BBC BLOGS - Fergus's Medical Files
« Previous | Main | Next »

Can smoking be stubbed out?

Fergus Walsh | 20:32 UK time, Wednesday, 9 March 2011

Cigarettes on display in a shop

I have just spent the day in Blackpool which has the highest rate of adult smoking in England. Here, 35% of adults smoke, compared with 21% across England as a whole.

If smoking is to be stubbed out then something drastic needs to happen in this seaside town.

I was also staggered by the news that one in three pregnant women in Blackpool smoke - twice the national rate.

We met two mums who smoked while pregnant. One said she was devastated when told her daughter's low birth weight was down to her smoking. But she has still not kicked the habit.

Most smokers here told me they started aged 13 or 14 - one man said he was 10.

Why is smoking so prevalent here? It is a deprived area with high unemployment.

And put simply, poorer communities smoke more than affluent ones.

"A Smokefree Future", published in 2010, said that until the mid-1950s, socio-economic groups smoked at similarly high rates. Since then, as evidence has emerged of the harm it causes, a wide gap has emerged, and tobacco use is now said to be the primary reason for the gap in healthy life expectancy between rich and poor.

People from disadvantaged groups are less likely to give up than the more affluent or educated. Children often follow the patterns of behaviour set down by their parents and peer groups. It is this cycle of smoking and ill-health that tobacco control strategies need to address.

And Blackpool says it is trying to fight back. Its "Altogether Now" strategy is aimed at encouraging residents to improve their health. The premiership football ground is completely non-smoking and the players are health champions.

Any smoking reduction strategy has to be geared towards the young - around 200,000 young people take up smoking in England each year.

In that vein, the ban on tobacco displays was welcomed by NHS Blackpool.

Jane Roberts, head of tobacco control, said: "Cigarettes are not like Mars bars - children should not see them when they walk into a shop."

She said removing displays would also help prevent impulse purchases by smokers.

But smokers were more dubious about the suggestion that tobacco should be sold in plain packaging.

One worker in a hard hat summed up the mood: "It would not stop me from smoking. I do it because I like it. Plain packaging won't make any difference."

But some did think that removing the brightly coloured logos and trademarks might deter the young.

The government says it has an open mind on plain packaging, but the idea has now gone out for lengthy consultation.

The tobacco industry would fiercely oppose any further restrictions on the sale of what is, after all, a legal product.

Some argue that the measures are another sign of the nanny state in action.

Britain has come a long way since the heyday of tobacco in the late 1940s when eight out of 10 men smoked.

When I first worked at Broadcasting House in London the newsroom had a constant fug of cigarette smoke. I remember one brilliant writer who used to light up a cigar each afternoon as he prepared to dictate the headlines to a typist.

Smoking on the Underground, in planes and in coaches was permitted and tobacco advertising was everywhere. Now you can't light up in a pub or workplace, and a ban on sales of cigarettes from vending machines is due to come in later this year, subject to a legal challenge.

A lot has changed - but 100,000 people in Britain still die from smoking-related causes each year.

The statistics are sobering. One in two life-long smokers will be killed by their habit. Sadly, my mother was one of them.

De-normalising smoking is a key part of discouraging the young from taking up the habit.

And if smoking rates do come down further it will have a dramatic benefit on the health of the nation.

Comments

or register to comment.

  • 1. At 9:45pm on 09 Mar 2011, John Ellis wrote:

    To take this problem to hand properly we need to start with the people whom make the tobacco products and what actually goes in the mix to flavour it. the process must be as passive as it it responsive to the public who use tobacco products.

    We have strived over the years to clean up all types of harmful emissions from what we do. Cars, planes, houses all modified to suit the current health thinking. yet we do not do this with such a social harmful drug as tobacco?

    It would be interesting to see data from the raw tobacco used before processing to the end result on toxicity and chemical content and then see were these can be modified or altered to reduce harm from toxic materials within the smoked product. If such things were undertaken a lot of the harm from smoke could be eliminated making the product less harmful while working with traditional methods of harm reduction.

    Then we come to package.......
    Tobacco is essentially a currency when it comes to identification and fraud. How will the retail/black markets mingle with no true form of identification that current modern packages have? holographic labels etc are the only thing that would identify a product after the change to the blank pack. I believe the current market of illicit/counterfeit tobacco is 1 billion with only packaging standing as the means of identifying real from fake.

    Complain about this comment

  • 2. At 10:04pm on 09 Mar 2011, tom_p_willis wrote:

    Another option would be make tobacco illegal. Any existing users would be declared addicts, and get their tobacco from the NHS at the current cost. Then there would (hopefully) be no new users.

    Complain about this comment

  • 3. At 11:06pm on 09 Mar 2011, John_from_Hendon wrote:

    Here is a why not....

    Why not require a certificate of private health insurance to be presented prior to each purchase of any tobacco product. Such insurance to cover all treatment of any illness that might be caused or aggravated by smoking or being the cause of an illness is others possibly caused or aggravated by passive smoking. Also make it illegal to buy any tobacco product not for one's own use. And such insurance certificate shall be presneted for inspection to any authorised person if the possession of any tobacco product is suspected and then found to be being carried or stored in any property owned or controlled by a smoking suspect.

    The logic is that smokers personally pay the price for their own choices.

    Passive smoking also needs to be curtailed: so ban smoking in public, in vehicles, at sea etc. even if the only person present is the smoker.

    Smokers could then kill themselves with their vile addiction, but not be able to harm others either financially or health-wise.

