Javed Khan Report – Time To Make Smoking Obsolete

Today Javed Khan, Charity Executive, released his independent review into the government's ambition to make England smoke free by 2030.

Included in the detailed report were 15 recommendations to the government in what he described as a “comprehensive tobacco control approach” to reduced smoking rates across the UK.

Javed Khan went on to call out 4 of these recommendations. These 4 were what he considered as 'critical to a smoke free ambition.'

Javed Khan wants to see improved Stop Smoking Services and campaigns

The first of these recommendations was to reverse reduced funding to smoking cessation campaigns and quit smoking services. A change which he said could potentially save the NHS 2.4 billion over time by making smoking obsolete. Javed wants to see the government invest an additional £125 million into funding smoking cessation efforts.

Local Stop Smoking services would receive £70 million of this, distributed across the UK by rates of smoking prevalence. People who use a local stop smoking service have a significantly improved chance of quitting for good. Smokers who receive the right support are three times more likely to quit successfully than those who try to quit alone.

Mass media campaigns that encourage people to quit smoking would make up a further £15 million of the fund. This would see government funded stop smoking messages back on TV, radio and across social media.

Where will this additional money come from? One suggestion that Javed Khan made is to introduce a levy on tobacco products. This would operate similarly to the recently introduced 'sugar tax'. It would mean that tobacco manufacturers would have to pay increased tax on their products. The tobacco industry currently makes around a billion pounds of profit every year by exploiting the most disadvantaged communities. In his report, Khan firmly stated that we should "make them pay for the harm they create."

Increased legal age to buy tobacco products

The second, and perhaps most publicised, recommendation make by Javed Khan in his review was to increase age of sale for one year every year. New Zealand is already implementing a year-on-year increase in legal smoking age and Denmark is exploring this too. He urged the UK government to join them and that this would make a clear message that they are committed to making smoking obsolete. Never starting to smoke is much easier than having to quit. The recommendation is based on the theory that raising the age of sale could stop people from ever starting smoking. Research shows that most smokers start their addiction before the age of 20. Khan proposed that the year-on-year increase could potentially be implemented by 2026. This would mean that no child aged 14 or under today will ever be able to legally buy a cigarette.

One argument by some people against the increase has been that we are restricting people's freedom and their 'right to choose'. In response to this, Khan was clear that “tobacco is a uniquely dangerous product” and “Smoking kills and ruins lives". He went on to point out that smoking was so dangerous "if cigarettes were invented today, they would not be legalised."

Promoting vaping as a quit smoking tool on Javed Khan’s critical action list

The third of the recommendations that Javed Khan reported as being critical to making the UK smoke-free by 2030 was promoting vaping as a quitting tool. He described how he had been “persuaded to support vaping as a healthier substitute to smoking” after speaking to healthcare professionals at the top of their field across the world. They all supported the view that "vaping is much safer than cigarettes and should be recommended”. Research also shows that “vaping is an extremely effective quit tool“. Khan was clear in his review that "in our efforts to help smokers quit, to dramatically decrease people's risk of cancer, heart disease and strokes - vaping has to be an option". He went on to say that, while vaping is not totally risk free, "the alternative of smoking is far, far worse".

The inclusion of vaping in Khan's four most critical actions in reducing smoking rates across the UK, further builds on backing over the last few years by major health organisations to support vaping. It follows positive statements about the benefits of vaping made by The Royal College of Physicians (RCP), the Royal College of Midwives (RCM), the Office for Health Improvement and Disparities (OHID, previously part of Public Health England). In 2021 NICE also updated their guidance to quit services across the UK. They recommend that they should ensure that they make a vape option available to smokers looking to quit.

Improved focus on quitting smoking within the NHS

The fourth and final of Khan's critical recommendation's was to improve the focus within the NHS on the prevention of smoking. The NHS has already set out a number of long-term commitments to helping people to quit smoking. He reiterated that it is important that those commitments do not get reduced or derailed. He also advised that more can be done within the NHS to make quitting smoking a main focus. Khan urged the NHS to commit to ensure every interaction a smoker has with a healthcare professional should involve advice on quitting smoking.

Raising the cost of cigarettes and more bans in public places

Other recommendations outlined in Javed Khan's review included substantially raising the cost of tobacco duties by 30% across all tobacco products immediately. This would see the price of cigarettes and tobacco increase significantly. He supported this recommendation with research from across the world that shows that one of the most effective ways of stopping someone from starting smoking is to make it too expensive to do so.

He also discussed a potential introduction of a tobacco licence to limit where tobacco is available. This would potentially mean a ban on places like supermarkets being able to sell tobacco and on online tobacco sales.

Khan also wants to see an increase in smoke-free places across hospitality and outdoor places, particularly where children might be. This could even see smoking banned in beer-gardens and outside areas of pubs and bars in the future.

He campaigned for more support to help pregnant smokers. Smoking in pregnancy increases the risk of miscarriages, still birth and congenital abnormalities. However 10% of pregnant women still smoke. In some regions such as Blackpool, rates of pregnant smokers can be as high as 20%. Research recently showed vaping to be as safe as nicotine patches for pregnant smokers looking to quit.

Finally, he asked for a new £8 million fund to support local collaboration and partnerships. This would ensure tackling smoking is 'prioritised at all levels' by driving more smoking cessation action.

The majority of smokers want to quit but cannot

Professor Chris Whitty, Chief Medical Officer spoke on Javed Khan's review today. He described the report as a "call to arms" in tackling smoking rates across the UK. He said we must not underestimate the "sheer staggering scale of the health harm” caused by cigarettes. Smoking is associated with around a quarter of cancer deaths and smoking is one of the most easily reversible and major causes of heart attacks and heart disease amongst young people.

He went on to say how “The majority of smokers wish to quit but cannot”. The increased support in helping smokers to quit is vital in achieving a smoke-free ambition.

Here at Totally Wicked we welcome the publication of Javed Khan's Independent Review. Getting the right support in place for smokers to quit is essential in improving the health of our nation. It is especially positive to see even more support for vaping as a quit smoking aid amongst the recommendations. We know first-hand just how effective vaping can be in helping smokers to quit. Totally Wicked help thousands of smokers to transform their lives every year, both through our own customers and through working with Health Improvement Partnerships (HIP) across the country. We are hopeful that this report will help to further debunk the myths surrounding vaping and allow more smokers to seek the support they need to quit.

Totally Wicked CEO and IBVTA Chairman, Marcus Saxton, has been speaking to BBC Radio Lancashire and BBC Radio 4 this week to discuss the report and also help tackle some of the myths around vaping.

What are your thoughts on Javed Khan’s review? Is the government doing enough to help smokers? Would you like to see smoking banned in more public spaces?