5 April 2022

Give up to level up – how going smoke-free can boost the poorest regions


Much confusion has surrounded the Government’s impassioned commitment to ‘levelling up’. Ostensibly it is designed to reduce imbalances between different regions of the UK without negatively impacting wealthier areas, boosting the income of every household.

However, despite the raft of Government proposals to this effect, there remains a gaping chasm on health and earnings in greater London, compared with other areas.

And with Javed Khan, former Chief Executive at Barnardo’s, now appointed to look at ways to reduce smoking rates among young people, it is surprising that politicians are having to scratch their heads when a low-cost, high impact solution is staring them in the face.

The health benefits and savings that come from switching from smoking to vaping are clear. Smoking kills 78,000 people every year, and thousands more of the UK’s 6.9 million smokers are living with debilitating smoking-related illnesses. These, in many cases, hinder the ability to work and generate economic growth.

When it comes to mortality, new research from the Adam Smith Institute shows that making England smoke free would save 2 million years of life lost to smoking across the regions – a staggering figure.

To surmise this statistic, we asked the question: ‘What would happen if the adult smoking rate in the North East, North West and Yorkshire and The Humber was reduced to the same prevalence as London, through smokers switching to vaping?’

We formulated the answer by applying World Health Organisation estimates of average life expectancy gains from quitting smoking to each age group of ‘switchers’. We then adjusted the total according to the relative risk of e-cigarettes (95% safer than smoking, according to Public Health England).

Results showed 384,634 years of life would be saved in the North East, 923,942 in the North West and 630,589 in Yorkshire and The Humber. This makes for a total of nearly two million (1,939,165) years of life saved by levelling up health in these regions through accelerating the adoption of vaping.

But whilst the evidence to support vaping is clear, smokers’ knowledge of this lags behind the science. Worryingly, this has worsened over time. In 2014, 15% of smokers thought that vaping was as or more harmful as smoking. This figure increased to 32% in 2021. Some 24% just didn’t know.

That means 56% of smokers were clueless as to whether or not vaping was more or less safe than tobacco combustion.

Considering the draconian advertising restrictions on such products, this may come as little surprise. If these are eased, vital education on vaping could reach the masses.

And while controversial, considerations should also be made to promote heated tobacco products and snus – a nicotine pouch that sits behind the lip and helped Sweden achieve the lowest smoking rates in Europe.

Then there is the cost benefit of switching from smoking to vaping. An average smoker spends £1900 a year on cigarettes, more than two and a half times that of vaping (£720). Smokers in the North East could boost their disposable incomes by around £1,600 per year if they switched to vaping: an increase of nearly 11%. Smokers in the North West could boost their disposable incomes by an additional £1,075 per year if they switched to heated tobacco: an increase of around 6.5%. And smokers in Yorkshire and The Humber could boost their disposable incomes by around £866 per year if they switched to nicotine pouches: an increase of 5.4%.

Doubling down on tobacco harm reduction is a clear, impactful, evidence-based means of helping smokers on low incomes to deal with the rising cost of living. While the UK can cement its status as a world-leader in smoking cessation, it can only do so if it actually informs smokers of the alternatives through advertising. Levelling up requires a level playing field for the very tools that can help address the problem. Without this, the PM’s ambitious project risks being snuffed out.

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