SMOKING CESSATION

Smoking Cessation

Smoking Cessation

Introduction

Tobacco smoking remains the single, largest preventable cause of ill-health and premature death in the UK and most developed nations (Peto et al., 1994). In the UK, it is responsible for more than 100,000 deaths a year, more than all other drugs combined. Smoking has been characterised as a “paediatric disease”, since the majority of people become smokers during adolescence (Kessler, 1995). Furthermore, the younger a person starts smoking, the greater the subsequent risk to health (Royal College of Physicians, 1992). The decline in smoking prevalence in the UK is partly attributable to older adults quitting (Goddard, 2006) and partly due to the steady increase in the proportion of young people who have never smoked (Goddard, 2006; NCSR, 2007).

Whilst most smoking related diseases occur in middle and older age groups, adolescents who smoke have more respiratory infections, poorer lung function, and for those with asthma, a worsening of symptoms compared to non-smokers (Royal College of Physicians, 1992). There is also growing evidence that youth smoking is a marker for mental health problems in adulthood (Mathers et al., 2006) and there is some evidence to suggest that anxiety and depression in teenagers increases the likelihood of nicotine dependence (Patton et al., 2006).

Deterring young people from smoking may be seen as the holy grail of tobacco control since the majority of smokers take up the habit during adolescence (Royal College of Physicians, 2000). Logically one would expect a “prevention is better than cure” approach to solve the tobacco epidemic. However, despite the fact that significant resources have been deployed to tackle youth smoking, children persist in experimenting with cigarettes and in many cases become long-term users of tobacco.

This study examines trends in smoking among young people in the UK since 2000 together with an overview of the latest health education theory and practice relating to adolescent tobacco use.

Smoking trends

Smoking prevalence in the UK peaked among adults in the early 1970s (Goddard, 2006) and since then has been steadily declining as more adults have quit the habit. By contrast, overall smoking prevalence among adolescents has persisted at a more or less constant level since the collection of national data in the early 1980s (NCSR, 2007) and has only shown signs of a slight fall since the late 1990s, largely among boys, despite decades of school-based interventions to dissuade children from taking up the habit.

The first national1 survey to measure smoking among adolescents took place in 1982 (Dobbs and Marsh, 1982). In England, the proportion of 15-year-old girls who smoked regularly fell from 33 per cent in 1996 to 25 per cent in 2005 whilst an even bigger fall was recorded among 15-year-old boys, from 28 per cent to 16 per cent during the same period (NCSR, 2007). Most importantly, the proportion of teenagers in England who reported that they had never smoked rose from 47 per cent in 1982 to 61 per cent in 2004 (NCSR, 2007). A similar fall in smoking prevalence has been recorded in Scotland (SALSUS, ...