Sheila Duffy: Continuing to make smoking a thing of the past

Smoking remains far and away our largest preventable cause of ill health and death. Picture: John Devlin

The fifth session of the Scottish Parliament has begun. Once they have settled in to their new offices, found out who’s got which job and recruited their office staff, the new MSPs will have to consider what issues to focus on over the next five years.

I would guess that Scotland’s health, and health inequality, will be at the top of many lists. If someone were able to offer these MSPs a popular, cost-effective means of greatly improving health, saving the NHS money, supporting businesses and putting significant funds into the pockets of our poorest communities, you imagine they would jump at the chance.

I’m hoping that they do, because I have exactly such a proposal for them.

Robust action on tobacco from successive Scottish administrations has helped sustain a steady decline in the smoking rate. Yet the latest Scottish Household Survey still indicates an adult smoking rate of 20 per cent in 2014. That translates into nearly 900,000 people in Scotland who have significantly increased risks of cancer, heart disease, dementia, stroke and diabetes.

Smoking remains far and away our largest preventable cause of ill health and death, so that around 300,000 people in Scotland will currently be living with serious illness due to tobacco use. They each spend an average of £125 a month on tobacco and smoking costs push an extra 32,000 Scottish households over the poverty line, while deepening the poverty experienced by many others.

Crucially, surveys year after year show that most people in Scotland who smoke say that they want to stop. The harm caused by tobacco arises from engrained habit and addiction rather than from lifestyle choice.

The Scottish Government has set a target of a “tobacco-free generation” by 2034. This is defined as a 5 per cent smoking rate by 2034 – which ASH Scotland articulates as achieving a situation where cigarettes are out of sight, out of mind and out of fashion and the only people who smoke are the small number of informed adults who actively choose to do so.

The national tobacco strategy sets an intermediate target of a 12 per cent smoking rate by 2021, the lifetime of this Parliament. If this goal can be achieved then, over time and compared with the latest survey figures 350,000 people in Scotland will benefit from the single, largest gain which anyone who smokes can achieve for their health

Reduced smoking-related admissions would lead to annual savings of between £100 million and £170m from NHS budgets, to be spent on other priorities. Scotland’s economy will benefit, with employers hit by 1 million fewer sick days each year

The poorest fifth of communities will gain an extra £100m of disposable income every year

All of these gains would result from meeting an existing Scottish Government commitment. To ensure that these gains are successfully delivered we need robust political action, of the sort which has helped achieved the reduced smoking rates to date.

In this session of the Parliament we need to see clear recognition that tobacco use is part of the problems faced by people with mental health issues, and a commitment that stop smoking support should be offered as part of the care provided. We need robust, well-resourced action from police, trading standards and others to keep tobacco out of the hands of our children and illicit tobacco out of our communities. We need to ensure financial support services, from money advice to food banks, understand that smoking is not a lifestyle choice but a further burden on the already disadvantaged and that stop smoking support is one element of the road to financial stability.

Recently Scotland celebrated ten years of smoke-free enclosed public spaces, a move that seemed risky at the time yet which has been uniquely successful and smoothly implemented and remains one of the Scottish Parliament’s most popular actions. As of last month all tobacco manufactured for use in the UK must come in plain, standardised packaging. Soon packets without brand imagery will present consumers with a more honest presentation of the product.

There is a long way to go on Scotland’s journey towards being tobacco-free in 2034. But the evidence is clear that a tobacco-free generation will not just be healthier, but wealthier and fairer too. Our successes to date, achieved against huge opposition from vested commercial interests, should inspire us that we can get there.

• Sheila Duffy, chief executive, ASH Scotland