    The problem with all these ideas is that there will be a black market in tobacco and criminal gangs will make huge criminal profits! (See Prohibition.)

    Alternatively perhaps we could put something in the water (or more rationally the cancer sticks / coffin nails) that made smokers violently sick every time the took a puff (or in every twentieth fag)!

    Smoking is an addiction, a physiological and emotional addiction so draconian steps will never be completely successful. However we must dissuade the young from taking up the filthy habit so plain packaging is a good idea.

    One last wheeze - once we have plain packaging compel manufacturers to put parts of diseased cancerous lungs randomly in every tenth packet rather than their evil product! Then show adds of smokers opening such packets in situations where they are trying to be sophisticated.

    Complain about this comment

  • 4. At 11:13pm on 09 Mar 2011, John Ellis wrote:

    Tom I'm sure gardeners around the UK would love you for that suggestion tobacco plants are very good for black fly infestations. Nicotine is used as a pesticide as well on certain crops.

    It has its place in the natural world and gardening and farming much like the opium poppy which will grace the gardens of the UK this summer. Its how we use it that the problem.

    Complain about this comment

  • 5. At 02:12am on 10 Mar 2011, Paul Punta wrote:

    This comment was removed because the moderators found it broke the House Rules.

  • 6. At 08:46am on 10 Mar 2011, xipde wrote:

    I live in sheltered accommodation and passively smoke all the time as the hallways are not aired I have asthma & it s hell
    But I still dont see the morality of kicking smokers when they are obeying the law - It seems like some dodgy entrapment deal to say "go ahead smoke away! then make them bad guys - The only moral way to do it is to make it illegal. We know that the reason this isnt being done is because of the lost tax revenue and the loss of keeping in with the tobacco companies - Supping with the devil requires a long spoon - But this idea from those who reviled the "Nanny State" is a bit rich -

    Complain about this comment

  • 7. At 09:46am on 10 Mar 2011, John_from_Hendon wrote:

    #6. xipde wrote:

    "The only moral way to do it is to make it illegal. "

    Moral, yes but given the evidence of Prohibition in the USA, not effective. If making things illegal worked we would have no drugs problem. I prefer the option of poring scorn on smokers ghastly habit. Make smokers be subject to sets of practical jokes - for example vile diseased lungs in a packet of cigarettes on a random basis. Illegality with addictive substances only creates a very profitable criminal distribution system.

    I would also hope that smokers were put to the bottom of all heath service queues - or that they should fear that this will happen. You have my greatest sympathy with your sheltered accommodation problem - but I did think that smoking in such places was already banned and if it isn't it should be.

    Complain about this comment

  • 8. At 10:53am on 10 Mar 2011, HardWorkingHobbes wrote:

    the last sentence:
    "And if smoking rates do come down further it will have a dramatic benefit on the health of the nation."

    No it wont, smokers die younger, that is an acceptable fact.
    So if we had a population that didn't smoke there would be far more cases of dementia, alzheimer's and other geriatric illnesses, more cases of parkinsons, arthritis, more cases of hip / knee replacements due to bones wearing out in the older population and all other physical problems due to living in old age.

    The older we get the more medical help we need just to keep going, more is spent on us by the NHS in the last 10% of our life than the preceding 90%. Cancer kills quickly and cheaply (compared to other ailments).

    A non-smoking population is one where the majority is old, frail infirm and requiring a huge amount of NHS resources just to keep going.

    And that’s before you consider the pension cost of everyone living longer.

    Smokers pay a high % of tax and die before they get to reclaim it, for that they should be applauded and have our gratitude.

    Complain about this comment

  • 9. At 11:52am on 10 Mar 2011, Mike wrote:

    I now stay away from the arguments that smoking is bad for you - (same goes for eating meat and dairy) - if they want to feel and look terrible and shorten their life then it's up to them - just keep it away from me.

    Complain about this comment

  • 10. At 11:57am on 10 Mar 2011, eeyore wrote:

    My word. There are some weird and appalling suggestions coming from the holier than thou brigades. Yeah, dried up segments of cancerous lung in plain packets, sold only to those who present private insurance dockets, and then being thrown out of the NHS.

    Its enough to drive one to smoke.

    So what do we do about those who drink too much or are clinically obese. I'm trying to come up with something that beats the gnarled lung ideas, but am struggling. How about some faeces to top of that pint and instead of the odd chocolate spread.

    Enjoy your breakfast JFH

    Complain about this comment

  • 11. At 12:34pm on 10 Mar 2011, Marnip wrote:

    What do you mean the moral thing to do is to ban smoking?

    I don't consider it moral to restrict people from putting anything in their own bodies - and yes, that goes for all other drugs. To me, there is nothing legitimate about prohibition, ignoring all the arguments over its effectiveness. If your own body is not something you have complete sovereignty over, what is?

    Yes, I can imagine the responses this will attract - people pointing out rabidly that it's not just MY body, cigarette smoke affects everyone else and puts a burden on the NHS.

    In anticipation of those kinds of replies, allow me to respond now: We can no longer smoke in public places (even private establishments such as pubs - silly name really) and given the polution in the air from cars and such like, I fail to see how an argument can be made about passive smoking from having a cigarette outside.

    With regards to the cost argument to the NHS, you are creating a slippery slope situation (and not a fallacious one!). The NHS is paid for through taxes anyway, so in all fairness we have a right to use it. More importantly though, if we're going to start using responsibility as a way of assigning costs in national healthcare, are we then to apply the same to heart disease from overeating, diabetes from sugar intake, liver damage through alcohol consumption and so on?

