There is an opportunity to reduce England's health inequality and save lives, but only if the government sets out bold plans to make England smoke-free by 2030 writes, Sir Kevin Barron and Sir Charles Walker MP.

For the past three years, Brexit has dominated so much of British politics. As a consequence, many areas of public policy – including important issues that affect the everyday lives of our constituents – have not had the attention they deserve. Eradicating the scourge of smoking is one such issue.

It's a year since we introduced a Ten Minute Rule Bill in Parliament. The essence of our proposals was to encourage behaviour change: reduce harm caused by nicotine usage by ensuring smokers have the facts about less-harmful alternatives and incentivise tobacco manufacturers to shift away from cigarettes towards less-harmful products, and ultimately to stop selling cigarettes altogether.

There are still more than six million people in England who smoke,[i] and every day, the habit kills more than 200 people.[ii] Those deaths are more preventable than ever with a wide, and growing, range of alternative ways to give up cigarettes.

This country is a global leader in harm reduction ? reducing the appeal of cigarettes with tax increases and marketing prohibitions, while encouraging the use of less-harmful alternatives. We have made great progress ? only 20 years ago, one third of adults in Britain smoked[iii] – but we must not get complacent. The pace of decline is slowing and without a bold set of new measures, it could take at least three decades for the UK to wipe out smoking altogether.

The next Government must focus on securing the long-term future of the NHS and delivering on the ambition for England to go smoke-free by 2030, as set out in the Prevention Green Paper back in July. 

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Quitting smoking completely is clearly the best option for any smoker. But many have tried and failed often in the past, so we need to do more to reduce the harm they face. Electronic cigarettes have been around for nearly a decade, and a large part of the fall in smoking prevalence over that time is due to people switching from cigarettes to vaping. But their usage is now plateauing, so we need to do more to encourage new, and better, alternatives. We should always have an evidence-based approach to ensure that smokers have confidence in the new products and technologies that come to market, and we strongly support the Government's commitment to commission independent research into the new heat-not-burn devices. 

In addition, we must find new ways to get information directly to smokers. Misconceptions around the benefits of e-cigarettes have been growing and statistics from Public Health England show that nearly half of all smokers do not realise that smoke-free alternatives are less harmful than smoking.

[iv] The recent stories about vaping-related deaths in the USA ? which the authorities actually say is due to vapers mixing illegal cannabis into e-cigarettes ? are only likely to further damage confidence in the products and likelihood that smokers will switch away from cigarettes. 

The strong regulatory framework we have in the UK – put in place to protect product quality – is one of the reasons why the problems experienced in America have not been replicated here. But we also need to do much more to empower smokers with better knowledge about the evidence, and the facts, or else tens of thousands of smokers will die as a result. This should include inserts in cigarettes packs about alternative products, direct mail and email communications to smokers ? channels that protect unintended audiences from seeing the messages and products. Without being able to inform smokers with the facts, we will get miss the smoke-free target of 2030 by decades.

Finally, we should make the cigarette companies pay for the damage they have caused. It's a simple principle of the 'polluter pays,' and we should follow it. A levy on the tobacco companies should be established to develop a fund to provide help and support for smokers, while also encouraging the tobacco manufacturers to shift away from combustible products to less-harmful alternatives. Money could then be directed where it is needed most ? the 50-100 local authorities with the highest levels of smoking prevalence ? to support their cessation services, as well as funding the research on e-cigarettes, heated tobacco, and other new smoke-free products that come to the market.

We have the chance to save lives, reduce the health inequality and the heart-breaking impact smoking has on smokers' friends and families, and to provide smokers with the one-on-one support they need, all without having to rely on the already stretched resources of the NHS. After the general election, the next government has the chance to set out the bold measures we need to make England smoke-free by 2030.

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