Andrew Lansley – 2012 Speech on Smoking and Health

Below is the text of a speech made by the then Secretary of State for Health, Andrew Lansley, on the subject of ‘Smoking on Health’.

I’m very glad to be here today.  I’m grateful to the RCP for your work and this opportunity.

Smoking remains one the biggest public health challenges. And it has been for a long time.

Historical context

When the NHS started in 1948, 82% of men smoked.

Fourteen years later, in 1962, there was the RCP’s ‘Smoking and Health’ report. It set out an agenda for controlling tobacco that doctors and governments followed for decades to come.

So in 1965, after calls from the RCP, all TV adverts for cigarettes were banned.

In 1984, smoking was banned on tube trains, and banned on stations a year later.

In 1995, Virgin and United Airlines banned smoking on transatlantic flights.

Then of course, there was the smoke free legislation of 2007 which I was Conservative health spokesperson at the time.

I said it should be a free vote for MPs. By making sure it was a free vote in our Party, we pushed Labour to give a free vote to their MPs too – knowing that this would mean a full ban, not the partial one the Government had sought.

It turned out to be one of the most successful pieces of legislation any of us can remember. MPs voted for it, not because we were told to by the whips, but because we believed in it, because the evidence was there and because we knew we had a chance to reduce the cases of respiratory diseases and cancer, and also to reduce the number of heart attacks caused by secondhand smoke..

And now, I think our health reforms have the potential to be the next step on that path.

By devolving more power to doctors, nurses and health professionals, more influence will be given to those who know the harms of smoking, and are determined to reduce it.

Health professionals know their communities, they know their patients. They know the areas, they know the shops, they know the temptations, they know the pressures. And because they know all this, they also know something else – they know how best to get people to stop.

Our plans, for the first time, will place a legal duty on the NHS to reduce health inequalities. And when you think how smoking disproportionately harms people in the poorest areas, you begin to realise the opportunity these reforms create.  To focus resources and attention on what is a deadly habit and such a significant source of inequalities.

We’re not going to tell health professionals how to do their jobs. But I do want to see clinical commissioning groups working with local groups and their local authorities specifically to deal with problems like smoking.

And I do expect to see Health and Wellbeing Boards and leadership of Directors of Public Health backing them up, guiding priorities and providing advice and research, with a particular focus on public health issues like smoking.

This is a huge opportunity. And it’s one we have to grasp.

Because despite the medical consensus, the shift in public opinion and even progressive legislation, people still smoke.

And overall, smokers appear to be less motivated to quit than they were a few years ago. A survey by the Office of National Statistics in 2009 showed that only 63% of smokers wanted to stop altogether, compared to 72% at the turn of the millennium.

So we need to up our action.  As Healthy Lives, Healthy People set out, successful public health campaigns rely on cumulative interventions over time.  A constant push for positive change.

And that is what we will do. With central government, NHS and local government all helping people make healthier choices.

Tobacco cannot now be sold from vending machines inEngland.  That removed, at a stroke, a source of cigarettes that underage smokers could access as often as they liked.

It was estimated that inEngland, about 35 million cigarettes were being sold to people under age of 18 every year. That is why vending machines had to go.

It’s not window dressing, or fiddling around the edges. That’s a real development that will stop people, particularly young people, from smoking.  We went to court to fight the tobacco companies that didn’t want the laws, and we won.

And the tobacco industry was defeated on tobacco displays too. We were gearing up for another court case but they dropped their action just a few days before Christmas.  So in a month’s time, tobacco displays in supermarkets will end. And displays in other shops will end in 2015.

Of course we have some of the highest priced tobacco inEuropeand we will carry on with a high tax policy.  In the last budget, the Chancellor significantly increased the tax on rolling of tobacco.

And of course, we’re helping those who want to quit.

Since January, over a quarter of a million Quit Kits have been distributed.

Our local stop smoking services are amongst the best in the world.  It’s a fact that smokers trying to quit do better if they use them.

We will continue to work with clinicians, so every time a smoker sees a doctor, nurse or any other member of the NHS they should be encouraged to kick the habit. Making every contact count.  At the moment, clinicians in some parts of the country are already doing this, I want to see it adopted throughtout the NHS .

And the Tobacco Control Plan, published just a year ago, set out our strategy for comprehensive tobacco control.

It set out how tobacco control will be delivered as part of the new public health system. How decisions will be taken locally to target the particular problems that particular communities have. We know very well that smoking rates  do vary dramatically between communities.

And we will try especially hard to help two particular groups.

Firstly, we want to dramatically cut the number of pregnant women who smoke. Reducing rates of smoking at time of delivery from 14% to 11% by the end of 2015.

Secondly, children. Smoking is an addiction largely acquired by young people, so if we can make progress in this group then people’s health will benefit through their entire lives.

We have already reduced smoking rates among 15 year olds from 15% to 12%, four years ahead of schedule.

But we’re not going to let up. We can and will do more to stop young people taking up smoking in the first place.

So for example, we’re putting the finishing touches now to the consultation to come on tobacco packaging, which will be published soon.

