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Argumentative Essay on Smoking Cigarettes

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Health effects of smoking, economic implications, impact on non-smokers, the case for regulation, references:.

  • Centers for Disease Control and Prevention. (2020). Smoking & Tobacco Use. Retrieved from https://www.cdc.gov/tobacco/data_statistics/index.htm

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anti smoking laws essay

Persuasive Essay Guide

Persuasive Essay About Smoking

Caleb S.

Persuasive Essay About Smoking - Making a Powerful Argument with Examples

Persuasive essay about smoking

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Are you wondering how to write your next persuasive essay about smoking?

Smoking has been one of the most controversial topics in our society for years. It is associated with many health risks and can be seen as a danger to both individuals and communities.

Writing an effective persuasive essay about smoking can help sway public opinion. It can also encourage people to make healthier choices and stop smoking. 

But where do you begin?

In this blog, we’ll provide some examples to get you started. So read on to get inspired!

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  • 1. What You Need To Know About Persuasive Essay
  • 2. Persuasive Essay Examples About Smoking
  • 3. Argumentative Essay About Smoking Examples
  • 4. Tips for Writing a Persuasive Essay About Smoking

What You Need To Know About Persuasive Essay

A persuasive essay is a type of writing that aims to convince its readers to take a certain stance or action. It often uses logical arguments and evidence to back up its argument in order to persuade readers.

It also utilizes rhetorical techniques such as ethos, pathos, and logos to make the argument more convincing. In other words, persuasive essays use facts and evidence as well as emotion to make their points.

A persuasive essay about smoking would use these techniques to convince its readers about any point about smoking. Check out an example below:

Simple persuasive essay about smoking

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Persuasive Essay Examples About Smoking

Smoking is one of the leading causes of preventable death in the world. It leads to adverse health effects, including lung cancer, heart disease, and damage to the respiratory tract. However, the number of people who smoke cigarettes has been on the rise globally.

A lot has been written on topics related to the effects of smoking. Reading essays about it can help you get an idea of what makes a good persuasive essay.

Here are some sample persuasive essays about smoking that you can use as inspiration for your own writing:

Persuasive speech on smoking outline

Persuasive essay about smoking should be banned

Persuasive essay about smoking pdf

Persuasive essay about smoking cannot relieve stress

Persuasive essay about smoking in public places

Speech about smoking is dangerous

Persuasive Essay About Smoking Introduction

Persuasive Essay About Stop Smoking

Short Persuasive Essay About Smoking

Stop Smoking Persuasive Speech

Check out some more persuasive essay examples on various other topics.

Argumentative Essay About Smoking Examples

An argumentative essay is a type of essay that uses facts and logical arguments to back up a point. It is similar to a persuasive essay but differs in that it utilizes more evidence than emotion.

If you’re looking to write an argumentative essay about smoking, here are some examples to get you started on the arguments of why you should not smoke.

Argumentative essay about smoking pdf

Argumentative essay about smoking in public places

Argumentative essay about smoking introduction

Check out the video below to find useful arguments against smoking:

Tips for Writing a Persuasive Essay About Smoking

You have read some examples of persuasive and argumentative essays about smoking. Now here are some tips that will help you craft a powerful essay on this topic.

Choose a Specific Angle

Select a particular perspective on the issue that you can use to form your argument. When talking about smoking, you can focus on any aspect such as the health risks, economic costs, or environmental impact.

Think about how you want to approach the topic. For instance, you could write about why smoking should be banned. 

Check out the list of persuasive essay topics to help you while you are thinking of an angle to choose!

Research the Facts

Before writing your essay, make sure to research the facts about smoking. This will give you reliable information to use in your arguments and evidence for why people should avoid smoking.

You can find and use credible data and information from reputable sources such as government websites, health organizations, and scientific studies. 

For instance, you should gather facts about health issues and negative effects of tobacco if arguing against smoking. Moreover, you should use and cite sources carefully.

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Make an Outline

The next step is to create an outline for your essay. This will help you organize your thoughts and make sure that all the points in your essay flow together logically.

Your outline should include the introduction, body paragraphs, and conclusion. This will help ensure that your essay has a clear structure and argument.

Use Persuasive Language

When writing your essay, make sure to use persuasive language such as “it is necessary” or “people must be aware”. This will help you convey your message more effectively and emphasize the importance of your point.

Also, don’t forget to use rhetorical devices such as ethos, pathos, and logos to make your arguments more convincing. That is, you should incorporate emotion, personal experience, and logic into your arguments.

Introduce Opposing Arguments

Another important tip when writing a persuasive essay on smoking is to introduce opposing arguments. It will show that you are aware of the counterarguments and can provide evidence to refute them. This will help you strengthen your argument.

By doing this, your essay will come off as more balanced and objective, making it more convincing.

Finish Strong

Finally, make sure to finish your essay with a powerful conclusion. This will help you leave a lasting impression on your readers and reinforce the main points of your argument. You can end by summarizing the key points or giving some advice to the reader.

A powerful conclusion could either include food for thought or a call to action. So be sure to use persuasive language and make your conclusion strong.

To conclude,

By following these tips, you can write an effective and persuasive essay on smoking. Remember to research the facts, make an outline, and use persuasive language.

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Persuasive Essay

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  • Published: 21 January 2021

The effects of tobacco control policies on global smoking prevalence

  • Luisa S. Flor   ORCID: orcid.org/0000-0002-6888-512X 1 ,
  • Marissa B. Reitsma 1 ,
  • Vinay Gupta 1 ,
  • Marie Ng   ORCID: orcid.org/0000-0001-8243-4096 2 &
  • Emmanuela Gakidou   ORCID: orcid.org/0000-0002-8992-591X 1  

Nature Medicine volume  27 ,  pages 239–243 ( 2021 ) Cite this article

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Substantial global effort has been devoted to curtailing the tobacco epidemic over the past two decades, especially after the adoption of the Framework Convention on Tobacco Control 1 by the World Health Organization in 2003. In 2015, in recognition of the burden resulting from tobacco use, strengthened tobacco control was included as a global development target in the 2030 Agenda for Sustainable Development 2 . Here we show that comprehensive tobacco control policies—including smoking bans, health warnings, advertising bans and tobacco taxes—are effective in reducing smoking prevalence; amplified positive effects are seen when these policies are implemented simultaneously within a given country. We find that if all 155 countries included in our counterfactual analysis had adopted smoking bans, health warnings and advertising bans at the strictest level and raised cigarette prices to at least 7.73 international dollars in 2009, there would have been about 100 million fewer smokers in the world in 2017. These findings highlight the urgent need for countries to move toward an accelerated implementation of a set of strong tobacco control practices, thus curbing the burden of smoking-attributable diseases and deaths.

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Decades after its ill effects on human health were first documented, tobacco smoking remains one of the major global drivers of premature death and disability. In 2017, smoking was responsible for 7.1 (95% uncertainty interval (UI), 6.8–7.4) million deaths worldwide and 7.3% (95% UI, 6.8%–7.8%) of total disability-adjusted life years 3 . In addition to the health impacts, economic harms resulting from lost productivity and increased healthcare expenditures are also well-documented negative effects of tobacco use 4 , 5 . These consequences highlight the importance of strengthening tobacco control, a critical and timely step as countries work toward the 2030 Sustainable Development Goals 2 .

In 2003, the World Health Organization (WHO) led the development of the Framework Convention on Tobacco Control (FCTC), the first global health treaty intended to bolster tobacco use curtailment efforts among signatory member states 1 . Later, in 2008, to assist the implementation of tobacco control policies by countries, the WHO introduced the MPOWER package, an acronym representing six evidence-based control measures (Table 1 ) (ref. 6 ). While accelerated adoption of some of these demand reduction policies was observed among FCTC parties in the past decade 7 , many challenges remain to further decrease population-level tobacco use. Given the differing stages of the tobacco epidemic and tobacco control across countries, consolidating the evidence base on the effectiveness of policies in reducing smoking is necessary as countries plan on how to do better. In this study, we evaluated the association between varying levels of tobacco control measures and age- and sex-specific smoking prevalence using data from 175 countries and highlighted missed opportunities to decrease smoking rates by predicting the global smoking prevalence under alternative unrealized policy scenarios.

Despite the enhanced global commitment to control tobacco use, the pace of progress in reducing smoking prevalence has been heterogeneous across geographies, development status, sex and age 8 ; in 2017, there were still 1.1 billion smokers across the 195 countries and territories assessed by the Global Burden of Diseases, Injuries, and Risk Factors Study. Global smoking prevalence in 2017 among men and women aged 15 and older, 15–29 years, 30–49 years and 50 years and older are shown in Extended Data Figs. 1 , 2 , 3 and 4 , respectively. We found that, between 2009 and 2017, current smoking prevalence declined by 7.7% for men (36.3% (95% UI, 35.9–36.6%) to 33.5% (95% UI, 32.9–34.1%)) and by 15.2% for women globally (7.9% (95% UI, 7.8–8.1%) to 6.7% (95% UI, 6.5–6.9%)). The highest relative decreases were observed among men and women aged 15–29 years, at 10% and 20%, respectively. Conversely, prevalence decreased less intensively for those aged over 50, at 2% for men and 9.5% for women. While some countries have shown an important reduction in smoking prevalence between 2009 and 2017, such as Brazil, suggesting sustained progress in tobacco control, a handful of countries and territories have shown considerable increases in smoking rates among men (for example, Albania) and women (for example, Portugal) over this time period.

In an effort to counteract the harmful lifelong consequences of smoking, countries have, overall, implemented stronger demand reduction measures after the FCTC ratification. To assess national-level legislation quality, the WHO attributes a score to each of the MPOWER measures that ranges from 1 to 4 for the monitoring component (M) and 1–5 for the other components. A score of 1 represents no known data, while scores 2–5 characterize the overall strength of each measure, from the lowest level of achievement (weakest policy) to the highest level of achievement (strongest policy) 6 . Between 2008 and 2016, although very little progress was made in treatment provision (O) 7 , 9 , the share of the total population covered by best practice (score = 5) P, W and E measures increased (Fig. 1 ). Notably, however, a massive portion of the global population is still not covered by comprehensive laws. As an example, less than 15% of the global population is protected by strongly regulated tobacco advertising (E) and the number of people (2.1 billion) living in countries where none or very limited smoke-free policies (P) are in place (score = 2) is still nearly twice as high as the population (1.1 billion) living in locations with national bans on smoking in all public places (score = 5).

figure 1

To assess national-level legislation quality, the WHO attributes a score to each MPOWER component that ranges from 1 to 5 for smoke-free (P), health warning (W) and advertising (E) policies. A score of 1 represents no known data or no recent data, while scores 2–5 characterize the overall strength of each policy, from 2 representing the lowest level of achievement (weakest policy), to 5 representing the highest level of achievement (strongest policy).

Source data

In terms of fiscal policies (R), the population-weighted average price, adjusted for inflation, of a pack of cigarettes across 175 countries with available data increased from I$3.10 (where I$ represents international dollars) in 2008 to I$5.38 in 2016. However, from an economic perspective, for prices to affect purchasing decisions, they need to be evaluated relative to income. The relative income price (RIP) of cigarettes is a measure of affordability that reflects, in this study, what proportion of the country-specific per capita gross domestic product (GDP) is needed to purchase half a pack of cigarettes a day for a year. Over time, cigarettes have become less affordable (RIP 2016 > RIP 2008) in about 75% of the analyzed countries, with relatively more affordable cigarettes concentrated across high-income countries.

Our adjusted analysis indicates that greater levels of achievement on key measures across the P, W and E policy categories and higher RIP values were significantly associated with reduced smoking prevalence from 2009 to 2017 (Table 2 ). Among men aged 15 and older, each 1-unit increment in achievement scores for smoking bans (P) was independently associated with a 1.1% (95% UI, −1.7 to −0.5, P  < 0.0001) decrease in smoking prevalence. Similarly, an increase of 1 point in W and E scores was associated with a decrease in prevalence of 2.1% (95% UI, −2.7 to −1.6, P  < 0.0001) and 1.9% (95% UI, −2.6 to −1.1, P  < 0.0001), respectively. Furthermore, a 10 percentage point increase in RIP was associated with a 9% (95% UI, −12.6 to −5.0, P  < 0.0001) decrease in overall smoking prevalence. Results were similar for men from other age ranges.

Among women, the magnitude of effect of different policy indicators varied across age groups. For those aged over 15, each 1-point increment in W and E scores was independently associated with an average reduction in prevalence of 3.6% (95% UI, −4.5 to −2.9, P  < 0.0001) and 1.9% (95% UI, −2.9 to −1.8, P  = 0.002), respectively, and these findings were similar across age groups. Smoking ban (P) scores were not associated with reduced prevalence among women aged 15–29 years or over 50 years. However, a 1-unit increase in P scores was associated with a 1.3% (95% UI, −2.3 to −0.2, P  = 0.016) decline in prevalence among women aged 30–49 years. Lastly, while a 10 percentage point increase in RIP lowered women smoking prevalence by 6% overall (95% UI, −10.0 to −2.0, P = 0.014), this finding was not statistically significant when examining reductions in prevalence among those aged 50 and older (Table 2 ).

If tobacco control had remained at the level it was in 2008 for all 155 countries (with non-missing policy indicators for both 2008 and 2016; Methods ) included in the counterfactual analysis, we estimate that smoking prevalence would have been even higher than the observed 2017 rates, with 23 million more male smokers and 8 million more female smokers (age ≥ 15) worldwide (Table 3 ). Out of the counterfactual scenarios explored, the greatest progress in reducing smoking prevalence would have been observed if a combination of higher prices—resulting in reduced affordability levels—and strictest P, W and E laws had been implemented by all countries, leading to lower smoking rates among men and women from all age groups and approximately 100 million fewer smokers across all countries (Table 3 ). Under this policy scenario, the greatest relative decrease in prevalence would have been seen among those aged 15–29 for both sexes, resulting in 26.6 and 6.5 million fewer young male and female smokers worldwide in 2017, respectively.

Our findings reaffirm that a wide spectrum of tobacco demand reduction policies has been effective in reducing smoking prevalence globally; however, it also indicates that even though much progress has been achieved, there is considerable room for improvement and efforts need to be strengthened and accelerated to achieve additional gains in global health. A growing body of research points to the effectiveness of tobacco control measures 10 , 11 , 12 ; however, this study covers the largest number of countries and years so far and reveals that the observed impact has varied by type of control policy and across sexes and age groups. In high-income countries, stronger tobacco control efforts are also associated with higher cessation ratios (that is, the ratio of former smokers divided by the number of ever-smokers (current and former smokers)) and decreases in cigarette consumption 13 , 14 .

