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Where industry is involved, public health can get pushed aside for profit. We can’t choose the circumstances we’re born into, but it’s not all a game of chance. Even if children are told that cigarettes are health risks, they’re less likely to avoid them if they see them in media and for sale where they live, or see family and friends, who have been subject to the same pressures, using them. Seeing something regularly can make that thing seem more normal and less risky. What might this look like in real life? A child living in a more deprived area might live with someone who smokes, grow up near to more shops that sell cigarettes, be exposed to more tobacco imagery in the media, and have friends that smoke. “Someone born in one of the least deprived areas in the UK is going to be much more protected from all the things that are going to make a kid want to try a cigarette, compared to a kid living in one of the most deprived areas.” “If your parents smoke you are much more likely to smoke and continue to smoke, and so that creates a cycle,” says Hartmann-Boyce. And one of the most powerful determinants is the family environment – in particular, parental smoking. “Cigarettes have been engineered over time to be as addictive as possible, so if you start using them as a younger person, by the time you are older you are often so addicted that it is incredibly difficult to quit, especially without the right support.”Ĭhildren’s exposure and access to tobacco is determined by both environmental and social factors. “There are a number of forces at play, and I think it’s important to note that most people who start smoking do so as children,” says Hartmann-Boyce. These include the pressures and opportunities someone has faced over the course of their life, as well as their current circumstances, collectively known as the ‘wider determinants of health’.
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The factors that underly health and health behaviours are many and complex. Why are some people more likely to smoke? To understand disparities in smoking, we also need to look at factors that determine how likely someone is to smoke. “We also know that there is some disparity in access to medications and behavioural support, which are and should be offered for free.”įor example, stop smoking services, which provide medications and behavioural support, aren’t currently available in all areas of the UK, despite these services offering the best chance of success for people looking to quit.īut differences in the availability of stop smoking support are only part of the picture. They tend to start smoking earlier, and therefore there’s more for them to overcome when they’re trying to quit smoking,” adds Hartmann-Boyce. “People from less advantaged groups tend to be more heavily addicted. Those include people in deprived areas, people with mental health conditions, and the LGBTQ+ community.” says Hartmann-Boyce. “We know that there are certain groups in the population who are more likely to smoke. We spoke to Professor Jamie Hartmann-Boyce about the groups most at risk.
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And because some groups are more likely to smoke and find it harder to stop, smoking is also the single biggest driver of cancer inequalities. Smoking is the biggest preventable cause of cancer. For many, that first puff paves the way to long-lasting addiction. Some people are more likely to try a cigarette than others, and often factors outside of our control can make all the difference.
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So, why do we continue putting our health at risk, if we know how to be healthy?įor people who smoke it’s not as simple as avoiding cigarettes because they’re unhealthy and costly. This question is fundamental to understanding inequalities in cancer, and the answer is very complex.Īround 4 in 10 cancer cases in the UK are preventable, through things like not smoking and keeping a healthy weight. But if most people know that smoking is bad for them, why is this the case? We know that smoking is more common in some population groups than others.
And it’s not ‘news’ anymore – 94% of UK adults recognise smoking as a risk factor for cancer when prompted.* Decades of research show that smoking increases the risk of at least 15 different types of cancer. The link between tobacco and cancer is very well established. Smoking causes cancer, but what causes smoking? In this piece, we investigate what’s behind differences in smoking with Jamie Hartmann-Boyce, Associate Professor in evidence-based medicine at the University of Oxford. Our first post looked at what health inequalities are, and how we can reduce them.
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This is the second instalment of our series on health inequalities, where we explore the unfair and avoidable differences in cancer incidence and outcomes across society. This entry is part 1 of 2 in the series Health inequalities