Scottish Parliament Election Manifesto, 2016

Download ASH Scotland's manifesto for the 2016 Scottish Parliament Election (pdf)

Supporting information

Ensure the next generation grows up free from tobacco

Stop neglecting the physical health of people with mental health issues

Give preventing dementia the same importance as dementia care or cure

Put tobacco out of sight, out of mind and out of fashion

Focus e-cigarette debates on the goal of reducing tobacco use

Defend the historically low levels of illicit tobacco

Introduction: Tobacco use is intrinsically linked to inequality

Scotland's health inequalities

Wealth inequality drives health inequality. Scotland's health inequalities have been regarded as the worst in Western Europe, according to the Human Mortality Database (as quoted by the Report of the Ministerial Task Force on Health Inequalities). 

Social and economic determinants of smoking

Tobacco use is highly determined by social and economic pressures. Smoking rates in the 20% most deprived communities, as determined by the Scottish Index of Multiple Deprivation, stand at 34% according to the Scottish Household Survey 2014. In the 20% least deprived, smoking prevalence is 9%. The same survey shows that 46% of those seeking work and 48% of those who are permanently disabled smoke. Higher smoking rates mean greater health impacts but also increased financial pressure due to the economic costs of smoking. 

Smoking prevalence is known to be higher among those with mental ill-health. One study found that those with mental illness in the last month were almost twice as likely to smoke as those who had never had mental ill-health. 

Smoking is also more prevalent among prisoners, 74% of whom smoked in 2013, and children in care.

Smoking is rarely a simple, freely-made, lifestyle choice - surveys consistently indicate that two thirds of Scotland's smokers want to quit. The majority of smokers began as children, with the vast majority beginning before the age of 25.

Further reading

ASH Scotland has produced a range of materials on the impact of smoking on health inequalities:

• our one page FastFacts briefing (November 2015)
• our full briefing paper
• information about the work we do to help tackle inequalities.

NHS Health Scotland has an information page on health inequalities.

Ensure the next generation grows up free from tobacco

Scotland's Charter

The majority of smokers began as children. Scotland’s Charter for a Tobacco-free Generation is aimed at organisations whose work directly or indirectly impacts on young people and families.

The aim of Scotland's Charter for a Tobacco-free Generation is to:

• raise awareness to the Scottish Government’s tobacco control strategy and the goal of creating a tobacco-free generation of Scots by 2034;

• support organisations whose work directly or indirectly impacts on young people and families;

• inspire organisations to take action to reduce the harm caused by tobacco.

The charter is supported by the British Heart Foundation, the British Lung Foundation, Chest, Heart and Stroke Scotland, Cancer Research UK, Children 1st and many more organisations.

Stop neglecting the physical health of people with mental health issues

Motivation to quit

Two thirds of smokers in Scotland express a desire to quit smoking, according to the Scottish Health Survey. A 2009 review in Addiction found that people with mental health issues were as likely to want to quit as the general population, although there were variations depending on the type of mental illness experienced.

A neglected group

We say that physical health for this group has been neglected because sufficient resources have not been put into helping smokers with mental health problems to quit. Smoking in the general population has declined from 31% in 1999 to 20% in 2014, but a similar drop has not been seen among those living with mental ill-health. Life expectancy for people with many mental illnesses is substantially lower than for the general population.

Further reading

Our work on mental health

Give preventing dementia the same importance as dementia care or cure

Dementia is a rising problem

The number of people with a diagnosis of dementia in Scotland will double over the next 25 years unless risk factors are addressed. A meta-analysis of studies in 2007 showed that the risk of developing dementia is up to 70% higher amongst those who smoke heavily. But preventing this rise has not been central to discussions of dementia care. A separate initiative is needed to tackle dementia prevention, learning from campaigns on issues like cancer prevention and heart health.

Further reading

ASH Scotland's briefing on dementia

Put tobacco out of sight, out of mind and out of fashion

Tobacco retailers

As of December 2015, there were just fewer than 10,000 businesses listed on Scotland's Tobacco Retailers' Register as able to sell tobacco. NHS National Services Scotland lists around 1,250 pharmacies in Scotland as of August 2015, a ratio of roughly 8 tobacco outlets to 1 pharmacy. As of 2014, the Scottish Government estimated there to be 887,264 smokers in Scotland, a ratio of around 90 smokers to 1 outlet.

Every one hundred cigarette packets sold costs a local community 15 days of life. And research has shown that deprived communities have a higher density of outlets than average, which is linked to higher youth and adult smoking.

Focus e-cigarette debates on the goal of reducing tobacco use

The facts about e-cigarettes

ASH Scotland has produced a range of information about e-cigarettes, including our briefing paper and our one page FastFacts briefing. We estimate that over 100,000 people in Scotland currently "dual use" both tobacco and e-cigarettes. This is based on the Scottish Health Survey's figure that 5% of the Scottish population use e-cigarettes, and ASH in London's estimate that two thirds of e-cigarette users simultaneously use tobacco.

Defend the historically low levels of illicit tobacco

The scale of illicit tobacco

Tobacco tax gap figures from HMRC show that illicit cigarettes now take up a far smaller share of the tobacco market than at the start of the century. Since 2000/01, illicit cigarette market share has gone from 22% to 10%  As the market is declining (with adult smoking rates across Great Britain estimated to have fallen from 26% in 2002 to 19% in 2013), there has been a reduction of 76% in terms of real volume of illicit tobacco sold. Over the same time period there has been a fall of 33% in the volume of illicit hand-rolling tobacco sold in the UK. Overall, it is clear that illicit tobacco is at a historically low level in the UK.

How the industry presents illicit

The tobacco industry presents illicit as a rising challenge. This is often linked to attempts to challenge public health measures such as standardised packaging for cigarettes.

Further reading

ASH Scotland's FastFacts one-page briefing on illicit tobacco
A recent Scotsman article about illicit tobacco by Chief Executive Sheila Duffy