Demise of smoking greatly exaggerated
The Office for National Statistics published its annual statistical bulletin on smoking earlier this week.
Here are some of the main points:
In the UK, in 2019, 14.1% of people aged 18 years and above smoked cigarettes, which equates to around 6.9 million people in the population.
If these estimated figures are accurate (see below) it means that one in seven adults in the UK still smoke.
The number (and proportion) continues to fall but let's put this in perspective:
6.9 million is approximately half the number of people that voted for the Conservative party in the 2019 general election, almost twice the number that voted for the Lib Dems (3.67m), and eight times the number that voted for the Green Party (864,743).
Yes, smokers are a minority but not an insignificant one and their habit makes a huge contribution to the local and national economy.
The proportion of current smokers in the UK has fallen from 14.7% in 2018 to 14.1% in 2019.
The ONS describes this fall as 'significant' by which I think they mean 'statistically significant' but is it significant in other ways?
For example, can it be linked to anti-smoking legislation such as plain packaging or the ban on ten-packs introduced in May 2017?
Not really. According to ONS stats, the smoking rate fell from 15.8% in 2016 to 15.1% in 2017, then 14.7% in 2018 and 14.1% in 2019.
Prior to those measures the smoking rate fell far more dramatically – from 19% (2014) to 17.2% (2015), then 15.8% (2016) – a fall generally attributed to the simultaneous growth of vaping.
Talking of which:
In Great Britain, 5.7% of respondents in 2019 said they currently used an e-cigarette, which equates to nearly 3 million adults in the population.
According to the ONS:
This proportion is significantly higher than that observed in 2014, when data collection began, when only 3.7% vaped. In 2019, changes in proportions of those who said they vaped were not statistically significantly different from the previous year.
However they spin it (do I detect the hand of Public Health England in that statement?) it's clear that the proportion/number of vapers in the UK stalled last year.
It's not the first time vaping has flatlined - it happened a few years ago before a mini surge took the figure up to three million where it appears to have settled.
The ONS doesn't speculate why this is happening so I may return to the subject in another post. Meanwhile it's worth noting that:
In 2019, the proportion of vapers was highest among current cigarette smokers (15.5%).
This indicates there is still a substantial number of dual users – over one million, according to my calculation, or a third of all vapers in the UK.
It is commonly assumed that all dual users are transitioning to vaping but, in my experience, there are still a lot of smokers who vape only when they can’t smoke. Cigarettes remain their preferred choice.
Overall though I expect the 2020 ONS figures to be rather more more interesting. First, they should tell us how many smokers 'quit for Covid'. (I suspect it will be significantly less than the 300,000 predicted by ASH.)
The stats should also indicate how many smokers switched to e-cigarettes as a result of the menthol cigarette ban:
Demand for vapes and e-cigarettes has surged more than elevenfold since Covid-19 and the UK ban on menthol tobacco cigarettes, according to one of the UK’s largest retailers of vapes.
Long-term however I'm struggling to see where further significant growth is going to come from.
There will always be a market for e-cigarettes but as long as they are advocated by public health campaigners as a smoking cessation tool – with the ultimate goal of coming off nicotine altogether – I don't see how that is going to strengthen their appeal to confirmed smokers.
Instead of communicating the pleasure of vaping, all I hear from vaping advocates is an endless cycle of stock phrases such as 'harm reduction', 'quit smoking', #VapingSavesLives and #WeAreNotTobacco.
That's not how to get confirmed smokers on side. Everyone knows the risks yet one in seven adults in the UK still choose to smoke. There's a simple reason for that. Many of them enjoy smoking and don't want to quit!
On the subject of which, the ONS says:
In Great Britain, more than half (52.7%) of people aged 16 years and above who currently smoked said they wanted to quit.
Do you remember when we were told ad nauseum that 70% of smokers wanted to stop smoking? Presumably, as smoking rates fall, this estimate will continue to fall too.
The question is, at what point will government and the anti-smoking industry leave smokers alone and accept that adults have a right to smoke without being badgered and bullied to stop?
Final point. I don't dispute that smoking rates are falling (that's clearly evident) but even the ONS admits that:
The data described in this bulletin are based on self-reported behaviours; it is possible that the findings underestimate cigarette consumption and, to a lesser extent, cigarette smoking prevalence (for example, evidence suggests that when respondents are asked how many cigarettes they smoke per day, there is a tendency for respondents to round the figure to the size of the cigarette packet); underestimates of consumption are likely to occur in all age groups.
Either way, the demise of smoking is greatly exaggerated.
The government wants to reduce the smoking rate to 12% by 2022, with England declared 'smoke free' by 2030.
The first target is already in doubt (although it's probably achievable with some statistical jiggery pockery by PHE and the Department of Health), but I don't think anyone believes England will be 'smoke free' (ie smokers reduced to 5% of the population) within ten years.
To achieve that would require the type of authoritarian public health policies that would make even Matt Hancock blush.
After Covid-19 both the government and PHE should have far more important priorities – like how to prevent or tackle a genuine public health emergency.
So what if 6.9 million people are still smoking? Unlike a contagious disease it's a personal choice to smoke and tobacco doesn't destroy the economy. Quite the opposite.
If that doesn't focus minds nothing will.