Seventy years ago, the British government recognised that smoking caused lung cancer, thanks to a breakthrough in medical science. In an interview to mark the anniversary, Sir Richard Peto, a pioneer in this area, highlighted one way in which the discovery was significant. It led, he said, to a boost for public health comparable with 19th-century improvements in sewerage and water quality.
The shift in attitudes to smoking did not happen suddenly. The tobacco and vapes bill championed by Rishi Sunak, which fell when he called an election, was the culmination of a decades-long process. If the law is resurrected by the next government – as seems likely given the inclusion of similar measures in Labour’s manifesto – it will become illegal to sell tobacco to anyone born since 2009, and vapes will be more tightly controlled.
It seems extraordinary now, but millions of people did not accept that smoking was harmful as late as the 1990s. Sir Richard said that smokers “didn’t emotionally believe it” – so invested were they in their habit, and unwilling to think that the government would allow a dangerous product to be advertised. For decades, the UK government (along with others) opted for voluntary agreements in preference to laws. In one extraordinary episode, Philip Morris, the tobacco company, took out an injunction against Thames TV, because it objected to a documentary using footage of cowboys with lung disease to challenge the “Marlboro man” image.
Between 1951 and 1964, about half of doctors in the UK who had been smokers gave up. But a decade later, almost half of all adults still smoked, and as the death toll climbed and evidence emerged of the harm caused by passive smoking, pressure increased. The World Health Organization began referring to a smoking epidemic. Gradually, advertising became more restricted and health warnings were ramped up. The last Labour government ended tobacco sponsorship of sports (though Tony Blair played a role in securing an exemption for Formula One) and, in 2007, banned smoking in indoor public places.
In the UK, about 13% of adults (six million people) smoke and tobacco is associated with 80,000 deaths each year. Mr Sunak’s decision to push for tighter controls was out of step with his own party’s instincts. But Chris Whitty, England’s chief medical officer, lent support and drew attention to the hypocrisy of rightwing language around freedom and choice in relation to a harmful addiction.
It is 25 years since a Hollywood film, The Insider, dramatised big tobacco’s efforts to muzzle its critics. Since then, awareness has grown of how oil and gas businesses used the same playbook in seeking to create doubt around science that threatened their profits. But in the UK, this year, the tobacco industry lost a crucial argument.
The Conservatives’ record on public health is atrocious. Low points have included the delayed cap on stakes at fixed-odds betting terminals, which caused Tracey Crouch to resign in 2018; and Boris Johnson’s rejection of a national food strategy. Rising malnutrition and poor dental health among children track rising poverty and are a grim legacy. The tobacco and vaping industry will continue to lobby politicians, and push new products. But if pre-election promises are kept, people growing up today are likely to gain increased protection from this deadly habit, seven decades after the risks of smoking were established.
