ASH Wales welcomes fall in the number of smokers in Wales

ASH Wales has welcomed the news from the latest National Survey for Wales that smoking prevalence in the country has dropped from 19% to 17%.
However, it warns that with over 450,000 people in Wales continuing to light up, and prevalence highest in the country’s most deprived communities, reducing smoking should remain a major public health priority.

According to the latest figures from the National Survey for Wales 2018-2019, 17% of adults in Wales now smoke, 18% of men and 16% of women.
Smoking rates are highest in Wales’ poorest communities with 21% of adults smoking in the most deprived areas, a fall of 7 percentage points since the 2017-18 survey was undertaken. Smoking prevalence remains at 13% in the least deprived areas.

Overall the figures mean the Welsh Government is now 1% off its target to reduce smoking prevalence to 16% of the population by 2020.
The decrease follows a year of continued investment in national stop smoking services in Wales. Robust tobacco control measures and the introduction of smoke free spaces across Wales have also led to the country moving one step closer to becoming smoke-free.
Smoking looks to become even less common when the Public Health (Wales) Act 2017 comes into force, banning smoking in school grounds, hospital grounds and playgrounds.

First Minister Mark Drakeford, described the results of the survey as “extremely positive” and said the Welsh Government remains committed to tackling smoking prevalence in Wales:

“The latest National Survey for Wales showing a further drop in smoking rates is extremely positive – we are now very close to reaching our target of cutting adult smoking rates to 16% by 2020. We are committed to doing all we can to reducing smoking rates across Wales and supporting smokers who want to quit.

“Our Public Health (Wales) Act includes new measures to restrict smoking in outdoor children’s play areas and educational settings, further helping to protect children and young people from second hand-smoke.”

Suzanne Cass, CEO of ASH Wales, said she hoped the results reflect a shift in attitudes towards smoking in Wales: “Smoking is responsible for thousands of deaths in Wales every year, at a huge cost to the country’s NHS, not to mention the devastating impact on families.

“We are encouraged to hear smoking rates have fallen and believe this is due to a combination of factors including smoking bans, smoke free spaces and the rise in the popularity of e-cigarettes as a smoking substitute.
“It is our hope that these changes reflect a change in attitudes towards smoking, which was once perceived as a normal lifestyle choice but is now viewed by many as a life-threatening addiction which destroys lives.”
She went on to say however, that despite the decline in smoking rates there is still much work to be done in tackling smoking prevalence, particularly among the most deprived areas of Wales.

“We cannot afford to be complacent when it comes to tobacco control. Great progress has been made however, smoking remains a major cause of health inequalities, poverty and death in Wales, with prevalence still highest in our most deprived communities.
“Smoking rates among our young people remain stubbornly high, with 9% of 15-16-year-olds still smoking weekly and the availability of illegal tobacco provides a ready supply of deadly cigarettes at pocket money prices.
“Reducing smoking prevalence in Wales must remain a major public health priority and form part of any agenda aimed at improving the nation’s health.”

Ten reasons why smoking is bad for the planet

Tobacco agriculture causes huge environmental damage. According to the World Health Organisation an estimated 200,000 hectares of forests and woodlands are cut down each year because of tobacco farming

– Contrary to popular belief, cigarette butts are not biodegradable and remain in the environment for up to 15 years once they have been discarded

– Cigarette butts contain plastic. Many of those dropped into the streets fall down the drains and eventually find their way into the sea creating what Sir David Attenborough has described as a ‘toxic soup’

– The filters within cigarettes contain harmful chemicals including arsenic, lead and nicotine that pollute the waterways and endanger the animals that ingest them

– Cigarettes butts are the most littered item in the world and it is estimated that 122 tonnes of smoking related litter is dropped every day

– One cigarette butt left to soak in water for 96 hours will release enough toxins to kill half of the salt or fresh water fish that are exposed to it

-In 2017 cigarette butts were found to be the fourth most common littered item on beaches in Wales during the Marine Conservation Society’s Great British Beach Clean

– Discarded cigarette butts often get caught between paving stones or trapped in tree grates making them expensive and difficult to clean up

-Cigarette ends have been found in the guts of whales, dolphins, turtles and sea birds, which have mistaken them for food

– When animals ingest cigarette butts it leads to inflammation of the digestive system, a blockage in the gut which can be fatal and leaching of toxic chemicals into the bloodstream

Top Welsh surgeon warns men to stop smoking or risk suffering erectile dysfunction

SMOKING is a major cause of impotence and low sperm count, a leading Welsh surgeon has warned as part of Men’s Health Week.
Professor Gareth Brown, Consultant Urological Surgeon at the Royal Glamorgan Hospital, has urged male smokers to quit the habit or risk suffering erectile dysfunction and reduced sperm count.