    For the record, I certainly do smoke, but I also play football twice a week, eat healthily and go to gym a couple of times additionally per week. I'm willing to bet I'm in far better physical condition than most of the holier-than-thou lot.

    I ask people to think for one second about how much you value your freedom, and whether you really believe that it's moral to involve yourself in other adults' decisions about their own bodies.

    Complain about this comment

  • 12. At 12:42pm on 10 Mar 2011, Lewis Standing wrote:

    You should see the amount of medical students who smoke, it's enough to give you a brain haemorrhage

    Complain about this comment

  • 13. At 12:53pm on 10 Mar 2011, John_from_Hendon wrote:

    #10.eeyore wrote:

    "My word. ...."

    But why bother about smoking if we are not going to do anything about it? You get the point I think! Smoking hurts smokers and non smokers - you are not going to argue with that are you? It harms the country too via putting excess costs on the NHS which we all pay for. Against that of course it reduces social security and pension costs by killing smokers earlier. Should we stop all cancer treatment for smokers - it makes economic sense!

    It is also silly to equate doing something that is only harmful with doing things that are essential to life but harmful only in excess.

    I had a lovely breakfast of fresh fruit, orange juice and a small quantity of cereal, thank you for asking.

    How would you get addicts away from their damaging addiction, or wouldn't you bother? If you wouldn't bother how does that equate to the big society!!!!

    Complain about this comment

  • 14. At 12:57pm on 10 Mar 2011, John_from_Hendon wrote:

    This comment was removed because the moderators found it broke the House Rules.

  • 15. At 1:04pm on 10 Mar 2011, John_from_Hendon wrote:

    #12. Lewis Standing wrote:

    "You should see the amount of medical students who smoke, it's enough to give you a brain haemorrhage"

    Quite true! There is I think something rather pathetic in the personality of many doctors, and indeed dentists. They do not heed their own advice. One only has to look at the older membesr of the trades to see that! Many wouldn't pass a medical! (Unless it is fiddled by one of their pals!)

    Complain about this comment

  • 16. At 1:11pm on 10 Mar 2011, 151179 wrote:

    10. At 11:57am on 10 Mar 2011, eeyore wrote:

    "So what do we do about those who drink too much or are clinically obese"

    Here's a radical thought - how about leaving them in peace to make their own adult decisions too? Why do the pro-smokers / drinkers always have to resort to throwing other groups (usually the 'fatties') under the bus by claiming their digressions are somehow worse when surely it would be more productive for everyone whose lifestyles are under attack by a resurgent Bully State (sorry 'nudge agenda') to unite and fight some of these proposals?

    We all pay taxes. Smokers and drinkers more than fat people, but even then far more of us work (and hence contribute through NI) than the media witch-hunters would have you believe. This argument aside, being fat doesn't in any way affect thin people, unless they've managed to have their apparent right to not have to look at us in the street supported by Govt and I don't think even this bunch of lifestyle fascists would be able to justify that. There are existing laws to protect sober members of the public from drunken / disprderly behaviour, attacks on NHS staff etc, they're just not enforced. Ditto those intended at preventing non-smokers unwillingly breathing secondhand smoke, which is the point at which a ceasefire should have been called in the war on smokers.

    It is not the job of Government to protect us from ourselves, particularly in a society which offers diminishing rewards and for most the prospect of a drawn out, poverty-stricken old age which (as we're constantly being reminded in another divide-and-rule tactic) will still cost the working population a fortune.

    In particular this nasty little compound word 'denormalisation', the buzz-phrase of the new politics of behaviour manipulation or 'nudge' terrifies and angers me in equal measure because it's basically a more palatable synonym for 'state-sponsored stigmatisation'. The use of social mores and the deliberate stigmatisation of those who refuse to conform (basically fat people, smokers and drinkers) is the central theme of the Fib-Cons' public health strategy and frankly it's sinister, Orwellian and has no place in a modern social democracy, particularly when there is considerable research in the public domain which suggests that many of the supposed health effects of 'obesity' can also be corellated with the stress and loss of self-worth generated by the sort of discrimination and prejudice which (despite paying lip service to the entirely incompatible area of psychological wellbeing) this Govt apparently want to see a lot more of. There have been many historical instances of regimes (normally totalitarian ones) mobilising media and social pressure against those it has deemed in some way 'undesirable' - they've never ended well and I can't see how this will either.

    Today plain packaging on cigarettes, calorie counts on menus and minimum prices and health warnings on alcohol. Tomorrow compulsory 'fat camps' and the prohibition of smoking and booze? Japan fines people whose waist sizes exceed a certain, predefined limit; Singapore separates out the fat children in a class and makes them exercise in front of other students in an effort to 'shame' them thin. Neither society tolerates smoking, drinking, or for that matter most other forms of 'difference' and nonconformity, but then they don't have our traditions of tolerance and eccentricity. We on the other hand should be dragging ouselves away from the media propaganda / distraction machine and fighting to protect these things.

    Are we headed toward that Brave New World-esque society? The one thing that has become clear about the public health lobby is that they are driven by dogma and never, ever satisfied - they see the 'success' of one measure as the green light to then agitate for something more draconian and so on. Civil liberties, individual choice and the once accepted idea of treating people as rational adults capable of making their own health decisions are absolute anathema to the likes of the National Obesity Forum, CASH, ASH, Alcohol Concern and the myriad other pressure groups whose ability to 'demand' laws and policies suggests they now enjoy power on a par with any Governmental department.

