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Smoking

Smoking facts and figures

Smoking and CHD

The World Health Organisation's MONICA study (2000) estimated that the declines in incidence of coronary heart disease were due to decreases in smoking (amongst men), mean blood pressures and blood cholesterol concentrations.

A study of 1981-2000 data from England and Wales found that, of the 58% of coronary heart disease deaths prevented or postponed due to changes in risk factors, decreasing smoking from 39% in 1981 to 28% in 2000 had the largest influence (accounting for 48% of the reduction). While beneficial changes in cholesterol and blood pressure explained much of the remaining decline.

In 1991, smoking was responsible for about 24% of deaths from coronary heart disease in men and 11% of deaths from coronary heart disease in women. However, a more recent report suggests that these figures now stand at 20% of cases of or deaths from coronary heart disease in men and a shocking 17% of cases of or deaths from coronary heart disease in women.

This may reflect the changing prevalence of risk factors between the two sexes over the last century with a large increase in the numbers of women smoking after World War Two. These data suggest that a fifth of all cases of coronary heart disease could be avoided if smoking in the UK was reduced to zero.

It is estimated that smoking caused 30,600 deaths from cardiovascular disease (CVD) in 2000 in the UK. Around one in eight deaths from CVD (14% in men and 12% in women) were attributable to smoking, according to British Heart Foundation statistics in 2005.

Trends in tobacco smoking

Since the 1970's smoking in the UK has declined. Initially the reduction was rapid, from 45% among adults in 1974 to 35% in 1982. The rate then slowed in the 1980's and in the last few years appears to have levelled off at 29% prevalence among male adults and 25% prevalence among female adults, primarily because of the high uptake of smoking among young adults.

Thirty-five percent of adults aged 20-34 years smoke compared with 16% of those aged 60 or more. The rate of decline in smoking has been faster among men than among women.

In 2003, 28% of men and 24% of women smoked cigarettes in Great Britain, according to the Office for National Statistics results from the 2003 General Household Survey. 

In England, public health targets for smoking were announced in 1998. The Smoking Kills targets for smoking among adults were to reduce rates to 26% by 2005 and 24% by 2010.

The most recant data suggest that these should be met in women, but not met in men. The official smoking rate, as reported by the General Household Survey, shows that the 2005 milestone has already been met, with overall smoking levels falling to 26% in 2003. However, smoking rates in men increased between 2002 and 2003 to 28%, and unless this trend is reversed the Smoking Kills target of 24% by 2010 may be missed.

Social class and smoking

Cigarette smoking is more common among manual social groups than non-manual groups. In 2000, 35% of men and 30% of women in manual groups smoked compared to 23% of men and 22% of women in non-manual groups.

Ethnicity and smoking

Smoking rates vary considerably between ethnic groups in the UK. In men, rates are particularly high in the Bangladeshi (42%), Irish (39%) and Black Caribbean (42%) communities. Among women, smoking rates in ethnic minority communities are very low (8% or lower), with the exception of Black Caribbean and Irish women who have similar rates to women in the general population (25%).

References:

(1) Time for a smoke? One cigarette reduces your life by 11 minutes. M. Shaw et al. BMJ 2000; 320:53.
(2) The pathology of cigarette smoking and cardiovascular disease. An update. Ambrose JA and Baura RS. J. Am Coll Cardiol 2004;43:1731-7.
(3) Effectiveness of a large-scale distribution programme of free nicotine patches: a prospective evaluation. The Lancet 2005;365:1849-54.

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