Tobacco Dependence Treatment in England

In England (as in the United Kingdom of Great Britain and Northern Ireland as a whole) smoking prevalence in adults (aged 16 and over) has been falling in both men and women since the 1970s (1). During the 1990s, however, this decline levelled off, as the diagram below illustrates. Currently, in England 27% of adults smoke – 28% of men and 26% of women. Over the last 20 years there has been a similar trend in 11–15-year-olds, in whom preva-lence has fallen only very slightly. In 1982, 11% of 11–15-year-olds were regular smokers (defined as at least one cigarette a week on average), 11% of boys and 11% of girls. In 1999, the figures were 9%–8% of boys and 10% of girls (1). There are currently about 13 million smokers in Britain (2) and a large socioeconomic gradient: 15% of professionals smoke compared with 39% of unskilled manual workers (1). This gradient has become steeper as more profession-als have stopped smoking. There is also evidence of higher dependence within the more deprived smokers (3). Most smokers (82%) start as teenagers and most – about 70% in Britain (see footnote) – say they want to stop (1). Even among those who want to stop, the unaided cessation rate measured at one year is less than 5% (4). In the United Kingdom of Great Britain and Northern Ireland more than 120 000 people a year are killed as a result of smoking, mainly through lung cancer, chronic obstructive pulmonary disease and coronary heart disease. This represents one in five of all deaths (1.2). Half of all lifelong smokers are killed by their smoking in middle age (35 to 69 years), and the average loss of life is 15 to 20