one in nine smokes – do not think the government is doing enough to eradicate access to tobacco.

The recommendations of the report

The report offers a wide range of radical and far-reaching recommendations to combat these statistics, pushing the government to apply more practical methods to meet its 2030 promises.

Dr Khan offers four main proposals. The first focuses on investment and encourages the government to introduce further taxes and levies on the tobacco industry in order to meet the estimated £125 million needed to fund anti-smoking services and support schemes. His second suggestion, and the one that has attracted most media attention since the review’s publication, is the continuous raising of the legal limit of smoking by one year, every year, with the long-term plan of phasing out smoking entirely within a few generations. These kinds of measures would follow the likes of New Zealand, where it will be illegal to purchase tobacco products if you were born after 2008.

As a way of negating some of the difficulties around quitting smoking with these new policy introductions, Khan supports the promotion of vaping as a cleaner alternative to smoking, and an aid for those looking to quit. He admits this method is not ‘risk free’, but compared to traditional tobacco it’s a far better option. Lastly, Dr Khan strongly recommends a review of the NHS’s role in the anti-smoking project. Noting the £2.4 billion it costs the NHS yearly in treating the effects of smoking, he urges that every branch of the Health service, from GPs and psychiatrists to midwives and dentists, introduce anti-smoking schemes into every step of patient interaction where needed.

A selection of additional measures, focusing on smoking within media and advertisements, are presented. These include an 18 rating, and 9 pm watershed, on media that includes smoking, as well as on-screen health warnings where applicable. Khan supports a high-scale anti-smoking media campaign, introducing a retail tobacco licence and drastically limiting the public places legally designated for smoking, especially those accessible to children, such as those in hospitality.

Dr Khan ends his report with an ardent plea directly to the government, urging them to introduce these new measures rapidly and to full effect:

‘These interventions are critical as they will lead to exponential gains in reducing health disparities. The supporting recommendations I have set out, present a holistic response to the challenge we face. Taken together, and if implemented in full, I believe these actions will get the government to its 2030 target and then lead to a smokefree generation. But to get there, there can be no short cuts, no quick fixes, no excuses.’

All evidence presented by polls, reports and statistics makes clear the extremely urgent case for implementing new regulations to phase out smoking in England entirely. The intense pressure it already puts on health services and national support systems makes the current lacklustre approach by the government all the more frustrating. The starkly presented warnings of an imminent health disaster without immediate change, supplied by Dr Khan, make for deeply concerning reading.

About the author: James Taylor is a contributing writer and editor graduating from the University of Glasgow, with personal interests including transnational cultures and political affairs.