Intended for healthcare professionals


Government has failed to deliver on smoke-free pledge for England, say leading doctors

BMJ 2021; 374 doi: (Published 21 July 2021) Cite this as: BMJ 2021;374:n1860

Linked letter

Open letter on the second anniversary of England’s announcement that it would be smoke-free by 2030

  1. Gareth Iacobucci
  1. The BMJ

The government has failed to take the “bold action” required to meet its pledge to make England smoke-free by 2030, and should introduce a levy on tobacco manufacturers to fund a more comprehensive strategy, a group of experts have urged.

Two years ago, ministers made a pledge to make England smoke-free by 2030, underpinned by making smoked tobacco obsolete and smokers quitting or moving to reduced risk products like e-cigarettes.

But in an open letter1 to the prime minister and health secretary, published today in The BMJ, leading doctors, professional bodies, and charities said there was “still no sign to date of the ‘bold action’ the government promised to deliver this crucial public health objective.”

They added, “Although we are a world leader in tobacco control, the current rate of decline in smoking is insufficient to deliver the ambition. Indeed, since it was announced, over 200 000 children under 16 in England have started smoking, two thirds of whom will go on to become daily smokers.”

Smoking is likely to have killed more people last year than covid-19 and will continue to do so for many years without government action, the letter says. It adds that delivering the smoke-free ambition “would play a major role in achieving government manifesto commitments to increase healthy life expectancy by five years by 2035, while reducing inequalities and levelling up the nation.”

The letter urges the government to implement a US-style “polluter pays” levy on tobacco manufacturers to fund a “comprehensive and sustained” smoke-free strategy, as recommended in the All Party Parliamentary Group (APPG) on Smoking and Health’s recommendations for the forthcoming tobacco control plan.

The APPG report describes how a levy on tobacco manufacturers could raise £700m (€811; $954) in year one alone without the costs being passed on to smokers, now that the UK has left the European Union. “This could pay for delivery of the tobacco control plan and provide additional funding that public health desperately needs,” the letter says.

The experts highlighted that Imperial Tobacco made £71 for every £100 in sales in 2019. “These are extreme profits, many times higher than those made by other consumer product manufacturers,” the letter says. “The time has come to make the tobacco manufacturers pay to end the epidemic they and they alone have caused.”


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