Specifically, our results suggest that men are, in general, more responsive to tobacco control interventions compared to women. Notably, with prevalence rates for women being considerably low in many locations, variations over time are more difficult to detect; thus, attributing causes to changes in outcome can be challenging. Yet, there is already evidence that certain elements of tobacco control policies that play a role in reducing overall smoking can have limited impact among girls and women, particularly those of low socioeconomic status 15 . Possible explanations include the different value judgments attached to smoking among women with respect to maintaining social relationships, improving body image and hastening weight control 16 .

Tax and price increases are recognized as the most impactful tobacco control policy among the suite of options under the MPOWER framework 10 , 14 , 17 , particularly among adolescents and young adults 18 . Previous work has also demonstrated that women are less sensitive than men to cigarette tax increases in the USA 19 . Irrespective of these demographic differences, effective tax policy is underutilized and only six countries—Argentina, Chile, Cuba, Egypt, Palau and San Marino—had adopted cigarette taxes that corresponded to the WHO-prescribed level of 70% of the price of a full pack by 2017 (ref. 20 ). Cigarettes also remain highly affordable in many countries, particularly among high-income nations, an indication that affordability-based prescriptions to countries, instead of isolated taxes and prices reforms, are possibly more useful as a tobacco control target. In addition, banning sales of single cigarettes, restricting legal cross-border shopping and fighting illicit trade are required so that countries can fully experience the positive effect of strengthened fiscal policies.

Smoke-free policies, which restrict the opportunities to smoke and decrease the social acceptability of smoking 17 , also affect population groups differently. In general, women are less likely to smoke in public places, whereas men might be more frequently influenced by smoking bans in bars, restaurants, clubs and workplaces across the globe due to higher workforce participation rates 16 . In addition to leading to reduced overall smoking rates, as indicated in this study, implementing complete smoking bans (that is, all public places completely smoke-free) at a faster pace can also play an important role in minimizing the burden of smoking-attributable diseases and deaths among nonsmokers. In 2017 alone, 2.18% (95% UI, 1.8–2.7%) of all deaths were attributable to secondhand smoke globally, with the majority of the burden concentrated among women and children 21 .

Warning individuals about the harms of tobacco use increases knowledge about the health risks of smoking and promotes changes in smoking-related behaviors, while full advertising and promotion bans—implemented by less than 20% of countries in 2017 (ref. 20 )—are associated with decreased tobacco consumption and smoking initiation rates, particularly among youth 17 , 22 , 23 . Large and rotating pictorial graphic warnings are the most effective in attracting smokers’ attention but are lacking in countries with high numbers of smokers, such as China and the USA 20 . Adding best practice health warnings to unbranded packages seems to be an effective way of informing about the negative effects of smoking while also eliminating the tobacco industry’s marketing efforts of using cigarette packages to make these products more appealing, especially for women and young people who are now the prime targets of tobacco companies 24 , 25 .

While it is clear that strong implementation and enforcement are crucial to accelerating progress in reducing smoking and its burden globally, our heterogeneous results by type of policy and demographics highlight the challenges of a one-size-fits-all approach in terms of tobacco control. The differences identified illustrate the need to consider the stages 26 of the smoking epidemics among men and women and the state of tobacco control in each country to identify the most pressing needs and evaluate the way ahead. Smoking patterns are also influenced by economic, cultural and political determinants; thus, future efforts in assessing the effectiveness of tobacco control policies under these different circumstances are of value. As tobacco control measures have been more widely implemented, tobacco industry forces have expanded and threaten to delay or reverse global progress 27 . Therefore, closing loopholes through accelerated universal adoption of the comprehensive set of interventions included in MPOWER, guaranteeing that no one is left unprotected, is an urgent requirement as efforts toward achieving the Sustainable Development Goals by 2030 are intensified.

This was an ecological time series analysis that aimed to estimate the effect of four key demand reduction measures on smoking rates across 175 countries. Country-year-specific achievement scores for P, W and E measures and an affordability metric measured by RIP—to capture the impact of fiscal policy (R)—were included as predictors in the model. Although the WHO also calls for monitoring (M) and tobacco cessation (O) interventions, these were not evaluated. Monitoring tobacco use is not considered a demand reduction measure, while very little progress has been made in treatment provision over the last decade 7 , 9 . Further information on research design is available in the Life Sciences Reporting Summary linked to this paper.

Smoking outcome data

The dependent variable is represented by country-specific, age-standardized estimates of current tobacco smoking prevalence, defined as individuals who currently use any smoked tobacco product on a daily or occasional basis. Complete time series estimates of smoking prevalence from 2009 to 2017 for men and women aged 15–29, 30–49, 50 years and older and 15 years and older, were taken from the Global Burden of Disease (GBD) 2017 study.

The GBD is a scientific effort to quantify the comparative magnitude of health loss due to diseases, injuries and risk factors by age, sex and geography for specific points in time. While full details on the estimation process for smoking prevalence have been published elsewhere, we briefly describe the main analytical steps in this article 3 . First, 2,870 nationally representative surveys meeting the inclusion criteria were systematically identified and extracted. Since case definitions vary between surveys, for example, some surveys only ask about daily smoking as opposed to current smoking that includes both daily and occasional smokers, the extracted data were adjusted to the reference case definition using a linear regression fit on surveys reporting multiple case definitions. Next, for surveys with only tabulated data available, nonstandard age groups and data reported as both sexes combined were split using observed age and sex patterns. These preprocessing steps ensured that all data used in the modeling were comparable. Finally, spatiotemporal Gaussian process regression, a three-step modeling process used extensively in the GBD to estimate risk factor exposure, was used to estimate a complete time series for every country, age and sex. In the first step, estimates of tobacco consumption from supply-side data are incorporated to guide general levels and trends in prevalence estimates. In the second step, patterns observed in locations, age groups and years with smoking prevalence data are synthesized to improve the first-step estimates. This step is particularly important for countries and time periods with limited or no available prevalence data. The third step incorporates and quantifies uncertainty from sampling error, non-sampling error and the preprocessing data adjustments. For this analysis, the final age-specific estimates were age-standardized using the standard population based on GBD population estimates. Age standardization, while less important for the narrower age groups, ensured that the estimated effects of policies were not due to differences in population structure, either within or between countries.

Using GBD-modeled data is a strength of the study since nearly 3,000 surveys inform estimates and countries are not required to have complete survey coverage between 2009 and 2017 to be included in the analysis. Yet, it is important to note that these estimates have limitations. For example, in countries where a prevalence survey was not conducted after the enactment of a policy, modeled estimates may not reflect changes in prevalence resulting from that policy. Nonetheless, the prevalence estimates from the GBD used in this study are similar to those presented in the latest WHO report 28 , indicating the validity and consistency of said estimates.


Summary indicators of country-specific achievements for each MPOWER measure are released by the WHO every two years and date back to 2007. Data from different iterations of the WHO Report on the Global Tobacco Epidemic (2008 6 , 2009 29 , 2011 30 , 2013 31 , 2015 32 and 2017 20 ) were downloaded from the WHO Tobacco Free Initiative website ( https://www.who.int/tobacco/about/en/ ). To assess the quality of national-level legislation, the WHO attributes a score to each MPOWER component that ranges from 1 to 4 for the monitoring (M) dimension and 1–5 for the other dimensions. A score of 1 represents no known data or no recent data, while scores 2–5 characterize the overall strength of each policy, from the lowest level of achievement (weakest policy) to the highest (strongest policy).

Specifically, smoke-free legislation (P) is assessed to determine whether smoke-free laws provide for a complete indoor smoke-free environment at all times in each of the respective places: healthcare facilities; educational facilities other than universities; universities; government facilities; indoor offices and workplaces not considered in any other category; restaurants or facilities that serve mostly food; cafes, pubs and bars or facilities that serve mostly beverages; and public transport. Achievement scores are then based on the number of places where indoor smoking is completely prohibited. Regarding health warning policies (W), the size of the warnings on both the front and back of the cigarette pack are averaged to calculate the percentage of the total pack surface area covered by the warning. This information is combined with seven best practice warning characteristics to construct policy scores for the W dimension. Finally, countries achievements in banning tobacco advertising, promotion and sponsorship (E) are assessed based on whether bans cover the following types of direct and indirect advertising: (1) direct: national television and radio; local magazines and newspapers; billboards and outdoor advertising; and point of sale (indoors); (2) indirect: free distribution of tobacco products in the mail or through other means; promotional discounts; nontobacco products identified with tobacco brand names; brand names of nontobacco products used or tobacco products; appearance of tobacco brands or products in television and/or films; and sponsorship.

P, W and E achievement scores, ranging from 2 to 5, were included as predictors into the model. The goal was to not only capture the effect of adopting policies at its highest levels but also assess the reduction in prevalence that could be achieved if countries moved into the expected direction in terms of implementing stronger measures over time. Additionally, having P, W and E scores separately, and not combined into a composite score, enabled us to capture the independent effect of different types of policies.

Although compliance is a critical factor in understanding policy effectiveness, the achievement scores incorporated in our main analysis reflect the adoption of legislation rather than degree of enforcement, representing a limitation of these indicators.

Prices in I$ for a 20-cigarette pack of the most sold brand in each of the 175 countries were also sourced from the WHO Tobacco Free Initiative website for all available years (2008, 2010, 2012, 2014 and 2016). I$ standardize prices across countries and also adjust for inflation across time. This information was used to construct an affordability metric that captures the impact of cigarette prices on smoking prevalence, considering the income level of each country.

More specifically, the RIP, calculated as the percentage of per capita GDP required to purchase one half pack of cigarettes a day over the course of a year, was computed for each available country and year. Per capita GDP estimates were drawn from the Institute for Health Metrics and Evaluation; the estimation process is detailed elsewhere 33 .

Given that the price data used in the analysis refer to the most sold brand of cigarettes only, it does not reflect the full range of prices of different types of tobacco products available in each location. This might particularly affect our power in detecting a strong effect in countries where other forms of tobacco are more popular.

Statistical analysis

Sex- and age-specific logit-transformed prevalence estimates from 2009 to 2017 were matched to one-year lagged achievement scores and RIP values using country and year identifiers 34 . The final sample consisted of 175 countries and was constrained to locations and years with non-missing indicators. A multiple linear mixed effects model fitted by restricted maximum likelihood was used to assess the independent effect of P, W and E scores and RIP values on the rates of current smoking. Specifically, a country random intercept and a country random slope on RIP were included to account for geographical heterogeneity and within-country correlation. The regression model takes the following general form:

where y c,t is the prevalence of current smoking in each country ( c ) and year ( t ), β 0 is the intercept for the model and β p , β w , β e and β r are the fixed effects for each of the policy predictors. \(\mathrm{P}_{c,\,t - 1},\,\mathrm{W}_{c,\,t - 1},\,\mathrm{E}_{c,\,t - 1}\) are the P, W and E scores and R c , t −1 is the RIP value for country c in year t  − 1. Finally, α c is the random intercept for country ( c ), while δ c represent the random slope for the country ( c ) to which the RIP value (R t − 1 ) belongs. Variance inflation factor values were calculated for all the predictor parameters to check for multicollinearity; the values found were low (<2) 35 . Bivariate models were also run and are shown in Extended Data Fig. 5 . The one-year lag introduced into the model may have led to an underestimation of effect sizes, particularly as many MPOWER policies require a greater period of time to be implemented effectively. However, due to the limited time range of our data (spanning eight years in total), introducing a longer lag period would have resulted in the loss of additional data points, thus further limiting our statistical power in detecting relevant associations between policies and smoking prevalence.

In addition to a joint model for smokers from both sexes, separate regressions were fitted for men and women and the four age groups (15–29, 30–49, ≥50 and ≥15 years old). To assess the validity of the mixed effects analyses, likelihood ratio tests comparing the models with random effects to the null models with only fixed effects were performed. Linear mixed models were fitted by maximum likelihood and t -tests used Satterthwaite approximations to degrees of freedom. P values were considered statistically significant if <0.05. All analyses were executed with RStudio v.1.1.383 using the lmer function in the R package lme4 v.1.1-21 (ref. 36 ).

A series of additional models to examine the impact of tobacco control policies were developed as part of this study. In each model, cigarette affordability (RIP) and a different set of policy metrics was used to capture the implementation, quality and compliance of tobacco control legislation. In models 1 and 2, we replaced the achievements scores by the proportion of P, W and E measures adopted by each country out of all possible measures reported by the WHO. In model 3, we used P and E (direct and indirect measures separately) compliance scores provided by the WHO to represent actual legislation implementation. Finally, an interaction term for compliance and achievement to capture the combined effect of legislation quality and performance was added to model 4. Results for men and women by age group for each of the additional models are presented in the Supplemental Information (Supplementary Tables 1–4 ).

The main model described in this study was chosen because it includes a larger number of country-year observations ( n  = 823) when compared to models including compliance scores and because it is more directly interpretable.

Counterfactual analysis

To further explore and quantify the impact of tobacco control policies on current smoking prevalence, we simulated what smoking prevalence across all countries would have been achieved in 2017 under 4 alternative policy scenarios: (1) if achievement scores and RIP remained at the level they were at in 2008; (2) if all countries had implemented each of P, W and E component at the highest level (score = 5); (3) if the price of a cigarette pack was I$7.73 or higher, a price that represents the 90th percentile of observed prices across all countries and years; and (4) if countries had implemented the P, W and E components at the highest level and higher cigarette prices. To keep our results consistent across scenarios, we restricted our analysis to 155 countries with non-missing policy-related indicators for both 2008 and 2016.

Random effects were used in model fitting but not in this prediction. Simulated prevalence rates were calculated by multiplying the estimated marginal effect of each policy by the alternative values proposed in each of the counterfactual scenarios for each country-year. The global population-weighted average was computed for status quo and counterfactual scenarios using population data sourced from the Institute for Health Metrics and Evaluation. Using the predicted prevalence rates and population data, the additional reduction in the number of current smokers in 2017 was also computed. Since models were ran using age-standardized prevalence, the number of smokers was proportionally redistributed across age groups using the sex-specific numbers from the age group 15 and older as an envelope.

The UIs for predicted estimates were based on a computation of the results of each of the 1,000 draws (unbiased random samples) taken from the uncertainty distribution of each of the estimated coefficients; the lower bound of the 95% UI for the final quantity of interest is the 2.5 percentile of the distribution and the upper bound is the 97.5 percentile of the distribution.

Reporting Summary

Further information on research design is available in the Nature Research Reporting Summary linked to this article.

