Intended for healthcare professionals


Sunak’s smoke-free generation: spare a thought for the tobacco industry

BMJ 2023; 383 doi: (Published 12 December 2023) Cite this as: BMJ 2023;383:p2922

Linked Editorial

New Zealand reverses landmark tobacco controls

  1. Greg Hartwell, clinical assistant professor1,
  2. Anna B Gilmore, professor of public health2,
  3. May C I van Schalkwyk, honorary research fellow1,
  4. Martin McKee, professor of European public health1
  1. 1London School of Hygiene and Tropical Medicine, London, UK
  2. 2Tobacco Control Research Group and Beacon for 21st Century Public Health, Department for Health, University of Bath, Bath, UK

Proposed legislation aims to phase out smoking, but we must prevent it being blocked, diluted, or delayed through industry interference

The UK prime minister’s call for a smoke-free generation, which follows similar measures in New Zealand,1 would have been unimaginable for previous Conservative leaders. Rishi Sunak’s two immediate predecessors, Liz Truss and Boris Johnson, have already argued against the plan.23 Their comments are likely to be a precursor of a major campaign, led by the tobacco industry and the thinktanks it funds, to undermine this proposal. Such groups may well be feeling increasingly confident after the new coalition government scrapped New Zealand’s smoke-free plans—a move causing widespread dismay among health experts and dubbed “catastrophic” for Māori communities.4

To prevent the UK legislation—which will progressively increase the age at which tobacco products can be bought—from being watered down or similarly abandoned, it is essential that politicians, the media, and the health community anticipate the arguments and tactics that will be used against the plans. These are easy to identify given evidence showing the tobacco industry has repeatedly used the same tactics and arguments to block, amend, or delay previous legislation.5 Drawing on this extensive literature,56 we highlight three main arguments that will be used and explain why they are spurious.

Countering the playbook

The first arguments posed by the tobacco industry will invoke libertarianism, notions of erosions of “freedom,” and “slippery slope” tropes, appealing to the Conservative Party’s core support.57 If the “nanny state” government bans smoking, what “simple pleasures” will they come after next? This of course wilfully ignores the enormous harms from tobacco, including passively to non-smokers. As the government’s command paper outlines powerfully—smoking is by far the greatest contributor to disease burden in the UK, and the single largest cause of the health inequities that the Conservative’s “levelling up” philosophy seeks to close.8

This argument also overlooks the fact smoking is an addiction initiated in childhood—a vulnerable period of risk taking when that harm is not fully comprehended and so called choices are easily manipulated by commercial marketing. In adulthood, people who smoke express near universal regret for starting.89 In line with this, polling shows the smoke-free generation announcement was supported by 81% of Conservative members, even higher than the 61% figure for the general public.10 Despite efforts by industry to convey the opposite, support for population level measures to protect future generations from tobacco harms comes from both sides of the political spectrum.

Secondly, industry will also seek to frame the smoke-free generation as unworkable and impossible to police. The Institute of Economic Affairs, a thinktank that has been funded by the tobacco industry for many years,11 was on BBC News at 10 within hours of Sunak’s announcement, arguing that the policy was unenforceable; it has claimed the same for every major tobacco control measure in the past.6 History has repeatedly shown, however, that when public support gets behind a population health measure—such as wearing seatbelts or banning smoking in public places—even the most entrenched norms can quickly crumble. As they are pushed out by new healthier social norms, formal policing becomes increasingly unnecessary. The world simply moves on and absorbs progressive public health changes, revealing the industry’s warnings of endless logistical difficulties to be baseless.

Thirdly, industry will claim severe unintended consequences and dystopian outcomes,5 particularly their favourite canard: increases in cigarette smuggling. Its predictions that plain packaging and tobacco tax rises would increase smuggled products were wrong,1213 and its position is hypocritical given that it has orchestrated and benefited from smuggling.1415 Similarly, industry will stoke widespread fears around negative economic impacts and job losses, particularly for retailers. Despite industry’s shroud waving, public smoking bans did not empty pubs, just as plain packaging did not decimate newsagents. The retail groups publicly making these claims have in fact repeatedly been shown to have been established and funded by industry to make its arguments palatable,616 most recently in opposition to New Zealand’s smoke-free generation policy.17

As this final example suggests, each of these arguments will be voiced by an array of third parties, including front groups and “astroturf” organisations which conceal their industry sponsorship, as well as “experts” for hire.56 The reason is simple: an industry whose products are carefully designed to be highly addictive and that kill up to two thirds of long term users8 would garner no sympathy for its real worries—that the policy will reduce cigarette sales and youth uptake, exactly as intended.5 As with plain packaging debates in the UK, careful orchestration from industry will ensure its arguments become pervasive, giving misleading impressions of widespread public opposition.6 Its strategy will also be hyper-adaptable,18 even to the point of occasional contradictions (for example, claiming unworkability while simultaneously portending mass unintended negative impacts), and it will aim to exploit all available channels of influence.

It is therefore crucial that UK politicians—and lawmakers in the many other countries that will inevitably take inspiration from this groundbreaking plan—are alert to these strategies, understand their disingenuity, and reject them outright. This will require critical media reporting, which must not give false equivalency to industry’s hype, and, in contrast to past failures,19 must expose the funding of individuals and organisations opposing the smoke-free generation legislation using readily available resources such as the University of Bath’s Tobacco Tactics website.1119 This policy, with its potential to phase out tobacco use over time, could save vast numbers of lives. It has never been more vital for MPs to resist industry pressure, act in the public interest, and be remembered as being on the right side of history.


  • Competing interests: We have read and understood BMJ policy on declaration of interests and declare that GH has a Fellowship (MH052) funded as part of the Three NIHR Research Schools Mental Health Programme. ABG is supported by Bloomberg Philanthropies Stopping Tobacco Organisations and Products project funding ( and the SPECTRUM Consortium (MR/S037519/1), which is funded by the UK Prevention Research Partnership (UKPRP). UKPRP is an initiative funded by the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), the Health Foundation, and Wellcome and Bloomberg Philanthropies (Stopping Tobacco Products and Organizations). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

  • Provenance and peer review: Not commissioned; not externally peer reviewed.