    Complain about this comment

  • 17. At 1:56pm on 10 Mar 2011, Alastair wrote:

    JFH spewed:

    How would you get addicts away from their damaging addiction, or wouldn't you bother? If you wouldn't bother how does that equate to the big society!!!!

    ----------------------------

    I'm no smoker but holier-than-thou rants like yours certainly makes me almost want to. Your attitude is shameful, it really is. What about free choice? people are entitled to it, as long as its the same as yours eh?

    If people want to smoke, let them smoke. It's already banned inside, so i don't have to breathe in their fumes. They're taxed up the wazoo and more than cover the costs of any medical costs they may incur over the years as well enough to cover other people as well if you run the numbers, Packages are about to be banned on public display. Not Draconian enough for you though eh John? After having the misfortune of reading your posts i'm glad you are no where near a position of legislative power, where would you go next after you've 'rightfully' done in a sub-group you don't like? People like you always find someone to point that oh so judgemental finger at, maybe you should try pointing it at yourself.

    Complain about this comment

  • 18. At 2:04pm on 10 Mar 2011, DanielNB wrote:

    @Fergus, am I reading those figures correctly? If 35% of adults in Blackpool smoke then presumably roughly a third of the adult women smoke? Now if 1 in 3 pregnant women in Blackpool smoke, which of course is also a third, are you saying that none of the women in Blackpool who smoke actually quit during pregnancy?

    Complain about this comment

  • 19. At 2:16pm on 10 Mar 2011, Ivan Denisovich wrote:

    For some time now I have been concerned about the BBC’s track record for impartially in its reporting of health issues in general and smoking in particular. This item may give us a clue in that a senior reporter reveals his passionate dislike of smoking and gives us some insight into his reasons.

    This is fine as it is an editorial piece and it is fair and reasonable for him to express his opinions. What is not fair or reasonable is his statement of opinion as fact or the use of dubious statistics supports his case. For example, I challenge Fergus to justify his claim that it is a fact that 100.000 people die of smoking related causes each year with evidence from an objective source. My concern is that this slack attitude to the use of statistics spills over from editorial content and influence the way that the BBC reports the news.

    From a personal perspective, I fail to see why we are so obsessed with forcing people to die in ways that Fergus and his medical friends approve of. Death is not avoidable and I would say that the health of the nation is measured in things much more important than disease statistics. One of the most worrying indicators of the sickness of our society is the fact that a senior BBC reporter feels that it is OK to use the Orwellian term de-normalise with reference to 10 million of his fellow citizens.

    Complain about this comment

  • 20. At 3:32pm on 10 Mar 2011, John_from_Hendon wrote:

    #17. Alastair wrote:

    ""JFH - How would you get addicts away from their damaging addiction, or wouldn't you bother?"

    What about free choice?

    What rubbish you write. It is established beyond any doubt that smoking kills many people is an uncomfortable and painful and costly way. Have you overlooked this fact!

    If we do not strive by all means at out disposal to resist this addiction we are no better than the paddlers of the deadly weed. Is that your position? - I'm all right jack and as for the rest of you I don't give a toss? If it is please say so. Your libertarian nonsense destroys lives and it does it painfully and often tragically - but that is your idea of a good thing!!!! I have watched too many lives cut short in agony in hospices, unable to breath and with bodies riddled with cancer and perhaps most tragically seen their parents and children weeping over their coffin. But you don't care do you!

    Complain about this comment

  • 21. At 3:49pm on 10 Mar 2011, John_from_Hendon wrote:

    #17 Alastair, (continued)

    I've just scanned back through your positing since last July and from my perspective you are entirely self-centred and do not show any feeling or shared responsibility for your fellow man, or indeed woman. Your criticise every attempt to tackle any issue, without offering any suggestions. In short your attitude to any suggestion on anything is negative. I'm sorry that you lost your job a while back and I wish you success in finding another, if you haven't done so yet, but try to be kinder to your fellow man and try to see the World through their eyes. I am also sorry that you voted Tory, as they have been a disappointment to you!

    Your attitude to smoking is just the same as you attitude to drugs. Nothing to do with me and so I don't care. But you should.

    Complain about this comment

  • 22. At 4:13pm on 10 Mar 2011, Mike wrote:

    Very interesting on the 'health experts' that smoke and I would agree the that the vast majority of doctors, nurses and consultants are hardly physical role models. Obese, smokers & drinkers. I'd never go to a doctor for advice of health, fitness or diet. They don't walk the walk.

    Complain about this comment

  • 23. At 4:23pm on 10 Mar 2011, Mike wrote:

    JFH

    Totally agree with you. People who smoke don't care about their health. There's already tons of information out there. The answer is to make it impossible to smoke or buy cigarettes. Who in the right mind would want to inhale smoke into their lungs anyway and smell like an ashtray. And anybody who smokes in front of children should be had up for child abuse.





    Complain about this comment

  • 24. At 6:29pm on 10 Mar 2011, Ivan Denisovich wrote:

    I think that I understand what Fergus is intending when he says de-normalise but surely he understands that you cannot de-normalise an activity that is as common and as long standing as smoking without de-normalising the people partaking in that activity. And by de-normalise we really mean ostracise, stigmatise and ridicule because the reality is that 10 million UK citizens are now exposed to the vicious hatred expressed by anti-smokers who feel that it is now OK to use words like vile and filthy to describe smokers or to accuse them of being child molesters.

    You only have to read he comments on this blog or any BBC HYS on this subject to see the depth of hatred and contempt with which some people regard smokers. I am not a smoker but to read such bile and vitriol upsets me deeply and I cannot help but think that people only think it is acceptable because the process of de-normalisation makes them feel that they have the backing of medics, politicians and now it would seem, key employees of the most important media outlet I can think of.