Data availability

The dataset generated and analyzed during the current study is publicly available at http://ghdx.healthdata.org/record/ihme-data/global-tobacco-control-and-smoking-prevalence-scenarios-2017 ( https://doi.org/10.6069/QAZ7-6505 ). The dataset contains all data necessary to interpret, replicate and build on the methods or findings reported in the article. Tobacco control policy data that support the findings of this study are released every two years as part of the WHO’s Global Report on Tobacco Control; these data are also directly accessible at https://www.who.int/tobacco/global_report/en/ . Source data are provided with this paper.

Code availability

All code used for these analyses is available at http://ghdx.healthdata.org/record/ihme-data/global-tobacco-control-and-smoking-prevalence-scenarios-2017 and https://github.com/ihmeuw/team/tree/effects_tobacco_policies .

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The study was funded by Bloomberg Philanthropies (grant 47386, Initiative to Reduce Tobacco Use). We thank the support of the Tobacco Metrics Team Advisory Group, which provided valuable comments and suggestions over several iterations of this manuscript. We also thank the Tobacco Free Initiative team at the WHO and the Campaign for Tobacco-Free Kids for making the tobacco control legislation data available and providing clarifications when necessary. We thank A. Tapp, E. Mullany and J. Whisnant for assisting in the management and execution of this study. We thank the team who worked in a previous iteration of this project, especially A. Reynolds, C. Margono, E. Dansereau, K. Bolt, M. Subart and X. Dai. Lastly, we thank all GBD 2017 Tobacco collaborators for their valuable work in providing feedback to our smoking prevalence estimates throughout the GBD 2017 cycle.

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Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA

Luisa S. Flor, Marissa B. Reitsma, Vinay Gupta & Emmanuela Gakidou

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L.S.F., M.N. and E.G. conceptualized the study and designed the analytical framework. M.B.R. and V.G. provided input on data, results and interpretation. L.S.F. and E.G. wrote the first draft of the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Emmanuela Gakidou .

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Extended data

Extended data fig. 1 prevalence of current smoking for men (a) and women (b) aged 15 years and older (age-standardized) in 2017..

Age-standardized smoking prevalence (%) estimates from the 2017 Global Burden of Disease Study for men (a) and women (b) aged 15 years and older for 195 countries. Smoking is defined as current use of any type of smoked tobacco product. Details on the estimation process can be found in the Methods section and elsewhere 3 .

Extended Data Fig. 2 Prevalence of current smoking for men (a) and women (b) aged 15 to 29 years old (age-standardized) in 2017.

Age-standardized smoking prevalence (%) estimates from the 2017 Global Burden of Disease Study for men (a) and women (b) aged 15–29 years old for 195 countries. Smoking is defined as current use of any type of smoked tobacco product. Details on the estimation process can be found in the Methods section and elsewhere 3 .

Extended Data Fig. 3 Prevalence of current smoking for men (a) and women (b) aged 30 to 49 years old (age-standardized) in 2017.

Age-standardized smoking prevalence (%) estimates from the 2017 Global Burden of Disease Study for men (a) and women (b) aged 30–49 years old for 195 countries. Smoking is defined as current use of any type of smoked tobacco product. Details on the estimation process can be found in the Methods section and elsewhere 3 .

Extended Data Fig. 4 Prevalence of current smoking for men (a) and women (b) aged 50 years and older (age-standardized) in 2017.

Age-standardized smoking prevalence (%) estimates from the 2017 Global Burden of Disease Study for men (a) and women (b) aged 50 years and older for 195 countries. Smoking is defined as current use of any type of smoked tobacco product. Details on the estimation process can be found in the Methods section and elsewhere 3 .

Extended Data Fig. 5 Percentage changes in current smoking prevalence based on fixed effect coefficients from bivariate mixed effect linear regression models, by policy component, sex and age group.

Bivariate models examined the unadjusted association between smoke-free (P), health warnings (W), and advertising (E) achievement scores, and cigarette’s affordability (RIP) and current smoking prevalence, from 2009 to 2017, across 175 countries (n = 823 country-years). Linear mixed models were fit by maximum likelihood and t-tests used Satterthwaite approximations to degrees of freedom. P values were considered statistically significant if lower than 0.05.

Supplementary information

Supplementary information.

Supplementary Tables 1–4: additional models results.

Source Data Fig. 1

Input data for Fig. 1 replication.

Source Data Extended Data Fig. 1

Input data for Extended Data 1 replication.

Source Data Extended Data Fig. 2

Input data for Extended Data 2 replication.

Source Data Extended Data Fig. 3

Input data for Extended Data 3 replication.

Source Data Extended Data Fig. 4

Input data for Extended Data 4 replication.

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Flor, L.S., Reitsma, M.B., Gupta, V. et al. The effects of tobacco control policies on global smoking prevalence. Nat Med 27 , 239–243 (2021). https://doi.org/10.1038/s41591-020-01210-8

