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Tobacco plan aims to produce England’s first smoke-free generation

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3480 (Published 18 July 2017) Cite this as: BMJ 2017;358:j3480

Re: Tobacco plan aims to produce England’s first smoke-free generation

We welcome the new ambitious tobacco plan and there is much in it to commend.(1) The plan highlights the importance of smoking as a public health area in need of urgent action. It also describes the tremendous costs that smoking has on society including: families; employers; and the NHS.

The reduction in smoking prevalence in this country really has been a great public health achievement. More so when we take into account that the UK has two of the world’s largest tobacco companies that are still performing strongly.(2,3)

Those that have so far not been able to quit the habit are likely to need considerable support. In addition, it is crucial that they do not exchange this health harming behaviour for another one. That is why we firmly believe that a long term, comprehensive public health strategy is required.(4) It needs to include: mental health; healthy eating; alcohol and other drugs. Also it needs to promote health throughout the lifespan.

Targeting young people is an excellent idea. However the new tobacco control plan fails to mention that what is needed is high quality personal social and health education (PSHE) provided by trained teachers and nurses.(2) Mandatory PSHE programmes in all schools would ensure that children are provided with the key information and skills to make sound decisions about their health.

Another important element that is missing from the plan is a timescale for many of the proposals. Without deadlines, many of the organisations will not act with the urgency that is necessary.

The most important element missing from the plan is funding. These ambitious proposals have not been costed. Moreover the recent public health cuts will severely threaten the successful implementation of the plan.(5,6) If the Government is to achieve its vision of a ‘smoke-free generation’ then more funding is needed, particularly for public health departments that could drive forward the plan at a local level.

References
1) Department of Health. Towards a smoke-free generation: a tobacco control plan for England. Jul 2017. https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil...

2) Watson M and Lloyd J, 2017. Re: Over 1000 doctors sign letter calling for new tobacco plan for England. British Medical Journal Rapid Response 9th January 2017.
http://www.bmj.com/content/356/bmj.j18/rr

3) Watson M C. The scandal of big tobacco’s behaviour in the developing world The Guardian 18th July 2017. https://www.theguardian.com/business/2017/jul/17/the-scandal-of-big-toba...

4) Watson M C and Tilford S. Re: Next government must tackle public health “ticking time bomb,” says BMA. British Medical Journal Rapid Response 15th May 2017.
http://www.bmj.com/content/357/bmj.j2325/rr-0

5) Watson M C and Lloyd J. Raiding the public health budget. Action is needed to tackle current public health threats BMJ 2014;348:g2721

6) Watson M C and Lloyd J. Need for increased investment in public health BMJ 2016;352:i761.

Competing interests: No competing interests

21 July 2017
Michael Craig Watson
Associate Professor in Public Health, (Trustee of the Institute of Health Promotion and Education, http://ihpe.org.uk/).
Dr Emily Clare Baxter, St. George's Medical Practice, Roundhouse Medical Centre, Langsett Road, Barnsley. S71 1RY
University of Nottingham, Faculty of Medicine and Health Sciences, Queen's Medical Centre, Nottingham. NG7 2HA