As a smoker, the question is not whether smoking will kill you, but how. Most common is cardiovascular disease (heart disease or stroke) at 43 per cent, rather than lung cancer at 28 per cent. Female smokers are more at risk, especially if taking the contraceptive pill, and the worst impact is on babies from mothers who smoke.
So pretty bad.
Are governments Acting?
Yes, since the 50s taxation, regulation, and education have been put in place to reduce the prevalence of smoking in developed countries. Now this has gone global with the Framework Convention on Tobacco Control (2005). The stated intention of the signatories to the FCTC is ‘to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke’.
The treaty covers 90 per cent of the world’s population (Indonesia being the major exception) and signatories have to implement measures to reduce the harm from tobacco. These include: protection from tobacco smoke – bans on smoking in public spaces, education, bans on sales to minors, health warnings on packages (65 per cent of signatories have implemented measures in these areas). And two thirds of signatories have banned advertising and sponsorship.
So there does seem to be a strong, coordinated desire to accelerate the reduction in tobacco use.
Paradoxically, as a consequence of tobacco taxation, smoking has become a revenue generator for many governments – in the UK £10bn pa vs £2.7bn costs to NHS from smoking(2) – so perhaps they don’t want everyone to stop smoking just yet.
Have any been successful?
The UK is one of the leaders in tobacco control and has been able to reduce the proportion of smokers considerably (in 1948, 82 per cent of men smoked and 41 per cent of women).
Prevalence of cigarette smoking by sex in Great Britain, 1974 to 2010
Source: General Lifestyle Survey, Office for National Statistics
Source: Action on Smoking and Health, 2013
This decline in smoking is mirrored in many countries with progressive legislation, including emerging markets, so the measures do appear to be working and the Framework Convention Alliance for Tobacco Control (FCTC) is likely to accelerate their introduction globally.
Where next?
Graphic packaging is being brought in globally and this may lead to a step change in the rate of decline of smoking, and is being keenly fought by the industry which has brought two legal challenges, the first of which has been defeated. But this could lead to a step change in smoking prevalence.