    De-normalising may well help reduce the number of lung cancer deaths in the UK but is that the only measure of the health of a nation? Surely it can’t be right to foster hatred and social division in this way?

    Complain about this comment

  • 25. At 08:43am on 11 Mar 2011, Grey Animal wrote:

    One thing that we might do to improve matters is to combat the widespread notion that it is extremely difficult to stop smoking. I know so many people (for years I was one of them) who are discouraged from attempting to give up because they believe that they're almost certain to fail.

    Last year I decided that I was going to stop smoking. I did the research, and found that the most effective way currently known is to use a nicotine agonist medication (varenicline) with weekly support sessions from a smoking cessation team. I chose not to use nicotine replacement products as I didn't want to stay hooked on nicotine, coupled with the fact that they don't appear to be as effective.

    Even with this, when I did my self-assessment at my first session with my cessation advisor, I could only rate my confidence of being able to quit at 2/10.

    The first couple of days after quitting were uncomfortable, but were nowhere near as unpleasant as I'd imagined they would be. Even now I still get the odd, occasional nostalgic moment of missing smoking, but with time they have become steadily less frequent and less intense.

    If I'd known how easy I would actually find it to quit, I think I would have done so years ago. Instead of berating people for smoking, we should be supporting and encouraging them to quit at every opportunity we have.

    Complain about this comment

  • 26. At 10:11am on 11 Mar 2011, Mtwain2011 wrote:

    Fascinating piece of information !

    But how shocking was it to know that a mom was just not able to withhold her smoking habits until she had delivered; and that for the sake of her baby - a child that is yet to see this world. Ridiculous, to say the least.

    It is more than true that the hazards of smoking are more prevalent in the poorer and disadvantaged groups. Also banning the eye-catching contents on the packets and other advertising strategies of these harmful products can do wonders in reducing smoking activities, especially in the young ones . While I am not sure of the same in the case of a life-long user, it would at least do well to stop a new joiner.

    As long as smoking is legal, it would continue to be a person's personal choice as to whether he wants to take it up as a beginner or give it up as a long-time smoker. But the simple and the most baffling question that might occur often in one's mind is “ WHAT IS WRONG IN BANNING SOMETHING THAT IS INJURIOUS TO HEALTH ?”

    Perhaps the act of drinking also has got its own misfortunes.

    Another idea that comes up to my mind is to increase the cost of these health-injurious things. Do it in such a way that only the rich can afford to use it regularly, since your study states that “the well-to-do citizens have good control over their smoking habits.

    But nevertheless, your piece of article is simply wonderful. Hats off to you!

    Complain about this comment

  • 27. At 10:14am on 11 Mar 2011, Megan wrote:

    Perhaps some proper science might help persuade people - the dodgy statistics and lying propaganda currently peddled as 'health promotion' doesn't convince anyone, and make it easy to ignore.

    Smoking does not CAUSE lung cancer. It can be a contributing factor, smokers may more likely to contract it... but nobody yet knows the actual cause let alone how to cure it, so the blatant lies told serve only to annoy and bring the whole health promotion industry into disrepute.

    Complain about this comment

  • 28. At 11:22am on 11 Mar 2011, Robert Simpson wrote:

    The general contempt for the idea of individual liberty, responsibility and autonomy is, frankly, sickening.

    For the those endorsing the idea of prohibition I would point to the current drug policy which is quite literally more damaging than the drugs themselves. Making something illegal doesn't make it go away, it just means the industry is unregulated and in the hands of the unscrupulous. Heroin for example in its pure form is relatively benign to the body, addictive yes, but not overtly damaging. But because of prohibition its cut with things that ARE damaging and because of variations in purity people are dying of overdoses.

    Lets look at that objectively; because a substance has been decreed a risk to put into your body you put in place a system that INCREASES the risks associated with using that substance? How is that *moral*, ethical or even sane?
    A far more rational approach would be to legalise, regulate and tax set to cover the social costs of that substance. Educate by all means but if people chose to do it RESPECT that choice and if people decide the need help to stop then the tax money gained can be used for exactly that purpose.

    However, rational thinking and the healthy lobby and clearly not on speaking terms. The healthy lobby to varying degrees is on a crusade; live as they decree or face denormalisation.

    Complain about this comment

  • 29. At 11:48am on 11 Mar 2011, Ivan Denisovich wrote:

    @Mtwain2011 reminded me of that lifelong unrepentant smoker Mark Twain who in a letter dating back to 1870 said:

    “...when they used to tell me I would shorten my life ten years by smoking, they little knew the devotee they were wasting their puerile word upon -- they little knew how trivial and valueless I would regard a decade that had no smoking in it!”

    Mark Twain died in 1910 and in the vibrant real world is regarded by many as a literary genius. In the dull world of the anti-tobacco lobby he is a statistic contributing to the convoluted torturing of numbers that lies behind Fergus’s statement that “One in two life-long smokers will be killed by their habit.” He died of a heart attack which makes him a candidate. The fact that he was 74 at the time, relatively long lived for his generation and that the link between smoking and heart disease is not well understood are of course irrelevant to those more interested in snappy sound bites than scientific accuracy. Fergus may be right but we have no way of knowing so the claim and its implication that those one in two people would have lived if they hadn’t smoked is really a statistical sleight of hand.

