Following neatly on from last week’s look at alcohol policy and independence, it’s time to look at one old vice (smoking) alongside a much newer one (vaping).
Health impacts of smoking
You’ll all know this – even the smokers amongst you – but it’s an understatement to say that “smoking is bad for you”.
Nicotine addiction – Nicotine is a stimulant that causes adrenaline, dopamine and serotonin to be released, increasing mental sharpness and a feeling of calmness. Only cocaine and heroin are more addictive than nicotine (Radical Wales: Legalise Drugs) and a tolerance to nicotine can be built up quickly, resulting in harsh withdrawal symptoms.
Cancer – Up to 70 chemicals present in cigarette smoke are cancer-causing. According to Cancer Research UK, smoking causes up to 60% of all cases of lung cancer and is linked to 16 other types. Chewing tobacco (such as snus) is also linked to mouth and throat cancers.
Chronic Obstructive Pulmonary Disease (COPD) – A group of lung diseases whereby the airways within the lungs become blocked by inflamation. These include asthma, bronchitis and – if left unchecked – emphysema, where the parts of the lung that exchange oxygen and carbon dioxide (alveoli) disintegrate. COPD can be managed but can never be cured. Once it reaches the emphysema stage the only treatment option to delay death is a lung transplant.
Heart & blood disorders – Smoking causes fatty deposits to build up inside arteries which restrict blood flow, increasing the risk of strokes and heart attacks. Nicotine caused blood vessels to constrict, increasing blood pressure. Over time this may lead to blood vessels losing their flexibility and “hardening” (atheriosclerosis).
Oral health – Alongside bad breath, smoking stains teeth and can lead to tooth loss and gum disease. To make matters worse, toothpastes aimed at smokers are more abrasive and can damage the tooth enamel leading to an increased risk of decay.
Fertility & pregnancy problems – A good blood supply is essential to male fertility (for obvious reasons). As well as impotence, smoking is linked to lower sperm counts and lower quality sperm – all reversible if a man quits smoking. For women, smokers have lower chances of fertilised eggs attaching to the wall of the uterus – again this is reversible.
Smoking during pregnancy has been linked to Sudden Infant Death Syndrome (aka. cot death), lower birth weights and increased risk of premature births and miscarriages.
Passive smoking – What makes smoking uniquely dangerous amongst drugs is that it can negatively affect the health of everyone near a smoker. Smokers only take in 15% of the smoke from a cigarette, the rest spreads around them. Passive smoking can trigger asthma in children and adults and if exposed to second-hand smoke over a longer period, increases the risk of non-smokers developing heart and lung diseases – up to an including lung cancer.
Health impacts of vaping
Vaping is significantly safer for a person’s health compared to smoking, but it’s not harmless.
Vapes don’t use or generate the same toxic cancer-causing chemicals present in burning tobacco. The main by-product is steam. That means there’s no evidence yet of a “passive vaping” risk either.
Vaping is also recommended by many health organisations as an effective means to help people quit smoking.
However, vapes still contain nicotine – which, as noted, is highly addictive – and some of the chemicals used in vape flavourings will cause side effects.
The truth is we don’t know enough about the long-term impact of vaping to say anything other than, “It’s healthier than smoking, but you shouldn’t start vaping unless you’re moving from tobacco”.
Smoking & the NHS
According to the latest report from Public Health Wales1, up to 11% of ALL deaths of people aged 35 years and over in Wales during 2022 were related to smoking in some way. That’s 3,845 people.
To put that in perspective, around 1,000 people were killed or seriously injured in road accidents in Wales over the same period.
Additionally, smoking-related illnesses resulted in over 17,000 hospital admissions – up to 5,000 more than alcohol and dwarfs the number of admissions relating to illegal drugs (around 4,500).
The mortality rate is also significantly higher in more deprived areas than in less-deprived areas because smoking rates are higher.
A Welsh Government estimate from 20222 suggests that smoking-related illnesses cost the Welsh NHS over £300million per year.
Smoking, Vaping & Devolution
The Senedd has more control over smoking and vaping than they do over alcohol.
There is no specific exception regarding smoking and vaping in the Government of Wales Act 2006, meaning powers – other than those over taxes and duties – haven’t been reserved to the UK Government.
Resultingly, the Senedd has been responsible for changing rules around smoking:
- Ban on smoking in indoor public places and public service work vehicles (2007).
- Ban on smoking in private vehicles carrying under-18s (2015).
- Ban on smoking in “enclosed” or “substantially enclosed” workplaces (2021).
- Ban on smoking in certain outdoor public places including hospitals, playgrounds and school grounds (2021).
- Ban on smoking indoors in hotels, self-contained holiday accommodation and mental health units (2022).
Vaping has been a different matter. An attempt to restrict public vaping as part of a Public Health Bill failed when the Bill was voted down following a row between Labour and Plaid Cymru (Leighton Andrews’ infamous “cheap date” quip).
New rules and laws restricting vaping are being co-ordinated across England, Scotland and Wales. The first of these will ban single-use vapes (mainly for environmental reasons) from June 2025.
The other major change in the pipeline is the UK Government’s Tobacco and Vapes Bill. This Bill – which will require the Senedd’s consent – proposes:
- Banning tobacco sales to anyone born after 1st January 2009.
- Restrictions on how vapes are promoted to children, including flavours, display and packaging.
- Granting the Senedd additional powers to restrict public vaping.
- Introducing a new licensing regime for the sale of tobacco, herbal smoking products, cigarette papers and vapes.
- The introduction of a new duty/tax on vapes.
1. Public Health Wales (24th September 2024). “Smoking attributable mortality and hospital admissions for Wales, 2020-22”. Available here: https://phw.nhs.wales/news/over-10-percent-of-deaths-in-wales-due-to-smoking/
2. Welsh Government (26th July 2022). “A smoke-free Wales: Our long-term tobacco control strategy”. Available here: https://www.gov.wales/tobacco-control-strategy-wales-html
