Government targets to make England smokefree by 2030 are “further off track” than previously believed, according to a study published today.
A team from UCL, which led the research, found from June 2017 to February 2020, smoking prevalence fell by 5.2% a year, but this rate of decline slowed to 0.3% between April 2020 to August 2022) and was particularly noticeable among advantaged social groups.
Lead author Dr Sarah Jackson, of UCL Institute of Epidemiology and Health Care, said: “Smoking prevalence has been falling among adults in England at a steady rate for more than 20 years. Our data show that this decline has stalled, with an increase in quitting potentially having been offset by a rise in people taking up smoking or an increase in late relapse.
“These findings make bold policy action more urgent. The Government was already not on track to meet its target for England to be smokefree by 2030. This study shows we are even further off track than we thought.”
The study, funded by Cancer Research UK and published in BMC Medicine, examined survey responses from 101,960 adults between June 2017 and August 2022.
Based on the survey responses, the researchers estimated the proportion of smokers in England as 16.2% in June 2017, which fell to 15.1% by March 2020. In August 2022, this figure was 15.0%.
The researchers used data from the Smoking Toolkit Study, in which a different sample of 1,700 adults in England are interviewed each month, to establish if the pandemic had resulted in sustained changes in smoking patterns.
They found a 40% increase in attempts to quit the habit during the pandemic compared to pre-pandemic and a sustained 120% increase in the proportion of people stopping smoking, but this was offset by a rise in the number of people taking up smoking during the same period.
Smoking prevalence increased among 18- to 24-year-olds at the start of the pandemic and decreased among 45- to 65-year-olds at the same time.
The flattening in the decline of smoking prevalence was particularly pronounced among households whose highest earners were in professional, managerial or clerical jobs.
Smoking prevalence declined very slightly among those in disadvantaged social groups – whose highest earners are in manual, semi- or unskilled jobs, or are unemployed.
The researchers say switching to home working for many non-manual jobs during the pandemic may have contributed to loneliness and poor mental health, making people in those jobs less inclined to try to stop smoking.
They add manual workers may have had more financial disruption, which resulted in smoking becoming less affordable, as well as increased exposure to Covid-19 due to work, making stopping a higher priority for health reasons.
They write: “In working toward the smokefree 2030 target, there is a need for action to reignite progress in reducing smoking among the more advantaged social grades and identify ways to accelerate the decline among less advantaged groups.”
The UK Government is aiming for England to be smokefree by 2030, defined as adult smoking rates of 5% or less. An independent review in 2022 concluded that without further action, England would miss this target by at least seven years. Wales also has a 2030 target, while Scotland’s smokefree target is 2034.
Senior author Professor Jamie Brown, of UCL Institute of Epidemiology & Health Care, said: “The Government’s proposal to make it an offence to sell tobacco products to anyone born after 2008 could get us much closer to a smokefree 2030. Other bold actions that have been proposed, such as increasing investment in mass media campaigns and distributing a million e-cigarettes to smokers, could also make a significant difference.”
Jackson SE, Tattan-Birch H, Shahab L et al. Have there been sustained impacts of the Covid-19 pandemic on trends in smoking prevalence, uptake, quitting, use of treatment, and relapse? A monthly population study in England, 2017-2022. BMC Medicine 14 December 2023.
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