Cigarettes have undoubtedly lost their lustre in the UK. Once a mainstay in the hand of any aspirational figure, smokes are declining in popularity. Currently only about 14 percent of the adult population indulge. Fifty years ago, it was closer to 50 percent. Numbers continue to go down year by year. Between 2018 and 2019 the population of smokers in the UK as a proportion of the adult population fell by four per cent.
However, the uneven distribution of smoking across the UK paints a more complex picture. While the proportion of smokers in affluent areas is as low as 6 per cent, in less wealthy locations smoking rates are much higher, just shy of 22 per cent. These also tend to be areas where higher proportions of people are unemployed and have attained less education, two factors also closely linked to smoking.
These facts suggest that propensity to smoke is rooted in culture and circumstance, not just down to the whims of an individual. Efforts to reduce smoking for such people must focus on the root causes rather than blanket approaches that might do them more harm than good.
Unfortunately, what we get from our policy-makers instead are grand, sweeping, virtue-signalling promises. The most recent target of these whims are e-cigarettes. The common argument against smokeless products like these is that they encourage younger people to take up smoking later on, by enticing them into the world of nicotine via flavour and design. For this reason they have become the target du jour for everyone from Sajid Javid to the World Health Organisation.
This is despite the fact that e-cigarettes have been widely praised as a safer alternative to smoking. Public Health England found e-cigarettes to be 95 percent safer than cigarettes, and they are touted as a legitimate tool to help people quit smoking by the NHS.
Personally, the bombardment of anti-smoking education experienced in my youth worked on me, as I am sure it did for many others, and I am grateful for that. Though sometimes gratuitous and eye-roll inducing, it got the message across. Even as the daughter of two smokers, it never seemed an attractive habit. Though it does not work for everyone, being informed from a young age that smoking was dangerous for both health and looks was an effective prevention for me. Given the smoking-status of people I know now, it seems it was effective for many others across the UK too.
A few months spent living in Turkey reminded me that the UK’s attitude on smoking is far from the global norm and is the perfect example of why not all smoking prevention is created equal. The whole country, young and old, male and female, seemed to constantly have a cigarette in hand, and it did not surprise me to learn that the population of Turkey collectively smokes 118.5 billion cigarettes a year.
This is despite strict rules on where you can smoke; health warnings and plain packaging; and the prohibition on advertising of tobacco products. The country also made the importation, buying and selling of smokeless products illegal in 2020.
A recent study found that young people in Turkey who smoked were aware of the laws and of programs to help them quit, but that this often had little effect. They smoked because people around them did and it’s what they knew. Aside from direct bans on the sale of cigarettes, the most effective intervention was education on the harms of tobacco smoking and one of the strongest indicators that a young person wouldn’t smoke was their education level in general.
Just as they did in the UK, attitudes are slowly changing in Turkey, but the nature of such beliefs are that they are slow to shift. And this is true too for the enclaves of Britain where smoking continues to be a bigger issue. Declaring a new enemy in the fight against smoking everyday doesn’t help. Education does.
So instead of attacking e-cigs, let’s continue to inform people of the harms of tobacco use, so that they can make personal and informed decisions. And let’s improve education more broadly to give people better opportunities. These are much more effective strategies that don’t distract from the real issues.
The dangers of smoking are real, but banning e-cigarettes, or the next fad, isn’t going to change that.