The Scottish Government has declared a vision for Scotland to be “tobacco-free”. Some people worry such a shift cannot be delivered by free actions, and will require some form of coercion to drive it along. That’s not how I want to do it – and looking at the numbers we can clearly see that’s not how it has to be.
The tobacco-free target is defined as reducing the adult smoking rate to 5% by 2034. It does not mean nobody smokes.
The smoking rate currently stands at 21%, suggesting the tobacco-free goal might be some way off and will require some serious shifting to get us there. But, crucially, a consistent two-thirds of Scottish smokers say that they want to stop. This means that the actual willing adult smokers are just 7% of the population – and nearly 90% of the journey to this tobacco-free Scotland is helping those smokers who actively want to be free from their addiction. Who could argue with that?
So the number of willing smokers is small and getting smaller – that 7% figure is down from around 10% in 1999. At the current rate of decline it will drop below 5% before 2034 – so that a Tobacco-free Generation really is about setting people free from tobacco. This vision is not about banning smoking, but about protecting children and helping those smokers who wish to stop. It reduces smoking to the small number of adults who actively choose to do so.
The complicating factor is of course that smoking is addictive and many (although not all) who want to stop find it difficult to do so. This is why we need new and better systems of support.
Most smokers who quit do so on their own, often finding it easier than they thought they would. We all know smokers who want to quit so let’s get that message out and encourage them to give it a go. If they relapse then let’s reassure them that this is not failure but a normal part of the process.
Others find quitting more difficult. And for these people continued funding of NHS Stop Smoking Services, which greatly increase their chances of success, is a proven and cost-effective use of scarce public funds.
But with so many people, mostly from disadvantaged groups, paying a high price for an addiction they don’t want to have we also need to look beyond the health message and to involve poverty and equality interests. When the financial costs of being addicted to smoking are so high, why is stop smoking support not a central concern for debt advice services and citizens advice bureaux? When smoking is so intricately bound up in mental health problems, and the single biggest factor in this group dying 10-20 years early, why is nicotine management not at the heart of support provided to this group?
Any support organisation engaging with disadvantaged groups will be supporting a population that is disproportionately, and unwillingly, affected by smoking. To make Scotland tobacco-free, as both government and people wish, it’s time to integrate stop smoking support across the wide range of support services. Mainstreaming support for those who want to stop smoking is the best way to help smokers achieve the freedom from tobacco they consistently say that they want.
This is a shortened version of an Agenda piece which originally featured in the Herald.