While the Government stands accused of giving a confusing message on smoking, some doctors are taking matters into their own hands. Last week in Manchester a heart patient who was refused hospital tests because of his smoking history died.
Dr Kenneth Calman, the Chief Medical Officer at the Department of Health, has said that without 'doing something special' the Government's first target - to reduce smoking by a third in 11- to 15-year-olds by 1994 - was unlikely to be met.
Health campaigners have no doubts about what the special something might be. The British Medical Association, the Health Education Authority and Ash (Action for Smoking and Health) speak with one voice in their call for a total ban on cigarette advertising, a change to government policies for smoking in public places, and major Budget day increases in the price of tobacco.
The next meeting for EC health ministers is in November but the Government has given no sign that it will change its view and support the call for an advertising ban.
An average of 30 per cent of the population continues to smoke (29 per cent women; 31 per cent men), a drop of 16 per cent overall in 20 years. Britons are still smoking about 95 billion cigarettes a year, according to Ash. On present trends this will reduce by only 5 million by 2000, and not the desired 30 million necessary to meet the overall target.
The national habit costs the NHS pounds 437m a year and represents 50 million working days lost through smoking-related diseases. It produces tax revenue worth more than pounds 6bn. The lower the social class the more difficult it is to break the habit. In 1972, 44 per cent of employers and managers were smokers, but this was down to 24 per cent by 1990. But 48 per cent of unskilled manual workers still smoke (64 per cent in 1972).
Patti White, co-ordinator for the Health Education Authority's tobacco programme, said that campaigners needed to think hard about helping such people to stop. 'It is no point saying, think how much you will save - you can spend it on a holiday. Many of these people cannot possibly take holidays. Smoking may be one of the few luxuries they can afford. These are very difficult problems. Better-off people have many more ways of treating themselves.'
In 1990, according to government statistics, 25 per cent of 15-year-old girls were 'regular smokers' - the same as in 1982. But the total had dropped to 22 per cent in 1988.
Mark Flannagan, deputy director of Ash, said: 'There has been a proliferation of low-tar brands and a great deal of advertising in women's magazines. The idea that smoking makes you slim is very strongly held and the increasing use of cigarettes being smoked in glamour photography may reinforce a young woman's desire to smoke.'
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