United Kingdom: Mission makes recommendations for quitting smoking

A mission into smoking in the United Kingdom, led by Javed Khan, a former director of a charitable NGO, has just released its findings. The mission makes twelve recommendations for intensifying public health policies to combat smoking, as the country is currently lagging far behind in its goal of achieving a smoke-free England.

The Tobacco Mission, mandated by the Department of Health, was set up in the United Kingdom to assess the objective of reducing the rate of adult smokers to below 5% by 2030. With this in mind, several options were considered, including having the tobacco industry bear part of the health costs, based on the polluter-pays principle, raising the age of prohibition on the sale of tobacco products, or even gradually banning the sale of tobacco, or further regulating access to electronic cigarettes.[1].

Delay in targets despite popular support in the UK

In his conclusions, Javed Khan believes that, as things stand, England risks missing the seven-year target. This delay is even more pronounced among the most disadvantaged population groups, who will have to wait until 2044 to reach a target initially set for 2030. As in France, smoking is a social marker in England and contributes to widening health inequalities within the population. However, the mission notes increasingly broad public support for anti-smoking policies: 46% of English people believe that the government is not doing enough, including 52% among 18-24 year-olds. Conversely, 6% of those surveyed say that too much action is being taken to combat smoking in the country.

Stepping up investment in tobacco control

Javed Khan emphasizes the need to intensify the fight against smoking, by investing an additional £125 million per year, or approximately €145 million. In particular, this investment should be partly devoted to improving the care and support provided to smokers in quitting. According to the fact-finding mission, if the government is unable to finance this investment itself, other solutions exist, such as the introduction of a tax on the tobacco industry under the "polluter pays" principle, or the establishment of a specific corporate tax. According to the report, the tobacco industry is still capable of generating particularly high profit margins (67%), compared to everyday consumer products (12 to 20%).

Protecting the UK's youth by gradually raising the legal age of sale

Regarding the accessibility of tobacco to minors, several scenarios were evaluated, such as raising the legal age for purchasing tobacco products to 25, or banning the sale of tobacco to anyone born after a certain date. In his conclusions, Javed Khan recommends that the government take the second option, raising the age of sale by one year each year, "until no one can buy a tobacco product in this country." Here too, Javed Khan indicates clear public support for raising the legal age: 63% of English people support raising it to 21.

Significantly and abruptly increase taxation on all tobacco products

The report, which highlights the effectiveness of tax policies in the fight against smoking, considers it a priority to initiate a significant increase in taxes on all tobacco products, designed to cause a sudden price increase of at least 30%. Such a policy would, according to Javed Khan, lead to a reduction in demand for 12% in the short term, and 35% in the long term, while increasing tax revenues by more than £1 billion. In detail, the report also highlights the need to end the duty free for tobacco products, and to sharply increase import duties.

Reducing tobacco accessibility through a licensing system

With the dual objective of limiting product accessibility and preventing illicit trade, the report also highlights the need to establish a licensing system for the sale of tobacco and vaping products, as well as a complete ban on online tobacco sales. Furthermore, Javed Khan calls on the government to remove the ability of supermarkets to sell tobacco products and to prohibit the introduction of any new tobacco products onto the market, with a view to freezing the market and preventing the emergence of attractive new products.

A comprehensive smoking cessation program

In addition to these four main recommendations, the mission on smoking notably mentions the need to fight locally against the illicit trade in tobacco products, to reduce the attractiveness of smoking by completely rethinking the appearance of cigarettes (health messages on each stick, repellent colors, etc.) and by strengthening the regulations on new products, to intensify the denormalization of tobacco by increasing the number of smoke-free spaces, to encourage smokers to quit or otherwise to turn to vaping products, to strengthen local support services for smokers, to invest fifteen million in a media prevention campaign, and another fifteen million intended to encourage pregnant women to quit.

FT

[1] Gov.uk, The Khan review, Making smoking obsolete Independent review into smokefree 2030 policies Dr Javed Khan OBE, 09/06/2022, (accessed 20/06/2022)