Scotland's Future is Smoke Free: A Smoking Prevention Action Plan

CHAPTER 2
SMOKING AND YOUNG PEOPLE

"We will ensure the best possible start in life for children and young people in Scotland through our approach to targeting early years and to early intervention."Shona Robison, Minister for Public Health, in launching the Health Inequalities Task Force -October 2007

The challenge

2.1 Traditionally, smoking rates in the UK are higher among 15 year old girls than in most European countries but, among boys of the same age, are among the lowest in Europe. Latest Scottish surveys results ⁷ for 2006 suggest smoking prevalence among 15 year olds has declined since its peak in 1996 from 30% for both boys and girls to 12% and 18% respectively. Regular smoking is more common among disadvantaged young people, especially girls. The SPWG report points to clear evidence to suggest that, while many young people continue to take up the habit in their early teens, many young people start to smoke or progress to regular smoking once they leave school.

2.2 Smoking disproportionately affects those already disadvantaged by poverty and is a major contributor in health and premature mortality inequalities. Thus, while declines in teenage smoking are welcome, the Scottish Government is determined to reduce these figures even further.

2.3 If we are to be successful in stopping young people from becoming smokers we need to understand why they start to smoke in the first place. It is clear they do so for a variety of reasons. There is no single cause. Inevitably our choices are influenced by our surroundings. Parents, brothers and sisters who smoke are a powerful influence as are our peers. The images of smokers and smoking portrayed in the media also have an impact. However, the single most important factor which turns a beginner into a regular smoker is the addictiveness of nicotine in tobacco.

2.4 Some children and young people, of course, will experiment with smoking, whatever parents, teachers, doctors, or the Scottish Government say. Many experiment with smoking thinking they will give up when they want to but underestimate just how highly addictive smoking is. To underline this, the SPWG report points to recent research suggesting that addiction to nicotine can develop very quickly within a few months or sometimes a few weeks.

2.5 That said, while nicotine may explain why people become and remain regular smokers, it is not the factor which drives someone to try a cigarette in the first place. The SPWG report highlights clear evidence that the marketing of cigarettes has been successful in encouraging young people to smoke and suggests that the ban on tobacco advertising and promotion is being undermined by other opportunities which exist for other forms of marketing (such as cigarette displays) and the positive images of smokers and smoking which appear in the media, including youth media (e.g. magazines and films).

2.6 The SPWG report calls for a fundamental reassessment of the approach to health promotion and education to ensure smoking prevention activity constantly evolves to address the needs and circumstances of Scottish young people of the day, and especially those at most risk of starting to smoke. It also calls for steps to reduce the attractiveness of smoking. Moreover, the report underlines the need for more rigorous enforcement of the laws restricting the sale of tobacco to under 18s and strategies to deal with illicit sales of tobacco; and effective fiscal policies to reduce the affordability of cigarettes.

2.7 Thus the challenge is to put in place a programme of action to make cigarettes and other tobacco products less affordable, less available, and less attractive to children and young people. This requires ownership and action from a wide range of individuals and organisations including NHS Boards, Local Authorities, third sector bodies and the business sector.

The approach

2.8 In framing these proposals, we aim to deliver a co-ordinated programme of measures responding to all the factors which influence behaviour. This will include measures to:-

• Educate and promote healthy lifestyles: making clear to children and young people the risks associated with smoking and to do everything possible to counter the idea that there is any link between smoking and glamour, celebrity, maturity and independence, and to increase associations between smoking and seediness, unattractiveness, obscurity, childishness and dependence. ( Chapter 3)
• Reduce the attractiveness of cigarettes: countering positive images of cigarettes in the media and at points of sale and reducing the opportunities for children and young people to be exposed to smoking. ( Chapter 4)
• Reduce the availability of cigarettes: enforcing the law vigorously to avoid cigarette sales to minors and prevent access to smuggled/counterfeit cigarettes. ( Chapter 5)
• Reduce the affordability of cigarettes: ensuring cigarette prices are sufficiently high to discourage children and young people from smoking. ( Chapter 6).