What next after smoke free?

What next after smoke free?
Deborah Arnott, Director, Action on Smoking & Health (ASH)

Abstract
Once smokefree legislation has been introduced in summer 2007 the UK will have pulled all known levers to cut smoking prevalence. The government's current tobacco control strategy is evidence-based and needs to be maintained, but its not sufficient. The most disadvantaged in society still have the highest rates of smoking prevalence and these have not declined significantly in the last thirty years. At current rates of decline , it will take us 25 years to halve the numbers smoking and there will still be over 5 million smokers in the UK.

So what next? The Royal College of Physicians is shortly to publish a new report which calls for a revision of nicotine regulation to enable smokers who can't quit to have access long-term to safer forms of nicotine than smoked tobacco.

While quitting will always be the gold standard, over 70% of smokers are not yet ready to quit. In the interim it is better that they use less harmful forms of nicotine rather than carry on smoking. A harm reduction strategy is required which would give smokers access to less harmful forms of nicotine in a form and a price that is attractive as an alternative to smoking. A switch of only 1% of the population a year from smoking to less harmful nicotine sources, a conservative target, would save around 60,000 lives in only 10 years.

Such a strategy would encourage the development and sale of new, low harm nicotine products competitive to cigarettes in their nicotine delivery. This strategy would be a market-based, low-cost public health intervention. But it needs the strong support of those working in smoking cessation, who have contact with smokers who want to quit but aren't yet able to. Smoking Cessation Advisors could ensure that long-term nicotine users are advised that it's better to carry on using medicinal nicotine products than to relapse back to smoking.

We would like to ask the meeting to support the release of a statement that says: The UK National Smoking Cessation Conference supports the RCP's call for an overhaul of nicotine regulation to give smokers long-term access to less harmful forms of nicotine as a real alternative to smoking. We call on the government to take steps to implement such a strategy now."