Could a generational smoking ban help the UK kick the habit forever?

Good morning. Although smoking in the UK has been in decline for more than half a century, the harm it does remains staggering. About 76,000 people die, and more than half a million people are admitted to hospital, as a result of smoking in England each year. Two out of three smokers will die from a smoking-related disease. And the overall cost of smoking to the UK economy, factoring in healthcare costs, lost productivity and environmental harms, is estimated at up to £17bn a year.

In parliament yesterday, the government introduced its tobacco and vapes bill – which will raise the legal age of smoking every year by a year, a genuinely radical measure that experts say has the potential to effectively eliminate smoking within a generation. Today’s newsletter, with Dr Sharon Cox, a behavioural scientist at UCL’s Tobacco and Alcohol Research Group, is about how it will work – and what might get in the way. Here are the headlines.

Five big stories

In depth: ‘This is a really massive public health win’

After a change in government in New Zealand led to the abandonment of plans to ban smoking for future generations, the bill introduced in the UK parliament is genuinely pioneering. If it becomes law, which appears very likely given cross-party support, it will make the UK the only country in the world to be using such a policy to seek a “smoke-free generation” – defined as reaching 5% or less of the population using cigarettes.

“Those of us working in tobacco control have been calling for more preventative measures for a long time, helping people not to start as well as helping people quit,” said Dr Sharon Cox. “This is a really massive public health win.”

What’s the policy?

From the beginning of 2027, nobody born on or after 1 January 2009 – 15 years old today – will ever legally be sold tobacco. That will be enforced by increasing the legal smoking age – currently 18 – by one year every year. So, in 2028, the minimum age will be 19; in 2037, it will be 28; in 2050, it will be 41, and so on. Nobody who is legally allowed to smoke today will ever be affected by the ban.

It makes sense to start with a focus on the youngest potential smokers, said Cox, because “it is very unusual for people to start smoking as they age. But in adolescence, people are impressionable, there is social pressure and a desire to experiment – and there is a path from experimentation to regular use.”

What’s the evidence for it?

Since no other country has this policy in place, there’s no real-world test of the policy’s impact. But there are good reasons to believe it can succeed. “What we know is that when the age of sale is raised, that has a direct impact on youth uptake,” Cox said. For example, when the smoking age was raised from 16 to 18 in the UK, there was a 30% reduction in smoking prevalence for 16 and 17-year-olds. And statewide laws in the US raising the smoking age from 18 to 21 also had an immediate and sustained impact on the number of 18 to 20-year-olds smoking.

The government has meanwhile modelled the possible impact of the new policy in the UK. It says that if there is a 30% reduction in people who take up smoking, and assuming no other policy or social changes in the meantime, the proportion of 14 to 30-year-olds who smoke could be expected to drop from 13% today to 7.3% in 2030 and 1.3% in 2040.

Are there any arguments against it?

The most vociferous argument against a generational smoking ban is about freedom: critics say that the policy is a draconian impingement on personal liberty that denies younger people the rights which older people take as a given – even as that older generation continues to do what it wants.

The Institute for Economic Affairs, a libertarian thinktank (which has previously acknowledged receiving funding from the tobacco industry), published a research paper making this case last year. It argued that “the ban infantilises one cohort of adults, discriminates on the basis of age and raises issues of intergenerational unfairness” and asked, given the growth in vaping: “Why not allow cigarettes to become obsolete through market forces?”

Against this argument for freedom is the fact that many smokers wish they didn’t have it. “Most people who smoke wish they’d never started,” Cox said – and about nine in 10 of them did so before they were 21. About two-thirds say they want to quit. Overall, 75% of the public support the “smoke-free generation” ambition – and even among smokers, 42% support it against 27% opposing, with 31% unsure. In the past, the popularity of other anti-smoking measures has only increased after they have been introduced.

“Of course there are arguments about the nanny state,” said Cox. “But is it really a restriction of liberty to reduce the likelihood of disease and premature death?” She points out that there are other widely accepted policy measures which involve some sort of reduction in liberty in exchange for protecting lives: we might think of speed limits, or gun control laws. “We have policies that protect people all the time,” Cox said. “I think most people get that.”

What else needs to happen?

“One of the key ways young people circumvent minimum ages is when tobacco products are sold illicitly,” Cox said. “It would be naive to bring in this type of policy and not have any enforcement to back it up.” To combat that potential problem, there will be new powers for local authorities to issue on-the-spot £100 fines to retailers found selling cigarettes to underage buyers.

Meanwhile, there will also be £30m more annually to support enforcement agencies in cracking down on illicit cigarette sales, £70m more to help people quit, and a new national campaign to explain the changes.