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anti smoking laws essay

235 Smoking Essay Topics & Examples

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  • Drug Addiction in Teenagers: Smoking and Other Lifestyles In the first part of this assignment, the health problem of drug addiction was considered among teens and the most vulnerable group was established.
  • Anti-Smoking Communication Campaign’s Analysis Defining the target audience for an anti-smoking campaign is complicated by the different layers of adherence to the issue of the general audience of young adults.
  • Smoking as a Risk Factor for Lung Cancer Lung cancer is one of the most frequent types of the condition, and with the low recovery rates. If the problem is detected early and the malignant cells are contained to a small region, surgery […]
  • Smoking Cessation Project Implementation In addition, the review will include the strengths and weaknesses of the evidence presented in the literature while identifying gaps and limitations.
  • Maternal and Infant Health: Smoking Prevention Strategies It is known that many women know the dangers of smoking when pregnant and they always try to quit smoking to protect the lives of themselves and the child.
  • A Peer Intervention Program to Reduce Smoking Rates Among LGBTQ Therefore, the presumed results of the project are its introduction into the health care system, which will promote a healthy lifestyle and diminish the level of smoking among LGBTQ people in the SESLHD.
  • Tackling Teenage Smoking in Community The study of the problem should be comprehensive and should not be limited by the medical aspect of the issue. The study of the psychological factor is aimed at identifying the behavioral characteristics of smoking […]
  • Peer Pressure and Smoking Influence on Teenagers The study results indicate that teenagers understand the health and social implications of smoking, but peer pressure contributes to the activity’s uptake.
  • Smoking: Benefits or Harms? Hundreds of smokers every day are looking for a way to get rid of the noose, which is a yoke around the neck, a cigarette.
  • The Culture of Smoking Changed in Poland In the 1980-90s, Poland faced the challenge of being a country with the highest rates of smoking, associated lung cancer, and premature mortality in the world.
  • The Stop Smoking Movement Analysis The paper discusses the ideology, objective, characteristics, context, special techniques, organization culture, target audience, media strategies, audience reaction, counter-propaganda and the effectiveness of the “Stop Smoking” Movement.”The Stop Smoking” campaign is a prevalent example of […]
  • Health Promotion Plan: Smokers in Mississippi The main strategies of the training session are to reduce the number of smokers in Mississippi, conduct a training program on the dangers of smoking and work with tobacco producers.
  • Smoking Health Problem Assessment The effects of smoking correlate starkly with the symptoms and diseases in the nursing practice, working as evidence of the smoking’s impact on human health.
  • Integration of Smoking Cessation Into Daily Nursing Practice Generally, smoking cessation refers to a process structured to help a person to discontinue inhaling smoked substances. It can also be referred to as quitting smoking.
  • E-Cigarettes and Smoking Cessation Many people argue that e-cigarettes do not produce secondhand smoke. They believe that the e-fluids contained in such cigarettes produce vapor and not smoke.
  • Outdoor Smoking Ban in Public Areas of the Community These statistics have contributed to the widespread efforts to educate the public regarding the need to quit smoking. However, most of the chronic smokers ignore the ramifications of the habit despite the deterioration of their […]
  • Nicotine Replacement Therapy for Adult Smokers With a Psychiatric Disorder The qualitative research methodology underlines the issue of the lack of relevant findings in the field of nicotine replacement therapy in people and the necessity of treatment, especially in the early stages of implementation.
  • Smoking and Drinking: Age Factor in the US As smoking and drinking behavior were both strongly related to age, it could be the case that the observed relationship is due to the fact that older pupils were more likely to smoke and drink […]
  • Poland’s Smoking Culture From Nursing Perspective Per Kinder, the nation’s status as one of Europe’s largest tobacco producers and the overall increase in smoking across the developing nations of Central and Eastern Europe caused its massive tobacco consumption issues.
  • Smoking Cessation Clinic Analysis The main aim of this project is to establish a smoking cessation clinic that will guide smoker through the process of quitting smoking.
  • Cigarette Smoking Among Teenagers in the Baltimore Community, Maryland The paper uses the Baltimore community in Maryland as the area to focus the event of creating awareness of cigarette smoking among the teens of this community.
  • Advocating for Smoking Cessation: Health Professional Role Health professionals can contribute significantly to tobacco control in Australia and the health of the community by providing opportunities for smoking patients to quit smoking.
  • Lifestyle Management While Quitting Smoking Realistically, not all of the set goals can be achieved; this is due to laxity in implementing them and the associated difficulty in letting go of the past lifestyle.
  • Smoking in the Actuality The current use of aggressive marketing and advertising strategies has continued to support the smoking of e-cigarettes. The study has also indicated that “the use of such e-cigarettes may contribute to the normalization of smoking”.
  • Analysis of the Family Smoking Prevention and Tobacco Control Act The law ensures that the FDA has the power to tackle issues of interest to the public such as the use of tobacco by minors.
  • “50-Year Trends in Smoking-Related Mortality in the United States” by Thun et al. Thun is affiliated with the American Cancer Society, but his research interests cover several areas. Carter is affiliated with the American Cancer Society, Epidemiology Research Program.
  • Pulmonology: Emphysema Caused by Smoking The further development of emphysema in CH can lead to such complications caused by described pathological processes as pneumothorax that is associated with the air surrounding the lungs.
  • Smoking and Lung Cancer Among African Americans Primarily, the research paper provides insight on the significance of the issue to the African Americans and the community health nurses.
  • Health Promotion and Smoking Cessation I will also complete a wide range of activities in an attempt to support the agency’s goals. As well, new studies will be conducted in order to support the proposed programs.
  • Maternal Mental Health and Prenatal Smoking It was important to determine the variables that may lead to postpartum relapse or a relapse during the period of pregnancy. It is important to note that the findings are also consistent with the popular […]
  • Nursing Interventions for Smoking Cessation For instance, the authors are able to recognize the need to classify the level of intensity in respect to the intervention that is employed by nurses towards smoking cessation.
  • Smoking and Cancer in the United States In this research study, data on tobacco smoking and cancer prevalence in the United States was used to determine whether cancer in the United States is related to tobacco smoking tobacco.
  • Marketing Plan: Creating a Smoking Cessation Program for Newton Healthcare Center The fourth objective is to integrate a smoking cessation program that covers the diagnosis of smoking, counseling of smokers, and patient care system to help the smokers quit their smoking habits. The comprehensive healthcare needs […]
  • Smoking Among the Youth Population Between 12-25 Years I will use the theory to strengthen the group’s beliefs and ideas about smoking. I will inform the group about the relationship between smoking and human health.
  • Risks of Smoking Cigarettes Among Preteens Despite the good news that the number of preteen smokers has been significantly reducing since the 1990s, there is still much to be done as the effects of smoking are increasingly building an unhealthy population […]
  • Public Health Education: Anti-smoking Project The workshop initiative aimed to achieve the following objectives: To assess the issues related to smoking and tobacco use. To enhance the health advantages of clean air spaces.
  • Healthy People Program: Smoking Issue in Wisconsin That is why to respond to the program’s effective realization, it is important to discuss the particular features of the target population in the definite community of Wisconsin; to focus on the community-based response to […]
  • Health Campaign: Smoking in the USA and How to Reduce It That is why, the government is oriented to complete such objectives associated with the tobacco use within the nation as the reduction of tobacco use by adults and adolescents, reduction of initiation of tobacco use […]
  • Smoking Differentials Across Social Classes The author inferred her affirmations from the participant’s words and therefore came to the right conclusion; that low income workers had the least justification for smoking and therefore took on a passive approach to their […]
  • Cigarette Smoking Side Effects Nicotine is a highly venomous and addictive substance absorbed through the mucous membrane in the mouth as well as alveoli in the lungs.
  • Long-Term Effects of Smoking The difference between passive smoking and active smoking lies in the fact that, the former involves the exposure of people to environmental tobacco smoke while the latter involves people who smoke directly.
  • Smoking Cessation Program Evaluation in Dubai The most important program of this campaign is the Quit and Win campaign, which is a unique idea, launched by the DHCC and is in the form of an open contest.
  • Preterm Birth and Maternal Smoking in Pregnancy The major finding of the discussed research is that both preterm birth and maternal smoking during pregnancy contribute, although independently, to the aortic narrowing of adolescents.
  • Enforcement of Michigan’s Non-Smoking Law This paper is aimed at identifying a plan and strategy for the enforcement of the Michigan non-smoking law that has recently been signed by the governor of this state.
  • Smoking Cessation for Patients With Cardio Disorders It highlights the key role of nurses in the success of such programs and the importance of their awareness and initiative in determining prognosis.
  • Legalizing Electronic Vaping as the Means of Curbing the Rates of Smoking However, due to significantly less harmful effects that vaping produces on health and physical development, I can be considered a legitimate solution to reducing the levels of smoking, which is why it needs to be […]
  • Drinking, Smoking, and Violence in Queer Community Consequently, the inequality and discrimination against LGBTQ + students in high school harm their mental, emotional, and physical health due to the high level of stress and abuse of various substances that it causes.
  • Self-Efficacy and Smoking Urges in Homeless Individuals Pinsker et al.point out that the levels of self-efficacy and the severity of smoking urges change significantly during the smoking cessation treatment.
  • “Cigarette Smoking: An Overview” by Ellen Bailey and Nancy Sprague The authors of the article mentioned above have presented a fair argument about the effects of cigarette smoking and debate on banning the production and use of tobacco in America.
  • “The Smoking Plant” Project: Artist Statement It is the case when the art is used to pass the important message to the observer. The live cigarette may symbolize the smokers while the plant is used to denote those who do not […]
  • Dangers of Smoking While Pregnant In this respect, T-test results show that mean birthweight of baby of the non-smoking mother is 3647 grams, while the birthweight of smoking mother is 3373 grams. Results show that gestation value and smoking habit […]
  • The Cultural Differences of the Tobacco Smoking The Middle East culture is connected to the hookah, the Native American cultures use pipes, and the Canadian culture is linked to cigarettes.
  • Ban on Smoking in Enclosed Public Places in Scotland The theory of externality explains the benefit or cost incurred by a third party who was not a party to the reasoning behind the benefit or cost. This will also lead to offer of a […]
  • How Smoking Cigarettes Effects Your Health Cigarette smoking largely aggravates the condition of the heart and the lung. In addition, the presence of nicotine makes the blood to be sticky and thick leading to damage to the lining of the blood […]
  • Alcohol and Smoking Abuse: Negative Physical and Mental Effects The following is a range of effects of heavy alcohol intake as shown by Lacoste, they include: Neuropsychiatric or neurological impairment, cardiovascular, disease, liver disease, and neoplasm that is malevolent.
  • Smoking Prohibition: Local Issues, Personal Views This is due to the weakening of blood vessels in the penis. For example, death rate due to smoking is higher in Kentucky than in other parts of the country.
  • Smoking During Pregnancy Issues Three things to be learned from the research are the impact of smoking on a woman, possible dangers and complications and the importance of smoking cessation interventions.
  • The Smoking Problem: Mortality, Control, and Prevention The article presents smoking as one of the central problems for many countries throughout the world; the most shocking are the figures related to smoking rate among students. Summary: The article is dedicated to the […]
  • Tobacco Smoking: Bootleggers and Baptists Legislation or Regulation The issue is based on the fact that tobacco smoking also reduces the quality of life and ruins the body in numerous ways.
  • Smoking: Causes and Effects Considering the peculiarities of a habit and of a disease, smoking can be considered as a habit rather than a disease.
  • Smoking Behavior Under Clinical Observation The physiological aspect that influences smokers and is perceived as the immediate effect of smoking can be summarized as follows: Within ten seconds of the first inhalation, nicotine, a potent alkaloid, passes into the bloodstream, […]
  • Smoking Causes and Plausible Arguments In writing on the cause and effect of smoking we will examine the issue from the point of view of temporal precedence, covariation of the cause and effect and the explanations in regard to no […]
  • Smoking and Its Effects on Human Body The investigators explain the effects of smoking on the breath as follows: the rapid pulse rate of smokers decreases the stroke volume during rest since the venous return is not affected and the ventricles lose […]
  • Post Smoking Cessation Weight Gain The aim of this paper is to present, in brief, the correlation between smoking cessation and weigh gain from biological and psychological viewpoints.
  • Marketing a Smoking Cessation Program In the case of the smoking cessation program, the target group is made up of smokers who can be further subdivided into segments such as heavy, medium, and light smokers.
  • Smoking Cessation for Ages 15-30 The Encyclopedia of Surgery defines the term “Smoking Cessation” as an effort to “quit smoking” or “withdrawal from smoking”. I aim to discuss the importance of the issue by highlighting the most recent statistics as […]
  • Motivational Interviewing as a Smoking Cessation Intervention for Patients With Cancer The dependent variable is the cessation of smoking in 3 months of the interventions. The study is based on the author’s belief that cessation of smoking influences cancer-treated patients by improving the efficacy of treatment.
  • Factors Affecting the Success in Quitting Smoking of Smokers in West Perth, WA Australia Causing a wide array of diseases, health smoking is the second cause of death in the world. In Australia, the problem of smoking is extremely burning due to the high rates of diseases and deaths […]
  • Media Effects on Teen Smoking But that is not how an adult human brain works, let alone the young and impressionable minds of teenagers, usually the ads targeted at the youth always play upon elements that are familiar and appealing […]
  • “Passive Smoking Greater Health Hazard: Nimhans” by Stephen David The article focuses on analyzing the findings of the study and compares them to the reactions to the ban on public smoking.
  • Partnership in Working About Smoking and Tobacco Use The study related to smoking and tobacco use, which is one of the problematic areas in terms of the health of the population.
  • Cigar Smoking and Relation to Disease The article “Effect of cigar smoking on the risk of cardiovascular disease, chronic obstructive pulmonary disease and cancer in Men” by Iribarren et al.is a longitudinal study of cigar smokers and the impact of cigar […]
  • Quitting Smoking: Motivation and Brain As these are some of the observed motivations for smoking, quitting smoking is actually very easy in the sense that you just have to set your mind on quitting smoking.
  • Health Effects of Tobacco Smoking in Hispanic Men The Health Effects of Tobacco Smoking can be attributed to active tobacco smoking rather than inhalation of tobacco smoke from environment and passive smoking.
  • Smoking in Adolescents: A New Threat to the Society Of the newer concerns about the risks of smoking and the increase in its prevalence, the most disturbing is the increase in the incidences of smoking among the adolescents around the world.
  • The Importance of Nurses in Smoking-Cessation Programs When a patient is admitted to the hospital, the nursing staff has the best opportunity to assist them in quitting in part because of the inability to smoke in the hospital combined with the educational […]
  • Smoking and Youth Culture in Germany The report also assailed the Federal Government for siding the interest of the cigarette industry instead of the health of the citizens.
  • New Jersey Legislation on Smoking The advantages and disadvantages of the legislation were discussed in this case because of the complexity of the topic at hand as well as the potential effects of the solution on the sphere of public […]
  • Environmental Health: Tabaco Smoking and an Increased Concentration of Carbon Monoxide The small size of the town, which is around 225000 people, is one of the reasons for high statistics in diseases of heart rate.
  • Advanced Pharmacology: Birth Control for Smokers The rationale for IUD is the possibility to control birth without the partner’s participation and the necessity to visit a doctor just once for the device to be implanted.
  • Legislation Reform of Public Smoking Therefore, the benefit of the bill is that the health hazard will be decreased using banning smoking in public parks and beaches.
  • Female Smokers Study: Inferential Statistics Article The article “Differential Effects of a Body Image Exposure Session on Smoking Urge between Physically Active and Sedentary Female Smokers” deepens the behavioral mechanisms that correlate urge to smoke, body image, and physical activity among […]
  • Smoking Bans: Protecting the Public and the Children of Smokers The purpose of the article is to show why smoking bans aim at protecting the public and the children of smokers.
  • Clinical Effects of Cigarette Smoking Smoking is a practice that should be avoided or controlled rigorously since it is a risk factor for diseases such as cancer, affects the health outcomes of direct and passive cigarette users, children, and pregnant […]
  • Public Health and Smoking Prevention Smoking among adults over 18 years old is a public health issue that requires intervention due to statistical evidence of its effects over the past decades.
  • Smoking in the US: Statistics and Healthcare Costs According to the Centers for Disease Control and Prevention, tobacco smoking is the greatest preventable cause of death in the US.
  • Smoking Should Be Banned Internationally The questions refer to the knowledge concerning the consequences of smoking and the opinions on smoking bans. 80 % of respondents agree that smoking is among the leading causes of death and 63, 3 % […]
  • Microeconomics: Cigarette Taxes and Public Smoking Ban The problem of passive smoking will be minimized when the number of smokers decreases. It is agreeable that the meager incomes of such families will be used to purchase cigarettes.
  • Alcohol and Smoking Impact on Cancer Risk The research question is to determine the quantity of the impact that different levels of alcohol ingestion combined with smoking behavioral patterns make on men and women in terms of the risks of cancer.
  • Teenagers Motivated to Smoking While the rest of the factors also matter much in the process of shaping the habit of smoking, it is the necessity to mimic the company members, the leader, or any other authority that defines […]
  • Indoor Smoking Restriction Effects at the Workplace Regrettably, they have neglected research on the effect of the legislation on the employees and employers. In this research, the target population will be the employees and employers of various companies.
  • Hypnotherapy Session for Smoking Cessation When I reached the age of sixty, I realized that I no longer wanted to be a smoker who was unable to take control of one’s lifestyle.
  • Stopping Tobacco Smoking: Lifestyle Management Plan In addition, to set objective goals, I have learned that undertaking my plan with reference to the modifying behaviour is essential for the achievement of the intended goals. The main intention of the plan is […]
  • Smoking Epidemiology Among High School Students In this way, with the help of a cross-sectional study, professionals can minimalize the risk of students being afraid to reveal the fact that they smoke. In this way, the number of students who smoke […]
  • Social Marketing: The Truth Anti-Smoking Campaign The agreement of November 1998 between 46 states, five territories of the United States, the District of Columbia, and representatives of the tobacco industry gave start to the introduction of the Truth campaign.
  • Vancouver Coastal Health Smoking Cessation Program The present paper provides an evaluation of the Vancouver Coastal Health smoking cessation program from the viewpoint of the social cognitive theory and the theory of planned behavior.
  • Smoking Experience and Hidden Dangers When my best college friend Jane started smoking, my eyes opened on the complex nature of the problem and on the multiple negative effects of smoking both on the smoker and on the surrounding society.
  • South Illinois University’s Smoking Ban Benefits The purpose of this letter is to assess the possible benefits of the plan and provide an analysis of the costs and consequences of the smoking ban introduction.
  • Smoking Cessation in Patients With COPD The strategy of assessing these papers to determine their usefulness in EBP should include these characteristics, the overall quality of the findings, and their applicability in a particular situation. The following article is a study […]
  • Smoking Bans: Preventive Measures There have been several public smoking bans that have proved to be promising since the issue of smoking prohibits smoking in all public places. This means it is a way of reducing the exposure to […]
  • Ban Smoking Near the Child: Issues of Morality The decision to ban smoking near the child on father’s request is one of the demonstrative examples. The father’s appeal to the Supreme Court of California with the requirement to prohibit his ex-wife from smoking […]
  • The Smoking Ban: Arguments Comparison The first argument against banning smoking employs the idea that smoking in specially designated areas cannot do harm to the health of non-smokers as the latter are supposed to avoid these areas.
  • Smoking Cessation and Patient Education in Nursing Pack-years are the concept that is used to determine the health risks of a smoking patient. The most important step in the management plan is to determine a date when the man should quit smoking.
  • Philip Morris Company’s Smoking Prevention Activity Philip Morris admits the existence of scientific proof that smoking leads to lung cancer in addition to other severe illnesses even after years of disputing such findings from health professionals.
  • Tobacco Smoking and Its Dangers Sufficient evidence also indicates that smoking is correlated with alcohol use and that it is capable of affecting one’s mental state to the point of heightening the risks of development of disorders.
  • Virginia Slims’ Impact on Female Smokers’ Number Considering this, through the investigation of Philip Morris’ mission which it pursued during the launch of the Virginia Slims campaign in 1968-1970 and the main regulatory actions undertaken by the Congress during this period, the […]
  • Cigarette Smoking and Parkinson’s Disease Risk Therefore, given the knowledge that cigarette smoking protects against the disease, it is necessary to determine the validity of these observations by finding the precise relationship between nicotine and PD.
  • Tuberculosis Statistics Among Cigarette Smokers The proposal outlines the statistical applications of one-way ANOVA, the study participants, the variables, study methods, expected results and biases, and the practical significance of the expected results.
  • Smoking Habit, Its Causes and Effects Smoking is one of the factors that are considered the leading causes of several health problems in the current society. Smoking is a habit that may be easy to start, but getting out of this […]
  • Smoking Ban and UK’s Beer Industry However, there is an intricate type of relationship between the UK beer sector, the smoking ban, and the authorities that one can only understand by going through the study in detail The history of smoking […]
  • Status of Smoking around the World Economic factors and level of education have contributed a lot to the shift of balance in the status of smoking in the world.
  • Redwood Associates Company’s Smoking Ethical Issues Although employees are expected to know what morally they are supposed to undertake at their work place, it is the responsibility of the management and generally the Redwood’s hiring authority to give direction to its […]
  • Smokers’ Campaign: Finding a Home for Ciggy Butts When carrying out the campaign, it is important to know what the situation on the ground is to be able to address the root cause of the problem facing the population.
  • Mobile Applications to Quit Smoking A critical insight that can be gleaned from the said report is that one of the major factors linked to failure is the fact that smokers were unable to quit the habit on their own […]
  • Behavior Modification Technique: Smoking Cessation Some of its advantages include: its mode of application is in a way similar to the act of smoking and it has very few side effects.
  • Quitting Smoking: Strategies and Consequences Thus, for the world to realize a common positive improvement in population health, people must know the consequences of smoking not only for the smoker but also the society. The first step towards quitting smoking […]
  • Effects of Thought Suppression on Smoking Behavior In the article under analysis called I suppress, Therefore I smoke: Effects of Thought Suppression on Smoking Behavior, the authors dedicate their study to the evaluation of human behavior as well as the influence of […]
  • Suppressing Smoking Behavior and Its Effects The researchers observed that during the first and the second weeks of the suppressed behavior, the participants successfully managed to reduce their intake of cigarettes.
  • Smoking Cessation Methods
  • Understanding Advertising: Second-Hand Smoking
  • People Should Quit Smoking
  • Importance of Quitting Smoking
  • Cigarette Smoking in Public Places
  • Ban of Tobacco Smoking in Jamaica
  • Anti-Smoking Campaign in Canada
  • Electronic Cigarettes: Could They Help University Students Give Smoking Up?
  • Psychosocial Smoking Rehabilitation
  • The Program on Smoking Cessation for Employees
  • Tips From Former Smokers (Campaign)
  • Combating Smoking: Taxation Policies vs. Education Policies
  • The Program to Quit Smoking
  • Possible Smoking Policies in Florida
  • Smoking Ban in the State of Florida
  • Core Functions of Public Health in the Context of Smoking and Heart Disease
  • Smoking: Pathophysiological Effects
  • Putting Out the Fires: Will Higher Taxes Reduce the Onset of Youth Smoking?
  • Smoking Bans in US
  • Smoking as Activity Enhancer: Schizophrenia and Gender
  • Health Care Costs for Smokers
  • Medical Coverage for Smoking Related Diseases
  • Exposure to mass media proliferate smoking
  • The Realm of reality: Smoking
  • Ethical Problem of Smoking
  • The Rate of Smoking Among HIV Positive Cases.
  • Studying the Government’s Anti-Smoking Measures
  • Smoking Should Be Banned In the United States
  • Effectiveness of Cognitive Behavioral Theory on Smoking Cessation
  • Effectiveness of the Cognitive Behavioral Therapy for Smoking Cessation
  • Wayco Company’s Non-smoking Policy
  • Adverse Aspects of Smoking
  • Negative Impacts of Smoking on Individuals and Society
  • Dealing With the Increase in the Number of Smokers Between Ages 17 and 45
  • Cannabis Smoking in Canada
  • Smoking Ban in the United States of America
  • Dangers of Smoking Campaign
  • Should Cigarettes Be Banned? Essay
  • Smoking Ban in New York
  • Smoking and Adolescents
  • Trends in Smoking Prevalence by Race/Ethnicity
  • Business Ethics: Smoking Issue
  • Should Smoking Tobacco Be Classified As an Illegal Drug?
  • Where Does the Path to Smoking Addiction Start?
  • Public Health Communication: Quit Smoking
  • Are Estimated Peer Effects on Smoking Robust?
  • Are There Safe Smoking and Tobacco Options?
  • What Are the Health Risks of Smoking?
  • Does Cigarette Smoking Affect Body Weight?
  • Does Cigarette Smuggling Prop Up Smoking Rates?
  • What Foods Help You Quit Smoking?
  • How Can People Relax Without Smoking?
  • Does Education Affect Smoking Behaviors?
  • Is Vaping Worse Than Smoking?
  • Do Movies Affect Teen Smoking?
  • What Is Worse: Drinking or Smoking?
  • Does Smoking Affect Breathing Capacity?
  • Does Smoking Cause Lung Cancer?
  • Does Having More Children Increase the Likelihood of Parental Smoking?
  • Does Smoking Cigarettes Relieve Stress?
  • Does Time Preference Affect Smoking Behavior?
  • How Does Smoking Affect Cardiovascular Endurance?
  • How Hypnosis Can Help You Quit Smoking?
  • How Does Smoking Affect Brain?
  • How Nicotine Affects Your Quit Smoking Victory?
  • How Does Secondhand Smoking Affect Us?
  • Why Is Smoking Addictive?
  • How Smoking Bans Are Bad for Business?
  • Why Smoking Should Not Be Permitted in Restaurants?
  • Why Public Smoking Should Be Banned?
  • Why Has Cigarette Smoking Become So Prominent Within the American Culture?
  • What Makes Smoking and Computers Similar?
  • Does Smoking Affect Schooling?
  • What Effects Can Cigarette Smoking Have on the Respiratory System?
  • What Are the Most Prevalent Dangers of Smoking and Drinking?
  • Chicago (A-D)
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Smoking and Liberty

Smoking has been banned in numerous places in the western world. In many countries, it’s illegal to smoke in restaurants, bars, and even parks. It’s led to questions over whether these bans are justified or whether they’re taking away the liberty and freedoms of the general population.

