Some of the most successful ways of stopping children and adolescents from starting to smoke are revealed in the UK Health Development Agency’s (HDA’s) new evidence briefing, launched today. The evidence shows that schools, media campaigns, and even shopkeepers can play a significant role in preventing the uptake of smoking in young people.

With 38 percent of adults who currently smoke in the UK admitting to having started by the age of 161,the report brings fresh hope for health professionals working to reduce smoking initiation among the young.

The evidence briefing; ’Smoking and public health; a review of reviews of interventions to increase smoking cessation, reduce smoking initiation and prevent further uptake of smoking’, also details the clinical interventions that work best to help smokers of all ages quit the habit that kills over 120,000 people in the UK every year. This is the first time that systematic review level evidence on tackling smoking has been brought together in one comprehensive publication.

The evidence highlights that advertising campaigns targeting young people, either alone or combined with school-based education programmes, work well to prevent young people from taking up smoking. School-based interventions can include providing pupils with information on the short-term health consequences of smoking and on the social influences that encourage smoking, as well as training on resistance to pro-smoking messages they might see in the media.

The HDA has also identified that interventions with retailers - such as enforcement by the police or health officials of shops selling tobacco - can lead to a decrease in illegal sales to under-age smokers. This type of method works particularly well compared to simply providing retailers information on their legal obligations. Importantly, the evidence suggests that legislation alone is not enough to prevent tobacco sales to minors.

Professor Mike Kelly, Director of Evidence and Guidance at the HDA, says:

\"Smoking is a key public health priority as well as the principal cause of inequalities in death rates between rich and poor in this country. This HDA evidence highlights successful ways to reduce the take up of smoking amongst young people as well as confirming the effectiveness of methods to help people quit. The saying: ’prevention is better than cure’ is especially relevant - it is better to never start smoking than to try and give it up after getting hooked. Young people often smoke to emulate adult behaviour, so we need to keep up our efforts to reduce smoking in the adult population and support this with interventions that work to stop young people starting to smoke, to effectively tackle this problem.\"

The briefing also details the evidence on what works to help smokers of all ages to quit. Increasing the unit price of cigarettes is effective at stopping tobacco use in low-income and other groups. In a clinical setting, the report reveals that brief advice and information on quitting from a GP or healthcare professional or minimal contact time with a clinician, is successful in increasing abstinence rates among smokers - as do smoking quit lines and counselling sessions over the phone.

Evidence also shows that smoking cessation advice and counselling given by nurses and dentists is an equally effective way of encouraging smokers to stop compared to advice from doctors.

Mass media campaigns combined with other interventions are successful in increasing tobacco use cessation, and a variety of smoking cessation treatments work well for older people, including advice from health professionals, buddy support programmes and proactive telephone counselling.

The HDA publication, ’Smoking and public health; a review of reviews of interventions to increase smoking cessation, reduce smoking initiation and prevent further uptake of smoking’ is available online (pdf, 769k) or by calling 0870 121 4194.

Notes to editors

1. The direct link to the summary document is http://www.hda.nhs.uk/Documents/smoking_eb_summary.pdf

2. The Health Development Agency is the national authority on what works to improve people’s health and to reduce health inequalities. It works in partnership across sectors to gather evidence of what works, advise on standards and to develop the skills of all those working to improve people’s health.

3. Stopping children and adolescents from starting cigarette smoking has been one of the most difficult problems facing public health in recent decades. International expert opinion concludes that tobacco control policies that fail to address adult smoking will not succeed with young people either. Some of the main points that form this opinion are:

i) Reducing smoking among adults will lead to a quicker and bigger reduction of tobacco-related harm. This is because there is a higher level of smoking related mortality and morbidity among adults than teenagers

ii) Reducing smoking among adults will provide protection to the unborn and recently born from exposure to direct and indirect tobacco smoke

iii) Quitting by adults (especially by parents) reduces the likelihood of children taking up smoking

Reference: ’Cancer prevention A resource to support local action in delivering The NHS Cancer Plan’
HDA, 2002

For further information please contact Dr Tonya Gillis or Sophie Davison, HDA Press Office on 020 7061 3117/3125.

Smoking: The Facts

- Around 12 million adults in the UK smoke cigarettes

- 28% of men and 25% of women smoke

- More than 80% of smokers take up the habit as teenagers

- About half of all regular cigarette smokers will be killed by their habit

- The poor spend a disproportionately larger share of their income on cigarettes; smoking a branded pack of 20 cigarettes a day costs 1,600 a year

- Over two thirds of smokers in all social groups want to quit (66%)

- 57% of smokers would find it difficult to go without smoking for a day

1 General Household Survey, Living in Britain, 2002.