Limiting child access to cigarettes – Coalition must enforce health act

Our guest writer is Tom Yates, a working NHS doctor

Last month, health minister Andrew Lansley said his Department would “tell Parliament in due course”  whether it intends to implement measures, contained in the 2009 Health Act, banning cigarette vending machines and point of sale advertising of cigarettes. This was hardly re-assurring.

In the UK, cigarettes cause much more premature mortality than obesity or alcohol. One in two smokers will die from their habit. The poor smoke more than the rich and cigarettes are a major reason why poor men, across the developed world, are twice as likely to die in middle age (35-69) than rich men. In England and Wales, differences in rates of smoking explain 59 per cent of this excess risk.

Limiting children’s access to cigarettes is important – 40 per cent of adult smokers started smoking before the age of 16. The coalition have not yet committed to implementing the part of the Health Act that bans cigarette vending machines, a key measure to control child smoking.

Whilst only one in 100 cigarettes are bought from vending machines, one in eight regular smokers aged eleven to fifteen access their cigarettes in this way.

Bans on tobacco advertising reduce cigarette consumption and, given the large numbers of deaths attributable to smoking, even small decreases in consumption lead to significant falls in mortality. However, to be effective they need to leave tobacco companies no loopholes – no Camel Boots or Marlboro Classic Clothing.A comprehensive World Bank review concluded:

“Policymakers who are interested in controlling tobacco need to know whether cigarette advertising and promotion affect consumption. The answer is that they almost certainly do, although the data are not straight forward.

“The key conclusion is that bans on advertising and promotion prove effective, but only if they are comprehensive, covering all media and all uses of brand names and logos.”

Tobacco companies responded to the 2002 Tobacco Advertising and Promotion Act, which banned most forms of cigarette advertising, by producing new variants of existing brands, thereby increasing the impact and size of point of sale displays. If implemented in full, the 2009 Health Act will put a stop to large backlit point of sale displays, moving all cigarettes below the counter.

The tobacco industry and shop keepers are protesting loudly but their concerns about rises in tobacco smuggling and small retailers going out of business ignore the bigger picture.

Richard Peto argues that progress in reducing premature mortality is mostly made though small victories against major killers. He is right and the time to act is now.

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