The main argument against the removal of freedom and liberty is the fact studies have shown smoking, as well as second-hand smoke, is bad for us. It leads to lung disease, cancer, and poor oral health. One has to consider whether removing one supposed freedom, the freedom to smoke, is actually a step forward for the greater good.

Furthermore, most people in 2013 don’t smoke. Smoking has evolved into a social faux pas. Most people have become sensitive to the smell again. During the decades where the majority smoked, people were desensitised to the smells and the potential health risks of smoking.

If the majority of people have moved away from smoking, this must be considered a democratic step by people who no longer consider smoking as a positive thing.

Another aspect of the debate over smoking and liberty is whether smokers are infringing on the freedom of other people. Anti-smoking groups claim smokers are taking away the right of people to breathe clean air in favour of their own selfish desires.

Combine this argument with the fact most people either don’t smoke or are looking to quit smoking and it’s easy to see this argument has weight. Current legislation hasn’t actually banned smoking itself. It’s moved it to a place where the fumes from cigarettes no longer bother other people. Some would argue this has enabled non-smokers to breathe clean air and smokers to still smoke.

Although there was never any sort of nationwide referendum over whether smoking should be banned, those who did push laws through were democratically elected officials. Smoking bans didn’t appear overnight. The debates were already present when we, the general public, elected these officials.

These officials all had their own views on the matter. If we voted for them, it means they speak for the people. Technically, we have exercised our democratic right in the form of electing these officials with these beliefs.

As well as the fact we elected the people who drafted anti-smoking laws, look at the aftermath of the bans. In no area of the world has there been a concerted attempt to reverse the laws. The organisations arguing that smoking is infringing on our rights are a vocal minority.

The wider public are generally accepting of the smoking ban. And this has been demonstrated by the significant decrease in the number of people smoking on a regular basis. The health benefits revealed in various scientific studies have swayed the general public into accepting these anti-smoking laws.

In conclusion, smoking isn’t an infringement on our rights or freedoms. Anti-smoking laws were brought in only after many years of debate. And these debates were held by politicians the general public elected to speak for them.

Rather than infringing on our freedoms, anti-smoking laws appearing in the manner they have done have actually demonstrated we do have the democratic right to determine our own destinies.

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How To Write A Smoking Essay That Will Blow Your Classmates out of the Water

Writing a Smoking Essay. Complete Actionable Guide

A smoking essay might not be your first choice, but it is a common enough topic, whether it is assigned by a professor or left to your choice. Today we’ll take you through the paces of creating a compelling piece, share fresh ideas for writing teen smoking essays, and tackle the specifics of the essential parts of any paper, including an introduction and a conclusion.

Why Choose a Smoking Essay?

If you are free to select any topic, why would you open this can of worms? There are several compelling arguments in favor, such as:

  • A smoking essay can fit any type of writing assignment. You can craft an argumentative essay about smoking, a persuasive piece, or even a narration about someone’s struggle with quitting. It’s a rare case of a one-size-fits-all topic.
  • There is an endless number of  environmental essay topics ideas . From the reasons and history of smoking to health and economic impact, as well as psychological and physiological factors that make quitting so challenging.
  • A staggering number of reliable sources are available online. You won’t have to dig deep to find medical or economic research, there are thousands of papers published in peer-reviewed journals, ready and waiting for you to use them. 

Essential Considerations for Your Essay on Smoking

Whether you are writing a teenage smoking essay or a study of health-related issues, you need to stay objective and avoid including any judgment into your assignment. Even if you are firmly against smoking, do not let emotions direct your writing. You should also keep your language tolerant and free of offensive remarks or generalizations.

The rule of thumb is to keep your piece academic. It is an essay about smoking cigarettes you have to submit to your professor, not a blog post to share with friends.

How to Generate Endless Smoking Essay Topic Ideas

At first, it might seem that every theme has been covered by countless generations of your predecessors. However, there are ways to add a new spin to the dullest of topics. We’ll share a unique approach to generating new ideas and take the teenage smoking essay as an example. To make it fresh and exciting, you can:

  • Add a historic twist to your topic. For instance, research the teenage smoking statistics through the years and theorize the factors that influence the numbers.
  • Compare the data across the globe. You can select the best scale for your paper, comparing smoking rates in the neighboring cities, states, or countries.
  • Look at the question from an unexpected perspective. For instance, research how the adoption of social media influenced smoking or whether music preferences can be related to this habit.

The latter approach on our list will generate endless ideas for writing teen smoking essays. Select the one that fits your interests or is the easiest to research, depending on the time and effort you are willing to put into essay writing .

How To Write An Essay About Smoking Cigarettes

A smoking essay follows the same rules as an academic paper on any other topic. You start with an introduction, fill the body paragraphs with individual points, and wrap up using a conclusion. The filling of your “essay sandwich” will depend on the topic, but we can tell for sure what your opening and closing paragraphs should be like.

Smoking Essay Introduction

Whether you are working on an argumentative essay about smoking or a persuasive paper, your introduction is nothing but a vessel for a thesis statement. It is the core of your essay, and its absence is the first strike against you. Properly constructed thesis sums up your point of view on the economic research topics and lists the critical points you are about to highlight. If you allude to the opposing views in your thesis statement, the professor is sure to add extra points to your grade.

The first sentence is crucial for your essay, as it sets the tone and makes the first impression. Make it surprising, exciting, powerful with facts, statistics, or vivid images, and it will become a hook to lure the reader in deeper. 

Round up the introduction with a transition to your first body passage and the point it will make. Otherwise, your essay might seem disjointed and patchy. Alternatively, you can use the first couple of sentences of the body paragraph as a transition.

Smoking Essay Conclusion

Any argumentative and persuasive essay on smoking must include a short conclusion. In the final passage, return to your thesis statement and repeat it in other words, highlighting the points you have made throughout the body paragraphs. You can also add final thoughts or even a personal opinion at the end to round up your assignment.

Think of the conclusion as a mirror reflection of your introduction. Start with a transition from the last body paragraph, follow it with a retelling of your thesis statement, and complete the passage with a powerful parting thought that will stay with the reader. After all, everyone remembers the first and last points most vividly, and your opening and closing sentences are likely to have a significant influence on the final grade.

Bonus Tips on How to Write a Persuasive Essay About Smoking

With the most challenging parts of the smoking essay out of the way, here are a couple of parting tips to ensure your paper gets the highest grade possible:

  • Do not rely on samples you find online to guide your writing. You can never tell what grade a random essay about smoking cigarettes received. Unless you use winning submissions from essay competitions, you might copy faulty techniques and data into your paper and get a reduced grade.
  • Do not forget to include references after the conclusion and cite the sources throughout the paper. Otherwise, you might get accused of academic dishonesty and ruin your academic record. Ask your professor about the appropriate citation style if you are not sure whether you should use APA, MLA, or Chicago.
  • Do not submit your smoking essay without editing and proofreading first. The best thing you can do is leave the piece alone for a day or two and come back to it with fresh eyes and mind to check for redundancies, illogical argumentation, and irrelevant examples. Professional editing software, such as Grammarly, will help with most typos and glaring errors. Still, it is up to you to go through the paper a couple of times before submission to ensure it is as close to perfection as it can get.
  • Do not be shy about getting help with writing smoking essays if you are out of time. Professional writers can take over any step of the writing process, from generating ideas to the final round of proofreading. Contact our agents or skip straight to the order form if you need our help to complete this assignment.

We hope our advice and ideas for writing teen smoking essays help you get out of the slump and produce a flawless piece of writing worthy of an A. For extra assistance with choosing the topic, outlining, writing, and editing, reach out to our support managers .

Essay on Smoking

500 words essay on  smoking.

One of the most common problems we are facing in today’s world which is killing people is smoking. A lot of people pick up this habit because of stress , personal issues and more. In fact, some even begin showing it off. When someone smokes a cigarette, they not only hurt themselves but everyone around them. It has many ill-effects on the human body which we will go through in the essay on smoking.

essay on smoking

Ill-Effects of Smoking

Tobacco can have a disastrous impact on our health. Nonetheless, people consume it daily for a long period of time till it’s too late. Nearly one billion people in the whole world smoke. It is a shocking figure as that 1 billion puts millions of people at risk along with themselves.

Cigarettes have a major impact on the lungs. Around a third of all cancer cases happen due to smoking. For instance, it can affect breathing and causes shortness of breath and coughing. Further, it also increases the risk of respiratory tract infection which ultimately reduces the quality of life.

In addition to these serious health consequences, smoking impacts the well-being of a person as well. It alters the sense of smell and taste. Further, it also reduces the ability to perform physical exercises.

It also hampers your physical appearances like giving yellow teeth and aged skin. You also get a greater risk of depression or anxiety . Smoking also affects our relationship with our family, friends and colleagues.

Most importantly, it is also an expensive habit. In other words, it entails heavy financial costs. Even though some people don’t have money to get by, they waste it on cigarettes because of their addiction.

How to Quit Smoking?

There are many ways through which one can quit smoking. The first one is preparing for the day when you will quit. It is not easy to quit a habit abruptly, so set a date to give yourself time to prepare mentally.

Further, you can also use NRTs for your nicotine dependence. They can reduce your craving and withdrawal symptoms. NRTs like skin patches, chewing gums, lozenges, nasal spray and inhalers can help greatly.

Moreover, you can also consider non-nicotine medications. They require a prescription so it is essential to talk to your doctor to get access to it. Most importantly, seek behavioural support. To tackle your dependence on nicotine, it is essential to get counselling services, self-materials or more to get through this phase.

One can also try alternative therapies if they want to try them. There is no harm in trying as long as you are determined to quit smoking. For instance, filters, smoking deterrents, e-cigarettes, acupuncture, cold laser therapy, yoga and more can work for some people.

Always remember that you cannot quit smoking instantly as it will be bad for you as well. Try cutting down on it and then slowly and steadily give it up altogether.

Get the huge list of more than 500 Essay Topics and Ideas

Conclusion of the Essay on Smoking

Thus, if anyone is a slave to cigarettes, it is essential for them to understand that it is never too late to stop smoking. With the help and a good action plan, anyone can quit it for good. Moreover, the benefits will be evident within a few days of quitting.

FAQ of Essay on Smoking

Question 1: What are the effects of smoking?

Answer 1: Smoking has major effects like cancer, heart disease, stroke, lung diseases, diabetes, and more. It also increases the risk for tuberculosis, certain eye diseases, and problems with the immune system .

Question 2: Why should we avoid smoking?

Answer 2: We must avoid smoking as it can lengthen your life expectancy. Moreover, by not smoking, you decrease your risk of disease which includes lung cancer, throat cancer, heart disease, high blood pressure, and more.

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How Can We Balance Ethics and Law When Treating Smokers?

A physician is a valued member of society on whom many individuals rely for both professional advice and support during times when they may feel to be at a disadvantage, whether it be physically or mentally. An issue on the rise today concerns the population of smokers in our society. Many are coming to share the opinion that physicians should not provide treatments for smokers. Some of the opinions are based on the claim that smokers are morally responsible for their medical conditions. But, providing care in a fair manner includes not treating differently those who suffer from addiction. Moreover, it is important to recognize that allocating medical resources based on moral responsibility will undermine the physician–patient relationship which is necessary for the practice of medicine. Many countries have codes and policies that physicians must legally follow in terms of providing treatments. With acceptance of the fact that the patient may be unable to execute the decisions made by the physician, it is the legal duty of the physician to provide care and not abandon the patient. An analysis of the many policies around the world brings forward certain changes that must be made in order to make sure that physicians fulfil their legal duty, which is to provide care. As such, this article looks into the existing ethical dilemma in treating smokers around the world, with a review of some policies that will guide our approach in this matter.


Mrs X, a 61-year-old female patient in a long-term care facility, has been abusing tobacco since her teens. She has multiple comorbidities including a history of mental illness and chronic obstructive pulmonary disease (COPD). She also recently underwent emergency hernia repair. Her attempts to refrain from smoking resulted in an improvement of the healing of her wound, but it opened every time she relapsed. After much encouragement, Mrs X enrolled in a smoking cessation program and tried to follow the program’s regimen, but unfortunately yet again slipped back into a pattern of heavy smoking. Dr Y is becoming frustrated with the patient’s inability to commit to her treatment and is concerned about possible health complications secondary to her inability to stop smoking. He therefore decides to remove Mrs X from his practice and refer her to Dr Z.


