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A decades-long decline in smoking in England has nearly ground to a halt since the pandemic, a study suggests.
The rate of decline slowed from 5.2% in the years before the pandemic to just 0.3% between April 2020 and August 2022, according to the research.
The lead researcher said it was likely more young people were taking up smoking and “bold” action was needed.
The government said it was taking “bold action” to make England smoke-free, including raising the legal age.
Based on surveys with 101,960 adults representative of the population, researchers estimated 16.2% smoked in June 2017, falling to 15.1% by the start of the pandemic, in March 2020, but just 15% in August 2022, since when the the slower rate of decline has remained consistent.
Office for National Statistics data also shows a year-on-year decline in smoking between 2000 and 2020.
Anti-smoking efforts
The study suggests a 120% rise in the proportion of people giving up, during the pandemic, and a 40% rise in the number of attempts to quit.
But these were offset by a rise in the number of people taking up the habit, including an increase among 18- to 24-year-olds.
In 2019, the government set a target for England to be “smoke-free” by 2030.
But the researchers, from University College London (UCL), say this will be missed and are urging the government to “reignite” anti-smoking efforts.
Lead author Dr Sarah Jackson, of UCL’s Institute of Epidemiology and Health Care, told BBC News the results suggested a “step change” in young people smoking, at the start of the pandemic.
“It definitely does seem like progress in reducing the number of young adults taking up smoking has slowed down,” she said.
Researchers noted higher levels of stress and social isolation among younger adults during the pandemic.
But Dr Jackson said others factors could also be to blame and warned against complacency.
‘Uniquely lethal’
“It’s really concerning there has almost been the assumption that we have solved the problem of smoking among young people,” she said.
Young adults may start smoking because they believed e-cigarettes were equally bad for them, Dr Jackson said.
“There has a been lot of talk about vaping and there has been a real disconnect about the risks of vaping and risks of smoking among young people,” she said.
“The risks of vaping are substantially lower than the risks of smoking.
“Smoking is uniquely lethal, yet most of the concern is about young people vaping.”
The researchers supported a government proposal to raise the smoking age, which would mean a child turning 14 this year could never legally buy cigarettes.
The research, funded by Cancer Research UK and published in the journal BMC Medicine, also suggests, between April 2020 and August 2022:
Smoking decreased among 45- to 65-year-olds
The stall in the decline of smoking was most pronounced among advantaged social groups
Former smokers relapsing back into the habit may also account for some of the slowing of the decline
The switch to homeworking during the pandemic may have contributed to loneliness and poor mental health, making people less inclined to quit smoking, the researchers said.
But manual workers may have had more financial disruption, leading to smoking becoming less affordable.
The charity Action on Smoking and Health said smoking rates would decline in response to government action, as they had historically.
“The ambitious programme recently announced by the government can put us on track,” chief executive Deborah Arnott said, “but no time must be lost in turning words into action.”
The Department of Health and Social Care said it had doubled funding for stop-smoking services, helping 360,000 people quit, and was planning to provide a million free vapes to smokers.
Wales has a 2030 smoke-free target, while Scotland’s is 2034.
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