We are the first country inEuropeto be giving that idea serious consideration, and that’s something I think we can be very proud of.

Obviously it’s only a consultation at the moment, so nothing’s set in stone. But that also means it’s a great opportunity to shape policy from here on in.

When it comes out, I want to see responses from everyone with an interest. From tobacco control experts, shop owners, to smokers to ex smokers, and even the manufacturers themselves.  But make no mistake – everyone who responds will be asked upfront about any links they have with the tobacco industry.

We will listen to the arguments and opinions people have, and we will not taking any options off the table just yet. It will be a real opportunity to make sure your opinion is heard.

So I do encourage everyone, when the consultation opens, to get involved.

Smokefree homes and family cars

Another thing we’ll be doing from the centre is running a marketing campaign about the dangers of secondhand smoke, to encourage people to take action voluntarily to protect the health of their families, particularly children.

This is one of the areas that we can all agree needs further action.

When the smokefree legislation came in, people used to make spurious arguments about how it would affect the atmosphere in jazz clubs, as if everyone had a better time if there was a pall of smoke clogging up the trombones.

Funnily enough, those same people didn’t mention the cars full of smoke that children have no option but to breathe. Or in their front rooms. Or the kitchens. Or anywhere children can be forced to inhale someone else’s smoke. That’s the reality of secondhand smoke, and it’s why smokefree environments are so important.

Even though more people are making their own homes smokefree, as the college’s 2010 report described, far too many children are still exposed to secondhand smoke.  We have to change that. We have to encourage as many smokers as possible not to expose their families to their smoke.

And in the next year, that will be one of the things our television-led campaigns will focus upon.

Harm reduction

We’ll also be looking at the best ways to reduce the damage that tobacco does to smokers’ bodies, even if they can’t or won’t break their addiction to nicotine.

As you know, although nicotine is an addictive substance in cigarettes, the damage  mostly comes from the inhalation of the smoke itself.

Anything we can do to reduce that damage is well worth doing, even if some smokers can’t kick the nicotine.

NICEis drawing up guidance on how that might happen.

And the MHRA has supported using nicotine patches, gum, inhalators and lozenges as alternatives to smoking, making it safer for the smoker themselves but also reducing secondhand smoke.

We are also encouraging manufacturers to come up with new types of nicotine replacement products that are cheaper, more socially acceptable and easy to get hold of and use.

That last point I think is an important one. For nicotine replacement treatments to be really effective, the safest forms of nicotine should also be the most straightforward to buy in the first place.

In that respect I would especially like to recognise the leadership of Professor John Britton, the Chair of the RCP’s Tobacco Advisory Group and co-chair of the UK Centre for Tobacco Control Studies, for his leadership in this and other fields.

International reputation

It’s helping cement our reputation as a world leader on stopping tobacco use.

In 2010, theUKwas ranked as having the most effective tobacco control policies across the 30 European counties that were surveyed.

And we are recognised as leading the world in helping people to quit smoking as well.

According to this month’s issue of Tobacco Control, we are at the top of the international league table when it comes to the WHO’s MPOWER approach to tobacco control – one of only four countries in the world to get score of four out of five.

I’m also very proud that we’re active members of the Framework Convention on Tobacco Control.

We have made a big contribution, including supporting the development of guidelines on secondhand smoke, tobacco ingredients, packaging and labelling, and we led the development of guidelines on smoking cessation.

Those guidelines will help governments across the world improve their own tobacco control strategies.

And both at home and internationally, we will continue to act against the vested and commercial interests of the tobacco industry.

As Secretary of State for Health, I haven’t met with those companies. Not now or when I was in Opposition as the Conservative’s health spokesman.  Their interests are not my interests.  My objective is to achieve smoke-free communities; theirs is to make a profit from selling intrinsically harmful products.  We don’t have common ground.  This is not like alcohol, where there is a level of responsible drinking and potential shared campaigns between Government and retailers.  That’s why there is no place in the Responsibility Deal for tobacco companies.  There is no responsible level of tobacco consumption.

Conclusion

So let me conclude, the foundations for our current ambition for reducing smoking were laid 50 years ago with the RCP’s report.

After that, with cause and effect laid out so clearly, the tide of public and political opinion shifted dramatically.

So while celebrating the 50th anniversary of that report, we should also celebrate what’s happened since then, both inside and outside the RCP and look to the future.

Government, healthcare professionals, health charities, academics, employers and individuals themselves have all contributed to 50 years of progress.

Sometimes it’s been frustrating and slow, sometimes we’ve made real progress quickly. But if I compare the number of smokers I see when I’m walking down the street today, compared to when I first started off onWhitehallas a Civil Servant in the 1970s, the shift has been dramatic.   We do not have the lowest levels of smoking in the world, but we have come a long way and I am ambitious that we can go further and faster.

Promoting good health; preventing ill-health, reducing health inequalities.  All of these will be the result of the implementation of our Tobacco Control Plan and with your leadership here at the RCP and the opportunities given by the new Public Health service, to improve health, to reduce health inequalities, to support Healthy Lives and Healthy People.  That will be our objective.