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Introduction
Over the past 50 years, tobacco has been unmasked as a wolf in sheep's clothing: a lethal combination of a highly addictive drug and, when smoked, a host of toxic chemicals capable of causing a wide range of serious diseases. It has been estimated that smoking has caused around 685,000 premature deaths in Scotland in the last 50 years and still results in over 13,000 deaths a year 1.
Given what we now know about tobacco, if it were to be introduced as a new product today, it is inconceivable that it would be allowed onto the market. Arguably, the only justification for its continued legal status in the United Kingdom is that there are already over ten million adult smokers. To deny them legitimate access to cigarettes would create an immense black market with unacceptable social consequences. Nevertheless, there is widespread agreement that we should do all we can to prevent and dissuade young people from starting to smoke. Even sections of the tobacco industry now acknowledge that tobacco is addictive and dangerous, and that children should be protected from it.
In A Breath of Fresh Air for Scotland, published in 2004, the Scottish Executive made a commitment to working towards making Scotland "a society in which everyone aspires to live a healthy smoke-free life and has access to the support that can help them realise this ambition" 2. It set out an Action Plan for putting this commitment into action. It has three main aims:
- To help as many smokers as possible to stop smoking if they wish to;
- To protect the public from the effects of second-hand smoke;
- To prevent as many people as possible from starting to smoke.
Since A Breath of Fresh Air for Scotland was published, much more progress has been made than most people would have thought possible even five years ago. We now have a nation-wide network of smoking cessation services, helping thousands of people to quit. For those who need it to help give up, nicotine replacement therapy ( NRT) is available free on prescription or can be purchased over the counter in pharmacies.
On March 26, 2006, the historic legislation banning smoking in enclosed public places came into effect. It has already been hailed as a huge success, dramatically reducing exposure to tobacco smoke in all enclosed public places.
If smoking is to be made a thing of the past, the third great challenge is to prevent people from becoming smokers. In order to advise the Scottish Executive how this should be done, the Smoking Prevention Working Group ( SPWG) was set up as a sub-group of the Scottish Ministerial Working Group on Tobacco Control. It was asked to make recommendations for the development of a new long term smoking prevention strategy to guide future tobacco control prevention activity at national and local levels. This would include reviewing current national communication and education programmes and the development of a long term communication strategy. The SPWG was also asked to advise Ministers on the question of evidence to support raising the age of sale of tobacco products from the current age of 16. The group's formal remit is set out below:
General
- to scope current national and local activity aimed at preventing smoking among young people in Scotland since 1999;
- to review the evidence of effectiveness of different approaches to preventing smoking among young people;
- to identify gaps in our knowledge which require to be filled; and
- to make recommendations to assist the development of a new long-term integrated smoking prevention strategy.
Specific to age of purchase
- to consider in relation to the age of purchase:
- the significance of the legal age limit in relation to uptake of smoking;
- the evidence on this from other countries; and
- to make recommendations to Ministers.
The group met on six occasions between August 2005 and May 2006. It considered a wide range of evidence from research in this country and abroad. It received presentations on key aspects such as prevention in schools and use of the media.
It is therefore the aim of this report to recommend a comprehensive range of measures designed to prevent people from starting to smoke and becoming regular smokers. Each of our recommendations has its own justification as a contribution to smoking prevention, but we hope that collectively they will have an effect even greater than the sum of the parts. Our intention is to help move Scotland decisively towards a future where smoking is a thing of the past.
Definitions
In this report, young people refers to the age group 10-25 years although some of our evidence may refer to individuals who were younger or older than this.
Regular smoking is defined as smoking at least weekly among under 16s and at least daily among over 16s. These differences reflect the definitions used in the main surveys cited in this report.
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