He explained that smoking restricts blood flow to the penis, and said that it also affects the quality and quantity of men’s sperm, potentially leading to infertility in male smokers:

Professor Gareth Brown

“I think with all the press and publicity today most people are aware of how unhealthy smoking is but they don’t associate it with being a cause of erectile dysfunction. We now know that smoking leads to a narrowing of the blood vessels caused by some of the chemicals inhaled, and also through the formation of a plaque called atherosclerosis which restricts the blood flow to the penis leading to erectile dysfunction.

“It can also cause male infertility by affecting sperm production by reducing the quality and quantity.”

Professor Brown went on to say, however, that quitting smoking can reverse or reduce some of these effects:

Stopping smoking can improve and in some cases may reverse the symptoms particularly fertility and erectile dysfunction. It depends on the quantity and duration smoked. Long term smoking has detrimental effects some of which cannot be reversed, however smoking cessation can stop symptoms progressing and make treatments more effective.”

An Australian study carried out by researchers from Imperial College London in 2006, found that men who smoke a pack or more of cigarettes daily are nearly 40% more likely to be impotent than non-smokers. Meanwhile even smoking less than 20 cigarettes a day was found to increase the risk of impotence by 24%.
Across Wales, 21% of men smoke compared to 17% of women. Smoking rates are highest in the most deprived areas the country; 28% compared to 13% in the most affluent areas.

Suzanne Cass, CEO of ASH Wales, urged male smokers to seek help to quit: “We know that breaking the cycle of addiction is a huge challenge for smokers. But our message to men is that they don’t need to suffer in silence.
“NHS Wales’ Help me quit service offers free tailored support to all smokers in Wales and is just a phone call or email away. Taking your first step on the journey to a smoke-free life won’t be easy but it’s a move you’ll never regret.”

Martin Tod is Chief Executive of the Men’s Health Forum, organisers of Men’s Health Week. He said:

Even today, in Wales, nearly one man in five dies before the age of 65 – before retirement age – and smoking is still the biggest avoidable cause of early death for men in Wales. Men are still more likely to smoke than women. But smoking doesn’t just kill men, it’s also a big cause of impotence and low sperm count. There’s no shame in getting help to quit. Addiction is tough to tackle, but there’s good free support out there and it makes a real difference.”

Across Wales 19% of adults smoke and there are 5,388 smoking attributable deaths in Wales every year. Smoking costs the NHS in Wales £302million a year and in 2017 lung cancer caused more deaths in Wales than bowel and breast cancer combined.

Dr Ramsey Sabit, is Respiratory Consultant at Spire Cardiff Hospital and the Cardiff and Vale University Health Board. He said: “We know that half of smokers will die of a condition directly related to their habit and that a smoker will lose an average of 10 years off their life expectancy.

So, my message to male smokers is simple – if you want to live a longer life with less chance of a whole host of chronic diseases, then it is essential to stop smoking. It is never too late to give up but giving up completely is essential as even a few cigarettes per day increase your risks of smoking related disease.”

For support to give up smoking contact Help Me Quit on 0800 085 2219.

Survey reveals support for tougher tobacco control in Wales including smoking bans in town centres

The people of Wales are calling for tougher measures to reduce smoking prevalence, including bans on smoking in all town centres.

Results from the latest ASH Wales Cymru YouGov survey into attitudes towards tobacco control in Wales have been published to mark World No Tobacco Day and reveal overwhelming support for new measures and outdoor smoking bans.

Of those surveyed, 59% said they would support a ban on smoking in all town centres in Wales and 63% agreed smoking should be banned in the outdoor eating areas of cafes and restaurants. Meanwhile 63% of those surveyed said they would support a move to ban smoking in all cars.

According to the survey, nearly half (47%) of Welsh adults feel the government is not doing enough to reduce smoking prevalence in Wales up from 39% in 2018. A total of 68%, said they would support new government action to reduce smoking rates to less than 5% by 2035.

There was strong support too for measures aimed at reducing smoking among young people; 58% said they would support raising the age of sale limit for tobacco from 18 to 21. Meanwhile 83% called for businesses to be required to hold a valid licence to sell tobacco which would be removed if they were found selling to underage smokers more than once.  The survey also found 67% of Welsh adults support banning smoking from entertainment media aimed at young people.

