The need for a new Tobacco Control Plan: an issue of justice
BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j342 (Published 24 January 2017) Cite this as: BMJ 2017;356:j342
- Nicholas S Hopkinson, reader in respiratory medicine1,
- Jane Dacre, president2,
- Lesley Regan, president3,
- Helen Stokes-Lampard, chair4,
- Simon Wessely, president5,
- Neena Modi, president6,
- John Middleton, president7,
- Andrew Furber, president8,
- Parveen Kumar, chair9,
- Penny Woods, chief executive10,
- John Moxham, chair11,
- Shirley Cramer, chief executive12,
- Richard Thompson, former president2,
- Ian Gilmore, former president2,
- Carol Black, former president2,
- George Alberti, former president2,
- Margaret Turner-Warwick, former president2,
- Sheila Hollins, former president5,
- Cyril Chantler, former chair13,
- Hilary Cass, former president6
- on behalf of 1100 healthcare professionals and public health experts
- 1Imperial College London, London, UK
- 2Royal College of Physicians, London, UK
- 3Royal College of Obstetricians and Gynaecologists, London, UK
- 4Royal College of General Practitioners, London, UK
- 5Royal College of Psychiatrists, London, UK
- 6Royal College of Paediatrics and Child Health, London, UK
- 7UK Faculty of Public Health, London, UK
- 8Association of Directors of Public Health, London, UK
- 9British Medical Association Board of Science, London, UK
- 10British Lung Foundation
- 11Action on Smoking and Health, London, UK
- 12Royal Society of Public Health, London, UK
- 13The King's Fund and the UCL Partners academic health science network, London, UK
- n.hopkinson{at}ic.ac.uk
The prime minister’s commitment to “fighting against the burning injustice that if you’re born poor, you will die on average nine years earlier than others”1 is welcome and achievable. As her government has acknowledged,2 half of this difference in life expectancy is due to the higher rates of smoking among the least affluent, so major improvements can be achieved by driving down smoking rates among the most disadvantaged in society.3
Torjesen reports on the British Thoracic Society’s call for the NHS to do more to help smokers quit.4 But the evidence, both at home and abroad, is that lowering smoking rates requires a comprehensive and sustained government strategy.56 Many measures, such as the advertising ban, taxation, and standardised packaging, are self sustaining. But to succeed in reducing inequality, the government also needs to ensure adequate funding for the recurring costs of measures that are known to be effective—mass media campaigns, smoking cessation services, and tackling tobacco smuggling. Adequate funding for tobacco control is also core to the “radical upgrade in prevention and public health,” which the NHS Five Year Forward View recognised as essential to ensure the “future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain.”7
Unfortunately, over a year has now passed since the government’s previous Tobacco Control Plan expired. Despite the public health minister making a statement to Parliament about the importance of a new strategy with new ambitions,8 no publication date has been set.9 Past experience shows that commitment from health ministers is not sufficient; if the prime minister is really committed to social justice she needs to put her weight behind publication of a new Tobacco Control Plan without further delay.
Competing interests: None declared.