1. Smoking Still Kills Protecting children, reducing inequalities Hazel Cheeseman Director of Policy Action on Smoking & Health The future of tobacco control

3. Figure 2.1 Adult smoking prevalence in England 1980-2013 Smoking Still Kills: PROTECTING CHILDREN, REDUCING INEQUALITIES England has made excellent progress reducing smoking rates

4. Figure 2.2 Adult smoking prevalence 1980-2012 in France, Germany, England, Australia, Canada and California Smoking Still Kills: PROTECTING CHILDREN, REDUCING INEQUALITIES Progress is not inevitable

5. 5 Smoking Still Kills Traffic: 1,850 Obesity: 34,100 Smoking: 79,100 Alcohol: 6,669 Suicide: 5,377 Illegal drugs: 1,605 HIV: 504 Leading cause of preventable death

6. Smoking Still Kills Wide inequalities between rich and poor

7. Can’t afford not to take action Smoking costs society £13.9 billion every year In Hertfordshire smoking costs society £287.9 million every year (£1,811 per smoker) this includes NHS costs, lost productivity, cost of social care, costs to business etc 108 tonnes of litter (25 tonnes of which discarded on the street)

8. Can’t afford not to take action Smoking means that a further 17,200 individuals in Hertfordshire need social care: –Cost to council over £11 million –Cost to individuals over £8 million A further 16,500 people need informal care from a friend or family member Smokers need care on average 9 years before those who don’t smoke

9. Can’t afford not to take action 89,400 households that include a smoker in Hertfordshire 27% of them are living below the poverty line If they quit 5,300 households would be lifted above the poverty line: –12,000 adults below pension age –2,800 adults above pension age –4,800 dependent children

10. Endorsed by >120 organisations including Hertfordshire BHF and CRUK funded - Editorial Board chair Peter Kellner PH Minister committed at launch on 9 th June to new strategy Smoking Still Kills

11. Vision to reduce smoking for all

12. Action needed New comprehensive strategy

13. Smoking Still Kills Tobacco Control plan for England has now finished New strategy under development Needs sustainable funding National, local and regional Tough new targets < 5% by 2035 across all socio- economic groups

14. Lesson from New York Taken from Better Health for London, the report of the London Health CommissionBetter Health for London

15. Comprehensive package of measures Legislative agenda –A levy on tobacco manufacturers –Introduce licensing system for retailers National and regional investment –Effective mass marketing campaigns –Appropriate regional investment Reduce affordability –Increase tax above inflation –Tougher measures to reduce smuggling Improve support to those quitting –Better delivery across NHS –Investment in services –Sound approach to electronic cigarettes Strengthen denormalisation –Smokefree places –Smoking in films

16. Action needed New funding mechanism

17. Smoking Still Kills - context NHS funding gap £22 bn by 2020 Needs ‘radical upgrade in prevention and public health’ to be bridged £200 million cut in Local Government public health budget – further cuts in the spending review Summer 2015 40% of councils told us they’d made cuts

18. A sustainable funding solution The polluter must pay Based on US model where tobacco companies fully fund tobacco regulation UK precedents Energy Company Obligation and s.106 Tobacco Company Obligation to pay for the harm they cause

19. TI can afford to pay Sales stagnant profits up

20. Where are we now? Consultation on a levy on tobacco companies and cross party interest/ support prior to the election July 2015 Chancellor announced would not proceed Continue to make the case to Treasury about the need for sustainable funding for tobacco control

21. The future of tobacco control New national strategy this summer Delivering on the vision for the future requires sustainable funding and a comprehensive approach – without which progress will stall BUT in the short term difficult choices to make. Need to: –Prioritise the most effective interventions –Work with partners (particularly the NHS) –Ensure support is targeted for those most in need