Smoking is a health risk to individuals, and it decreases the potential for benefit(s) from a variety of medical interventions. Extensive medical research has shown that nicotine is an addictive substance. 1 Many surgical outcomes (e.g. cardiac, respiratory, prosthetic, spinal surgeries) including wound healing have demonstrated relatively improved results if patients stop smoking a few weeks before surgery. A study that examined the effects of smoking before a joint replacement surgery found that the probability of a smoker getting a wound infection was 3.3–3.4 times higher compared to that of a non-smoker. 2 In addition, a faster reoccurrence of arteriosclerosis was observed in the smoking group, since the process of the arteries becoming blocked again was much faster in the smoking group compared to non-smokers. 3 A clinical study of patients treated for thoracolumbar fractures showed that the risk of impaired bone healing has been estimated to be 3 to 18 times higher in smokers. 4 Literature review states that patients should stop smoking 8 weeks prior to surgery in order to receive a benefit from it. 5 Unfortunately, many patients are not able to comply with these recommendations by their physician.

It is important to note that some data also suggest that the relationship between smoking and surgical outcomes is equivocal, meaning some smokers who have surgery have no complications. In fact, a study that assessed patients who underwent arthroplasty of the hip and knee found that patients who smoked had fewer comorbidities than patients who did not smoke. 6 Therefore, if we were to deny smokers access to surgical procedures, we are denying treatment to those patients who smoke, but who will not face any complications proceeding from treatment.


The World Medical Association has established international ethical standards for the practice of medicine. One of its tasks was to compile the International Code of Medical Ethics and policy statements on specific ethical issues.

The doctor is instructed not to “permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient.” 7

Doctors must be loyal to their patients and offer them all the information regarding their procedures prior to treatment. If a proposed treatment is beyond a doctor’s scope of practice, he/she should refer the patient to another suitable physician. 7 This is the decision that was made in the case of Mrs X, where Dr Y referred the patient to Dr Z, who agreed to provide the treatment.

Some doctors in England have refused to perform non-urgent coronary artery bypass surgery on smokers, requiring them to stop smoking first in order to be eligible for surgery. Surgeons have argued that non-smokers should be given preference over smokers for elective surgery because they will gain a greater benefit from it, and thus have a greater chance of complication-free survival. 8 Underwood and Bailey state that “coronary bypass surgery should not be offered to smokers” due to the fact that smoking will increase the risk of postoperative complications, along with increasing the progression of coronary artery disease. Therefore, the benefits from the procedure will be reduced due to the resulting complications that may likely occur. 9

Many also argued that smoking is self-inflicted, meaning that is was the patients’ choice, and thus they should not receive treatment. 10 But, what many do not realize is that this leads to a slippery slope, such that overeaters, non-exercisers, terrorists who cause their own injury, drunk drivers, and non-compliant patients should not receive medical treatment. For example, if rugby players break their fingers from playing, do we refuse to treat them because they should have not taken the risk of playing? Providing a treatment should not be based on the assignment of blame. 11 Moreover, it is important to recognize that people are entitled to make lifestyle choices, and thus we cannot deny or withhold treatment based on a choice that they have the right to make. 12 The point is that all the patients entering a health care facility must be seen as equal, despite the difficulty in doing so. The duty of medical staff is to help towards maintaining and improving the patient’s health, and therefore a patient must not be judged while this duty is carried out. Therefore, making it legally permissible to refuse treatment for smokers will only lead to the refusal of treatment for those who are unmotivated, unfit, and/or seen as undeserving of treatment. 10 The problem with this is: who is to determine what characteristics define someone as unmotivated and/or unfit? Ambiguity lies beneath these two terms. The licensing body of the UK states that a doctor must “take all possible steps to alleviate pain and distress whether or not a cure may be possible.” 13 Therefore, patients should be advised and educated about the effects that smoking has on their health, but we cannot penalize them by denying the treatment that they require in order to alleviate any pain and/or distress. Moreover, the British Medical Association stated that physicians should not make decisions for their patients who do not refrain from smoking, by posing ultimatums, as they are legally not allowed to do this. Dr Graham Jackson, a consultant cardiologist at Guy’s Hospital and editor of the British Journal of Clinical Practice , had published a 10-year American study which stated that the survival rate of smokers undergoing by-pass surgery was 68%, whereas the survival rate for non-smokers was 84%. 14 He stated: “The differences are not of sufficient scale to justify a ban on treating cigarette smokers.” David Blunkett, the Labour party’s health spokesman stated: “Everyone has a right to access to the National Health Services, no matter how foolish they have been in their own behaviour, whether that is in smoking or in fooling about in a boxing ring or on a rugby pitch.” 15

The Netherlands

In the Netherlands, there are laws in place which do not refuse treatment for smokers, regardless of the opinions of some doctors. One physician in the Netherlands wrote an article arguing that spending time on people who “willingly and knowingly damage their own and other’s health” was “wasted energy.” 3 He felt that it was his professional duty to make it clear to his patients that smoking is dangerous and therefore should not be taken lightly. The government responded to his article by stating that it is unacceptable to exclude patients on the basis of their behavior. The government of Netherland states that, regardless of whether the treatment makes a difference in the patient’s health, it is the duty of the physician to provide the appropriate treatment and include a complement of supportive care. 16 Patients cannot be discriminated against on the basis of their behavior, especially when it is a behavior that an individual has very little if any control over. 17

An editorial published in the Medical Journal of Australia states that smokers should not be offered a wide range of surgical procedures. 2 The main argument was that smokers receive less benefit from treatment. As stated earlier, rates of wound infection are higher in smokers compared to non-smokers, and thus they also lead to delays in hospital discharge, and increased costs for hospital care. 5 The issue of cost is prominent in countries such as Germany, France, the UK, and Italy, where over 73% of all EU27 health care spending was due to smoking. 18 The caveat here is that denying patients treatment for reasons of saving on hospital costs may result in worse health spending down the road secondary to denying the procedure (e.g. expensive medications, repeat hospitalizations, etc.). 15

The Royal Australasian College of Surgeons states that “Good medical practice involves … not prejudicing your patient’s care because you believe that a patient’s behavior has contributed to their condition.” 19 This includes realizing that many treatments offer patients a potential psychological benefit. The patients may feel that they are attaining benefit from the treatment, and may therefore feel relief. As a result, though physicians are morally obligated to educate their patients about the effects of smoking, and advise them to stop before surgery, it is their legal responsibility to provide their patients with treatment, regardless of whether or not the patients cease their behavior.

The College of Physicians and Surgeons of Ontario states that a physician must “act in patients’ best interests.” The document further states that physicians must “always be motivated by a regard for what is best for the patient.” 20 These statements come to show that as long as the patient was informed about the risks associated with smoking, a physician must act in the patients’ best interests regardless of whether the patient may attain benefit from the treatment. Therefore, though Ontarians in Canada need to legally advise their patients about the risks and benefits of the treatment, they must respect their patients’ wishes.


The principle of respect and equality towards all patients has to be applied in the care of infectious patients. The World Medical Association (WMA) states that infectious patients should not be exempt from a physician’s duty to treat. In the case of acquired immune deficiency syndrome (AIDS), the WMA Interim Statement on AIDS, adopted in October 1987, states that “Patients with AIDS and those who test positively for the antibody to the AIDS virus must be provided with appropriate medical care and should not be treated unfairly or suffer from arbitrary or irrational discrimination in their daily lives.” 21

Even the latest briefing note on Ebola virus disease issued by the World Health Organization discusses the rights, duties, and responsibilities of both workers and employers, emphasizing the necessity of adequate protective gear for health care staff. The necessity of adequate gear connects to the fact that all means are employed to ensure that health care workers are able to provide care for their patients.

Health care professionals who refuse to care for a patient without justification could suffer certain sanctions such as suspension from practice or a license revocation. 22 Nevertheless, we do not have similar sanctions applied to health care professionals who refuse to treat smokers (unless the patient was abandoned by the health care professional).

The doctor’s principal obligation must be to the patient’s best interests, both in preventing and treating illness, and in helping the patient to cope with sickness or the nearing of death. Doctors may not refuse to help a patient because the patient has an infectious disease, and therefore health care providers must accept the risks that come with their line of work. If this is the case, why then should smokers be refused treatment? The risks associated with complications induced by smoking must be accepted as well, as in the case of Mrs X, since smokers should not be an exception to the rule by being denied treatment due to addiction.


It is important to keep in mind that there is a close relationship between ethics and law ( Figure 1 ). For example, page one of The Canadian Medical Association Code of Ethics states that a physician must “Provide appropriate care to the patient, even when cure is no longer possible, including physical comfort, and spiritual and psychosocial support.” 23 This essentially states that even when a treatment shows no benefit to the patient, the physician must find ways to provide the patient with support and comfort. Furthermore, The American Medical Association states: “the social commitment of the physician is to sustain life and relieve suffering.” 23 Therefore, a treatment which has the capacity to save life and/or relieve suffering should be provided. It is important to recognize that, many times, providing a treatment is what gives a patient comfort and possibly psychological benefit.

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The Relationship Between Law and Ethics.

The WMA International Code of Medical Ethics states: “A physician shall act in the patient’s best interest when providing care.” 24 Therefore, if we decide to treat smokers by first denying treatment in an effort to have them refrain from smoking, we may wonder if it is generally wise to subject smokers to such pain and public humiliation. Would we be acting in the patients’ best interests by subjecting them to pain and public humiliation? Can we afford simply to respect the “traditions” of others and agree to disagree? Mistaking no answer in practice for no answer in principle will lead us to conforming to the beliefs of the majority. What many do not realize is that physicians are legally not allowed to pose ultimatums for their patients who do not refrain from smoking, since the patient has the human right to autonomy. The Singapore Medical Council states that “A doctor shall not allow his personal beliefs to influence his management of his patients.” 25 Therefore, despite the personal beliefs of physicians, in regard to patients who a smoke, physicians have the legal responsibility to care for their patients without discrimination.


Does our inability to have a certain policy in place, in regard to providing smokers with treatment, oblige us to respect all opinions equally? Of course not. In the same way, the fact that we may not be able to resolve specific dilemmas does not suggest that all competing responses to them are equally valid. Therefore, it is important to keep in mind the ethical and legal aspects of the doctor–patient relationship and the human rights of both individuals, in order to make a decision which will not be detrimental to the patient.

The WMA’s International Code of Medical Ethics states that there is only one reason for ending a physician–patient relationship: “Whenever an examination or treatment is beyond the physician’s capacity, he/she should consult with or refer to another physician who has the necessary ability.” 24 They go on to state that if a physician decides to end the physician–patient relationship for any other reason, the physician must “be prepared to justify their decision, to themselves, to the patient and to a third party if appropriate.” 24 As such, within the code itself, factors such as discrimination based on a patient’s behavior is not considered a valid reason for terminating the relationship. The Medical Board of Australia reinforces this statement by having a code that includes: “Not prejudicing your patient’s care because you believe that a patient’s behaviour has contributed to their condition.” 19

The Medical Board of Australia states that physicians must discuss “with patients their condition and the available management options, including their potential benefit and harm.” 19 The Board also states that physicians must be “recognizing and respecting patients’ rights to make their own decisions.” 19 These two statements reinforce that a physician must act in the best interests of patients by recommending treatments that provide benefit. If a patient seeks treatment that contradicts the physician’s opinion, then the physician must ultimately respect the patients’ wishes. It is important to keep in mind that sometimes a treatment can provide both the patient and the family with benefits and thus achieve the aims of both the patient and the family. Therefore, a doctor cannot simply deny treatment to smokers due to the fact that it provides no physiological benefit, since the wishes of the patient and family may still be granted through the treatment.

In Manitoba (Canada) there are currently no guidelines or rules regarding refusal of care based on behaviors such as smoking. A Winnipeg doctor had told patients who smoke that they have to quit or find a new physician. Dr Bill Pope of the College of Physicians and Surgeons of Manitoba states: “It’s not uncommon for physicians to say under certain circumstances, I’m not prepared to treat certain kinds of patients.” 26 Smokers are at risk for other complications after their treatments because they are not adhering to recommendations and physician advice, and thus do not quit smoking. Many times the lack of adherence is due to the fact that nicotine is addictive. Therefore, it is important to note that smoking cessation is not simply a non-adherence issue.

Physicians are required to advise their patients of the risks associated with smoking. If the physician does not notify the patient of the risks, he/she can be held liable if the patient develops complications associated with smoking. 16 It is important to note that a physician can also be held liable if he/she refuse to treat a smoker due to the patient’s inability to follow the physician’s advice and refrain from smoking, when the treatment can still be beneficial. 17 Hence, if Dr Y had decided no longer to provide treatment for Mrs X, since he felt that the constant treatments were non-beneficial due to her non-compliance regarding smoking, he should transfer her to another physician, such as Dr Z. If a physician decides to refuse to treat a patient, either due to the treatment being futile or the patient refusing to disengage from smoking, he/she must transfer the patient to another physician who is willing to accept the patient, in order not to be held liable. If another physician is not available, the physician should continue to provide treatment until a new physician can be located. 27 Before transferring the patient, the physician must give the patient a Notice of Withdrawal of Services, so that the patient can find alternative medical care. 17


Organ transplant surgery is one of the procedures denied to smokers with the justification that there is increased morbidity and mortality after the surgery among smokers. 15 It is believed that smoking in renal transplant patients is associated with increased graft failure, malignancies, and myocardial infarction. 28 However, it is almost impossible to perform a randomized, controlled trial that could establish a better survival rate after organ transplantation in patients who quit smoking before surgery. 28

We continue to face the ethical dilemma: do smokers deserve to be treated? We must discern between ethics and strong medical reasoning. The World Health Organization states: “donated organs should be made available to patients on the basis of medical need and not on the basis of financial or other consideration.” 29 Thus, discrimination based on behavior is not considered a factor of allocation. For example, The Canadian Society of Transplantation prepares eligibility criteria for different transplant surgeries. It emphasizes that “Patients should be strongly encouraged to stop smoking before kidney transplantation. Patients who continue to smoke may be eligible for kidney transplantation with full informed consent regarding their increased risk.” 30 The key word here is “may,” as the decision regarding who is to receive a transplant during times of low quantity is based on many factors including the patient’s “will to live, motivation and ability to follow post-operative directions.” 31

This once again raises the question of whether or not a smoker can be held responsible for an addiction, since an addiction can make it hard for a smoker to follow post-operative directions. If the actions of psychotic, contagious, and chronically ill patients are perceived to be beyond their control and yet they are unquestioningly treated, then the actions of smokers, who are not adherent with the recommendation to refrain from smoking due to a loss of control associated with their addiction, should therefore be treated on the same basis as the other patients suffering from diverse illness(s) and multiple comorbidities.