    “I don't want any of your statistics; I took your whole batch and lit my pipe with it”
    Mark Twain

    "If your result needs a statistician then you should design a better experiment."
    - Ernest Rutherford

    Complain about this comment

  • 30. At 01:09am on 12 Mar 2011, britbox wrote:

    100% of people die. That's the most important stat everyone overlooks.

    Smoking is not a healthy option, neither is drinking, eating red meat, paragliding, running with scissors....

    Lifestyle choices. Give me a lifestyle choice over an extra 5 or 6 years anyday.

    I trust all these houlier than thou non-smokers don't drink, because in 30 years time you'll be the next bunch under siege, with people quoting missed working hours, domestic violence, lack of libido, policing costs etc... They've already started, I kid you not. Last one standing, turn off the light.

    Complain about this comment

  • 31. At 08:46am on 12 Mar 2011, Flor wrote:

    Tobbacco and related products have given sucessive governments huge returns in taxes. Current NRT treatments provide pharmaceutical companies with large profits despite some statistical returns suggesting that the fail rate for NRT is as high as 94%.

    This week a report into the regulation of electronic cigarettes concluded that there was insufficient evidence of is side effects or otherwise to ban electronic devices or the liquid nicotines it utilises, and there will be further research undertaken over the next 18 months.

    From a personal and general observation of electronic cigarettes I have noted that the ability to duplicate the sensation of smoking and to have control over the amount of nicotine taken, gives a higher rate of success. Many who use and trade in these devices are concerned that the large pharmaceutical and tobacco companies are standing by ready to pounce on the electronic cigarette market and thus push its availablity and cost far from the people who currently use them.

    It is sad that the revenue from tobacco has increased over the years whilst the solutions have not been effective nor equally finacially beneficial for the government.

    I meet many people who have been given free NRT treaments on the NHS. they can glibly reel off a list of several products they have been given to try and conclude with "Didn't work". I have also met perhaps one hundred or more people from all over the UK and hundreds more via the internet worldwide, who conclude that using electronic cigarettes has allowed them to live a healthier and better quality of life without sacrificing the enjoyment they had from smoking. These individuals have sourced and obtained their own smoking cessation products and are happy to continue to do so.

    Perhaps the government could take a leaf from their book and offer a little help with something that is seemingly working for a lot of people worldwide.

    Complain about this comment

  • 32. At 4:10pm on 12 Mar 2011, Megan wrote:

    Interesting thoughts on the 'electronic cigarette' - my dearly beloved, who smokes, has commented that it is not purely a physical addiction to nicotine that he notices when he tries to cut down, but the need to do something with his hands and mouth.

    He's found one solution for occupying his mouth, but only feels comfortable when in private... he sucks on a dummy (pacifier)!

    Complain about this comment

  • 33. At 6:19pm on 12 Mar 2011, gedarnet wrote:

    Really well done
    I wish all the more fun and interest
    Accepted traffic and greetings

    Complain about this comment

  • 34. At 11:10am on 13 Mar 2011, grim wrote:

    Through taxation smokers make a major contribution (over £7 billion) to the economic health of the nation, far in excess of the cost (estimated to be £1.5 billion) of treating so-called 'smoking-related diseases' on the NHS.

    Complain about this comment

  • 35. At 9:27pm on 13 Mar 2011, grim wrote:

    The World Health Organization's first study on SHS is a textbook example of the right way to conduct an epidemiological study. Unfortunately for them, it yielded unexpected results.
    Fact: The press release doesn't mention the one statistically significant result from the study, that children raised by smokers were 22% less likely to get lung cancer.

    Complain about this comment

  • 36. At 11:45am on 14 Mar 2011, Jaytack wrote:

    Sorry MIKE, there is no evidence that eating meat and dairy is bad for you. That is the general belief but our ancestors survived for 2.5 million years eating only meat, fish, eggs and nuts/berries etc. We know without doubt that smoking is bad for the health of the consumer and anyone nearby.

    The way to stop the smoking is to increase the tax on tobacco by 10% every year for the next 10 years and, at the same time, reduce the allowed amount of tobacco importation by 10% every year. By 2022 we should have tobacco very difficult to obtain and extremely expensive.

    The EU has just banned the use of herbal health remedies and will be severely restricting the levels of vitamins and minerals that can be purchased. They ecourage bad habbits because they attract tax revenues and then discourage good habbits because there is no tax income! Add to that: governments will not stop dentists putting mercury in your teeth despite it being the most probable cause of Alzheimer's disease.

    What a world.....
    JJ

    Complain about this comment

  • 37. At 8:46pm on 14 Mar 2011, Garry Knight wrote:

    Please stop using the word "habit". It's a drug addiction. And it needs to be treated like a drug addiction, with both withdrawal treatment and psychotherapy to deal with the underlying pathology. Until this happens the problem will continue.

    Complain about this comment

  • 38. At 9:45pm on 14 Mar 2011, John Pembridge-Hore wrote:

    I am a Certified Hypnotherapist based in West London.
    I am currently studying for the world’s first Bsc in Clinical Hypnotherapy, at St Mary’s University College Twickenham. I will then continue onto to a Master in Sports Psychology then complete a PhD in Positive Psychology. Specialising in PTSD and sports psychology.

