2 in 3 smokers wish they could stop and 9 in 10 wish they had never started. Photo: Getty
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Why we should ban the sale of cigarettes to people born after the year 2000

Someone who starts smoking at age 15 is three times more likely to die of tobacco related cancer than someone who starts in their mid-20s.

Humanity has never developed anything more deadly than the cigarette. The combination of its addictive power and devastating health effects, coupled with historical social norms and powerful advertising campaigns, killed 100 million people in the twentieth century. The World Health Organisation predicts that this continuing epidemic will kill a billion more in the twenty-first. Tobacco products cause the death of 50 per cent of their users and, for each death, 20 other people suffer from a smoking related disease. Allowing this cycle of addiction, suffering and death to continue is unconscionable.

One solution is to prohibit the sale of cigarettes to people born after the year 2000. As this generation reach 18 in 2018 they would be prevented from buying cigarettes for their lifetime in a move that would progressively phase out cigarette sales. This would have the effect of de-normalising smoking for an entire generation of children and slowly begin to reduce the harm caused by tobacco. Evidence published today in the Lancet shows the incredible effects that smoke-free legislation has had on child health, including reducing premature births and hospital attendances for asthma attacks. It’s time to apply the lessons from this evidence to the population as a whole.

This move may be unpopular among people who view banning the sale of cigarettes as a restriction of personal freedom. However, starting to smoke predominantly takes place in childhood and adolescence, as 80 per cent of smokers start in their teens. This decision is heavily influenced by peer pressure and a desire to appear more adult, rather than being dependent on rational choice. Almost 99 per cent of people think adolescents should be prevented from taking up smoking and to achieve this smoking must become socially unacceptable. This is particularly important as someone who starts smoking at age 15 is three times more likely to die of tobacco related cancer than someone who starts in their mid-20s. By the time smokers reach adulthood, the majority continue smoking to relieve the unpleasant sensation of nicotine withdrawal, rather than to gain any pleasurable effect from the nicotine itself. Addiction, by definition, cannot be an expression of free will. This is reflected in the fact that 2 in 3 smokers wish they could stop and 9 in 10 wish they had never started. If smoking were a true choice, there would be far fewer smokers in the world.

The inevitable comparison of this policy with alcohol prohibition in the 1920s is hard to ignore. However, substantial differences exist between the nature of alcohol and the nature of tobacco. Most people who smoke are nicotine addicts responding to withdrawal symptoms who wish they could stop. In contrast, the majority of people who drink alcohol do so recreationally for its pleasurable effects. Alcohol is substantially less addictive than nicotine and so a much smaller proportion of drinkers become alcoholics. If 90 per cent people who drank became alcoholics there would be total public outrage. In recognition of the harms caused by tobacco, over time there has been a supportive public response to tobacco legislation, including health warnings, advertising bans, smoke-free public places and preventing smoking in cars with children. It would be surprising to suddenly see a large proportion of the population take up clandestine smoking in response to this kind of ban, particularly as current smokers would be able to continue buying cigarettes without hindrance.

While smoking is still seen as socially acceptable in daily life and believed to be an expression of free will it is unlikely that there will be sufficient political will to call for an outright ban. However, this policy presents an opportunity to intervene for the generation who have not yet started smoking to prevent them from perpetuating the cycle of misery and suffering caused by nicotine addiction. It’s time to play the tobacco endgame and begin building the first smoke free generation.

Dr Tim Crocker-Buqué is a Speciality Registrar in Public Health Medicine

Photo: Getty
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Who will win in Stoke-on-Trent?

Labour are the favourites, but they could fall victim to a shock in the Midlands constituency.  

The resignation of Tristram Hunt as MP for Stoke-on-Central has triggered a by-election in the safe Labour seat of Stoke on Trent Central. That had Westminster speculating about the possibility of a victory for Ukip, which only intensified once Paul Nuttall, the party’s leader, was installed as the candidate.

If Nuttall’s message that the Labour Party has lost touch with its small-town and post-industrial heartlands is going to pay dividends at the ballot box, there can hardly be a better set of circumstances than this: the sitting MP has quit to take up a well-paid job in London, and although  the overwhelming majority of Labour MPs voted to block Brexit, the well-advertised divisions in that party over the vote should help Ukip.

But Labour started with a solid lead – it is always more useful to talk about percentages, not raw vote totals – of 16 points in 2015, with the two parties of the right effectively tied in second and third place. Just 33 votes separated Ukip in second from the third-placed Conservatives.

There was a possible – but narrow – path to victory for Ukip that involved swallowing up the Conservative vote, while Labour shed votes in three directions: to the Liberal Democrats, to Ukip, and to abstention.

But as I wrote at the start of the contest, Ukip were, in my view, overwritten in their chances of winning the seat. We talk a lot about Labour’s problem appealing to “aspirational” voters in Westminster, but less covered, and equally important, is Ukip’s aspiration problem.

For some people, a vote for Ukip is effectively a declaration that you live in a dump. You can have an interesting debate about whether it was particularly sympathetic of Ken Clarke to brand that party’s voters as “elderly male people who have had disappointing lives”, but that view is not just confined to pro-European Conservatives. A great number of people, in Stoke and elsewhere, who are sympathetic to Ukip’s positions on immigration, international development and the European Union also think that voting Ukip is for losers.

That always made making inroads into the Conservative vote harder than it looks. At the risk of looking very, very foolish in six days time, I found it difficult to imagine why Tory voters in Hanley would take the risk of voting Ukip. As I wrote when Nuttall announced his candidacy, the Conservatives were, in my view, a bigger threat to Labour than Ukip.

Under Theresa May, almost every move the party has made has been designed around making inroads into the Ukip vote and that part of the Labour vote that is sympathetic to Ukip. If the polls are to be believed, she’s succeeding nationally, though even on current polling, the Conservatives wouldn’t have enough to take Stoke on Trent Central.

Now Theresa May has made a visit to the constituency. Well, seeing as the government has a comfortable majority in the House of Commons, it’s not as if the Prime Minister needs to find time to visit the seat, particularly when there is another, easier battle down the road in the shape of the West Midlands mayoral election.

But one thing is certain: the Conservatives wouldn’t be sending May down if they thought that they were going to do worse than they did in 2015.

Parties can be wrong of course. The Conservatives knew that they had found a vulnerable spot in the last election as far as a Labour deal with the SNP was concerned. They thought that vulnerable spot was worth 15 to 20 seats. They gained 27 from the Liberal Democrats and a further eight from Labour.  Labour knew they would underperform public expectations and thought they’d end up with around 260 to 280 seats. They ended up with 232.

Nevertheless, Theresa May wouldn’t be coming down to Stoke if CCHQ thought that four days later, her party was going to finish fourth. And if the Conservatives don’t collapse, anyone betting on Ukip is liable to lose their shirt. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.