“It’s really important to couple this with the support for people to quit smoking – you have to do it together,” Cox said. “We should be clear that these services have been decimated over the last decade, so this is at best restoring them. But it’s really welcome that there is going to be mass media around this – we haven’t seen that for a really long time, and it makes a big difference.”

The other key factor to address in smoking, she added, is in the huge inequality in health outcomes that it perpetuates. NHS data shows that the rate of smoking-related hospital admissions for the poorest 10% is double that among the richest; only 2.5% of women smoke in the least deprived local authority in the country, against 19% in the most deprived – a statistic that partly explains a 17-year gap in life expectancy.

“To take that on, you really need to target the stop-smoking resources on the poorest areas,” Cox said. “When we talk about children smoking in the future who are more likely to circumvent the ban, it will overwhelmingly be the ones from poorer backgrounds, with parents and siblings and adults around them smoking. But it can’t be about stigmatising smokers. The answer to that part of it isn’t to denormalise them – it’s to offer them help to quit.”

What else we’ve been reading

The day before her death in Switzerland, Paola Marra (above), a woman with terminal stage 4 bowel cancer, spoke to Robert Booth about her decision to end her life at Dignitas and the urgent need for legislative change in the UK. Nimo

Owen Jones has held Labour party membership since he was 15; he’s just cancelled it, and is calling for those on the left to support Green and independent candidates. Whatever your own view, the case he makes is worth your attention. Archie

After a quiet weekend alone, Elle Hunt started wondering about the merits of spending extended periods of time in your own company. In her column this week, she lays out the distinction between loneliness and solitude, arguing that the social stigma around solitude holds us all back from making the most of it. Nimo

Jonathan Jones has an excoriating piece on Damien Hirst after works by the conceptual artist dated by his company to the 1990s were found to have been made in 2017. It was Hirst’s formaldehyde shark that made Jones want to be an art critic, he writes – “yet now we know Hirst has taken a chainsaw to that glorious past.” Archie

Adrian Chiles has written a moving article on his father’s death and how, despite a lifetime of preparation for it, he was still unprepared for the shock that comes from the loss of a parent. Nimo

Sport

Tennis | Andy Murray (above) was rewarded for his per­severance in a brutal first-round match at the Miami Open as he ­recovered from a set down to outlast Matteo Berrettini 4-6, 6-3, 6-4. After the win, which was only Murray’s fourth of the year, he signed a camera lens: ““Life in the old dog yet!”

Football | At the start of the Euro 2024 qualifiers, Luxembourg’s previous 56 matches in the competition had yielded 15 points. Now they stand two games from qualification. Nick Ames explains the feverish mood that has now hit the grand duchy, extending to a promise from the football federation’s president to shave his trademark moustache if the miracle happens.

Horse racing | The Jockey Club has decided not to apply for an injunction to deter possible incursions on to the Aintree track by animal rights activists at next month’s Grand National meeting. Protests before last year’s Grand National by Animal Rising, which included an attempt by protesters to scale a perimeter fence and glue themselves to one of the track’s obstacles, caused the race to be delayed by 15 minutes.

The front pages

“MI6 chief and civil service head resign from all-male Garrick Club” is the top story in the Guardian today. “Defeats deal fresh blow to Rwanda migrant bill” says the Times. The Daily Mail has “Mortgage hope as economy turns a corner … at last” and the i joins in with “UK on track for summer interest rate cuts”, as does the Financial Times: “Inflation’s fall to 3.4% keeps summer rate cuts on track”. “Pension triple lock WILL be in Tory manifesto” promises the Daily Express. “Mental health culture has gone too far, says Stride” – that’s the Daily Telegraph. “The lipstick, make-up and leopard print go unworn” – the husband of Coronation Street star Julie Goodyear opens up to the Daily Mirror about her dementia. “Fentanyl Phantom” – that’s what the Metro calls a “poisoner who watched victims die” during a “2-year murder mission” involving 20 fake personas.

Today in Focus

Cartoon of the day | Ben Jennings

The Upside

A bit of good news to remind you that the world’s not all bad

Eleven Guardian writers have compiled a list of songs to inspire primary schoolchildren and get them excited about music. Jenny Stevens recommends Dolly Parton’s Coat of Many Colours, a song that is “fundamentally” about poverty: “It might say to the many kids in Britain who find themselves in destitution today that they are seen, they are known, and that there are people who still care – even if this government does not.”

Phil Hebblethwaite puts forward some impressionistic classical music to tap into the unlimited capacity of a child’s imagination. For some catharsis, Ciaran Thapar recommends My 19th Birthday by Dave and for the rule breakers Shaad D’Souza suggests sticking on Kero Kero Bonito’s Only Acting. For more inspiration, you can read the full list here.

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