    Hypnotheray has been proved to be the quickest and most effective way to give-up smoking, I believe if you smoke or drink excesively you should need insurance for any treatment you get related to these two well known problems causing activities. with the advent of the web and 24 hour instant news ignorance or stupidity is no excuse for doing things that will cause you permanent longterm health issues. any other potentially dangerous activites people would not think twice about get insurance to cover any problems that may arise during these activities.

    so saying all that do you bloggers have a view about:

    St Marys is sponsoring the world’s first PhD in Clinical Hypnotherapy, and is currently building a purpose built Clinical Hypnotherapy Clinic. I was wondering with the advent of EEG and Brain–Computer Interface (BCI) to prove the immediate and long term benefits of hypnotherapy in treating most psychological conditions, do you believe now is the time for the general public and the media to take clinical hypnotherapy more seriously, and to ensure that this merging field is Government regulated not self.

    As I have seen the power and benefits of effective clinical hypnotherapy on treating people with severe psychological conditions, on the other hand someone can read a book then set themselves up as a hypnotherapist (very very scary)

    I served in the army from 1979 to 1990, and I am bombarding various government departments to ensure that current and past service personnel get the physical and psychological help they need at all times.

    P.S. Numerous research programmes and studies have shown that cigarettes are not addictive just a habit, and to say otherwise justifies to like mined people why they can't give up smoking.

    John Pembridge-Hore

    Complain about this comment

  • 39. At 11:31am on 15 Mar 2011, Roberet wrote:

    very interesting article www.electronic-cigarette.ie

    Complain about this comment

  • 40. At 1:42pm on 15 Mar 2011, Pawan wrote:

    Hi Fergus

    Can I contact you off air regarding a story? We were at school in the same year. I am now a GP.

    Complain about this comment

  • 41. At 5:07pm on 15 Mar 2011, Karen Leader wrote:

    I am a yo yo smoker, in other words after 38 years of smoking I still have the habit. I agree that it is a childhood addiction, which continues or not depending on the social influences and level of addictive personality in the smoker. When I am smoking I am in denial, when I am not smoking I condemn smoking. Even a person who may defend smoking due to addiction surely would not be able to defend it if they are found to have given up smoking and then to develop a smoking related disease or watched a loved one die of any addiction related death. I cannot see how any substance that can lead to addiction that can then lead to detroying a persons health can be promoted to young people who don't yet know their own minds. I am furious that my nephews stand at the school gate and in the uniform in the town smoking under age and NOTHING is done to stop them by higher powers to support the parents. After 21 they may be too sensible to start so you have to 'get them young to get em hooked'. Smokers who already smoke don't need to be persecuted however, as this adds to the loss of hope that surrounds giving up. When smoking was first promoted as 'health giving' I can see why people took it up and kept it up. Now I can see no reason why kids should have any access to cigarettes and the punishments for the parents and the under age kids smoking and drinking, particularly the illegal under age behaviour in public places. Smoking and drinking is not only a legalised health disaster, for alot of young people it is also the gateway to other addictions. The only place to stop smoking starting in the first place is at the school.

    Complain about this comment

  • 42. At 5:30pm on 15 Mar 2011, MrBontana wrote:

    Interesting article. Smoking is one of those health issues that never seems to go away - no matter how many initiatives [Unsuitable/Broken URL removed by Moderator]there are (DoH included obviously [Unsuitable/Broken URL removed by Moderator], the force of the addiction is just too strong in many people. I am not a smoker myself, but many friends and family have tried every method in the book to stop and in the majority of cases they have failed (Chantix was just plain dangerous). Those that have succeeded have done so through sheer personal willpower or attitude change. I wish anyone trying to stop all the best......

    Complain about this comment

  • 43. At 8:15pm on 15 Mar 2011, pdw wrote:

    I smoked for 43 years and quit 5 months ago.

    Why? Not for any of the reasons given by commenters below, but because my doctor told me that if I did not I would develop Chronic obstructive pulmonary disease.

    All the other arguments and suggestions did not affect me because as one commenter said - I like smoking.

    So now I chew the gum instead of smoking. But I am glad I gave up - very hard though it is.

    pdw, Norway

    Complain about this comment

  • 44. At 7:25pm on 17 Mar 2011, haufdeed wrote:

    I have never smoked, and have never felt even the tiniest inclination to start smoking. However (strangely, it appears) I have never had any problem with others smoking. The "statistics" Fergus quotes are just nonsense, in my opinion, ignoring as they do the fact that every human being ever born has died of something, smokers, non smokers, vegetarians, vegans alike.

    As regards costs to the state, if smokers do die early, then they are saving the state a fortune in pensions, care, benefits, etc. Those savings must far outweigh the alleged NHS costs of smoking related illness, and I repeat- these people will die of something,sometime and at that point they will inevitably cost the NHS a fortune.

    So what is all the fuss about? These smokers are adults, if they are given the "facts" and decide to smoke anyway, what is to anyone else? Why not just leave them alone? Like all drugs, just tax it, then leave it to adult judgement.

    Complain about this comment

  • 45. At 11:43am on 21 Mar 2011, John Ellis wrote:

    on the subject of out of site out of mind... still on health this story just ran which is very poor to say the least.

    Mental health nurses 'set bad example to patients'
    http://www.bbc.co.uk/news/health-12732954

    First thing wrong is its the medication that causes the early death all the problems listed are in-fact side effects which accumulate and leads to a shortening of life. Maybe a study on illness V medication V years taken should be done to give a true picture of the situation with early death.

    Secondly if you expand this logic then fat teachers in school are to blame for fat kids are they not, All parents who drink are responsible for underage drinking. Then we turn this on its head again and look at the people who run the country with the same logic and observations applied how do their lifestyles and choices impact upon people with metal health.... Oh that's right they drive them deep into poverty into poor lifestyles which further deepens the probability of shortening of life either through illness or suicide.

    So are the nurses really to blame?

