Tobacco and Health Inequality

Shelia Duffy argues that tobacco use is a key driver of health inequalities

The current economic climate is creating a range of challenges for families and communities up and down the UK, felt most acutely in the most deprived areas. With new concerns dominating the agenda it can be difficult to find time to talk about the impact of smoking on Scotland’s poorer communities – even without the lingering myth that tobacco is a prop which people fall back on in difficult times, and ‘one of the only pleasures left’ for people on lower incomes (as ex Cabinet Minister John Reid put it).

Yet with rates of smoking four to fives times higher in the poorest areas than in the richest, tobacco use is a key driver of health inequalities, which are higher in the UK than in the rest of Central and Western Europe. And for the nearly 70% of smokers who say they want to quit, this is no prop but an unwilling addiction.

Tobacco continues to impact on people’s health and well-being in such a familiar way that it risks going un-noticed. Meanwhile a quarter of all adult deaths in Scotland are attributable to smoking – with tobacco killing half of its long term users. Crisps and sugary drinks just do not do this. 32% of these deaths were in Scotland’s most deprived areas – twice that of the most affluent groups. In these communities people smoke more heavily and are less likely to succeed in quitting. This killer destroys families, impacts on health and the day-to-day quality of life, while generating enormous profits for the tobacco companies. The cost of keeping up a tobacco addiction means that families have less to spend on food and housing.
It is time that we, as a society, did more to protect our more vulnerable citizens. Where is the sense of anger against an industry which long ago gave up any interest in the health of its customers, with a long track record of lies and deception and which every day put its own profits before the well-being of people? While so much is said about the ethical performance of the banks, very few smokers can even name the tobacco companies behind the all-too-familiar brands.

Yet the behaviour of the tobacco companies has been so bad that an international treaty, signed by our Government and nearly 170 others, sets out “an irreconcilable conflict between the tobacco industry’s interests and public health policy interests.” What other industry can claim such an accolade? And now, as if worried that others might take over the villain spot, we hear that British American Tobacco, with brands such as Lucky Strike and Rothmans and profits of nearly £6billion, doesn’t pay a single penny in UK corporation tax.

The Scottish Government is about to launch a new 5-year strategy on tobacco and health, with tackling inequality as a core theme running through the document. It is in the heart of our poorest communities where the battle will be most keenly fought. By working with communities to understand the role of tobacco in their lives, by supporting young people to make healthy choices on tobacco and by providing flexible stop-smoking support that can be tailored to the needs of all users we can aspire to the next generation growing up free from the harm and inequality caused by tobacco.

Shelia Duffy is the Chief Executive of ASH Scotland

From Healthier Scotland: the Journal