With World No Tobacco Day taking place on 31 May, it is an opportune time to recognise the ambitious goals set to make England smoke-free by 2030. The Tobacco and Vapes Bill lays down the biggest public health intervention in a generation, with an aim to break the cycle of addiction and disadvantage, putting the UK on track towards a smoke-free UK. This intention is to reduce smoking rates to below 5% (Hopkinson, 2020), with Scotland setting a similar target for 2034 (House of Lords Library, 2020). Smoking costs the economy and wider society £21.8 billion a year. This includes an annual £18.3 billion loss to productivity, as a result of smoking-related lost earnings, unemployment and early death, as well as costs to the NHS and social care of £3.1 billion. This is equivalent to the annual salaries of almost 700 000 nurses, half a million GPs, half a million police officers or over 500 million GP appointments (Department of Health and Social Care, 2024).
Despite having some of the lowest smoking rates in Europe, smoking is still a major contributor to premature death in Britain. Approximately 15% of adults in the UK are still smoking. To achieve the 5% target by 2030, the rate of change must accelerate by ‘40% faster’ than current predictions (House of Lords Library, 2020).
The UK has made significant progress in combating the tobacco epidemic through various policies, such as taxation to reduce tobacco affordability, the introduction of standardised packaging, display bans and smoke-free legislation. In 2006, Scotland implemented a smoking ban in enclosed public spaces and workplaces. This was followed by similar bans in England, Wales and Northern Ireland in 2007. The minimum age for purchasing tobacco was raised from 16 to 18 years in 2007 across Scotland, England and Wales, with plain packaging for cigarettes introduced in 2016.
Smoking exacerbates health inequalities, with over 25% of individuals in routine and manual occupations smoking, compared with just 10% in professional and managerial roles (Hopkinson, 2020). Hospital admissions linked to smoking are also notably higher in economically disadvantaged areas (House of Lords Library, 2020).
To achieve a smoke-free England by 2030, a collective effort from all sectors – including paramedicine – is essential. Paramedics, who provide emergency medical care and support in diverse community settings, have a critical role in helping reduce smoking-related harm. As part of the ‘smoke-free generation’ initiative, the sale of tobacco products to anyone born on or after 1 January 2009 has been banned (Royal Society of Medicine, 2023). There is a need for innovative policies, continuous commitment and an emphasis on addressing health inequalities to achieve this.
Paramedics are well positioned to support individuals who smoke, offering brief interventions, guidance and information on smoking cessation resources and connect individuals to relevant services. In line with the Tobacco and Vapes Bill, paramedics can also assist individuals in navigating vaping resources, particularly in community settings and schools to address concerns around potential harms and to promote healthier alternatives.
While implementing national policies may present challenges, the government's ongoing investment in smoking cessation services is critical in achieving the smoke-free goal. By increasing referrals and actively promoting smoking cessation services, paramedics will also be instrumental in achieving this target.