Editorial: Tobacco is a problem to be tackled, not dodged

In scrapping plans for cigarette packets, Mr Cameron has taken Britain backwards

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Of the 200,000-plus children who take up smoking each year, about half will become lifelong addicts. Of these, half will die from their habit. That is 50,000 deaths per year. Yet David Cameron has scrapped plans to force tobacco companies to use plain packets to market their lethal products, despite the evidence that such a move would make cigarettes less attractive to young people. A backward step, indeed.

When considering cigarettes, it is worth reflecting on the numbers. The H7N9 strain of bird flu now causing a global scare has infected 126 people in China in the past month and killed one in five of them. The smoking pandemic, meanwhile, snares millions around the world each year and has a death rate of 50 per cent.

In fact, the effects of smoking are so appalling that even a small statistical reduction can save many lives. Even if switching from branded to plain packs deters only a few children from experimenting with cigarettes, it would still have a marked impact on the nation’s health.

Nor is that the only way to reduce Britain’s annual smoking-related death toll. In spite of the harm caused, however, our efforts to prevent smoking, reduce its appeal or combat its ill effects are minimal. A specialist medical journal, The Lancet Respiratory Medicine, describes the situation as a “massive failure” of political and medical leadership.

Although six million people in England have used the NHS’s stop-smoking service since 2000 and two million have successfully given up (at least for a time), the facility still reaches only one in 10 smokers. And yet, despite such poor performance, England is a world leader in treatment and support to help smokers kick the habit. If any evidence were needed to illustrate the low priority attached to dealing with the scourge of tobacco in Europe, then this is surely it.

Britain has had some successes, notably the restrictions placed on advertising in 2003, the move to raise the minimum age for the purchase of cigarettes from 16 to 18 in 2007 and the ban on smoking in public, also in 2007. Together, such measures contributed to a sharp drop in the number of young smokers.

But there is so much more that could – and should – be done. Mandatory restrictions on the minimum size of packets, favoured by youngsters because they are cheaper, would be a start. More important still is to adopt a harm-reduction strategy for tobacco similar to that developed for hard drugs such as heroin and cocaine. That means giving smokers the drug they crave but in a form that is less damaging.

In fairness, nicotine-replacement therapy has been a cornerstone of stop-smoking services for more than a decade. But smokers too often find the delivery mechanism – chewing gum, say, or patches – expensive, ineffective and unsatisfying. Better substitutes are needed. One successful example is “snus”, a chewing tobacco increasingly used in Sweden – which now has the lowest smoking rate in the EU. Fears that snus might be a gateway to smoking have led to the product being banned outside Sweden. Perhaps it is time to reconsider.

Electronic alternatives are another promising development. Five years after e-cigarettes were introduced, their use is still low – only 7 per cent of Europe’s smokers have tried them and a mere 2 per cent use them regularly – but the market is growing rapidly. Yet a proposed revision of the EU Tobacco Products Directive could lead to the devices being all-but banned.

Neither commercial interests nor institutional inertia should be allowed to trump the interests of public health. And when it comes to plain packaging, the Prime Minister should think again.

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