How smoke-free is “smoke-free”? 2

The Sunday Herald recently devoted its front page to a headline story reporting that “Scotland is to become ‘smoke-free’ under ambitious plans being drawn up by Government ministers.”

In the story ASH Scotland gives a warm welcome to the idea. Not surprisingly the readers’ comments posted below were rather more mixed, but it is important to note that several contributors did not seem to understand what was being proposed.

Perhaps the problem lies in using the term “smoke-free” to describe a goal of reducing smoking to just 5% of the population. While this is a welcome and ambitious move (currently 23% of adults in Scotland smoke) it would still leave us with 200,000 smokers. Hardly “smoke-free”.

This is a question over how what label we give to the idea, rather than any doubt as to its merits. Since the advent of the Scottish Parliament, successive administrations have made Scotland an international leader in tackling the harm caused by tobacco use, with impressive results. The smoking rate amongst adults has fallen from 31% in 1999 to 23% today, saving the NHS millions and improving the health and wealth of hundreds of thousands of Scots. Yet tobacco is still responsible for a quarter of the deaths in our nation – it breaks up families, creates inequality, hurts our economy and leaves too many living with painful and debilitating illness.

We have no interest in condemning or criminalizing smokers. Banning smoking is not on our agenda. But how can we stand by, knowing that two thirds of Scotland’s 1 million smokers started before they were 18 and that 69% of them say that they want to quit their addiction? Preventing young people from taking up smoking, supporting smokers who want to quit and protecting people from second hand smoke are popular and effective health policies that should be pursued with vigour.

So how should we articulate our vision of a society where the only people who smoke are the small number of adults who willingly choose to do so? The “smoke-free” idea is imperfect, but it comes from the internationally accepted definition of this goal as a smoking prevalence of 5% or less.

We might instead call this a society that has achieved freedom from tobacco – a Scotland whose people can make their own choices and who are no longer beholden to this damaging, addictive substance. New Zealand has set a date of 2025 to reach such a goal. In Finland campaigners are pushing for a 2040 target. In Hong Kong smoking prevalence is already down at 11%.

This is a positive agenda in pursuit of an achievable goal. Delivering it will save lives, support families and create a healthier, wealthier and more equal Scotland.

How exactly we get there is another matter, and will be an ongoing theme of this blog (and of our conference in June).

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2 comments

  1. ‘So how should we articulate our vision of a society where the only people who smoke are the small number of adults who willingly choose to do so? The “smoke-free” idea is imperfect, but it comes from the internationally accepted definition of this goal as a smoking prevalence of 5% or less.’ The number of smokers who want to give up is (allegedly) 69 per cent of smokers. That means that 31 per cent of smokers want to keep smoking. There’s a big gap between 5 per cent and 31 per cent! Are we to assume this is natural wastage or that some coercion is going to take place?

  2. Thanks for the comment Belinda. ASH Scotland is not in favour of coercing people into quitting. As you note, most surveys show somewhere between two-thirds and three quarters of current adult smokers say they would like to quit. Supporting these people to achieve their aims, and persuading young people not to start, is how would like to make progress towards the 5% target.

    Regarding the 31% v 5% issue – 5% relates to the prevalence of smoking in the whole population. 31% relates to prevalence of ‘not wanting to quit/showing no interest in quitting’ within smokers (who are about 23% of the Scottish adult population). So actually, 31% of 23% of the population – or about 7% of the population – are smokers who currently don’t want to quit.

    Viewed in this way, achieving the target without coercive approaches seems reasonable and worth striving for.

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