John Griffiths AM, chairman of the Welsh Assembly’s Cross-Party Group on Smoking, said funding is needed to support smoking cessation activity in the community:

“As Chair of the Welsh Assembly’s Cross-Party Group on Smoking, I welcome the latest YouGov survey results which highlight that there is strong support for tackling smoking in Wales. The results show that nearly 70% of people would support new action to reduce smoking prevalence in Wales by 2035.

“Smoking is still the biggest cause of preventable mortality and health inequality in Wales and rates have stagnated at 19% since 2015. Community based actions at grass roots levels must have the financial support they need to effectively help people quit cigarettes for good. I look forward to continuing to work alongside ASH Cymru to further improve smoking cessation services and ensure we soon have a smoke-free Wales.”

Suzanne Cass is CEO of ASH Wales Cymru. She said the survey results prove how far the tide of public opinion has turned against smoking:

“These survey results show just how far we’ve come, from a society in which smoking was regarded as a normal part of daily life, to one where the public are demanding tougher measures to help stamp out this deadly addiction.

“There is now far greater awareness of the devastating health consequences of smoking with the older generation now suffering the consequences of a lifetime of smoking and 5,388 smoking related deaths in Wales alone every year.

“Thanks to a combination of tobacco control measures and campaigns to raise awareness of the impact of smoking on people’s lives, it is gradually become de-normalised, particularly among the all-important younger generation.”

The theme of this year’s World No Tobacco Day, is the impact of tobacco on lung health. Currently smoking prevalence in Wales stands at 19% of the adult population – 476,000 adults.

There are 5,388 smoking attributable deaths annually in Wales and the cost to the Welsh NHS is £302million. Across Wales lung cancer is the most common cause of cancer deaths – there were 1,891 deaths from lung cancer in 2017 and it accounted for over one in every five cancer deaths – more than bowel and breast cancer combined.

Tobacco and lung health – a global view

Dr Vinayak Prasad leads the World Health Organisation’s (WHO) Tobacco Free Initiative and is a world authority on the damage caused to health by smoking.  To mark World No Tobacco Day 2019, which this year focuses on lung health, we spoke to him about the impact of tobacco smoking globally.

 Does the impact of tobacco on lung health vary greatly across different countries?

The tobacco smoking risks are the same or similar across all countries. But the cause of death or disease patterns differ according to the way tobacco is used. For instance, in Southern Asia, there is a far greater use of smokeless tobacco, in other words chewing tobacco. So, in that part of the world diseases caused by chewing tobacco such as oral cancer are becoming predominant. It is also affected by which health conditions are more common in certain regions.

What are the links between smoking and tuberculosis?

Tuberculosis is a big problem in some countries and there a greater risk of mortality among those with TB who smoke. It is a cause of mortality that has been well established for more than a decade.  Smoking also more than doubles the risk of developing tuberculosis.

How big a threat is smokeless tobacco to global health?

Smokeless tobacco is used in over 80 countries and that’s huge. There are a lot of challenges in Sri Lanka for example, where smoking rates are still high but declining and smokeless tobacco use is rising. It is popular because it’s cheaper and it’s easily accessible for young people to consume and to use without being noticed in school.  80% of oral cancer deaths in that part of the world are because of one single product, smokeless tobacco.

Is there sufficient awareness globally about the harms caused by tobacco smoking?

Lung health and lung disorders are the most common disease factors in the world. This can come from multiple factors, whether it’s air pollution or tobacco. Interestingly in more than 30 countries where surveys have been carried out, 90% of people know that tobacco causes cancer, even in countries with a less literate population. However, it’s not the same story for  other conditions such as cardiovascular disease and COPD. Only 60 per cent know about these risks to lung health because of smoking.

How big is the impact of secondhand smoke globally?

The global picture is that more than 60% of secondhand smoke exposure affects women and children, which is a concern because they are not smokers but they are being affected. Children are hugely prone to asthma and to respiratory diseases from their parents smoking.

Most people don’t smoke in the workplace because of legislation but they go home and they tend to smoke.  The law of the land doesn’t prevent them from smoking at home at all. It’s more and more important to raise awareness of the harms of second-hand smoke.  And that cannot be imposed by law, it requires more community engagement and literacy. It’s very important, for instance, to teach children that it’s risky so they can go home and tell their parents that if they want to smoke they can go outside and smoke.

What should governments do to reduce the impact of tobacco on lung health globally?

World Tobacco Day 2019 is focused on tobacco and lung health to raise awareness of the negative impact of tobacco use on people’s health ranging from cancer to chronic respiratory diseases . And for us at this stage it’s important to raise awareness among all stakeholders. Tobacco control is the key factor to reducing NCDs (non-communicable diseases). Governments must prioritise tobacco control as part of their policies.

