More damned statistics

The latest Smoking Toolkit Study (STS) was published last week.

It includes the latest smoking rate (or 'cigarette smoking prevalence') for England which is estimated at 14.7%.

If it's accurate (there is a 95% confidence interval) it represents an insignificant drop of 0.1% from the 2020 figure of 14.8%.

Curiously the estimated smoking prevalence for Scotland has gone up from 13% in 2020 to 15.1% in 2021 but that stat seems to have gone under the radar.

In truth the 2020 figure of 13% seems unlikely because I've never known the smoking rate to be higher in England than in Scotland.

In contrast the estimated figures for Wales are 16.6% (2020) and 13.9% (2021) but the latter – which is 0.8% less than England – seems a bit odd too.

Perhaps it's the sample size.

The figures for England are based on 'representative samples of 1700-1800 adults (16+ years old)'. In Scotland the sample size was 450 (18+ years old) and in Wales it was just 300 (18+ years old) which may explain why the figures are so erratic.

I mention the STS figures because they follow the publication in November of data from the the Office for National Statistics’ Annual Population Survey that even the ONS said showed a 'sudden and implausible drop in adult cigarette smokers to 12.3% in April to December 2020'. (I wrote about it here.)

You can check the latest STS stats for yourself but they beg the question – who and what are we to believe?

It's important because government policy, including the long-awaited Tobacco Control Plan for England, will no doubt be influenced by the current trajectory of smoking prevalence.

Having set a target of becoming 'smoke free' by 2030, any suggestion that the long-term historical decline in smoking rates in England is stalling will almost certainly encourage even greater efforts to force smokers to quit.

With that in mind estimates of smoking prevalence need to be as accurate as possible, but are they?

As well as the figures being a trifle erratic, the STS can't even standardise the age range with 'adults' in England referring to those aged 16 and over but in Scotland and Wales it's 18+. Where’s the sense in that?

As for reduced risk products we're told that:

• Use of e-cigarettes in [the] adult population has remained relatively stable since late 2013

(The prevalence of e-cigarettes and heated tobacco use is currently 7.1%, as of October 2021, compared with 5.2% in October 2013. During that eight-year period it has dropped to 4.5% in October 2014 and 4.8% in January 2020, while peaking at 7.3% in July 2021. Is that 'relatively stable'?)

• Use of Juul and heated tobacco products is rare

• E-cigarette use by never smokers remains very rare but use among long-term ex-smokers has grown

• E-cigarette use in smokers and recent ex-smokers has plateaued

• Around half of e-cigarette users and the majority of NRT users are ‘dual users’ (also smoke)

Draw your own conclusions but it’s pretty clear that vaping has a long way to go before it overtakes smoking as a habit and should that day ever happen it will most likely be the result of coercion (more smokers forced to quit) rather than preference.

As an aside, the Smoking Toolkit Study is run by University College London (UCL) which also runs the Alcohol Toolkit Study.

Funding is provided by Cancer Research UK, the National Institute of Health Research (NIHR) and the Society for the Study of Addiction (SSA).

The STS team of 'investigators' includes Professor Robert West, a member of the Scientific Advisory Group for Emergencies (better known as SAGE), and Professor Susan Michie who, curiously, is a member of both SAGE and Independent SAGE.

West has been critical of the Government’s easing of Covid restrictions (face masks in particular) and last year it was reported that Michie wanted some regulations to stay in place in perpetuity.

According to the Daily Mail:

Social distancing and wearing face masks should stay forever, a Communist-supporting SAGE scientist has claimed.

Professor Susan Michie, of University College London, said she thinks the draconian restrictions should become part of people's every day routine.

Interestingly West and Michie are husband and wife having married in 2009.

I’m not suggesting any of this is relevant to the Smoking Toolkit Study (it isn’t) but it doesn’t surprise me that members of the tobacco control community are strong advocates of continuing Covid restrictions.

After all, governing people’s behaviour to the nth degree seems to go with the territory.

The question is, which mindset will prevail post Covid - the zero risk forever regulators or those who advocate a more liberal society, putting their faith in choice and personal responsibility?