Lec 11- Public health- Smoking

Question 1

Tobacco use- history

Answer 1

• First introduced to Britian in the sixteenth century

Question 2

Cigarettes

Answer 2

• Late 19th century
  
  • The invention of cigarette-making machines
    
    • Made mass consumption possible
• 1919
  
  • Cigarettes become the most popular form of tobacco
• At first, only men smoked cigarettes
• Women began to smoke cigarettes in the 1920s but not in large numbers until after the WW2

Question 3

The link between smoking and ill health

Answer 3

Question 4

Health consequences of smoking

Answer 4

Question 5

Health consequences of smoking

Answer 5

Question 6

Smoking and cancer

Answer 6

• By far most important avoidable cause of cancer in the UK
  
  • 19.4% of all cancer
    
    • 85.6% of lung cancers
    • 79.0% of laryngeal cancer
    • 65.5% of oesophageal cancer
    • 64.5% of oropharyngeal cancer

Question 7

Historical patterns in cigarette smoking and lung cancer rates

Answer 7

Question 8

Effects of stopping smoking at various ages on the cumulative risk (%) of death from. lung cancer up to age 75

Question 9

Secondhand smoke

Answer 9

• Meta-analyses suggest that
  
  • For non-smokers exposed to passive smoking at home or at work
    
    • 25% increased risk of developing lung cancer
  • For non-smokers subject to heavy exposure at work
    
    • 50% increased risk of developing lung cancer
• Smoking during pregnancy increases the risk of spontaneous abortion, pre-term birth, low birth weight and stillbirth

Question 10

Smoking and healthy inequality

Answer 10

• People in poorer social classes are more likely to die early due to a variety of factors
  
  • Among men, dominant factor is smoking
  • Accounts for over hald of the difference in risk of premature death between social classes
• Smoking is the single biggest preventable cause of health inequalities in the UK

Question 11

Cigarette smoking by income per year

Answer 11

Question 12

Smoking rates by area deprivation

Answer 12

Question 13

NHS stop smoking services

Answer 13

Question 14

Self-reported e-cigarette use, by cigarette smoking status

Answer 14

Question 15

Smoking ban

Answer 15

• Illegal to smoke in all enclosed workplaces in england since 1st July 2007
• Exemptions include
  
  • Nursing homes
  • Prisons
  • Theatre/TV set

Question 16

Restrictions on tobacco advertising

Answer 16

• A comprehensive ban on all tobacco advertising, promotion and sponsorship could decrease tobacco consumption by an average of about 7%, with some countries experiencing a decline in consumption of up to 16%

Question 17

Regulation of tobacco advertising

Answer 17

• TV advertising of cigarettes banned in 1965
• Ban on tobacco advertising in Labour 1997 General Election manifesto
• Tabacco advertising and promotion
  
  • Feb 2003- advertising in press and on billboards banned
  • May 2003- Direct marketing banned
  • Sponsorship of sporting events phased out from July 2003- Banned across EU Aug 2005

Question 18

Exposure to smoking on-screen and incidence of smoking

Question 19

Regulation of tobacco advertising

Answer 19

• Sale of tobacco from, and display of adverts on, vending machines banned in Oct 2011
• Regulations introduced requiring all large shops and supermarkets in England to cover displays from view in April 2012
  
  • All other businesses and smaller shops selling tobacco products from April 2015

Question 20

Incidence rate ratios for tabacco advertising 16 countries

Answer 20

Question 21

Plain packaging of cigarettes

Answer 21

• Plain packs rated as less attractive than branded equivalent packs, by both adults and children
• Plain packs were perceived to be poorer quality, poorer tasting and cheaper than branded equivalent packs
• Non-smokers and younger people responded more negatively to plain packs than smokers and older people

Question 22

Taxation of tobacco

Answer 22

• A tax increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and by up to 8% in low and middle income countries

Question 23

Tobacco taxation policies

Answer 23

• Duty on import introduced in 1660
• From 1997
  
  • Tobacco duty has been increased at a rate greater than inflation every year apart from 03-08 (Where it increased at the rate of inflation
• Duty on cigarettes sold in the UK is currently 16.5% of the retail price plus £4.57 per 20 cigarettes
  
  • Estimated that 77-88% of the recommended retail price of cigarettes is tax
• Price of a typical pack of premium cigarettes
  
  • Uk (9.16), Belgium (4.51), Spain (3.78), Belarus (0.60)

Question 24

Affordability of tobacco

Answer 24