United Kingdom: Effectiveness of tobacco control policies on mortality

Smoking is no longer the leading cause of preventable death in the UK for people aged 45 and over, according to a recent study published in BMC Public Health.[1]Obesity and excess body fat have contributed to more deaths in England and Scotland than smoking since 2014.

As smoking prevalence continued to decline in the UK, obesity prevalence steadily increased. The aim of this study was to determine whether adiposity now accounts for more deaths than smoking in the general population as a whole or in subgroups of it. To examine changes in the prevalence of smoking, obesity, and excess body fat among adults, the authors analyzed data collected between 2003 and 2017 from health surveys on 192,239 adults in England and Scotland, with an average age of 50.

In the UK, between 2003 and 2017, the percentage of deaths attributable to smoking decreased from 23.11 to 19.41, while deaths attributable to obesity and excess body fat increased from 17.91 to 23.11 for the general population. The authors estimate that deaths attributable to obesity and excess body fat exceeded those attributable to smoking in 2014. The crossover occurred earlier for men (2011) than for women (2014). It occurred in 2006 for those aged over 65 and in 2012 for those aged 45 to 64. Below 45, smoking remains the leading cause of death.

Comprehensive and effective anti-smoking measures have contributed to the decline in smoking

With tobacco control being a major target of public health interventions, smoking prevalence has fallen in the UK over the past two decades from 26.1% of adults (18+) in 2002 to 14.1% of the population in 2019.[2]The UK has strong tobacco control policies compared to many European countries, scoring highest on the tobacco control scale in 2019 (80 out of 100) among more than 30 European countries. The country has implemented comprehensive anti-smoking policies: regular tax increases, public information campaigns, plain packaging and health warnings on packaging, advertising bans, cessation assistance programs, and a complete ban on smoking in public places and workplaces.

This smoke-free policy was implemented in Scotland in 2006 and in the rest of the UK in 2007 and has been associated with a reduction in cardiovascular and respiratory diseases and pregnancy-related complications. Along with other measures, it has contributed to changing social norms in the UK, making smoking less acceptable in public places.[3]. According to one of the study's authors, public health interventions and policies aimed at reducing smoking prevalence have been successful in the country and national strategies to combat obesity and excess body fat should also be a public health priority.

©Generation Without Tobacco Keywords: United Kingdom, smoking, mortality, obesity

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[1] Ho, F.K., Celis-Morales, C., Petermann-Rocha, F. et al. Changes over 15 years in the contribution of adiposity and smoking to deaths in England and Scotland. BMC Public Health 21, 169 (2021). doi.org/10.1186/s12889-021-10167-3 [2] Fact sheet, Smoking Statistics in the UK, Action for Smoking and Health, April 2020 [3] Philip Emeka Anyanwu, PhD, Peter Craig, PhD, Srinivasa Vittal Katikireddi, FFPH, Michael James Green, PhD, Impact of UK Tobacco Control Policies on Inequalities in Youth Smoking Uptake: A Natural Experiment Study, Nicotine & Tobacco Research, Volume 22, Issue 11, November 2020, Pages 1973–1980, doi.org/10.1093/ntr/ntaa101 National Committee Against Smoking |