Research suggests UK will miss key health targets



young smoker

The UK Government is set to miss key health inequality targets, according to new research.

The paper, The great health challenge: levelling up the UK, also suggests an immediate ban on smoking would extend the working lives of both men and women, with the greatest impact found in more deprived areas.

It has been published in the journal, The Geneva Papers on Risk and Insurance: Issues and Practice and draws on research from Heriot-Watt University, Bayes Business School (formerly Cass), and the financial business consultants, Lane Clark and Peacock (LCP).

Our paper confirms that a smoking ban on those born in 2009 or later is one of the best ways to improve the health of people living in more deprived areas of the UK.

Professor Andrew Cairns, Heriot-Watt University

It comes as the Prime Minister Rishi Sunak’s ‘smoke-free generation’ legislation returns to the Commons this week.

The legislation, which dozens of Conservate MPs opposed at its second reading, would prevent people born after 2008 ever legally buying tobacco products.

Although the study agrees that a notional immediate outright ban on tobacco sales would eventually increase healthy life expectancy by 2.5 years, it would not be enough for the Government to meet the targets for reducing health inequalities set out in its levelling up white paper.

Andrew Cairns, Professor of Actuarial Mathematics at Heriot-Watt University, is one of the researchers behind the study.

He said: "Our paper confirms that a smoking ban on those born in 2009 or later is one of the best ways to improve the health of people living in more deprived areas of the UK. The findings vividly illustrate the transformative impact of this measure on the health landscape. It coincides with a parliamentary debate, signalling a concerted effort towards a healthier future for all."

Local government secretary Michael Gove’s 2022 levelling up white paper pledged to narrow the difference in ‘healthy life expectancy’ (HLE) between England’s most prosperous and most deprived local authorities by 2030, and to boost overall HLE by five years by 2035. HLE measures the number of years lived in at least reasonable health. In the UK, HLE has risen more slowly than life expectancy in recent decades – meaning people are typically spending more years in poor health, with obvious implications for NHS and social care budgets.

Lead author Les Mayhew, Professor of Statistics at Bayes Business School (formerly Cass), said: “It's clear that drastic smoking cessation intervention is necessary to increase healthy life expectancy across the population and to narrow pernicious health inequalities. The rolling ban proposed in the Government’s current legislation is a good first step but further research could strengthen the case for an outright ban.

“Policymakers need to commit to politically difficult policies even if improvements in population health are gradual and long-term. With an ageing population, the pressure on policymakers to intervene in behaviours that shorten working lives will become irresistible – as seen already with the current focus on sickness and disability benefits.”

The analysis confirmed that people who have never smoked typically enjoy an additional six years of HLE. Earlier research has shown that smoking kills around 78,000 people in England each year and leads to around 500,000 hospital admissions.

Recent research by the International Longevity Centre concluded that smoking cuts UK economic output by £19.1 billion, due to shorter working lives. Welfare and healthcare costs would boost that figure significantly. Men aged 30-60 who have never smoked are around 20 per cent more likely to be economically active than peers who smoke or previously smoked.

The latest study also concluded:

  • The nine-year gap in average life expectancy between the richest and most deprived local authority areas almost doubles, to 17 years, for years lived in reasonable or good health.
  • A one-year improvement in health expectancy increases life expectancy by 4.5 months. The gap between lifespan and healthspan gets smaller as a result so that people live both longer and in better health.
  • While an immediate tobacco ban would have a significant impact, additional measures to tackle other lifestyle factors such as poor diet, alcohol consumption and exercise would still be needed to help meet the 2035 target.
  • Lung cancer deaths in different local authority areas revealed a correlation with the number of years spent in good health. HLE was lowest in cities, including London, the north of England and the midlands – and notably low in an arch linking Liverpool, Manchester, Leeds and Hull.
  • A targeted campaign in areas with high levels of smoking would significantly reduce health inequalities but the results would take time to work through.
  • Targeted smoking cessation policies would extend working lives, reduce the welfare bill and ease pressure on NHS and social care budgets.

Mei Chan, Senior Statistician in LCP’s Health Analytics team, said: “Our study has shone a light on the importance of measuring how much time people spend in good health rather than just focusing on life expectancy. While recent political events have put the issue of smoking into the spotlight, the UK Government already had ambitious targets in place. It’s clear that more needs to be done to meet the ambitious target to improve healthy life expectancy by five years and narrow the gap between the richest and poorest areas."


Craig Philip

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