Thread by @MetroUK

'I am among the one in five people in the UK who smoke, contributing packet by packet to the £18billion we spend yearly on tobacco products'

@JessicaCVL asks: what will actually make smokers quit for good? 🚬

🧵👇
trib.al/TgtHcY5

My parents have kept the habit their whole lives, as did both sets of grandparents before them.

Having started in my early 20s and maintained a box-a-day addiction ever since, in many ways I’m a walking target for tobacco companies.

In theory, that should also make me a target for health interventions, too.

But I see the gory pictures on the box and ignore them, I pay the extra duty each time it’s upped, and I continue to light up despite knowing the implications.

I’m not alone in this – stats show 14.1% of British adults smoke despite extensive measures from the government to curb the habit.

So what’s not working?

We’ve come a long way since the 1960s, after a landmark US report showed a causal link between tobacco and lung cancer...

...And a bill was recently tabled in Parliament that would require manufacturers to print warnings such as ‘smoking kills’ on cigarettes themselves, and councils are being given power to create ‘smokefree pavements’

In this time we’ve seen smoking rates fall considerably...

...But progress has slowed since an initial drop following the introduction of tobacco controls.

✅The percentage of smokers in Britain is between 65% and 30% lower than in 1965, but just 7% lower than it was in 2006.

This follows a similar downward trend to most countries in the developed world, with smoker numbers falling dramatically in the 1970s before stagnating.

Smoking remains the ‘single largest avoidable health risk’ and the ‘most significant cause of premature death’ in the EU...🚭

...And our NHS currently spends £2.5 billion a year treating tobacco-related illnesses.

❌To meet the government’s goal of ‘eradicating’ smoking by 2030, more needs to be done❌

But if people know the risks and are being deterred from smoking at every angle, there must be a reason behind its continuing popularity.

On a personal level it’s stubbornness and nihilism.

I like being able to go outside and de-stress with a cig, and don’t have a positive outlook for the future of humanity.

It’s very much a ‘might as well enjoy small vices while the world burns’ mentality 🥂

@robertjwest, Professor of Health Psychology and Director of Tobacco Studies at University College London, says this might have something to do with cognitive dissonance:

'Almost all smokers have some level of dissonance – whatever they might say'

He continues:

'One of the tests is, if there was a pill I could give you, and from the moment you take this pill you would never want or need to smoke another cigarette as long as you live, would you take that pill?'💊

‘The vast majority of smokers would say yes.’

If quitting was as easy as that, we’d all do it.

The desire to stop smoking is only one part of the journey – and for some that’s where it finishes.

Largely, smokers support tobacco control measures, and want to quit

🚭🚭🚭

The problem is getting out of that mental cycle to inspire action, which is a lot harder when experiencing cognitive dissonance.

Matt Hawkins, co-director of Compassion In Politics, is calling for more funding from Westminster.

However, he feels a more holistic and balanced approach is necessary:

‘Compassion messages are especially effective in prompting long-term change' 🙌

‘Fear messages, by contrast, can shock – and in that way provoke'

‘But they are less effective in developing a positive commitment to a goal, behaviour, or strategy'

'They also run the risk of promoting social stigma: labelling, in this case smokers, as irresponsible, for example'

The burning question I had when researching this article was:

⚠️‘If smoking is so bad for us, why is it legal?’⚠️

A landmark report by @ProfDavidNutt ranking drugs based on the harm they cause (both to the user and others) placed tobacco sixth of the 20 studied.

Sitting between cocaine and amphetamines on the chart, tobacco was considered to be more harmful than banned substances such as ecstasy, cannabis, LSD, and methadone.

The only other legal drug among those looked at was alcohol, which came out top of the list for damage.

It stands to reason that, if government was fully committed to ending tobacco use for the greater good, they’d take steps to block its sale.

According to Hazel Cheeseman, deputy chief executive at Action On Smoking And Health (@AshOrgUK), however, it’s not that simple.

She says: ‘If you were to ban the product tomorrow, the likelihood is that you would have a very significant illicit market.'

❌‘So if your goal was to have fewer people smoking, banning it wouldn’t get you that.’❌

And the tobacco industry’s tactics to get – and keep – people hooked on nicotine are many.

From donating heavily to pro-tobacco think tanks to ‘wining and dining’ MPs, corporations employ various methods to influence those in power.

Untangling this web of money and authority was never going to be an easy task, but it would set a precedent that our nation’s health is the priority and cannot be bought.

New Zealand has recently shown that it can be done, this week revealing a groundbreaking ban.

But Robert and Hazel both say a ruling like this is unlikely to happen here.

In lieu of reform from the top, the onus is placed in the hands of the public to take responsibility for quitting a highly addictive substance that’s readily available and effectively state-sanctioned.

I had hoped that looking into the mechanics of smoking would give me a new zeal to quit.

In reality, I feel more jaded than ever. Despite well-meaning individuals working towards a common goal of better health, corruption muddies the waters around tobacco control.

The next cigarette I have likely won’t be my last, but one will be. 🚬

Even if I feel like a lost cause right now, perhaps I can be a cautionary tale for young people.

Perhaps seeing people like me pour money into smoking and struggle to quit over and over is deterrent enough.