The primary reason why individuals have argued against providing alcoholics a chance for a liver transplantation is because they feel that alcoholics are morally responsible for their alcohol-associated condition, and thus they should be placed lower on the priority list. We have heard a similar statement for smokers who are put lower on the priority list since they are said to be responsible for their smoking-associated condition. For example, alcoholic cirrhosis is a condition that is preventable by either abstaining from alcohol or using it in moderation. As such, about 85% of US liver transplant programs use the “6-month rule,” where patients are chosen for an organ transplant based on whether they can remain alcohol-free for 6 months. 32 One of the purposes of this rule is to help the liver recover, and perhaps even avoid the transplant due to the liver healing by itself. The second is to see whether or not the individual is capable of being alcohol-free, since this will reduce the chances of relapse. Again, a similar restriction is placed on smokers, to reduce the risk of harm after treatment. But it is important to make sure that physicians are aware of the fact that the survival rates of patients with conditions related to alcohol use or smoking can be “at least as good as those seen with other indications.” 33 Acknowledging this fact will improve patients’ access to liver and lung transplants, thus increasing the chances of saving a life.

Making decisions based on moral grounds also brings up the question of whether it is fair to refuse a transplant to a patient who had tried to overcome his/her addiction but, due to unfortunate circumstances, was not successful? For example, a patient who tries to overcome his/her addiction would seem more responsible than one who does not make efforts to quit. But then, what if a patient wanted to receive help to quit but was too poor to hire help and lived far from Alcoholics Anonymous or a smoking cessation program? 34 How would we be able to decipher the responsible patients from the non-responsible patients? This poses a problem for this method of allocating medical resources. Moreover, basing the allocation of medical resources on what the patient verbally says may put the patient–physician relationship in jeopardy. The patient must feel comfortable in giving the relevant medical information to his/her physician and giving lifestyle information which is critical to determining an appropriate treatment and success rate. But, if the patient realizes that what he/she says may affect the chances of receiving a treatment such as an organ transplant, he/she will find every reason to withhold information that may put his/her treatment options in jeopardy. 34 This now undermines the physician’s role as a health advocate and, furthermore, may not guarantee effective treatment for the patient. Therefore, allocating medical resources on the basis of moral responsibility will undermine two goals of the medical system—ensuring that patients have a medical safe harbor to turn to, and ensuring that they receive medical advocacy. 34


Thromboangiitis obliterans (TAO), or Buerger’s disease, is a non-atherosclerotic segmental vasculitis that affects the small and medium-sized arteries and veins of the extremities. 35 Buerger’s disease is strongly associated with exposure to tobacco and thus is prevalent among smokers. Cannabis which is a co-factor of tobacco may also increase the risk of Buerger’s disease. 36 Therefore, patients with Buerger’s disease are first and foremost told to quit smoking. Amputations are then recommended as a treatment option. It has been found that for those patients who do not stop smoking, most of the amputations occur due to relapses within the 6 years after diagnosis of Buerger’s disease. 37 Moreover, smokers who smoked for more than 20 years were found to have a significant correlation with further major amputations. 37 A study involving 27 cigarette smokers with Buerger’s disease found that all the smokers who reached cessation from smoking had improvement in the symptoms associated with their disease, and none of them had undergone amputation, compared to the 50% of patients who relapsed into smoking and needed an amputation. 38 These results reinforce the fact that cessation from smoking improves symptoms of Buerger’s disease and reduces the likelihood of needing an amputation. Since cessation of smoking seems currently to be the one prominent solution, more treatment alternatives and programs need to be developed for individuals who are highly dependent on smoking. On the other hand, some studies have found that there is no significant difference in the limb salvage rate of smokers compared to ex-smokers. This implies that smoking cessation may not be advantageous to patients with Buerger’s disease. 39 Regardless, it is important to recognize the fact that despite the patient’s addiction, physicians are still required to give their patients all the treatment options, while recommending practices which will help to reduce and alleviate the symptoms of the medical condition.


Patient abandonment takes place when a physician withdraws from caring for a patient and does not transfer his/her responsibilities to another physician who is qualified to provide care for the patient. This includes providing emergency treatment for the patient, even after the responsibilities have been handed over to another physician. Therefore, the previous physician still has the responsibility to provide care for the individual who was once his/her patient, in times of emergency, again showing that a physician cannot abandon his/her patient. Hence, if Mrs X suffered an emergency following the transfer of care to Dr Z, she is obliged to be treated by Dr Y. Overall, a physician has a legal duty to provide care to all patients regardless of their behavior and should therefore also have a valid reason before choosing to terminate a relationship which carries such value and importance to the patient. 27

This article aims to demonstrate that when discussing the refusal to treat smokers, we are actually bringing forward an interdependent world of facts, and thus science, ethics, and law should be taken into consideration when making decisions. It is therefore also important to keep in mind both science and ethics when making laws in health care.

“The interests of the patient should always be promoted regardless of financial arrangements; the health care setting; or patient characteristics, such as decision-making capacity, behavior, or social status.” 6 Having said that, and in full knowledge of the fact that there is a duty to treat even when the risk for doctors’ health or potential liability is significant, is it ethical to deny access to health care to a group of patients such as smokers?

No it is not, and the answer is also found in the basic explanation of the human right to health care: “Health services, goods and facilities must be provided to all without any discrimination. Non-discrimination is a key principle in human rights and is crucial to the enjoyment of the right to the highest attainable standard of health.” 40

With these Human Rights in place, society may continue to hold onto the fact that everyone will be cared for without discrimination, regardless of smoking behavior, which many have no control over. Physicians are valued members of society, and, as valued members, it is their legal duty to care for each individual to the best of their ability, and comply with the moral code which states that each individual has the right to health care.


The author is grateful to Shaira Wignarajah BSc who is presently studying for her Bachelors of Science in Kinesiology at York University, Jelena Miladinovic who is a BSc Clinical Research certificant, and Justin Chow MD who is at the University of Toronto, completing his postgraduate study in Cardiology, for their editing efforts in preparation of this material.

Conflict of interest: No potential conflict of interest relevant to this article was reported.

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What is Rishi Sunak’s anti-smoking bill and will it pass?

Health leaders have welcomed plan to create smoke-free generation – but PM is facing trouble from some Tory MPs

Rishi Sunak’s tobacco and vapes bill aims to create the UK’s first smoke-free generation, in a landmark public health intervention.

What is the ban and how would it work?

The tobacco and vapes bill ensures anyone turning 15 from 2024, or younger, will be banned from buying cigarettes, and aims to make vapes less appealing to children.

The legislation does not ban smoking outright, as anyone who can legally buy tobacco now will still be able to do so if the bill becomes law. It will make it illegal to sell tobacco products to anyone born after 1 January 2009. The plan was first reported by the Guardian , and announced by the prime minister in his speech to the Conservative party conference last year.

It will raise the age of tobacco sale by one year every year, with the aim of stopping today’s young people from ever taking up smoking.

As well as raising the smoking age every year, the legislation includes provisions to regulate the display, contents, flavours and packaging of vapes and nicotine products.

Trading standards officers will be able to fine retailers who ignore the new restrictions, with the revenue raised funding further enforcement.

What are the arguments in favour?

Health leaders , NHS bosses and medical professionals say phasing out smoking will save thousands of lives. Smoking kills about 80,000 people a year.

Ministers say smoking rates among those aged 14-30 could be near zero by 2040 as a result of the legislation.

Prof Steve Turner, the president of the Royal College for Paediatrics and Child Health , said: “By stopping children and young people from becoming addicted to nicotine and tobacco, we decrease their chances of developing preventable diseases later in life, and will protect children from the harms of nicotine addiction.”

The government says creating a “smoke-free generation” could prevent more than 470,000 cases of heart disease, stroke, lung cancer and other diseases by the end of the century.

Government figures show smoking costs the UK about £17bn a year, including £10bn through lost productivity alone. It says this cost dwarfs the £10bn raised through taxes on tobacco products.

And against?

Some Tory MPs have expressed concerns, with the former prime minister Liz Truss saying the plans are “profoundly unconservative”, and her predecessor, Boris Johnson, describing the ban as “nuts” .

Truss said earlier this year: “A Conservative government should not be seeking to extend the nanny state. It only gives succour to those who wish to curtail freedom.”

Kemi Badenoch, the business secretary, was the only cabinet minister to vote against the bill going to a second reading, arguing that the burden of enforcement would fall on private businesses, and that the bill undermined the principle of equality.

“We should not treat legally competent adults differently in this way, where people born a day apart will have permanently different rights,” she posted on X before the vote.

Other Tory MPs object to the plans because they claim they are unworkable and could lead to other things being banned. The former cabinet minister Sir Simon Clarke said: “An enforcement nightmare and a slippery slope – alcohol next?”

How soon will the bill pass ?

A final vote in the Lords is expected to take place in the middle of June after the bill passes its third reading there, but much has to happen in the Commons first.

Tuesday was MPs’ first opportunity to debate the bill and to vote on it. It cleared its first Commons hurdle by 383 votes to 67 , giving a majority of 316, with the support of the Labour party.

The committee stage comes later in April, when amendments can be tabled, before there is a vote on them in May and then a vote by MPs on the bill’s third reading.

What is the likelihood it will run into political trouble?

There was opposition from 57 Conservative MPs and six ministers, including Badenoch, Julia Lopez, Lee Rowley, Alex Burghart, Steve Baker and Andrew Griffith.

The Commons leader, Penny Mordaunt was reported to be wavering but in the end abstained, one of 106 Tory MPs who did not cast a vote. Some of these will have had other reasons for staying away, such as the chancellor, Jeremy Hunt, who was travelling to the International Monetary Fund in Washington.

Tory critics’ best hope for frustrating the bill will now be to overload it with amendments and slow down its passage.

Amendments are likely to include a push to introduce licensing for vaping retailers or to change the age of people affected.

Tory opponents also believe there could be more ideological opposition in the Lords.

The final vote in the Lords is expected to take place in June. While peers have been a block on Sunak’s flagship Rwanda deportation plan, they are not expected, ultimately, to stand in the way of the tobacco bill.

Which other countries have attempted a ban ?

A similar law had been expected to come into effect in New Zealand in July, but was repealed by the country’s new coalition government in February. The toughest anti-tobacco rules in the world would have banned sales to people born after 2009, cut nicotine content in smoked tobacco products and cut the number of tobacco retailers by more than 90%.

Countries with notable restrictions on smoking include Mexico, which has smoking bans at beaches, parks and some homes.

Portugal is aiming to become smoke-free by 2040, with plans to ban the sale of tobacco products in bars and cafes. Meanwhile, Canada became the first country to require health warnings to be printed on individual cigarettes.

More than a quarter of the world’s population are covered by smoking bans in public spaces, according to the World Health Organization.

Of the 74 countries with smoke-free policies, Ireland was the first to ban smoking in all indoor workplaces, in 2004.

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  • Creating a smokefree generation and tackling youth vaping: what you need to know

anti smoking laws essay

The Prime Minister has set out plans to build a better and brighter future for our children.

This includes the Tobacco and Vapes Bill, which was announced in the King’s speech on 7 November 2023 and introduced to Parliament on 20 March 2024. The Bill is now due to have its second reading on 16 April 2024.

The Bill includes a new law to stop children who turn 15 this year or younger from ever legally being sold cigarettes or other tobacco products, alongside measures to crack down on youth vaping and strengthen enforcement of these new laws.

This is in addition to a broader package of measures to tackle youth vaping – including banning the sale and supply of disposable vapes under environmental legislation and the new excise duty on vaping products announced in the Spring Budget.

Here’s what you need to know.

What are the key measures that have been announced?

We will create the first smoke-free generation so children turning 15 this year or younger will never be legally sold tobacco. The age of sale will be raised by one year each year to prevent future generations from ever taking up smoking, as there is no safe age to smoke.

To reduce the appeal of vapes to children, we also announced that new powers will be introduced to restrict vape flavours and packaging. The powers will also allow government to change how vapes are displayed in shops.

To crack down on underage sales, the government will also bring in quicker and simpler £100 on the spot fines (fixed penalty fines) for shops in England and Wales which sell tobacco and vapes underage. Local authorities will retain 100% of the proceeds to reinvest into enforcement of this Bill and other existing tobacco and vaping controls. This builds on a maximum £2,500 fine that the courts can already impose.

Vaping alternatives - such as nicotine pouches - will also be outlawed for children who are increasingly turning to these highly addictive substitutes.

Will the new laws impact current smokers?

The new laws will not impact current smokers. If you were born before 1 January 2009 shops will be able to continue selling you cigarettes and tobacco.

Will this lead to an illicit market?

No. History shows that targeted tobacco control measures have a positive impact on tackling the problems of illicit tobacco. For example, when the smoking age was increased from 16 to 18 the number of illicit cigarettes consumed fell by 25%.

The government is also providing additional powers and funding for enforcement to ensure the laws are effective.

How will the legislation be enforced?

Under the Bill, enforcement officers’ powers will also be strengthened with new powers in England and Wales to issue ‘on the spot fines’ of £100 to retailers breaching the law. This will help uphold the new laws and clamp down on underage sales of tobacco and vaping products.

These new powers to issue Fixed Penalty notices are in addition to a maximum £2,500 fine that courts can already impose.

The government will also be providing an additional £30 million a year for enforcement agencies to support work on underage and illicit sales of tobacco products and vapes.

Does this encroach on freedom of choice?

This is not about criminalising those who smoke or preventing anyone who currently smokes from doing so. Smoking will never be illegal and if you currently smoke legally, retailers will continue to be able to sell you cigarettes and other tobacco products.

But no parent wants their child to start smoking. This is about protecting future generations from the harms of smoking, saving thousands of lives and billions for the NHS.

Surely this isn't a big issue - people don't smoke anymore?

Smoking is still the number one preventable cause of death, disability and ill health, causing around 80,000 deaths per year across the UK.

Smoking rates in older teens remain high – over 12% of 16- to 17-year-olds smoke in England and over 30% of under 18 pregnant mother smoke. In recent years, the USA and Australia have seen the proportion of teenagers that smoke increase for the first time in decades.

Tobacco is uniquely harmful – there is no safe level of smoking. No other consumer product, when used as intended, kills two thirds of its long-term users and 75% of smokers would never have started if they had the choice again. It causes 1 in 4 cancer deaths.

Non-smokers are exposed to second-hand smoke – many come to harm through no choice of their own, including children, pregnant women and their babies.

The Bill will save thousands of lives. It will avoid up to 470,000 cases of strokes, heart disease, lung cancer and other lung diseases by 2100.

What about the tax revenue from tobacco?

Smoking costs the economy and wider society £17 billion a year, which far outweighs the  income per year that the Treasury receives from taxes on tobacco products.

Smoking costs to our NHS and social care system alone £3 billion every year – this is money that we can reinvest into cutting waiting lists and bolstering frontline care. Almost every minute someone is admitted to hospital because of smoking, and up to 75,000 GP appointments could be attributed to smoking each month – over 100 appointments every hour.

