How can we end tobacco use in the UK? Research from the Tobacco Control Research Group has been helping to hold the tobacco industry to account and supporting policy change for over 10 years. On World No Tobacco Day 2021, we consider the current status of smoking in the UK, and outline how our research can continue to contribute to change.
In 1962, the Royal College of Physicians (RCP) published a ground-breaking report called Smoking and Health. In a UK population of 56 million, just over 50% of men, and just under 50% of women, smoked cigarettes, and tobacco smoking was the leading cause of avoidable premature death and disability in the UK.
The 1962 report set out a series of recommendations on tobacco control for government, but progress was slow. In 1971, the RCP set up Action on Smoking and Health (ASH), to push for decisive action. Eventually, the combined pressure of academic research and advocacy led to a world-wide response, with the introduction of the World Health Organization’s (WHO) first global health treaty, the Framework Convention on Tobacco Control.
The costs of tobacco
Since then, the UK’s population has increased by over 10 million, and smoking rates have dropped significantly, yet tobacco is still the leading cause of avoidable premature disability and death, with 2020 seeing 94,000 tobacco-related deaths in the UK. This is more than the other top four preventable causes of death combined (high BMI, alcohol use, low physical activity, drug use). Research by ASH in 2018 reported that smoking costs the NHS £2.5 billion a year, and local authorities over £760 million in social care. Meanwhile, global tobacco companies report revenues in the billions.
World No Tobacco Day
World No Tobacco Day (WNTD) was launched by the WHO in 1987 to draw global attention to the immense harms caused by tobacco. This year’s theme is Commit to Quit, with WHO aiming to support 100 million people to give up tobacco. Summer 2021 should also see the publication of the England’s Tobacco Control Plan which will focus on how to achieve the government ambition to make England smoke-free by 2030.
Supporting people to stop smoking, or never to start, is key to reducing the social and economic burden of tobacco. But to underpin these efforts, there needs to be a solid policy agenda which enables effective tobacco control. And one of the biggest barriers to making this happen is tobacco industry interference.
Tobacco industry tactics
For over a decade, the University of Bath’s Tobacco Control Research Group (TCRG) has been drawing attention to the tobacco industry’s attempts to weaken, block and delay tobacco control measures. Through its years of academic research, and its investigative work on Tobacco Tactics, TCRG has identified numerous strategies used by the tobacco industry to disrupt tobacco control, including:
- Information management, where the industry attempts to control the narrative around proposed policy measures. With the implementation of plain packaging, for example, the industry formulated its own evidence to counter the proposals and tried to discredit independent research showing that plain packaging works to reduce tobacco use.
- Coalition management, where the industry uses organisations or individuals that it funds to make its arguments seem more credible. They act as media spokespeople and give the false impression of widespread opposition to proposed policies.
- Direct lobbying and influence on policy making – and the current UK government is, arguably, the most tobacco friendly in decades.
- Stoking fears about illicit trade, and its likely rise in response to increased tobacco control measures, despite evidence showing the industry has itself been complicit in tobacco smuggling.
The Global Tobacco Index measures how successful governments are at preventing the tobacco industry from disrupting policy. In 2018, the UK was top of the list, but in 2019/20, it dropped to 4th. This shows that counteracting industry tactics is a constant battle – and this has become particularly significant during the Covid pandemic, when we have seen the tobacco industry take advantage of a public health emergency to move closer to governments, delay legislation, promote “safer” products, and even encourage the publication of subsequently discredited research.
What can be done to counteract these tactics, so that the policy environment is robust enough to support public health ambitions to make tobacco obsolete? TCRG research continues to address these challenges, for example by:
- Understanding how taxation can be used to regulate pricing and influence purchase decisions
- Showing how the industry uses “front groups” to undermine publishing policies and share their own material via academic journals, and raising awareness of these groups and how they operate
- Demonstrating how the industry tries to circumnavigate product control by introducing special features and flavourings
- Working with partners to expose industry lobbying of national and international governments
Special recognition award
TCRG’s work has been recognised this year with a special recognition award from the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, presented as part of the WNTD 2021 Awards. The Director of TCRG, Professor Anna Gilmore, is part of the RCP’s Tobacco Advisory Group, and, along with colleagues in the Group, contributed to the RCP’s most recent report, Smoking and Health 2021: A coming of age for tobacco control? The new report considers what has changed in terms of tobacco control, and what still needs to change, since its first report almost 60 years ago.
It is hoped that TCRG’s research will help realise the recommendations in Smoking & Health 2021, to support a more ambitious tobacco control plan that finally ends tobacco use in the UK.