The government has set an ambitious goal to make England smoke-free by 2030, defined as reducing the smoking rate to below 5% (Hopkinson, 2020). Scotland set a similar target for 2034 (House of Lords Library, 2020).
Despite having some of the lowest smoking rates in Europe, smoking remains a significant contributor to premature death in the UK. Presently, approximately 15% of adults in the UK smoke cigarettes. To achieve the 5% target by 2030, the rate of change must surpass current predictions by a margin of ‘40% faster’ (House of Lords Library, 2020).
The UK has introduced taxation to decrease the affordability of tobacco products, the adoption of plain, standardised packaging and display bans and the implementation of smoke-free legislation. In 2006, Scotland banned smoking in enclosed public spaces and workplaces, with England, Wales and Northern Ireland implementing similar bans in 2007. Also in 2007, Scotland, England and Wales raised the minimum age for purchasing tobacco from 16 to 18 years.
Tobacco use plays a crucial role in exacerbating health inequalities. More than 25% of individuals in routine and manual occupations smoke, whereas only 10% of those in professional and managerial roles do so (Hopkinson, 2020). Hospital admissions linked to smoking are notably elevated in economically disadvantaged areas (House of Lords Library, 2020).
The government commissioned a review into its ambition to make England smoke-free by 2030 (Office for Improvement and Disparities, 2022; House of Commons Library, 2023). The recent proposal to create a smoke-free generation and ban the sale of tobacco products to anyone born on or after 1 January 2009 is a bold and necessary step toward a smoke-free future (Royal Society of Medicine, 2023). There has been much support in response to the announcement made in the King's Speech concerning a Tobacco and Vapes Bill. However, achieving this goal requires continued commitment, innovative policies and a focus on addressing health inequalities. The path to a smoke-free future is challenging but achievable.
All nurses have a key role to play in facilitating smoking cessation by supporting people to stop smoking, making every contact count (Royal College of Nursing, 2023). Nurses are ideally placed to encourage patients to quit smoking, provide accurate information and education, offer cessation resources and inform stakeholders on population health strategies to prevent initiation and reduce youth e-cigarette use. They can help people navigate appropriate resources for vaping, provide information about the harmful effects of smoking and vaping, and offer resources for those looking to quit.
Although implementing national policies may pose challenges, efforts are underway to achieve the desired impact (Waterall and Fisher, 2024). The Department of Health and Social Care (DHSC) (2023) is committed to providing up to £138 million annually from 2024-2025 to 2028-2029, to local authorities for stop-smoking services. The DHSC plans to facilitate 360 000 individuals annually in setting a quit date, resulting in 198 000 successful quits (measured as 4-week quits) as a result of the increased funding. Nurses are key to the success of smoking cessation services – people are more likely to engage with services when referred by a nurse – and nurses across all settings are ideally positioned to encourage increased referrals to these services.