More than four people out of ten in Scotland’s most deprived areas smoke, compared to less than one in ten in the best off. Almost a third of deaths in the most deprived areas are due to smoking, compared to 15 per cent in the most affluent – with a similar pattern for tobacco-related diseases.
These figures are just some of the statistics cited today by ASH Scotland ahead of next month’s election, as the campaigning organisation calls on Scotland’s political parties to make reducing health inequalities and tackling smoking key parts of their public health strategies.
Of course, nobody will be hugely surprised that ASH Scotland is calling for this – it’s their stock in trade, after all. But will anyone be listening?
After all, tackling smoking, as ASH Scotland has acknowledged, has been one of the successes of devolution. Scotland was the first country in the UK to introduce smoke-free legislation and it’s amazing how well it has bedded in. There has also been progress on smoking rates. For me, the most significant findings in the recent Health Behaviours in School-aged Children report from NHS Health Scotland and Edinburgh University, were not just that smoking has reduced in teenagers, but that the worrying gender gap – where more girls than boys were smoking – appears to have closed.
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Perhaps there is a sense that smoking is somehow “sorted” and it’s time to move on to Scotland’s other big problems, most notably alcohol and obesity? Not a bit of it, says Sheila Duffy, ASH Scotland’s chief executive – who, if anything, is calling for a renewed focus on the issue. “I think that in Scotland we’ve made huge progress in the last ten years, and I think that’s because we’ve had a comprehensive and strategic approach on tobacco. Adult smoking has fallen here whereas Wales hasn’t seen the same decline – and Wales hasn’t taken the same comprehensive strategic approach. “So yes, we’re making progress but we can’t take our eye off the ball – the tobacco companies are still out there and are still looking for new customers and we know they want to attract them young, so that they have lifelong customers.” Duffy said that ASH Scotland was very clear about what it wanted from political parties in the run-up to the election – and she told The Caledonian Mercury that she was encouraged by the feedback from politicians so far. “I think it’s time we had a new strategy – the first tobacco action plan was published six years ago and yes, it has been successful, but we need a new comprehensive approach going forward.” Such a tobacco control strategy would have “clear goals, challenging targets, and a robust evaluation programme”, she said, adding that required action would also include enforcing the legislation already in place. Duffy is optimistic that the forthcoming ban on displays of cigarettes and other tobacco products at point-of-sale will have a positive effect when it eventually does come in (implementation has been delayed in Scotland because of legal challenges by the tobacco industry). There is evidence, she said, that teenagers in particular are less likely to think that smoking is part of “normal” life, and less likely to assume that their friends smoke, when packs aren’t openly displayed in shops “alongside the sweets and newspapers”. There is less evidence about the effects of enforcing a uniform plain packaging for cigarettes, although she is hopeful that this would make a difference too. “Tobacco companies might no longer able to use words like ‘light’ and ‘mild’ but they use colours and packaging to signify that [the brand] is less harmful,” she said. She outlined specific steps to be taken by whoever next fills the health minister/secretary role:- Set targets relating to smoking prevalence and deprivation (there was a target of reducing smoking in most deprived areas from 37.3 per cent in 2004 to 33.2 per cent in 2008 which was superseded by general adult smoking prevalence targets in 2007);
- Ensure all relevant government health and social policies consider the impact of tobacco within communities;
- Develop effective social marketing campaigns which join up with local initiatives on the dangers of smoking and second-hand smoke;
- Set Scottish targets to reduce illicit tobacco as part of a fully-resourced multi-agency Scottish strategy to tackle illicit tobacco (illicit tobacco, though in general decline, remains an issue, particularly in disadvantaged areas);
- Invest and develop smoking cessation services to ensure they are easily accessible for smokers from less advantaged areas.
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