    Complain about this comment

  • 46. At 11:51am on 23 Mar 2011, bringmeatowel wrote:

    I have one thing to say - Free will.

    Sure, don't smoke around others but other than that it's nothing to do with anyone else. End of.

    Complain about this comment

  • 47. At 03:45am on 24 Mar 2011, Guy Hardrock wrote:

    Tobacco is awful... Heroin is ghastly...

    But neither of these, or any of a thousand other demons, does anywhere NEAR the harm that alcohol does.

    Smokers harm themselves, and may possibly harm others through 'second-hand smoke' - though it's a microscopic effect, at best, for all the noise one hears about it...

    ...but smoking doesn't spark aggression, anger, madness, and murder...

    Pour a few ounces of spirits down someone's throat all at once, and they're dead in minutes of alcohol poisoning. Has anyone ever smoked themselves to death... at one sitting..?

    Smoker's create a musty smell in car upholstery, but they don't kill and maim thousands while driving through loss of voluntary nervous system control...

    There's no comparison... except for the almost universal enthusiasm for alcohol in human society...

    Complain about this comment

  • 48. At 08:25am on 25 Mar 2011, Mike wrote:

    I've always found smokers to be totally irresponsible - if they don't care about their own chance their kids have got no chance - this is reflected with the number you see smoking in front of their children, even in a car - total disgrace and they should be jailed for child abuse. Also 200 million cigarette butts are thrown away every day in the UK and account for the highest percentage of litter.

    Complain about this comment

  • 49. At 10:44pm on 26 Mar 2011, Jules505 wrote:

    Let people smoke, if they want, away from others. I gave up two years ago after 40 years of 30 a day and feel fine, go to the gym regularly and have good general health - yes, it might come back to haunt me but I've got to die of something. My children, both large at birth, hate cigarettes and in their late twenties neither of them smoke and are fine, big sporty chaps. We might be lucky, for now, and admittedly a lot of people aren't, but it is their choice and there is enough education out there. Far more lethal to society are cannabis and alcohol - both affect the brain and, by the way, why do lots of youngsters continue to smoke? - a lot of the time it is because of the cannabis, which is mixed with tobacco to make a spliff, so youngsters inadvertently get addicted to smoking - hey two for one! Even if they only ever have a couple of spliffs, they will still crave cigarettes and seek to feed that particular addiction. I work in mental health and see the enormous damage cannabis does to youngsters. As to booze - whichever government gave out licences to any old grotty corner shop to allow them to sell strong alcohol, not always indiscriminately, ought to hang its head in shame. I counted up NINE shops in my small high street that were allowed to sell alcohol, yet there was no chemist's shop or greengrocer. Why HAS no government got rid of alcopops? Why are the brewers so powerful in this country? What about the morality of allowing children to have easy access to alcohol? This is where you positively need a "Nanny State"!

    Complain about this comment

  • 50. At 11:18pm on 28 Mar 2011, fran wrote:

    I am a Stop Smoking adviser and have found from my patients that quitting is a very personal thing; what works for one person, doesn't always work for the next. The same applies for preventing people from smoking. Young people who haven't started smoking should be given all the information they need to make an informed choice on the matter. Education is the key for them. Science lessons on the effects of the chemicals within cigarettes on the human body, sociology lessons on how it effects society. Give them that kind of infomation and they get to make an informed choice, then its their fault if they become ill through smoking.
    For current smokers, they should be incouraged to seek adivce from Stop Smoking advicers, GPs, nurses etc on either quiting, cutting down or just the health effects of smoking. But they CAN NOT be forced in to quitting. Studies have shown that smokers are more likely to quit if it is their choice. Raising the tax and reducing amount avaiable won't help, it will just encourage a black market to grow.

    PS Megan- if he is still in the process of quitting get him to have a look at the nicorette inhalator. Its good for smokers who miss the hand to mouth action. Some of my patients use it without the cartridges so theres no nicotine but they still have the action of smoking.

    Complain about this comment

  • 51. At 5:39pm on 27 Jun 2011, richard71 wrote:

    Interesting article, Mr. Walsh. I know people who smoke since over 40 years and I don't think they would quit if they would change the packaging. I've been to Singapore a few years ago and they have those horrible pictures on the package - at first you try to ignore it and it bothers you a bit, but after a while you don't care anymore.

    What really makes an impact is when the government increases the tax and consequently the price of cigarettes. I know people who quit because of that.
    Another thing which is quite popular at the moment is the electronic cigarette -> http://en.wikipedia.org/wiki/Electronic_cigarette
    The reviews are really good and people finally "quit smoking". As far as I know it's also available with nicotine but without all the other stuff. However, the government trys to ban it as well... -> http://new-smoke.com/e-cigarette-news/e-cigarette-ban-which-states-are-affected/

    At least thats what happening in the US and they are also looking into that issue here in the UK. I don't what the governemnt will do next... lets see.

    Complain about this comment

  • 52. At 01:28am on 11 Jul 2011, gaiusgracchus wrote:

    Smokers should be allowed to smoke as long as it does not affect ANYONE else, EVER.

    The pro-smoker contingent has stated here that they can't smoke in public places.
    But what about smoking in cars with others - especially children,
    and pregnant mothers smoking, and smoking at home in the presence of either elderly residents or children, or outside in areas that are confined spaces?

    As long as I NEVER have to catch a whiff of it, and no one without a choice like a baby or child has to be exposed to it, sure, by all means - smoke yourself to death.

    Complain about this comment

View these comments in RSS

BBC iD

Sign in

bbc.co.uk navigation

BBC © 2012 The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.