At a time when health policy discussions are rightly focused on NHS backlogs, striking workers and a lack of capacity within social care, Wes Streeting, the shadow health secretary, threw a new issue into the mix: he wants smoking to be phased out.

“It would make such a transformational impact on the health of individuals and on the health of the nation as a whole,” Streeting said in a recent interview with the Times. His proposal angered commentators on both sides of the political spectrum, but does he have a point?

Though Streeting never outlined how he would see smoking eventually phased out, the idea is not without precedent. New Zealand recently introduced a law that bans anyone who is now under the age of 14 (born on or after 1 January 2009) from ever being able to purchase cigarettes legally; the law makes it also illegal for older people to give them tobacco products.

The nation’s government hopes measures to ensure smoking is less affordable, accessible and addictive – including reducing the legal amount of nicotine allowed in tobacco products and making them available in reduced number of shops – will see it become the first country in the world to achieve “smoke-free” status, defined as an adult smoking rate of no more than 5 per cent.   

Currently, the proportion of smokers in the UK stands at 13.3 per cent (equating to 6.6 million people). There’s been a gradual fall in the number of smokers since indoor smoking was banned in enclosed public spaces in July 2007 (when 24 per cent of people smoked).

But would Britain tolerate a similar change in law? And if so, what impact would it have?

“I’ve been surprised that we’ve come as far as we have. The steady introduction of more bans, higher taxes on tobacco, banning advertising, has had this enduring effect over a long period of time,” Les Mayhew, the head of global research at the ILC health think tank, told Spotlight. However, “this fall in the prevalence [of smoking], whilst it’s been very welcome, it seems to be levelling out a bit now”, he added. In the past five years, smoking among adults has only dropped by 1.8 per cent.

In its 2019 manifesto, the Conservative Party set a target for England to be “smoke-free” by 2030, and the government’s levelling up white paper aimed to lower life expectancy gaps between affluent and struggling areas and add five years to life expectancy across the UK by 2035.

But the government is offering fewer opportunities to help smokers quit. Public health grants for councils to provide stop smoking services and tobacco control has been cut by 41 per cent in real terms, analysis from the Health Foundation charity shows. In addition to anti-smoking support facing the biggest cut out of all health areas, cuts to council “[grants] have been greater in more deprived areas”, the research notes.

Smoking is more prevalent in more deprived areas, and research indicates that a girl born today in one of the most deprived 10 per cent of local areas is expected to live 19 fewer years in good health than a girl born in the least deprived. Although a range of factors could contribute to this outcome.

Adopting a New Zealand-style approach, or outlawing smoking altogether in the UK, won’t be enough, however. Mayhew pointed to his recent research that concluded that even if smoking was banned tomorrow, the full societal health benefits won’t be seen for 40 years. But he described the New Zealand approach as “interesting and sensible” and something the UK could emulate.

“It’s easier to start with younger people who have never smoked than it is to start with hardened smokers,” Mayhew added, also stressing the importance of state action in addressing other negative outcomes – such as inactivity and poor mental health – associated with smoking. “You could go harder and faster, but I congratulate New Zealand for implementing this long overdue policy.” 

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