Responses to Questions
Question 1: What smoking prevalence rates for all groups couldwe aspire to reach in England?
The evidence in the consultation document supports the view that the Government should focus onreducing smoking among youth and those over 40.
The data for adult smokers
The table on page 74 of the consultation paper summarises the data from the 2004 update on the Doll
study. It shows that smokers who quit by about 40 have made little impact on their health.Specifically the table shows:
Smokers who quit before 35 have NOT reduced their life expectancy at all by smoking
Smokers who quit between 35 and 44 have reduced their life expectancy by about 0.75 years
However, those who quit after 40 see an increasingly sharp worsening of the consequences of smoking.
Smokers who quit between 45-54, 55-64 or after 65, have reduced their life expectancy by about2.5 years, 3.25 and 4.3 years respectively by smoking.
Consequences for public health policy
This means that from a public health point of view, by far the greatest gains come from getting thethose aged over 35, and especially those aged over 45, to quit. I suspect that this age group is relativelyeasy to reach as well.
Young, non-pregnant adults
In fact, the evidence from the consultation paper suggests the Government should be relatively relaxedabout smoking by non-pregnant young adults:
As long as individuals quit by around 40, they are doing little long-term harm to their own health
The health effects on other adults around them is significantly less negative than on the smokersthemselves, and this has been further reduced by the smoke-free legislation (both directly due tothe reduced smoking in public places, but equally importantly due to the increased culture of smoking outside private dwellings.)
For a non-smoker who lives in a non-smoking household the negative effects of other people'ssmoking are minimal (unlike abuse of alcohol and drugs).1.
Smoking does not lead to the unpleasantness (vomit, vocal abuse and noise), unprotected sex,and fights associated with young people's drunkenness. Nor does it lead to dangerous driving.2.
Smoking does not lead to the crime, social degradation and social exclusion associated withdrugs.3.
Non-smokers no longer have to go into smoky places
From the Government's / taxpayer's point of view, smoking is extremely profitable: Thegovernment's tax take is about £10 billion
; the cost to the NHS of smoking related disease isabout £1.5 billion.My conclusion from these facts is that the cost of smoking – both in terms of health and financially – is borne by the smokers themselves, and to a lesser extent by their families. Insofar as smoking is aninformed choice, then the government has little reason to interfere. In my view an exception to this is justified in the case of children living with smokers. (An adult who chooses to live with a smoker hasmade a choice in the matter; a baby born to a smoker has not.)
Average for men and women
Of this, about £8 billion is from excise tax that would not be replaced if this expenditure were directed to other goods.4
In addition the government loses about £3 billion due to smuggling.