Priorities for Health: Help more Scots kick the habit
November 2006
Introduction
In August 2006, BMA Scotland conducted a survey of members to identify their priorities for health. Around 600 doctors from all branches of the profession responded to the survey and their priorities for helping Scots to give up smoking are reflected in this policy briefing.
Background
Nearly 70% of doctors surveyed said that smoking is the most important public health issue facing Scotland. More than 13,000 people die every year in Scotland from tobacco use, the equivalent of 35 people a day.
Statistics show that 31% of adults in Scotland smoke, however more than two thirds (68%) of all smokers say they would like to give up smoking [Reference 1]. People in Scotland’s most depirved areas are almost three times more likely to smoke than the most affluent, with 41% of the most deprived smoking compared to 14% of the least deprived [Reference 2].
Figures also show that 6% of 13 year olds and 19% of 15 year olds are regular smokers. Of these 15 year olds, approximately 14% of boys and 24% of girls smoke [Reference 3]. Despite a general reduction in the number of teenage smokers, the figure remains significantly higher among girls. Most smokers begin in adolescence and research shows that the younger someone starts, the less likely they are to give up [Reference 4].
The average smoker will lose about 10 years of life because of their smoking [Reference 5]. Within just one year of stopping smoking, the risk of heart attack falls to about half of that of a continuing smoker.
Overall smoking levels among pregnant women have decreased to 22.7%, but more than one in five Scots women still smoke during pregnancy and more than 21% are still smoking at the time of the health visitor’s first visit (usually 10 days after baby is born). In deprived areas of Scotland, the figures are higher with more than 40% of mothers continuing to smoke when pregnant [Reference 6].
Smoking while pregnant has significant risks to the unborn baby for example an increased risk of cot death, poorer lung function and a higher chance of dying during the first four weeks of life [Reference 7]. Children born to mothers who smoked during pregnancy are also smaller and lighter and more likely to develop middle ear diseases. Women whose partner smokes are less likely to succeed in stopping smoking during pregnancy [Reference 7].
Passive smoke kills hundreds of people each year in Scotland, causes lung cancer, heart disease and asthma, aggravates asthma in adults, is known to cause middle ear and respiratory infections in children and is linked to cot deaths.
Passive smoke is also a risk to pregnant women as it has been linked to low-birth weight and premature birth. In the UK, two thirds of pregnant smokers have a partner who smokes and surveys show that just one in four men whose partners are pregnant make any change to their own smoking behaviour and just 5% (one in twenty) give up smoking [Reference 7].
Interventions:
Help more Scots to kick the habit
Smoking remains the biggest preventable cause of death in Scotland. The introduction of smoke free enclosed public places legislation in March 2006 protects the public from the deadly effects of passive smoke and helps reduce the amount of tobacco smoked. In May 2006, 61% of respondents stated they supported the new law, an increase from 56% in May 2005 [Reference 8]. However, more needs to be done to help reduce the number of people in Scotland who smoke.
Nearly 90% of doctors surveyed called for a targeted campaign to be introduced to encourage more smokers to quit, particularly young females.
- More smoking cessation support should be available to adults and parents to help those who wish to stop smoking stay stopped.
- A targeted campaign should be introduced to encourage more smokers to quit, particularly young females.
Stopping smoking before pregnancy avoids the risks associated with maternal smoking. Giving up in the first three months of pregnancy greatly reduces the risk of low birth weight and stopping at any stage during pregnancy brings health benefits.
More than eight out of ten pregnant women who smoke want to stop, but just three in ten manage to do so [Reference 7]. Approximately 92% of doctors surveyed believed that a targeted campaign should be introduced to tackle maternal smoking. Encouraging expectant and existing parents to stop smoking provides an opportunity to protect their health and the future health of the infant or child.
- A targeted campaign should be introduced to tackle maternal smoking.
- Smokers should be given clear, firm advice to stop smoking and offered suitable support, including referral to specialist services.
- Parents should be educated about the effects of smoking, not just on their own health, but on that of their children.
Although strategies have been introduced to help young people to stop smoking, to date, little has been done to limit young people having access to tobacco in Scotland. The law stipulating the minimum tobacco purchase age of 16 dates back to 1937, a time when the dangers of smoking were unknown.
Raising the minimum purchase age of tobacco from 16 to 18 would decrease the number of young people smoking in Scotland by reducing the availability and access to cigarettes [Reference 9]. 86% of doctors surveyed agreed that this measure would help reduce smoking prevalence. When coupled with improved enforcement of the higher age limit, young teenagers would find it more difficult to purchase tobacco from shops. 93% of doctors surveyed called for retailers to be encouraged to stop selling to underage children by the introduction of a licence to sell cigarettes, which would be removed for persistent offenders.
- The minimum age for purchase of tobacco should be increased to 18 to deter young people from taking up smoking at an early age.
- Age restrictions for the purchase of tobacco should be enforced.
- A licence to sell cigarettes to be introduced so that those who continue to sell to underage people would lose their licence.
1. Scottish Executive. Scottish Household Survey 2002.Edinburgh. 2003.
2. Scottish Executive. Scottish Household Survey 2005. Edinburgh. 2006.
3. BMA Scotland. Raising the purchase age of cigarettes from 16-18. 2005.
4. Hastings G & MacFadyen L. US study on adolescent smokers’ perceptions of tobacco control: summary of findings. Health Education Board of Scotland. Edinburgh. 1999.
5. Doll R. et al. Mortality in relation to smoking: 50 years’ observations on male British doctors. British Medical Journal. London. 2004.
6. Scottish Health Statistics. Birth and Babies. Smoking in pregnancy. July 2006.
7. BMA Board of Science and Education. Smoking and Reproductive Life. .London. February 2004.
8. Scottish Executive. MRUK Survey Public attitudes to smoking in public places. Edinburgh. May 2006.
9. BMA Board of Science and Education. Adolescent Health. London: BMA, 2003.
For more information:
BMA Scotland Public Affairs Office
Tel: 0131 247 3050/3052
Email: press.scotland@bma.org.uk