TOBACCO POLICY SPECIAL
Professor John Britton, chair of the Royal College of Physicians (RCP) Tobacco Advisory Group, spoke to NHE about smoking cessation – and the failure of the Government to properly fund health promotion messaging on tobacco.
S
moking kills people in lots of different ways – but the often fatal consequenc-
es of the breathing and lung problems caused by tobacco are often less well known by smokers than cancer and heart disease.
Many smokers know first-hand about the breathing difficulties that smoking causes, but few realise how often these become completely debilitating and life-threat- ening, such as with chronic obstructive pulmonary disease (COPD). An estimated 2.8m people have COPD – but fewer than a million have been diagnosed.
There are campaigns going on now to try to educate smokers on this topic (see pag- es 20-21 of this issue of NHE for more on Fresh’s ‘Every Breath You Take’ initiative, for example).
Speaking out
Professor John Britton, Professor of Epide- miology and Head of the Division of Epide- miology and Public Health at Nottingham University, chairs the Royal College of Phy- sicians (RCP) Tobacco Advisory Group and is director of the UK Centre for Tobacco Control Studies. He acknowledges that few smokers know much about COPD espe- cially, which he has branded a “cruel and progressive disease that ruins lives”.
He told NHE: “Smoking kills almost as many people through COPD as it does from lung cancer – it’s a big problem.”
Health professionals must have a role in trying to impact tobacco policy and legisla- tion, he said: “If you see that a disease is be- ing caused by something that could easily be prevented by a more logical policy, then it makes sense to say so.”
Steady progress
The Royal College of Physicians has three main priorities on tobacco: protecting children from passive smoking by driving down the prevalence of smoking in adults; plain packaging for tobacco products to remove “the last vestiges of promotion of cigarettes to young people”; and better nic- otine regulation to reduce harm, essentially by reforming medicinal nicotine product regulation to develop more effective and
22 | national health executive Nov/Dec 11
He said: “We’re making progress on smok- ing substitutes, because the MHRA and the Cabinet Office Behavioural Insight Team and NICE are all looking at harm reduction strategies. There is progress being made there, but it’s still at an early stage.
“Protecting children is gradually happening, but not as quickly as it should do. The best way to protect children is for adults to stop smoking, so there is an imperative there.
“Much of the advertising has been closed off, but plenty hasn’t, such as point of sale, which the Government has delayed imple- mentation of, and placement and use on film and television, which is not being ad- dressed.”
‘Missed opportunity’
In terms of getting the message across to smokers, he noted that no one message would work for everybody, explaining: “The important thing is to use as many different messages and media as possible: different smokers are different from each other. There isn’t one ‘button’ you can press which would make everybody say ‘that’s it, I’m going to quit now’. You’ve got to use a whole different range of messages and hope that everybody is affected by one of them.
“Health promotion messaging in tobacco safer cigarette substitutes.
We asked Professor Britton for his analysis on how much progress is being made on these three priority areas.
use has more or less ground to a halt in terms of central Government budgeting. I don’t know what different regions have got, but at national level we’ve had virtual- ly nothing over the last year, to my knowl- edge. I think that’s a huge missed opportu- nity: but then that’s true of tobacco policy generally, which has been weaker since the change of Government.”
Car smoking ban
Since speaking to NHE, Professor Britton has also backed the BMA’s call for a ban on smoking in cars.
He said: “Passive smoking is still a real issue, particularly in children and the vulnerable.
“A recent Royal College of Physicians re- port estimated that passive smoking in children accounted for over 20,000 cases of lower respiratory tract infection, 200 cases of bacterial meningitis, and 40 sud- den infant deaths. These and other ill- effects generate over 300,000 UK GP consultations, about 9,500 hospital admis- sions, and cost the NHS about £23.3m.
“The RCP believes smoke-free legislation should be extended to prohibit all smoking in cars and other vehicles. Governments and indi- viduals have a duty to protect children from exposure to smoke and to smoking.”
Prof John Britton
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