The concentration of smoking in disadvantaged groups can lead to a perception that we have just seen the lighter, less addicted smokers quitting, leaving behind a more hardened and committed smoking population who will resent or resist interference.
This pessimistic view would suggest that further reducing the smoking rate will get harder. But is it justified?
Of course if we want to know what smokers think we should ask them, as the Scottish Health Survey does every year.
So I was interested to see the answer to a Parliamentary Question tabled by Maree Todd MSP setting out how smokers’ views on wanting to quit have changed over the years. If we are seeing a hardening of views then the number of smokers saying they want to stop should decrease over time.
What the survey actually shows is that 70% of smokers say that they want to stop, exactly the same proportion as when the question was first asked back in 2003. It is striking that this figure has held up over a period when the overall number of smokers reduced by a quarter (from 26.9% to 21%).
If, as we might expect, it is the smokers who want to quit who are most likely to do so, that means those who continue to smoke are also changing over time – with more of them deciding that they want to quit.
The Scottish Health Survey also asks how many cigarettes each individual smokes every day. Again if the population is reducing to a hardened, committed core then we would expect this number to increase over time. Yet smokers tell us that the opposite is true, with the average daily number of cigarettes smoked falling steadily from 16.8 in 1995 to 12.6 today.
All this suggests that although the smoking population is more skewed towards disadvantaged groups, there are fewer smokers, they smoke less and most of them want to stop.
The health, social and financial costs imposed by smoking are all too familiar. What we need to shout from the rooftops is that generally these costs are reluctantly carried by those who can least afford them.
Helping people in disadvantaged communities who want to stop smoking is a matter of social justice.