Is any type of tobacco product safe?

There is no safe level of tobacco consumption. All tobacco products are harmful. Making this clear in legislation by including all tobacco products will help regulators, businesses and the public comply with the new laws.

Who has been consulted on this issue?

The government consulted on the measures in the Bill for 8 weeks from 12 October to 6 December 2023.

Nearly 28,000 responses were submitted in total and the majority of respondents (63.2%) agreed with implementing the smokefree generation policy. The consultation response can be viewed here: Creating a smokefree generation and tackling youth vaping: your views - GOV.UK (www.gov.uk)

The UK is party to the World Health Organization Framework Convention on Tobacco Control and has an obligation to protect the development of public health policy from the vested interests of the tobacco industry. To meet this obligation, we asked all respondents to disclose whether they have any direct or indirect links to, or receive funding from, the tobacco industry.

In line with the Convention, the views of respondents who disclosed links to the tobacco industry were summarised in the response, but not considered when determining policy.

When will the Smokefree Generation come into force? 

The Smokefree Generation policy will come into force in 2027 when current 15-year-olds turn 18. This will mean there will be a significant implementation period between the Bill being passed and the restrictions coming into force.

Will the Bill be enforced UK wide?

Thanks to constructive engagement from colleagues across the Devolved Administrations, these measures will apply not just in England, but across our entire United Kingdom – saving lives and building a brighter future.

What is the danger of children using vapes?

Children should never vape. The number of children using vapes has tripled in the last three years.

The active ingredient in most vapes is nicotine, which when inhaled, is a highly addictive drug. The addictive nature of nicotine means that a user can become dependent on vapes, especially if they use them regularly.

We have a duty to protect children from these potential harms, which is why we will be banning disposable vapes and bringing forward measures in the Bill to restrict vape flavours, displays and packaging. Reusable and refillable vapes will continue to play a valuable role in helping adults to stop smoking.

What about vape displays in shops, packaging and flavours?

Vapes have become highly appealing products for children because of the wide range of flavours, bright colours, use of cartoons and highly visible points of display in shops. Our new legislation will introduce powers to regulate the display of vapes, packaging and flavours.

The purpose of addressing these issues is to prevent the marketing of vaping to children.

Before using these powers, we will be undertaking a further consultation on the specific measures.

What else are you doing to tackle youth vaping?

The measures in the Tobacco and Vapes Bill are part of a broader package of measures to tackle youth vaping – including banning the sale and supply of disposable vapes under environmental legislation and the new excise duty on vaping products announced in the Spring Budget.

Why are disposable vapes an issue? 

Being cheap and easy to use, disposable vapes are also the vape of choice for children with 69% of current vapers aged 11 to 17 in Great Britain using disposable vapes (up from 7.7% in 2021). The evidence is clear that vapes should not be used by, or targeted at, children– due to the risk and unknown harms involved. That is why the Royal College of Paediatrics and Child Health has said disposable vapes should be banned.

There are serious environmental concerns over disposable vapes. Over 5 million disposable vapes are either littered or thrown away in general waste every week. This has quadrupled in the last year.

That is why we the UK Government, the Scottish Government and the Welsh Government intend to introduce legislation to implement a ban on the sale and supply of disposable vapes. The UK Government will also work with the devolved administrations to explore an import ban.

When will the disposable vape ban come into effect?

England, Scotland and Wales intend to bring in legislation as soon as possible. Any legislation taken forward will allow for an implementation period of at least six months, which takes into consideration concerns that businesses will require time to adapt.

What steps are being taken to address the potential emergence of a black market for disposable vapes?

We will support retailers to implement the new requirements by increasing funding for enforcement – government has announced £30 million extra funding per year for enforcement agencies including HMRC, Trading Standards and Border Force, to tackle the illicit market and underage sales.

Who is going to enforce this ban?

Trading Standards will lead on enforcing the ban within their local area.

It is expected that enforcement authorities would apply civil sanctions in the first instance and a failure to comply may result in authorities prosecuting for a criminal offence subject to a fine only after a failure to comply with a civil sanction.

Are you not worried that a ban on disposable vapes will turn adults towards smoking?

No. Adults who vape responsibly will be able to continue to do so.

We are not banning vapes as a whole, just disposable vapes – given the huge impact they have on the environment. Banning disposables will also prevent young people from accessing them.

Adult vapers will still be able to access refillable and reusable vapes.

We recognise the important part vapes can play in helping people quit smoking.  As part of the government’s Swap to Stop scheme, almost one in five of all adult smokers in England will have access to a reusable vape kit alongside behavioural support to help them quit the habit and improve health outcomes.

Key facts on smoking and vaping

  • Smoking is the single biggest entirely preventable cause of ill-health, disability and death. It leads to 80,000 deaths a year in the UK, and is responsible for 1 in 4 cancer deaths, and over 70% of lung cancer cases. Smokers lose an average of ten years of life expectancy.
  • Consequently, smoking puts a huge burden on the NHS - almost every minute of every day someone is admitted to hospital with a smoking-related disease and over 100 GP appointments every hour are due to smoking.
  • It also costs the economy and wider society £17 billion a year – this is equivalent to 6.9p in every £1 of income tax received, and equivalent to the annual salaries of over half a million nurses, 390,000 GPs, 400,000 police officers, or 400 million GP appointments.
  • Most smokers know the risks of smoking, want to quit but are unable to due to the addictive nature of tobacco. 4 in 5 smokers start before the age of 20 and are then addicted for life.
  • Vaping is less harmful than smoking and can play a role in helping adult smokers to quit. But our message is clear, if you don’t smoke, don’t vape – and children should never vape.  Youth vaping has tripled in the last three years, and 1 in 5 children have tried vaping.
  • Disposable vapes are clearly linked to the rise of vaping in children. They are cheap and easy to use, with 69% of current vapers aged 11 to 17 in Great Britain using them. They are also incredibly harmful to the environment. 5 million disposable vapes are either littered or thrown away in general waste every week. This has quadrupled in the last year.

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How does the UK’s new smoking law compare to other countries?

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MPs have backed a controversial new bill that, if passed, would ban the sale of tobacco to younger generations .

The proposed Tobacco and Vapes Bill would slowly raise the legal age to buy cigarettes and other tobacco products.

It would mean that no one born after 2009 (or Generation Alpha, currently aged 14 or under) will ever be able to legally buy tobacco products in the UK.

While the proposed bill won’t criminalise buying tobacco, shops selling cigarettes or vapes to children would be fined on the spot.

Labour supported the bill, but several Conservative MPs criticised the plans.

Conservative MP Sir Simon Clarke said Rishi Sunak’s plans to stop young people from ever smoking risks ‘making smoking cooler’ and ‘creating a black market’.

He told BBC Radio 4’s Today programme that he is ‘both sceptical and downright opposed’ to the plans.

The bill still needs to get through the scrutiny of the House of Lords before it becomes law.

If passed, it would be one of the strictest laws against smoking in the world. So, how does the UK compare to other countries?

The harshest anti-smoking laws in the world

No country has outright banned smoking, but Bhutan has come pretty close.

The tiny Himalayan country outlawed smoking in all public places in 2005, and five years later it banned the sale and production of tobacco in the country. Anyone selling tobacco faced three to five years in prison.

Close-up of a person smoking a cigarette.

However, in 2020, Bhutan lifted the ban in response to the Covid-19 pandemic.

The country wanted to keep its borders closed to protect people from coronavirus.

However, black market tobacco smugglers from India, where Covid-19 cases were high, tried to get into the country.

So, the tobacco ban was lifted to try to stop cross-border smuggling and limit the spread of the virus. However, the country still has laws in place to stop smoking in public places.

Mexico, where around 16% of the adult population smoke, also has some of the world’s strictest tobacco laws.

There’s a ban on smoking in all public spaces, including parks and beaches.

A person smoking on a beach.

It’s also banned at hotels, which means that the only place to legally smoke in Mexico is in private homes.

People caught lighting up – including tourists – could face fines of up to $300, which is around £241.

The country also has a complete ban on the promotion, advertising and sponsorship of tobacco products.

New Zealand’s smoking rollback

New Zealand would have joined Bhutan and Mexico as one of the world’s toughest smoking bans.

In 2022, the country announced plans to raise the smoking age year on year so that any born after January 2009 wouldn’t ever be able to buy cigarettes legally.

Woman giving up smoking and throwing cigarettes in to a bin

The proposed rules also set out banning the sale of cigarettes in supermarkets and creating special tobacco stores instead and lowering the legal amount of nicotine in tobacco products.

The new laws were due to come into effect in July this year.

However, when a new government came into power last year, New Zealand scrapped the ban .

The new Prime Minister Chris Luxon had previously been critical of the plans and had said that a ban would lead to a black market for tobacco.

The government said it would use the sale of cigarettes to fund tax cuts.

What about elsewhere?

More than 70 countries have anti-smoking laws.

In 2004, Ireland became the first country to ban smoking in workplaces.

Other countries, such as Spain, Greece and Hungary, soon followed.

The Portuguese government said that it wants to create a ‘smoke-free generation’ by 2040.

It plans to introduce laws to restrict the sale of tobacco products to licensed specialist shops and airport shops.

France banned smoking on beaches, outside schools and in forests and green areas.

In Sweden, only 6.4% of the population over 15 smoke daily – the lowest rate in the EU.

The government introduced policies such as taxes on cigarettes and restrictions on marketing to encourage people to give up the habit.

What about vapes?

Some countries have also banned e-cigarettes.

In December, the French parliament voted to plan single-use e-cigarettes.

Woman smoking an electronic cigarette on the street.

Meanwhile, in Australia, it’s illegal to import disposable vapes and e-cigarettes with nicotine in them will only be available to purchase with a prescription.

Mexico, Brazil and Argentina have gone even further. Along with 34 other countries, they have a complete ban on the sale of e-cigarettes.

In Thailand, those caught using an e-cigarette could face a fine or up to 10 years in prison.

What are the rules in the UK and what could change?

In 2007, the UK banned smoking in pubs, restaurants, nightclubs, workplaces and work vehicles.

The new law would not impact the 6.4 million adults in the UK who smoke today, but those born after 2009.

Prime Minister Rishi Sunak told the Conservative Party conference last year: ‘If we are to do the right thing for our kids, we must try and stop teenagers taking up cigarettes in the first place.’

MORE : Liz Truss’s book has some really boring anecdotes involving Stilton and Brian Clough

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You Can Still Smoke in Atlantic City Casinos. Workers Want to Ban It.

The New Jersey casinos are the last large refuge for smokers in the Northeast, but some employees say their health is at risk.

A woman smokes a cigarette while playing a slot machine.

By Erin Nolan

Atlantic City casino workers have tried unsuccessfully for years to persuade New Jersey lawmakers to outlaw smoking on gambling floors. On Friday morning, they took their efforts to court.

In a lawsuit filed in State Superior Court in Mercer County, groups representing thousands of casino employees accused state legislators of giving special treatment to casino owners by allowing them to let people smoke inside their facilities. The state has allowed casinos to “knowingly force employees to work in toxic conditions,” the workers argued in court documents, and as a result, casino workers have experienced “life-threatening illness and death.”

“Pretty much the worst thing we hear on this job is, ‘Can I have an ashtray?’” Lamont White, who has worked as a card dealer at numerous Atlantic City casinos since 1985, said in an interview. “Pretty much every worker in New Jersey is protected, except for casino workers.”

The lawsuit was filed against Gov. Philip D. Murphy and the state’s acting health commissioner, Kaitlan Baston. It asks the court to strike down the legal loophole exempting casinos from the statewide ban on indoor smoking.

Most states with legalized gambling prohibit smoking inside casinos. Even in states where it is allowed, some casino operators have banned it. Atlantic City, the nation’s most prominent gambling hub outside of Nevada, has become the last major refuge for smokers in the Northeast. (Most casinos in Las Vegas also allow smoking.)

The issue has long been contentious in New Jersey. In 2022, when legislation to prohibit smoking inside casinos was considered, the organization representing casinos opposed it. It argued that such a ban would be bad for business, at a time when they were contending with the lingering effects of the pandemic as well as the prospect of new competition from casinos in or around New York City.

But the Atlantic City casino workers said chronic exposure to “potentially deadly secondhand smoke” had caused them stress and health issues including cancer, asthma and heart disease. At least one worker, who did not smoke, died as a result of disease typically related to smoking, according to court documents.

A spokeswoman for the governor’s office said in a statement that the office does not comment on pending litigation, but she pointed to comments Mr. Murphy made during a televised interview in 2021.

“If legislation comes to my desk that would ban smoking in casinos, you should assume that I will sign it,” he said then.

The Casino Association of New Jersey declined to comment.

When state lawmakers passed the Smoke-Free Air Act in 2006, they prohibited indoor smoking virtually everywhere in New Jersey, but an exception was made for casinos.

The lawsuit was filed by the United Auto Workers, the union representing some casino workers, and an organization called Casino Employees Against Smoking’s Effects, or CEASE. In the suit, workers argue that the Smoke-Free Air Act, which cites health risks faced by employees exposed to secondhand smoke in the workplace, violates provisions of the New Jersey State Constitution that guarantee a right to safety and forbid lawmakers from passing “special laws” or granting “exclusive privilege” to corporations like casinos.

The “favoritism granted to corporate casinos,” they say in court documents, is “repugnant” and forces casino workers to “risk death and illness in order to work and provide for their families — unlike almost all other New Jersey workers.”

In 2022, a bill to ban smoking in New Jersey casinos appeared to have momentum but ultimately stalled.

Nicole Vitola, a founding member of CEASE and a dealer at the Borgata casino in Atlantic City, was among the workers who pushed for the casino smoking ban that year.

“We know there’s lawmakers who want this,” Ms. Vitola, 49, said. “But for some reason they are holding it back. This is another avenue we can try to do this, because every day we work in the smoke increases the chances we get sick.”

Nancy Erika Smith, a lawyer representing the workers, said forcing workers to expose themselves to secondhand smoke amounted to discrimination.

“It’s disgusting to sacrifice workers’ health because of some backroom politics where they don’t even have to explain themselves,” Ms. Smith said.

She argued that such a ban would not hurt the casinos’ bottom line and said the employees wanted the industry to be successful.

“Casinos are the economic engine of Atlantic City — nobody disputes that,” she said. “It’s almost a company town.”

An earlier version of this article misspelled the name of New Jersey’s acting health commissioner. She is Kaitlan Baston, not Kaitlin.

How we handle corrections

Erin Nolan is a reporter covering New York City and the metropolitan region. She is a member of the 2023-24 Times Fellowship class. Email her at [email protected] . More about Erin Nolan

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