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Tobacco remains a leading cause of death and disease globally. Yet, in the UK the least-advantaged groups in society are the most likely to be impacted, making tobacco use a significant driver of health inequalities across our population. This World No Tobacco Day, researcher Annika Theodoulou, discusses her work examining different stop smoking interventions and trends in smoking behaviours.

May 31 is marked annually by the World Health Organisation as World No Tobacco Day. Since 1987, this day has served as a public reminder of the deadly effects of tobacco use, the ongoing tobacco epidemic, and the global advances in research and public policy to fight against it.   

Today, some have voiced their opinions that this battle against smoking in Britain has already been won. This may be how it seems to some but unfortunately this is not the reality. 

Tobacco use (most commonly smoked in the form of cigarettes) remains a leading cause of death and disease globally. In the UK, more than 6 million adults smoke tobacco cigarettes. We know that smoking is a leading risk factor for many devastating diseases and places a heavy burden on individuals and healthcare services; but this burden is not evenly distributed. In higher-income countries, including the UK, a social gradient in tobacco use has developed. This means that people who are of lower socioeconomic status, for example with lower levels of educational attainment, on lower incomes, or living in social housing are more likely to smoke. 

This gradient means the least-advantaged groups in society are more likely to live with and die from smoking-related diseases. Consequently, tobacco use is a leading driver of health inequalities across our population 

Tobacco kills up to two-thirds of its users. It’s use not only impacts individuals but also burdens our healthcare systems. Latest figures show that the cost of smoking to the government in England has risen by 25%, costing at least £21.8 billion per year.  

The new Tobacco and Vapes Bill proposed by the UK government aimed to tackle tobacco use and foster a smoke free generation. The legislation proposed to raise the age of sale for all tobacco products by one year, annually from 2027 onwards. This would have meant that tobacco could never be legally purchased by anyone born after 1 January 2009 and was strongly supported by health organisations. Unfortunately, the announcement of the general election earlier this month halted this motion, with the Prime Minister confirming that this bill will not be actioned in the current parliament. 

Although the new legislation has been halted, it’s vital for both individuals and healthcare services that we continue to help people overcome tobacco addiction. In the Oxford Tobacco Addiction Group (OxTAG), within NDPCHS, we’re focusing on several research projects aiming to guide health practice and policy to specifically tackle health inequalities caused by tobacco smoking. 

Within this, my work focuses on two areas; understanding how a variety of effective stop smoking interventions perform across different socioeconomic groups (see Cochrane review protocol and preliminary findings) and exploring trends in smoking behaviours, quitting attempts and quitting success when measured by different indicators of socioeconomic status (e.g. education, employment status).  

In addition, I am also supporting the evaluation of a new opportunistic stop smoking service currently being offered through Citizens Advice Bureau’s (CAB) in Oxfordshire. Using this approach, we hope to be able to highlight the benefits of quitting smoking to peoples’ finances – recently found by researchers at UCL to be a key motivator for stopping smoking - and also target people who are most in need of assistance to quit. This work is supervised by Associate Professor Nicola Lindson, who recently had a paper published scoping the existing evidence for providing opportunistic smoking cessation support in financial support settings. 

Together these projects will paint a clearer picture of how we can support people across the UK to stop smoking, regardless of their socioeconomic status, ultimately aiming to improve health outcomes for patients and reduce the burden on individuals and services. 

Whoever the next elected party is, we hope that they prioritise measures to reduce the harm caused by tobacco, including raising the age of sale. We hope our work will guide policy and practices that will help increase quit rates for all, including those in greatest need to reduce the impact of tobacco use on health inequalities.  




Opinions expressed are those of the author/s and not of the University of Oxford. Readers' comments will be moderated - see our guidelines for further information.


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