Scotland’s Tobacco Control Action Plan – stubbing out smoking for good?

The Scottish Government has recently published their updated plan to tackle smoking in Scotland –  “Raising a Tobacco-free Generation: Our Tobacco-Control Action Plan 2018.” The Plan centres on the Scottish Government’s priority that, by 2034,  an entire generation of Scottish children will be smoke-free, defined as  5% or less of the adult population either regularly or occasionally smoking. The publication of the plan occurs at a time when lung disease continues to ravage communities across Scotland. According to the Scottish Public Health Observatory, tobacco accounts for around 10,000 premature deaths in Scotland each year. Scotland continues to have one of the highest rates of lung cancer in the UK – the NHS Information Services Division reports that 16.1% of all cancer diagnoses in Scotland in 2016 were for lung cancer. Lung cancer is much more common in the most deprived communities (up to 80% more than the least deprived communities), meaning that people at the lower end of the income scale are disproportionately blighted by smoking cigarettes. If you live in Glasgow, you are more likely to die from a lung condition than anywhere else in the UK. With this backdrop in mind, does the updated plan measure up to the scale of the challenge? The Plan reiterates the commitment to a smoke-free generation by 2034, but also contains some eye-catching proposals to support this aim. It is welcome that smoking will be swiftly banned in hospitals and prisons, with legislation expected later this year. Further measures to curb the spread of second hand smoke, including discouraging smoking in common areas of flats and tenements. Similarly, the Plan recognises the use of e-cigarettes as a smoking cessation aid and further guidance to healthcare professionals on their appropriate use will be of benefit to long-term smokers for whom other approaches to quitting have not worked. Despite the fanfare associated with radical new proposals, questions remain about basic commitments to reduce tobacco use. The BLF’s own report on the availability of stop smoking prescriptions showed a decrease of 40% on average across all health boards in just 2 years. Even more concerningly, areas with significant pockets of urban deprivation are amongst the areas with the largest decreases in the availability of nicotine replacement therapy drugs, with prescriptions in NHS Lanarkshire halving within the same 2 year period. Evidence shows that smoking cessation treatments are a cost-effective way to help people to quit, and reduce the preventable economic burden of tobacco use to the NHS, and clearly now is not the time to see any reductions in budgets available for smoking cessation. The British Lung Foundation exists to fight the corner for everyone who has a lung condition, and we know all too well the damage that smoking has caused to millions of lives in Scotland and across the UK. Given the challenges associated with eradicating tobacco use entirely, it is paramount that adequate funding is given to support smoking cessation services, and that these services are readily available and accessible in the communities that need them most. The Scottish Government’s bold words must now be met with solid financial commitments, to ensure that our children can breathe easy for many years to come.