Smoking claims almost twice as many lives in the deprived urban areas of the North and of London as it does in rural England. In cities such as Newcastle and Manchester, up to 40 per cent of deaths are caused by smoking, while in the more prosperous country areas of Devon, Cornwall and East Anglia smoking accounts for 20 per cent of deaths.

More than 1,600 people a week died from smoking, equivalent to 86,500 a year, in England between 1998 and 2002. Almost two thirds of the deaths (62 per cent) were among men.

The unequal impact of the habit is revealed in a map published by the Health Development Agency showing death rates across the 303 primary care trusts (PCTs) in England. It is the first time estimates of smoking-related deaths have been made for local areas represented by each PCT.

Sir Liam Donaldson, the Government's chief medical officer, said: "We are in the grip of a smoking epidemic. An estimated 106,000 people in the UK are dying needlessly each year because of smoking. The HDA's report starkly sets out the scale of the problem." Next week a white paper on public health is due to be launched, which is expected to call for new curbs on smoking in England. Sir Liam has twice called on the Government to ban smoking in public - in his annual reports released in 2003 and 2004 - but the Secretary of State for Health, John Reid, has resisted.

The pressure on Mr Reid was increased this week with the decision by the Scottish Executive to ban smoking in all public places, following the lead of Ireland, where a ban was introduced last year.

Overall, 27 per cent of adults in England smoke. The highest rates, of 40 per cent, are among 25 to 34-year-olds. Most try at some point to give up and just over one third of adults are estimated to be former smokers.

Better-off smokers find it easier to give up. The report says: "The pattern of current and ex-smoking across England is consistent with the suggestion that higher rates of smoking cessation are found in affluent areas."

Latest figures for the year to March 2004 show that more than half of those who set a quit date - 205,000 (57 per cent) - were still not smoking four weeks later.

Dame Yve Buckland, chairwoman of the Health Development Agency, said: "The poorer you are, the more likely you are to smoke. You're less likely to quit and you're more likely to die from smoking-related causes. The high levels of variation in smoking rates across the country are unacceptable." She added: "Over 70 per cent of smokers say they want to give up, and evidence shows that smoke-free workplaces can encourage this. As the largest employer in the country, we urge the NHS to lead by example on this."

The report shows that 85 per cent of lung cancer deaths are estimated to be due to smoking. In addition, smoking caused 11,500 deaths from heart disease in people over 65 and 17,400 deaths from chronic obstructive lung disease.

Despite the carnage, the death rate has fallen. In 1995, around 120,000 deaths were attributed to smoking. The report says the decline is likely to continue, but adds: "If sustained reductions are to be maintained, particular attention will need to be paid to groups where smoking is not reducing. This suggests that initiatives focusing on younger adults will be particularly important."

A total of 77 per cent of people want smoking outlawed in restaurants, while 58 per cent demanded a ban on smoking in enclosed public spaces, according to an NOP poll.

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