Today, around two hundred people will die from smoking in Britain alone. This is often compared to a plane of smokers crashing down everyday.

This makes for a powerful metaphor, but it needs updating. Because where these planes fall, and who the passengers are, is not evenly distributed. As the Marmot review update reveals, our poorest and most socially disadvantaged communities have suffered the most from austerity, and tobacco-related disease contributes to extensive morbidity and mortality within these areas.

The passengers on these planes also share some similarities: most often they are lower paid and facing what can be described as severe and multiple health and social comorbidities, with little or no support. Covid-19 will have exacerbated these circumstances. The metaphor should be that a plane crashes down on poorer towns and communities every day, taking money, resources, and family members.

A new Tobacco Control Plan for England will be released in Summer 2021. A central focus of this will be reducing the smoking prevalence rate to <5% by 2030. The current smoking prevalence rate in England is around 14.5%. If we consider the daily circumstances of many smokers, it brings into sharp focus just how little time there is to achieve an overall 9% reduction. But smoking prevalence among adults presenting with a serious mental illness, homelessness, or substance dependence is up to four times higher. This requires all those who are in a position to help to consider, what can we do to help smokers with these additional needs to quit?

These populations are not insignificant small groups who don’t deserve our attention, and they don’t just deserve our attention once all other smokers have quit. I last wrote about this a year ago, but there have been some developments in the evidence base, and I share my recommendations on how we can all work together for a smoke free future based upon these updates:

Read full article here.

Sharon Cox – The BMJ Opinion – 2021-04-20.

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