Tobacco and Public Health - TCSC Indonesia

oys who were regular smokers reported smoking 50 cigarettes in the past week compared
with girls’ 44. The number of cigarettes smoked by regular smokers has been
stable since 1982 (DH 2001).
Smoking prevalence increases sharply with age: in 2001, about 1 per cent of 11 year
olds smoked regularly compared with 22 per cent of 15 year olds (DH 2002). Gender
differences in regular smoking appear about age 13 and are maintained at 14 and 15.
Laws prohibiting the sale of tobacco to young people have existed since 1908, and
currently under the Children and Young Persons (Protection from Tobacco) Act 1991,
it is an offence to sell any tobacco product to anyone under the age of 16. In 2000,
80 per cent of regular underage smokers said they usually bought cigarettes from
shops. This proportion is lower than the period 1982–98, but greater proportions of
pupils mentioning other sources of cigarettes, such as purchasing from vending
machines or friends, has broadly increased over that period (DH 2001).
Socio-economic group
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A clear social class gradient in smoking prevalence has existed in Great Britain for
more than 20 years. The general decline in smoking in the last quarter century has
been less pronounced among those in manual occupational groups and as a result
smoking has become increasingly concentrated in these groups. In 2000, in social class I
(professional), around 15 per cent of men and 13 per cent of women smoke cigarettes;
in social class V (unskilled manual), prevalence among men is 39 per cent and 34 per cent
among women (Walker et al. 2001). These figures, however, disguise very high prevalence
rates among the most deprived groups—such as lone mothers living on state
benefit—among whom prevalence reaches over 70 per cent (Marsh and Mackay 1994).
Smoking and deprivation
The government has identified smoking as the greatest single factor contributing to the
gap in healthy life expectancy between the best and the worst off (DH 1998). Among
men, smoking accounts for over half of the difference in risk of premature death between
the social classes. Premature deaths from lung cancer are five times higher among men in
unskilled manual compared with those in professional work (Jarvis and Wardel 1999).
The success of better-off smokers is not due to motivation. Surveys have shown consistently
that about seven in ten smokers in England say they want to stop smoking and
those in lower socio-economic groups are just as motivated to quit as those in professional
groups. There is evidence to suggest both from survey data and from quantitative
measures that nicotine dependence increases with deprivation (Jarvis and Wardel
1999). As part of its comprehensive tobacco programme, the government has made
pharmaceutical aids to quit smoking available on National Health Service prescription.
It has also funded, through the NHS since 2000, a national network of smoking cessation
services that are free of charge.