Securing the smoke-free generation

With the air of a naval commander torpedoing his own ship and then complaining about it sinking, UK prime minister Rishi Sunak recently expressed “disappointment” that his tobacco control legislation would not be deliverable after he called an early general election.1 The Tobacco and Vapes Bill would have progressively increased the age requirement for legally buying tobacco products across the UK and was hailed as a landmark public health measure; the Association of Directors of Public Health called it “the single most important piece of health legislation in a generation.”2 In April 2024, despite almost half of Conservative MPs abstaining or voting against it, the Bill passed its first House of Commons reading, with support from opposition parties ensuring an overwhelming majority.3 Progress towards the statute book was looking increasingly likely, despite inevitable industry efforts to oppose the proposals.4

Decades of evidence would suggest that the tobacco industry will therefore have greeted the election announcement with delight: an opportunity not to be lost. Faced with policy measures that threaten profits, these companies perennially aim to defeat, weaken, or delay them.5 The announcement that the bill would not progress delivered on the last of these, and the inevitable political turmoil of electioneering and government-forming offers many windows to achieve the others. The Conservatives may have promised to bring back the bill in their manifesto,6 while Labour’s commits to “ensur[ing] the next generation can legally never buy cigarettes,”7 but the recent example from New Zealand/Aotearoa is a reminder of how progressive pre-election plans can be quickly discarded.8

So, what action can be taken to combat tobacco industry efforts and support the return of this important legislation in the coming months? Crucially, the health community can ensure parliamentarians and the wider public are primed to recognise that industry arguments against the policy are disingenuous and self-serving, but still pose a major risk.4 As the bill was being developed, for instance, Philip Morris International issued a legal threat which the government claimed, if taken further, would be an “unjustified attempt to delay or derail important legislative change.”9 Imperial Brands also wrote to the Department of Health and Social Care, complaining that the consultation on the policy was “unfair”10, while Japan Tobacco International described the ban in a magazine advert as “an experimental policy not supported by evidence.”11 As egregious as they are, these examples will be merely the tip of an interference iceberg, given the predictable supporting efforts of various industry-affiliated organisations to actively undermine the policy as well.12

If a bill is brought back, it is likely that industry will therefore again work vigorously to try to secure concessions and amendments as it passes through the legislative process. To counter this, we propose three key rationales that the health community can advocate, to try to secure the legislation’s return and safe passage.

Firstly, we must continue to emphasise, to politicians and the media, the overwhelming public support for this measure. YouGov polling has shown 67% of respondents back the plans, with just 14% opposing. The policy has a majority in every constituency in Great Britain and support across voters of all political persuasions.1314

Secondly, as the incoming government will face enormous health and economic challenges, it would be inexplicable to reject measures that would help reduce the annual £17 billion cost of smoking to the exchequer,15 or the 60 hospital admissions and 100 GP appointments every hour that have been attributed to it.16

Thirdly and closely linked, is the urgency of acting and the opportunity cost of failing to do so. As the government’s command paper emphasises, “tobacco use is the world’s single most preventable cause of death and disease” and a leading driver of health inequalities.16 The sheer scale of these unequal health burdens means that even small delays in implementation will inevitably have outsized impacts on death and disability, in a country where life expectancy is already declining and ill health is a major constraint on economic growth.1718 Hundreds of young people still take up smoking every day in England, most of whom will go on to become daily smokers19; on average, each of these new teenage addicts will lose 10 years of life, so the need for urgent action is evident.20

Whatever the political composition of the UK government after 4 July, as health professionals, we will need to use any, and all, opportunities to ensure that the smoke-free generation policy is restored. There is undeniably a lot to fix and the legislative timetable will be crowded, yet a bill is already drafted and should have widespread support among new MPs and in the Lords, allowing it to pass through parliamentary processes rapidly. The new government can secure a quick win which, as the polling cited shows, will be popular throughout the country. Conversely, failure to make this change a reality will leave future cohorts of young people vulnerable to the tobacco industry’s efforts and facing clear, concrete—but avoidable—harm.