The UK stands at a pivotal moment in public health history with the introduction of the Tobacco and Vapes Bill, a landmark legislation that aims to create a smokefree generation. However, achieving a truly smokefree future requires more than just preventing new smokers—it demands a comprehensive strategy to help existing smokers quit and address the economic burden tobacco places on our healthcare system and society.

The Cost of Smoking to Society

Smoking remains the leading cause of preventable death and ill-health in England, with approximately 74,000 smoking-related deaths per year. Beyond the devastating health impacts, smoking places an enormous economic burden on our society. Recent analysis estimates that smoking costs England a staggering £43.7 billion annually—far exceeding the £6.8 billion raised through tobacco taxes.

This financial burden includes:

• £27.6 billion in lost economic productivity
• £1.82 billion in NHS costs
• £13.9 billion in social care costs to local authorities
• £332 million in fire-related costs

Tobacco and Health Inequalities

Smoking is the single largest driver of health inequalities in England. Half of the gap in healthy life expectancy between the richest and poorest is attributable to smoking. This disparity is reflected in current smoking rates—21.7% of people in the most deprived groups smoke, compared to just 6.2% in the least deprived.

On current trajectories, the least affluent communities will not reach the same low smoking rates as the most affluent for another 25 years. This means smoking will continue to be a leading driver of inequality for decades to come without strategic intervention.

The Path Towards a Smokefree Future

The All-Party Parliamentary Group (APPG) on Smoking and Health has outlined a comprehensive roadmap to accelerate progress towards a smokefree country. This balanced approach rests on three pillars:

1. Ensuring No One Starts

The Smokefree Generation proposal in the Tobacco and Vapes Bill aims to prevent future generations from ever starting to smoke. Additionally, swift regulation of vape advertising, packaging, flavour descriptors, and retail displays will help protect children from taking up vaping.

2. Supporting Everyone to Stop

The APPG recommends a national target of reducing the number of smokers by 2 million by the end of this Parliament, with a vision to make smoking obsolete within 20 years. This would require:

• Maintaining current funding to local authorities and the NHS for tobacco control
• Investing an additional £97 million annually in stop smoking services targeting disadvantaged populations
• Continuing to reduce tobacco affordability through taxation
• Introducing inserts in cigarette packs and warnings on cigarette sticks to reinforce awareness of health harms

3. Removing Profit from Tobacco

The UK tobacco market is dominated by four manufacturers who make an estimated £900 million in profits annually while taxpayers bear the cost of tobacco-related harm. The APPG recommends:

• Implementing a ‘polluter pays’ levy on tobacco companies to raise £700 million annually
• Capping tobacco industry profits at levels comparable to other consumer products
• Requiring tobacco companies to publish sales data to support tobacco control strategies

Economic Benefits of a Smokefree Society

A smokefree future offers substantial economic benefits. When people quit smoking, they redirect their spending to other goods and services that contribute positively to the UK economy. Research suggests achieving a smokefree country could result in 135,000 additional full-time equivalent jobs worth almost £10 billion.

Additional investment in stop smoking services could deliver a return of £3.6 billion to public finances and £18.9 billion to the wider economy over five years.

Cross-Party Consensus on Tobacco Control

Tobacco control has historically enjoyed cross-party support, with Conservative, Labour, and coalition governments all taking significant steps to reduce smoking rates. The continuity of this approach is crucial, as progress can easily stall without sustained investment and comprehensive strategies.

The current Government has pledged to publish a roadmap towards a smokefree country and ensure that all hospitals integrate ‘opt-out’ smoking cessation interventions into routine care. These commitments, if fully implemented, will help accelerate progress towards a healthier, more equitable society.

Source: Ash