Prevention and protection

Smoking is a significant public health issue in Scotland and a leading cause of preventable ill health, premature death and disability.

You will find resources below to help you plan and improve services and implement smoke-free grounds.

  • It is estimated that 20% of the adult population smokes tobacco (22% of men and 19% of women).
  • Smoking is a leading cause of preventable ill health, premature death and disability.
  • There are over 10,000 smoking related deaths a year in Scotland.
  • Each year smoking is responsible for around 33,500 hospital admissions.
  • 11% of children aged 0-15 report exposure to second hand smoke at home.
  • People who die in middle age as a result of smoking lose an average of 22 years of life.
  • Smoking is a major risk factor for
    • stroke
    • a range of cancers
    • coronary heart disease
    • peripheral vascular disease
    • many respiratory conditions including Chronic obstructive pulmonary disease
    • many other diseases and conditions.

You can read more data on smoking on the Scottish Public Health Observatory (ScotPHO) website (external).

Smoking and health inequalities

There are clear links between tobacco use and inequality and therefore with health inequalities.

  • 34% of adults in the most deprived areas smoke cigarettes, significantly higher than 9% of those in the least deprived areas.
  • 29.3% of pregnant women in the most deprived areas are current smokers at their first antenatal appointment, compared to 4.5% in the least deprived areas.

A child born in a more socially deprived area of Scotland is more likely to

  • be growing up around smokers
  • be born into a family that smokes
  • have a mother who smoked during her pregnancy.

Children of smokers are more likely to start smoking themselves and continue to repeat the cycle of their own experience.

People living in the most deprived areas are

  • less likely to feel in control of their life
  • less likely to know where to get help to stop smoking
  • more likely to experience stress and mental health issues
  • likely to have less encouragement and social support to quit
  • likely to be less aware of the harm of smoking and second hand smoke
  • more likely to smoke heavily and have a stronger nicotine dependence and therefore find it harder to stop.

The World Health Organization (WHO) has produced policy guidance focusing on reducing inequalities relating to tobacco smoking. The guidance looks at

  • the complexity of smoking in terms of inequality
  • how tobacco increases inequalities over the life course
  • how the use of tobacco contributes to health inequalities
  • what tobacco policies need to consider to address inequalities
  • the widening socio-economic inequities in tobacco consumption.

You can read the full ‘Tobacco and inequities’ guidance (external) on the WHO website.

Creating a tobacco-free Scotland

The Scottish Government’s current tobacco control strategy ‘Creating a Tobacco-Free Generation:  A Tobacco Control Strategy for Scotland’ sets out the Scottish Government’s vision for a tobacco-free Scotland by 2034. It outlines the importance of reducing health inequalities and the role that reducing smoking rates in the most deprived communities can have on this. 

The strategy sets out action across the following themes

  • Prevention – creating an environment where young people choose not to smoke.
  • Protection – protecting people from second-hand smoke.
  • Cessation – helping people to quit smoking. 

National action on prevention

The action on prevention focuses on children and young people because we will never reduce smoking prevalence if we don’t address the new supply of smokers. Tobacco control work appears to be having an impact. This is reported in Information Services Division’s 2013 Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) report (external website), with rates of smoking now at their lowest recorded level.

Local action on prevention

The Scottish Public Health Observatory (ScotPHO) have created local tobacco control profiles to help with local planning. These provide data on

  • tobacco sales
  • smoking cessation
  • adult smoking prevalence
  • smoking related death and disease
  • smoking during and post-pregnancy.

National and local action on protection

The dangers of second hand smoke are widely recognised and thereby smoke-free environments are extremely important. This makes pregnant women a key group to reach, both to raise the awareness of the harms of smoking to themselves and their babies and as an opportunity for their child to grow up in a smoke-free home.

The Scottish Government’s Take it Right Outside campaign (external website) clearly communicates the harm of second-hand smoke and the importance of making the home smoke-free.

Our Healthy Working Lives website provides guidance on how to manage smoking in the workplace (external).

You may also be interested in our specific smoke free guidance for mental health services.

Smoke-free environments

New guidance has been developed to support local councils to develop and implement smoke-free policies across local authority owned and operated sites.

The guidance gives practical ways to implement smoke-free buildings and grounds and outlines the responsibilities of local authority partners.

Part of the national strategy to create a smoke-free Scotland by 2034 is the banning of smoking on hospital grounds. You can download our implementation guidance on how to manage and enforce this policy.

The Knowledge Network (external website) provides information on the smoke-free NHS grounds campaign as well as training, guidance and video clips.

You might also be interested in examples of local implementation from NHS Boards including a statement from the State Hospital.