Following the No Smoking Day campaign supported by all the major health organisations I now give details of the effects of smoking on the health of the public, particularly children. It is obvious that society should do as much as possible to stop people starting and if they do we should encourage them to quit.

The cost of smoking is high. In health terms, it is responsible for an estimated

120,000 premature deaths in the UK each year: 46,000 from cancer, 40,000

from circulatory disease and 34,000 from respiratory disease. It is also

responsible for a range of other diseases and conditions, including impotence

and infertility (Callum 1998).

Smoking has been identified as the primary reason for the gap in life

expectancy between rich and poor. Among men, it is responsible for more

than half the difference in the risk of premature death between the social

classes (Jarvis and Wardle 2006).

Children who smoke become addicted to nicotine very quickly. They also tend

to continue the habit into adulthood. Around two-thirds of people who have

smoked took up the habit before the age of 18 (The Information Centre 2006).

Because the risk of disease is related to the length of time a person has

smoked, people who take up smoking before the age of 18 face a greaterthan-

average risk of developing lung cancer or heart disease (Royal College

of Physicians 1992).

Children and young people who smoke are two to six times more susceptible

to coughs, increased phlegm and wheezing than their non-smoking peers

(Royal College of Physicians 1992). The habit can impair the growth of their

lungs and is also a cause of asthma-related symptoms in childhood and

adolescence (Muller 2007).

In recent years, little progress has been made to reduce the number of

children aged 11–15 who take up smoking. Between 1982 and 1998 the

proportion who smoked regularly1 fluctuated between 8% and 13%. Since

1999, rates have remained steady at between 9% and 10%. In 2006 in

England, 9% of 11–15 year olds said they smoked regularly – equivalent to

more than a quarter of a million young people.

Up to age 13, boys and girls are equally likely to smoke on a regular basis.

However, from age 14 girls take the lead: 14% of girls aged 14 and 25% of

girls aged 15 smoke regularly (compared with 10% and 16% of boys,

respectively) (The Information Centre 2007).

The highest prevalence of smoking is among people aged 20–24 (37% of men

and 30% of women) accounting for more than one million young adults (The

Information Centre 2006).

Access to cigarettes

Children and young people usually get cigarettes from friends, family and

shops, especially small corner shops. However, they also buy them from

adults who sell them from their own homes and from others involved in

organised criminal activities.

In a 2004 survey of more than 9000 pupils in 313 schools across England,

66% of children aged 11–15 who smoked currently had bought cigarettes from

a shop. Just over half (52%) said they had been refused a purchase at least

once. Sixty three per cent of children and young people who smoked were

also likely to have been given cigarettes by friends (58%) or by siblings (13%)

(The Information Centre 2006).

Factors associated with smoking

The factors associated with the uptake of smoking include environmental,

sociodemographic, behavioural and individual characteristics. Having a parent

or sibling who smokes is particularly strongly associated with uptake, as is

parents’ approval or disapproval of the habit (Goddard 1992; Stead et al.

1996). Tobacco use in adolescence is associated with many other behaviours

that can adversely affect health, including the use of alcohol or other drugs

(The Information Centre 2007).