Smoking-related cancer twice as prevalent among poor in England

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Smoking-related cancer twice as prevalent among poor in England

Overall cancer rates are higher among the wealthy, finds Cancer Research UK – but smoking and its cancers are now concentrated among the poor

Last modified on Mon 2 Aug 2021 19.03 EDT

Smoking causes almost twice as many cancer cases among the poor than the well-off, according to new findings that underline the close link between cigarettes and deprivation.

About 11,247 cases of cancer caused by smoking are diagnosed among the poorest 20% of people in England each year, but far fewer – 6,200 – among those in the top 20% income bracket.

Cancer Research UK, which produced the estimates, said the findings underlined why ministers should impose a levy on tobacco firms to help fund the cost of helping tobacco addicts to quit.

“It’s very concerning that smoking causes more cancer cases in more deprived groups,” said Michelle Mitchell, Cancer Research UK’s chief executive.

The difference in cancer incidence between rich and poor is so great that, combined with cuts to stop-smoking services in recent years, it threatens the government’s target of England becoming smoke-free by 2030, she added.

The number of people smoking would need to fall from its current record low of 15.5% to just 5% in order for that ambition to be achieved. While the proportion of people lighting up has fallen significantly over the last 20 years, it is increasingly concentrated among poorer groups.

People in the most deprived communities are two and a half times more likely to smoke than the top fifth of people by income, which is the main reason for the greater number of cancers there, CRUK said.

“This stark differential in cancer rates exists because of the iron chain linking smoking and disadvantage. Around a quarter of those who are unemployed or in routine and manual occupations smoke, compared with fewer than one in 10 working in management or the professions,” said Deborah Arnott, chief executive of the anti-smoking charity ASH.

Analysis by CRUK found that about 53,227 cancers a year are diagnosed among the poorest 20% of people in England as measured by the Office of National Statistics’s index of multiple deprivation. Of those, an estimated 11,247 – 21% of the total – are caused directly by smoking, it said.

More cancer cases occur in the wealthiest 20% – an estimated 63,828. However, far fewer of them – 6,200 – are the result of someone smoking, and they represent a much smaller percentage (10%) of all cases of cancer that occur in that part of the population.

Prof Linda Bauld, a public health expert at Edinburgh university, said: “This new study found that more cancer cases are caused by smoking in the most deprived 20% of the population. This is due to more people smoking in this group, likely because of several factors such as exposure to smoking, access to cigarettes, tobacco industry marketing, housing and income pressures, and access to health and social care, information and education.”

Arnott backed CRUK’s call for tobacco companies to be forced to contribute to a smoke-free fund, based on “the polluter pays” principle. “Tobacco manufacturers make extreme profits off the backs of the poor. The time has come to make them pay to end the epidemic that they and they alone have caused,” she said.

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