Public Health Milestone

Abstract

The ‘smoking epidemic’ of the 20th century will likely be viewed with incredulity by historians of the future. How could our society, fi rst in ignorance, but later with full knowledge have promoted and tolerated a habit that is the single greatest cause of preventable illness and premature death in the UK, killing more than 114 000 people in this country every year and costing the NHS about £1.5 billion a year (Peto et al, 2006)? Those historians will probably also recognize 1 July 2007 as a critical public health milestone in the fi ght to end this epidemic. As of 6 am on that day, it is against the law to allow smoking in virtually all enclosed public places and workplaces—offi ces, shops, factories, restaurants or pubs. Following similar legislation in Scotland in March 2006 and in Wales and Northern Ireland in April 2007, the UK has become the biggest jurisdiction in the world (by population) to have legally enforced protection from second-hand smoke. Research published by the British Thoracic Society and Action on Smoking and Health (2007) predicts substantial life-style changes following implementation of the ban, and documents public support for the legislation in England by more than 5:1. More importantly, almost 4 million smokers in England intend to quit in the fi rst year of this law. Substantial heath gains and reductions in smokingrelated deaths from cancers and respiratory and cardiovascular disease are expected. Delivering the support— counselling and nicotine replacement therapy (NRT)—needed to meet the increased demand to help smokers quit remains an enormous challenge for the NHS. Smoking cessation support with NRT doubles the success of quit attempts (Silagy et al, 2000), and, in this edition of Practice Nursing, Jennifer Percival outlines practical steps for nurses to play a signifi cant role in this process. It has taken more than 50 years to move from scientifi c proof that tobacco kills (Doll and Hill, 1950) to effective government action against a habit that generates £9 billion of tax revenue for the UK each year. While the fi ght is by no means over, the smoke-free legislation will help improve the health of the nation. The nursing profession can make a huge contribution.