The Smokefree 2030 ambition for England

The 2017-2022 Tobacco Control Plan for England

The Tobacco Control Plan for England was published in 2017 by the Department of Health and Social Care. It highlighted progress made since the previous Plan (2011) in reducing smoking prevalence but acknowledged there was still more work to do. The Plan set out several ambitions, including reducing the uptake of smoking in young people and the prevalence of smoking in pregnancy.

The smokefree 2030 ambition for England

In 2019, the Government published its green paper on preventative health; Advancing our health: prevention in the 2020s. Here, it announced an ambition for England to become ‘smokefree’ by 2030 – achieved when adult smoking prevalence falls to 5% or less.

What has the Government committed to on tobacco control?

The health disparities white paper

In February 2022, the then Health Secretary Sajid Javid announced the Government would publish a health disparities white paper in Spring 2022, “aiming to break the link between people’s background and their prospect for a healthy life”. As part of this work, the Government also launched two reviews, focussed on health disparities and linked to the white paper.

The first review would consider “potential ethnic bias in the design and use of medical devices”. The second review would consider the Government’s ambition to be smokefree by 2030, and would be led by Javed Khan, former CEO of children’s charity, Barnardo’s.

The Government later said that the Review would inform the forthcoming Tobacco Control Plan.

The Khan Review

The Khan Review: making smoking obsolete was published in June 2022. The Report found that “without further action, England will miss the smokefree 2030 target by at least 7 years, and the poorest areas in society will not meet it until 2044”.

The Review set out a package of 15 recommendations aimed at supporting the 2030 ambition, including four “critical must dos” for the Government:

1. Increased investment

I have set out the case for comprehensive investment now of an additional £125 million per year in smokefree 2030 policies, to fund the easily accessible, high quality support that smokers need to help them quit. This includes investing an extra £70 million per year in stop smoking services, ringfenced for this purpose.

If the government cannot fund this themselves, they should ‘make the polluter pay’ and either introduce a tobacco industry levy, or generate additional corporation tax, with immediate effect.

2. Increase the age of sale

The government must stop young people starting to smoke, which is why I recommend increasing the age of sale from 18, by one year, every year until no one can buy a tobacco product in this country.

3. Promote vaping

The government must embrace the promotion of vaping as an effective tool to help people to quit smoking tobacco. We know vapes are not a ‘silver bullet’ nor are they totally risk-free, but the alternative is far worse.

4. Improve prevention in the NHS

Prevention must become part of the NHS’s DNA. To reduce the £2.4 billion that smoking costs the NHS every year, the NHS must deliver on its commitments in the Long Term Plan. It must do more, offering smokers advice and support to quit at every interaction they have with health services, whether that be through GPs, hospitals, psychiatrists, midwives, pharmacists, dentists or optometrists. The NHS should invest to save, committing resource for this purpose.

Following the Review’s publication, the then Health Secretary, Sajid Javid, said the Government would consider the Review’s recommendations and that this would help to inform the upcoming white paper on health disparities. Mr Javid said it would complement this work by publishing a new Tobacco Control Plan, and that the Government was determined to address the challenges raised in the Review and to meet the smokefree 2030 target.

What’s happened to the health disparities white paper and the new Tobacco Control Plan for England?

In January 2023, Health Secretary Steve Barclay set out the Government’s intention to develop and publish a Major Conditions Strategy. Mr Barclay said “this work combines our key commitments in mental health, cancer, dementia and health disparities into a single, powerful strategy”.

In May 2023, the Government said its forthcoming Major Conditions Strategy “succeeds” the health disparities white paper.

Neil O’Brien, Minister for Primary Care and Public Health, said “tobacco and tobacco control will be threaded through the major conditions strategy”.

In a March 2023, with reference to the Major Conditions Strategy, the Government was asked if it still intends to publish a separate Tobacco Control Plan. The Government said

In the coming weeks, the Government will unveil a set of proposals to realise the Smokefree 2030 ambition and respond to the recommendations in the Khan Review. This will be separate to the Major Conditions Strategy.

The Government’s new proposals for tobacco and vaping control (June 2022)

During a statement in the Commons on 17 April 2023, Minister for Primary Care and Public Health, Neil O’Brien updated the House on measures the Government would implement to support more people to stop smoking and protect children from the use of vaping products.

The Government said it would introduce:

• A call for evidence into youth vaping to “identify opportunities to reduce the number of children (people aged under 18) accessing and using vape products, while ensuring they are still easily available as a quit aid for adult smokers”. This consultation was hosted by OHID, from April to June 2023.
• A national scheme to support one million smokers to ‘swap to stop’, by providing them with a free vaping kit. The scheme would run over two years initially and be targeted at “the most at-risk communities first – focusing on settings such as job centres, homeless centres, and social housing providers”.
• An updated HMRC strategy to address illicit tobacco, to be published in 2023.
• The Government also committed £3 million of new funding to create a specialised “illicit vapes enforcement squad” to enforce rules on the sale of vapes, address illicit vapes and underage sales.
• By 2024, provide a financial incentive to all pregnant women who smoke to support them to quit.
• A consultation, to be published in 2023, on introducing mandatory cigarette pack inserts “to refresh the health messaging on cigarette packets with positive messages and information to help people to quit smoking”.