Peter Moore: 'Smoking still has a macho ‘grown up’ image with the young. Somehow, we have to change this image'

Parliament will soon debate a bill to ban anyone born after 2009 from buying tobacco products. Anyone turning 15 this year will never be able to buy cigarettes legally. This legislation should come into force in January 2027. Is this a terrible infringement on civil liberties or a brilliant move to help public health? Surely when these 15-year-olds are adults they can make up their own minds. 

Smoking does not only affect the smoker.  Although adults can make their own choices smoking affects all of us, whether or not we smoke. 

For non-smokers passive smoking can lead to lung cancer, cervical cancer, asthma and strokes.  Living with a smoker increases the risk of heart disease by up to 30 per cent. After smoking was banned indoors in public places there were 1,200 fewer hospital admissions for heart attacks. In some parts of the UK 20 per cent of women smoke in pregnancy increasing their chances of having a stillbirth by almost 50 per cent. 

For me this is personal. My brother, who did not smoke but worked with smokers, died of cancer at the age of 43. I can never be certain that this was due to passive smoking, but it seems likely.

Smoking is killing an estimated 80,000 people a year in the UK. It is the cause of one in four cancer deaths and over 70 per cent of cases of lung cancer. Smokers die about ten years earlier than non-smokers.  When it is difficult to get a GP’s appointment there are over 100  GP appointments every hour for smoking related diseases. Every minute of every day someone is admitted to hospital due to smoking. 

It also affects the economy, again an issue for all of us. Every premature death is a tragedy for friends and family but it also affects the economy. As well as the huge cost to the NHS we lose fully trained workers. This costs the wider economy an estimated £17 billion a year, enough to employ over 500,000 nurses or 6.9p in the pound of income tax. 

So why pick on young people? 80 per cent of smokers started under the age of 20. Nicotine is highly addictive. These people will be addicted for life. The vast majority of smokers wish that they had never started. Hopefully this new legislation will stop young people from ever starting. 

Sadly, smoking still has a macho ‘grown up’ image with the young. Somehow, we have to change this image to the more realistic image of a smelly person with bronchitis. 

But will banning cigarette sales to younger people and increasing the age year on year help? Is it realistic? The legislation was introduced in New Zealand, but they have since dropped the idea. New Zealand’s plans were far more ambitious. It included dramatically reducing the amount of nicotine in tobacco products, cutting the number of shops that could sell tobacco and licensing those remaining.   The advantage of the UK law is that it does not affect people who are already addicted to nicotine. It is designed to stop the next generation from becoming addicted. The plan is evolution not revolution. 

Cutting tobacco advertising, ensuring tobacco products are hidden in shops and putting blunt messages on cigarette packets has helped. 

I was uncertain when smoking was banned in pubs and restaurants. I thought it a great idea but it would never work. Luckily, I was wrong. It has been very successful. It is now simply accepted that no one smokes in pubs and restaurants. 

In the 1980s comedy ‘Yes Minister’ the senior civil servant, Sir Humphry Appleby, criticised anti-smoking doctors. He argued that seeing their patients suffer and die from smoking made the medical profession biased.  He was absolutely right. Having seen many of my patients hardly able to breath with severe chest problems or die from lung cancer did make me biased. My hope is that a future generation of doctors will not be biased because, in a smoke free country, they won’t see these problems.