Smoking: standardised packaging and smoking rates in England

The Government announced on 21 January 2015 that they will bring forward legislation on standardised packaging on tobacco products.  The intention, subject to the agreement of Parliament, is that the Regulations be made before Parliament dissolves for the election. This follows a 2012 public consultation, an independent public health review and a further consultation on draft regulations.  The regulation-making powers also require that consent is sought from Ministers in the Devolved Administrations for regulations to extend across the UK.

The proposed regulations would introduce new requirements for the retail packaging of cigarettes and loose tobacco.  Packets would be a prescribed shape and would be a drab brown colour.  Names of brands would be in a fixed typeface and with a maximum font size.

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A general guide to how a standardised packet may look; may not be comprehensive or final.
Source:
Consultation on introduction of regulations

The Regulations are to be introduced under the Children and Families Act 2014.  This legislation has also introduced an offence of proxy purchasing of tobacco products in England and Wales and allows for regulations to introduce a ban on smoking in cars with children present (laid before Parliament in December 2014).

The Department of Health has reiterated that smoking will continue to be one of the most important challenges in public health.  With this in mind, the following map shows variation in smoking rates across England – specifically, differences in self-reported tobacco-smoking prevalence prevalence among adults across council and unitary authorities. The highest values were recorded in Hull (29.4%) and Blackpool (26.5%), and the lowest were found in Wokingham (10.5%) and Richmond (11.4%). Data is gathered via the Integrated Household Survey and presented by Public Health England as part of their Outcomes dataset.

Smoking prevalence among adults, England, 2013

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The map shows estimates of smoking prevalence based on a survey. Because the estimates are based on a sample of the population, however, it is possible that small differences between local areas can be explained by sample variability rather than genuine differences in smoking rates. As well as the estimated smoking rates, then, the survey gives ‘confidence intervals’ for each area. In Stockport, for instance, the survey found that 14.7% of adults smoke, with the lower confidence interval at 12.9% and the upper confidence interval 16.5%. These intervals are calculated at the 95% level, meaning that 95% of the time an equivalent survey of Stockport’s residents would fall between these upper and lower bounds. In other words, we can be 95% confident that the true rate of smoking among Stockport’s adults falls between 12.9% and 16.5%.

The following chart illustrates this by plotting the lower and upper confidence intervals for each area, in order of their estimated smoking rate in the survey. These lines are not completely linear since the confidence intervals vary with the sample size in each area.

The chart also helps to identify some of the uncertainty introduced by confidence intervals. As it shows, the upper confidence interval for smoking rates in Wiltshire is 18.7%, while the lower interval for Peterborough is 18.6%. This means that we can be reasonably certain that rates in Peterborough are higher than in Wiltshire – the survey recorded rates of 20.8% and 16.7% respectively – but it is still consistent with the 95% confidence intervals that a higher proportion of adults smoke in Wiltshire.

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While the survey gives us a useful broad picture of smoking rates across England, then, it does not allow us to definitively rank areas in terms of rates.

Sarah Barber & Carl Baker

Picture Credit: Cigarette by Raul Lieberwirth; Creative Commons Attribution 2.0 Generic (CC by 2.0)