It's 50 years since the publication of the Royal College of Physicians' landmark report on smoking, which set out a stark warning about the current and future dangers of cigarettes.

Although there had been previous warnings linking smoking to lung cancer, it was the 1962 report Smoking and Health that really broke through to the public, the health profession, and politicians.
Some doctors at the time believed that smoking was actually beneficial for improving circulation, and even recommended it to pregnant woman as a way to combat morning sickness.

While huge strides have been made in lowering smoking rates since the publication of the report, there remains a way to go before we can stub out smoking for good.

UK smoking prevalence has fallen substantially but still over 20 per cent of the population smokes - some ten million people.

“Smoking is still the biggest avoidable killer in the UK,” warns Professor John Britton, chair of the RCP tobacco advisory group.

Half of those will die from smoking, unless they quit, losing a total of one hundred million years of life.

Since 1962, over 6 million people have died as a result of smoking.

The smoking ban

But as awareness of the dangers of smoking has increased, so has the number of public policy measures to tackle it, such as the ban on smoking in public places and the ban on tobacco advertising and sponsorship.

The latest measure on visibility of tobacco, to be introduced on the 6 April 2012, will mean that all large shops in England will have to hide tobacco products from view, in a drive to cut the number of smokers and protect young people who are often the target of tobacco promotion.
Jean King, Cancer Research UK's Director of Tobacco Control, thinks the latest policy will make a difference.

“Around 80 per cent of smokers start before they turn 19, so it's vital that cigarettes are not seen as normal, harmless products instead of the deadly and addictive drugs they really are.
“Preventing young people from starting to smoke is vital and putting tobacco out of sight is a step towards putting them out of mind for the next generation.”

As well as these policy measures, the NHS has been playing its part in tackling smoking. NHS smoking cessation services have been established up and down the country and are going from strength to strength, supported by national guidance from NICE.

NICE has produced a suite of guidance on preventing smoking, including guidance on smoking cessation , workplace interventions advice, guidance to prevent children and young people from smoking, and guidance to help expectant mothers quit during pregnancy.

The public health team at NICE are also busy working on new pieces of guidance to cover harm reduction approaches, smoking cessation for acute and maternity services and smokeless tobacco.
Deborah Arnott, Chief Executive of Action on Smoking and Health (ASH), believes that NICE's guidance has played an important role in helping people give up smoking and will continue to do so in the future.

“The guidance is excellent but the challenge for NICE will come with the shift in public health from primary care trusts to local authorities. NICE will need to ensure that it continues to get the messages out there to this new audience.

“At the same time, NICE must also make sure that it continues to provide guidance for doctors in the NHS.”

A message echoed by staff at Bolton PCT who have been using NICE's guidance to develop a new service to flag up any patient who smokes and is admitted to the Royal Bolton hospital.
Smokers are offered advice and support on admission to hospital to encourage them to take up smoking cessation services.

So far, the service has produced outstanding results with just under half of the patients involved going on to successfully give up smoking.

Project lead Gary Bickerstaffe, Health Improvement Specialist at Bolton PCT, says: “Initially there was very little guidance around to help guide this work but as NICE started to produce specific guidance on smoking and public health we used it to ensure we had developed our service thus far in line with the guidance recommendations.

“Now we continually look to NICE guidance around smoking cessation including areas such as brief advice, brief interventions and service delivery to ensure that we are embedding the practices in line with best practice and a recognised strong evidence base.”

Source: NICE