The age people can legally buy cigarettes should be raised by one year, every year until no one can buy tobacco products, a Government-commissioned review has said.
The review, ordered by Sajid Javid, the Health Secretary, calls for radical action to reduce smoking rates, saying that without changes England will miss its targets to become "smoke-free" by 2030.
The independent review into tobacco control has been led by Dr Javed Khan, the head of Barnardo’s.
The most controversial proposal is to raise the legal age of sale of tobacco from 18 by one year, every year. The recommendation will now go to ministers.
Sources close to the Health Secretary indicated that he was "minded against" the proposals on age of sale, which the Prime Minister is thought likely to oppose.
In recent weeks, ministers have pushed back other public health policies, delaying moves to ban two-for-one deals on junk foods, and to restrict advertising.
It is among 15 recommendations which will be considered as part of wider plans to improve the health of the nation and reduce inequalities through the Health Disparities White Paper.
Earlier this year, the Health Secretary, commissioned an independent review into ways the Government can help more people quit smoking and live healthier lives.
It follows targets to make England "smoke-free" by 2030, which is defined as cutting smoking rates to just five per cent.
Almost six million people in England smoke, and tobacco remains the single biggest cause of preventable illness and death.
During the pandemic, the proportion of young adults aged 18 to 24 that smoke rose from one in four to one in three.
Officials said tackling tobacco use and supporting smokers to quit would help prevent 15 types of cancers – including lung cancer, throat cancer and acute myeloid leukaemia.
Recent data shows 1 in 4 deaths from all cancers were estimated to be from smoking.
The independent review also found smoking causes a disproportionate burden on the most disadvantaged families and communities. At its most extreme, smoking prevalence is 4.5 times higher in Burnley than in Exeter.
The review found that smokers in the most deprived areas of the country spend a higher proportion of their income on tobacco. The average smoker in the North East spends over 10 per cent of their income on tobacco, compared to just over 6 per cent in the South East.
'Without immediate action, England will miss its smoke-free target'
Commenting on the review, Dr Khan said: "In this review I have looked at our current smoke-free initiatives, along with the very best practice from around the world. I would like to thank the many valued voices that have made key contributions towards shaping this bold and ambitious report.
"Without immediate and sustained action, England will miss the smoke-free target by many years and most likely decades."
"A smoke-free society should be a social norm – but to achieve this, we must do more to stop people taking up smoking, help those who already smoke and support those who are disproportionately impacted by smoking.
"My holistic set of recommendations for government will deliver this, whilst saving lives, saving money and addressing the health disparities associated with smoking."
He added that the plans are not just aimed at current ministers. "My proposals are not just a plan for this Government, but successive governments too. To truly achieve a smoke-free society in our great country, we need to commit to making smoking obsolete, once and for all," he said.
'£12bn pours out of smokers' pockets each year'
Deborah Arnott, the chief executive of Action on Smoking and Health (ASH) said: "Javed Khan’s report sets out an ambitious vision, combining a call on Government to increase investment in tobacco control with tougher regulations, both of which are essential to achieve a smoke-free 2030.
"This is what the public wants too – research by YouGov commissioned by ASH to provide evidence for the review shows a substantial majority support stronger government interventions to tackle smoking.
"Twelve billion pounds pours out of smokers’ pockets each year exacerbating the cost of living crisis in our poorest communities. Only by making smoking obsolete can the government deliver on its levelling up mission for health and wellbeing."
Michelle Mitchell, the chief executive of Cancer Research UK, added: "Smoking is the biggest cause of cancer, with 1 in 4 deaths from all cancers estimated to be from smoking in the UK. The scale of the issue is undeniable, yet England remains off track to become smoke-free by 2030, and for the most deprived this won’t be achieved until the mid-2040s.
"This review provides the government with the steps needed to close the health inequality gap and make smoking obsolete; it must now implement the recommendations. With bold action, we can save countless lives."
