Light up to save the NHS

8 Jul 2017

Over the last week, The Times has published two articles in ‘commemoration’ of the Blair government’s smoking ban. The first of these, on Saturday, lauded the fact that “almost two million fewer Britons are smoking than a decade ago”, quoting statistics from the Office of National Statistics and Cancer Research that claim that in 2007 20.9% of British adults smoked compared to 16.1% in 2016. The result is that 1.9 million fewer people are smoking in Britain than a decade ago. The second piece, on Monday, informed us that Public Health England have told hospitals “to routinely question patients about their smoking and drinking habits in an attempt to save £1.2 billion”. Apparently “financial savings from preventing illness” could “help to close a £22 billion funding gap” in the NHS.


However, a more careful analysis of statistics would suggest that the perverse reverse is true; hospitals should be actively encouraging smoking in order to narrow this funding gap (notwithstanding the moral standpoint). Firstly, one must consider the lost tax revenue from there being fewer smokers. According to the Daily Mail, the average cost of a pack of cigarettes stands at £10.26. This is taxed at 82% (excise duty and VAT), meaning the government receives £8.40 for every pack bought. Assuming that the average smoker will buy a pack per day, simple arithmetic tells us that 1.9 million fewer smokers will result in £5.8 billion fewer pounds per year collected in tax.


Secondly, we ought to consider the fact that 'on average, smokers' life expectancy is 10 years less than non-smokers'. Given that the state pension is £122.30 per week, a little more basic arithmetic shows us that £12.1 billion extra per year will be dispensed on state pensions on a rolling basis for those who would otherwise have died 10 years previously from smoking-related illnesses. So far, this is a cumulative £18 billion per annum lost due to the reduction in smoking – nearly the entire NHS funding gap.


Furthermore, the ONS suggests that only 27% of smoking-related deaths are caused by cancer, the most expensive tobacco-induced condition. Given that nearly 40% of the population as a whole will be diagnosed with cancer at some point in their lives, the rate of cancer caused by smoking does not seem to be disproportionately high. The reality is that a larger number of smokers are carried off by heart attacks, in many cases costing the NHS next to nothing, owing to their sudden nature. Consequently, the reduction in smoking will result in another, incalculable cost – a study by the New England Journal of Medicine has suggested non-smokers have greater healthcare costs over time, especially now that dementia has overtaken heart disease as the UK’s main cause of death. That’s to say, not only is smoking globally profitable to the Treasury (taking into account tax revenue and reduced pensions), but it may even be profitable within the NHS itself.


Now or course there are many reasons to stop smoking, with beige teeth, halitosis and the quite separate whiff of general seediness ranking among the most convincing. However, statistical analysis proves the tiresome “save our NHS” argument is the one line that certainly shouldn’t be trotted out.




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