Nicotine 2024: Action on Smoking

Hello everyone and welcome to the Royal Society of Medicine, and this event: Nicotine 2024: Action on Smoking.??

My name is Andrew Moran, and I am the president-elect of the RSM Medicine and Society section.?

Medicine and Society aim to bridge the gap between medicine, the other health and care professions and wider society and those impacts on people health.??

We explore the potential, and the effects, of medical advances and scientific innovations on society, changes in national policy, practice, and education, exploring how these can improve outcomes for patients, and staff.?

Today's event is ‘Action on smoking’, because of the wide-reaching impacts smoking and nicotine addiction has on the NHS, patients, staff, wider society, and the wider world.??

Why do we still need action on smoking???

Smoking, nicotine, tobacco continues to have a significant global impact. A product unique, that kills its customers if used ‘as directed’??

The global burden of disease puts Tabacco as the 2nd highest behaviour risk factor globally in reducing people's healthy life expectancy. It's the second largest contributor to the impact on disability adjusted life years.??

Ranked first globally, and the UK, as the highest risk behaviour contributing to Deaths.??

In the UK, fingertips public health profiles 2022 says 12.7% of over 18s are current smokers. A figure similar in 2021, down from 19.8% in 2011, but Smoking rates are falling but slower now than over the past decade.??

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ONS data released 1st October 2024 shows smoking rates continue to fall. ?

“Around 6.0 million people aged 18 years and over (11.9%) smoked cigarettes in the UK in 2023; this is the lowest proportion of current smokers since records began in 2011, based on our estimates from the Annual Population Survey (APS).”? https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2023 ??

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It is the time to think about smoking differently and think about the Nicotine addiction not just the method to which people consumer it.??

Impacting on Nicotine is not something which takes a decade to achieve. At the individual person level changes can be seen quickly.??

My ‘favourite graph’ if we are allowed such things, is on screen now. In the impact of the 2007 smoking ban on myocardial infraction pre and post the ban in Liverpool.?

• https://pubmed.ncbi.nlm.nih.gov/24282240/ ?

In year reductions in admissions for both men and women, was followed by years of decline.?????

2006-07 is a long time ago, and since we have seen the rise in the popularity of vapes and changes in the sale of tobacco.??

It was good news earlier in the year when the then government brought forward new legislation to address tobacco and vapes with the headline no-one aged 14 or above would ever be able to legally buy cigarettes. And the new government has said they too will bring this legislation back to the commons.??

We need to move the conversation on tobacco from smoking to nicotine addiction. The shift allows us to think differently inside and outside the hospital about smoking. People know smoking is bad for you. But when we consider the nicotine as an addiction, we consider the wider determinates of health and the impact that has on people's lives.??

I find this is most elegantly illustrated by the Dahlgren and Whitehead influence on health.?

• https://www.pslhub.org/learn/improving-patient-safety/health-inequalities/the-dahlgren-whitehead-rainbow-1991-r5870/?

Where there are complications in people's lives, and struggles in everyday life, nicotine addiction can be there. Sir Chris Witty recently spoke to the RSM, describing this as a childhood addiction. Habits formed in early life, which may require more than 1 attempt to quit, and a deeper conversation about people lives to understand what's really going on.????

• https://www.rsm.ac.uk/events/rsm-studios/2023-24/ces15/?

Today we will discuss public health, policy, medicine, the determinants of health and how local authorities are partners in reducing nicotine addiction, and at the end of the day our 2 prize winners exploring the role of primary care and supporting people with their addiction through therapy see improved quitting success.??

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