Smoking in Britain: Strategy for Future Emancipation

SUMMARY The health cost of smoking in Britain, the national response to the problem and the reasons for failure to control k more effectively are discussed. A future anti‐smoking strategy should hinge on the two interacting key factors that maintain smoking, the dependence factor and the favourable social climate. Any tactic or measure that diminishes the effect of either of these factors should also diminish smoking. In the absence of an effective treatment applicable to large numbers of dependent smokers and with lack of fundamental knowledge of the nature of dependence, our ability to overcome the dependence factor is at present rather limited. But much could be done to intensify research in this area. On the other hand, the engineering of a change of social climate to one less favourably disposed towards smoking is quite feasible and potentially highly effective. This would, however, require a coordinated sustained intervention on a national scale, with a multi‐disciplinary organizing committee closely backed by the Government with adequate financial and legislative support. It would not be sufficient merely to curb commercial promotion of cigarettes; but it would be necessary to accompany this with anti‐smoking propaganda of a commercial advertising type and scale. Continuous evaluation and public reaction monitoring would be required to ensure maximal efficacy of such tactics as selective tax increases, tighter control of sales outlets and restriction of smoking in public places.