Breaking the deadly cycle of addiction

14,000 young people aged 11-15 try their first cigarette every year in Wales.

Earlier this month ASH Wales visited schools around Wales to talk to teenagers about the impact of smoking on them and their families. Many of those who admitted to smoking wanted to give up and wished they had never started, while others were surrounded by smokers in their family with no power to do stop them.

In his last annual report ‘Our Healthy Future’, the outgoing Chief Medical Officer for Wales Dr Tony Jewell said it was of particular concern that smoking rates amongst young people are still higher for 15-year-old girls than in other countries of the UK.

This is where the deadly cycle of addiction begins and where action needs to be targeted. Given that 8 out of 10 adult smokers admit to becoming addicted before the age of 19, prevention remains key if we are to have any chance of bringing down smoking rates from 23% to 16% by 2020.

Despite the cultural changes brought about by the smoking ban in enclosed public places and increased awareness of the dangers of second hand smoke, there remains much work to be done not only in terms of enforcement but in challenging the social norms around smoking particularly around young people.

Nowhere is this more stark than in the statistics on smoking in pregnancy. 16% of mothers in Wales smoke right through their pregnancy, compared with a UK average of 12%. In Wales, this figure is highest for mothers in the under 20 age group (1 in 3) and those in routine and manual occupations.

Smoking is a major risk factor for poor pregnancy outcomes, accounting for four to seven per cent of stillbirths, 13 per cent of preterm births, 26 per cent of sudden infant deaths and ten to 27 per cent of low birth weight babies.

According to the Stop Smoking Wales (SSW) Annual Report 2010/11, SSW was contacted by 314 pregnant women, well below the numbers of pregnant women smoking in Wales, indicating that the opt-out referral system in place is not working as effectively as it might. It also suggests that there are still many myths and cultural norms to be challenged around smoking in pregnancy which needs to done much earlier and much more effectively if we are to bring down the rate in Wales.

ASH Wales is pleased that the need to protect young people from the harmful effects of smoking underpins the Welsh Government’s Tobacco Control Action Plan. In 2011 it passed legislation banning cigarette vending machines, point of sale cigarette advertising will be prevented from 2012 in larger shops, and we are pleased to see the Welsh Government fully behind the campaign for the plain packaging of tobacco.

While legislation is key, it is vital that we continue to challenge the myths around smoking by de-normalising and de-glamorising it in front of our children, at home, in the car and in the playground, if we are to bring about long term sustainable changes to attitudes and behaviour.

We also need to do more to understand the motivations of people who smoke in order to provide appropriate and effective services that are tailored to their needs.

As Dr Jewell states in his report, cumulative tobacco control policies have evolved over more than 50 years since the harms of tobacco were first evidenced and continues to be a hard fought battle.

Easy access to effective, appropriate resources as well as direct engagement with target groups will be essential if we are to have any chance of winning it.

Elen de Lacy is  chief executive at ASH Wales