How to quit smoking cigarettes

Targets for the reduction of smoking

In December 1998 Smoking Kills – a White Paper on Tobacco3 was released, which included targets for reducing the prevalence of cigarette smoking among adults in England from 28% in 1996 to 24% by 2010 (with an interim target of 26% by 2005). These targets were based on unweighted GHS data. Since they will now be monitored using weighted data, it is suggested that they should be revised upwards by one percentage point. Since smoking is estimated to be the cause of about one third of all cancers, reducing smoking is also one of three key commitments at the heart of the NHS Cancer Plan4 . In particular, the Cancer Plan focuses on the need to reduce the comparatively high rates of smoking among those in manual socio-economic groups, which result in much higher death rates from cancer among unskilled workers than among professionals. The national target is to reduce the proportion of smokers in manual groups in England from 32% in 1998 to 26% by 2010. Comparisons of weighted and unweighted data

suggest that, as with the Smoking Kills targets, these should also be increased by one percentage point. These figures may also need further revision in the light of the recent introduction of the new socio-economic classification NS-SEC.

Trends in the prevalence of cigarette smoking

There was a fall of one percentage point in the overall prevalence of cigarette smoking among adults in Great Britain, from 27% in 2001 to 26% in 2002. The prevalence of cigarette smoking fell substantially in the 1970s and the early 1980s, from 45% in 1974 to 35% in 1982. After 1982, the rate of decline slowed, with prevalence falling by only about one percentage point every two years until 1990, since when it has levelled out. The fall in prevalence between 2001 and 2002 is on the borderline of statistical significance, but it should be noted that even during periods when the prevalence of smoking in the general population is changing little, upward and downward movements in survey estimates are to be expected. This is because of sampling fluctuations that make the detection of trends difficult. The series of weighted data shown for 1998 and later years suggests that there may have been a recent fall in the prevalence of cigarette smoking among men, though not among women. Prevalence is nevertheless still higher among men, with 27% of men and 25% of women being cigarette smokers in 2002. The fall among men

appears to be due to an increase in the proportion who say they have never smoked cigarettes regularly, rather than in the proportion who have given up smoking. In the 1970s, men were much more likely than women to be smokers. In 1974 for example, 51% of men smoked cigarettes, compared with 41% of women. Since then, the difference in smoking prevalence between men and women has reduced, although it has not disappeared completely. This change results mainly from a combination of two factors.

• First, there is a cohort effect resulting from the fact that smoking became common among men several decades before it did among women. In the 1970s there was a fall in the proportion of women aged 60 and over who had never smoked regularly.

• Second, men are more likely than women to have given up smoking cigarettes. It should be noted, however, that this difference conceals the fact that a proportion of men who give up smoking cigarettes remain smokers (by continuing to smoke cigars and pipes). This is much less common among women who stop smoking cigarettes. The effect of weighting on the 1998 and 2000 data suggested that the difference in prevalence between men and women may have been slightly underestimated by the unweighted data shown in previous reports, but this is less clear from the 2001 and 2002 data. Smoking among different age groups is another key area of interest. Since the early 1990s, the prevalence of cigarette smoking has been higher among those aged 20 to 24 than among those in other age groups. Up to the early twenties, more young people are starting to smoke than are giving up (as shown later in this chapter, almost one in five of those who have smoked at some time in their lives took up the habit after the age of 20). Since the survey began, there has been considerable fluctuation in prevalence rates among those aged 16 to 19, but this is mainly because of the small sample size in this age group. However, the fall in prevalence among young men aged 16 to 19 from 30% in 2000 to 22% in 2002 is statistically significant. There was no equivalent fall among young women of that age, and in 2002, women aged 16 to 19 were significantly more likely to smoke than were young men of similar age. This is interesting because since the early 1990s surveys of smoking among secondary school children have shown higher prevalence among 15-year-old girls than among boys of the same age, but this has not previously been reflected in the GHS data. At 15% in 2002, prevalence continues to be lowest among men and women aged 60 and over. Although they are more likely than younger people to have ever been smokers, they are much more likely to have given.

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