The WHO has a package of measures which we call MPOWER which are key demand reduction measures such as graphic warning labels on the products, banning tobacco advertisements and raising taxes. The UK has done extremely well in raising tobacco taxes.  Tax is the best instrument. That is the best levy.  It makes it difficult for the poor, the vulnerable, even the rich to consume so much tobacco. And it provides the government has additional revenue with which they could then help tobacco smokers to quit and launch awareness campaigns.

A classroom full of children still start smoking in Wales every day with the poorest teens most likely to take up the habit

New figures released today reveal the gap in smoking rates amongst Wales’ richest and poorest teenagers has widened.

According to the latest Health Behaviour in School-aged Children Report, youngsters from the most deprived families in Wales are now twice as likely to smoke compared to their affluent counterparts.

The survey of over 100,000 students, carried out by researchers at Cardiff University, showed 9% of 15-16-year-olds smoke at least once week, a figure that despite concerted efforts, has remained unchanged since 2013/14. More than 11,000 children still take up smoking every year in Wales

Differences in smoking rates across social classes remain a major concern as smoking is more than twice as common in adults in the most deprived areas of Wales (28%) compared to the least deprived (13%).

Across Wales smoking is a leading cause of death and ill health and a major driver of health inequalities.

Among those from the least affluent families, 6% of secondary school aged children now smoke at least weekly, compared to just 3% of those from the most affluent families.  This compares to 4% of the least affluent and 3% of the most affluent as reported in 2013/14.

Commenting on the latest figures, Suzanne Cass, CEO of ASH Wales, said: “It is shocking to discover that despite efforts to curb smoking among young people in Wales, a classroom’s worth of children continue to take up the habit every single day.

“Meanwhile the differences in the smoking rates between our richest and poorest youngsters are actually getting worse.

“Among the adult population of Wales, it is those people from the deprived areas that are the most likely to smoke. It is essential that we take action to prevent young people from those areas from becoming the next generation of adult smokers in Wales and from perpetuating the health inequalities that continue to blight our most deprived communities.”

Those who start smoking earlier in life are likely to become the heaviest smokers later in life as well as the least likely to quit. Research has shown the earlier children start smoking then carry on into adulthood, the greater their risk is of developing lung cancer or heart disease in later life.

The report also reveals the following differences in smoking prevalence and exposure to smoking between the most and the least affluent youngsters in Wales:

  • 46% of Year 11 students from the most deprived families first tried a cigarette at 13 or younger compared to 34% of the most affluent. In 2013/14, 61% of those from the least affluent families had tried at cigarette at 13 or younger, compared to 38% from the most affluent families.
  • 8% of young people were exposed to smoking during their most recent car journey – a significant decrease compared to 13% in 2013/14. This figure rises however depending on the young person’s background with 5% of those from a more affluent background having been exposed to smoke during their last car journey, compared to 14% from the most deprived families.  In 2013/14 23% of youngsters from a deprived background said someone was smoking the last time they were in a car, compared to 10% of youngsters from a more affluent background.
  • E-cigarette use has not been shown to vary greatly depending on a child’s background. 28% of those from the least affluent families said they had tried an e-cigarette, compared to 24% from the most affluent.  The figure was the same for both groups in 2013/14 at 12%. Only 4% of those from the least affluent backgrounds and 3% from the most affluent said they used e-cigarettes regularly.

Following the release of the figures, ASH Wales is calling for a more targeted approach to reducing youth smoking prevalence, with prevention and cessation work provided in those areas where it is most needed.

Suzanne Cass, CEO of ASH Wales, said: “It is clear from these figures that tobacco control policies designed to restrict young people’s access to cigarettes are not working, with no change in the number of pupils lighting up.

“Tobacco companies want nothing more than to trap these youngsters into a cycle

of addiction that will see them become their customers for life. The only way to break that cycle is to identify those most at risk of smoking and arm them with the tools they need to resist temptation or to quit.”

“We would like to see prevention and cessation support for young people available in both community and educational settings and families provided with the support they need to quit together. In addition, we believe smoking prevention work should form part of the new National Curriculum for Wales 2022.”

Currently 19% of the adult population in Wales smoke. There are around 5,388 smoking related deaths and 26,489 smoking related hospital admissions in Wales every year and the cost of this to NHS Wales is around £302 million a year.

Student Health and Wellbeing In Wales: Report of the 2017/18 Health Behaviour in School-aged Children Survey and School Health Research Network Student Health and Wellbeing Survey, was compiled by Cardiff University’s Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer).

Editor’s Notes

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