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Smoking destroys lives, and does so from the point of conception. In 2014 smoking is likely to have caused the death of over 5000 unborn or newly born babies, over 20 000 babies to be born prematurely or with low birth weight, 40 sudden infant deaths and over 165 000 new cases of childhood illness.1 Smoking in England alone will have killed around 80 000 adults,2 caused nearly 500 000 admissions to National Health Service (NHS) hospitals2 and consumed around £5 billion of the NHS budget.3 The total financial cost of smoking to wider society will have been nearly £14 billion,3 £4 billion more than the tax that tobacco generates3 and around 15% of the current UK national budget deficit.4 Adult smoking will also have exacerbated adult and child poverty, and contributed to initiating the next generation of children into smoking.5 These health and social effects identify smoking as by far the largest avoidable cause of death and disability in the UK. Preventing smoking should therefore be the first priority of health and social policy.

The UK leads Europe in implementing tobacco control policy,6 and has achieved a profound reduction in the prevalence of smoking among adults, which in 2013 fell below 20% for the first time in nearly a century.7 However this prevalence figure translates into around 10 million UK adults alive today who smoke, and of whom half will die from their smoking unless they can be persuaded and helped to quit.8 The headline success in reducing smoking prevalence is also not universal across society, since smoking remains twice as common among people in unskilled and manual occupations than in professional and managerial groups,2 and much higher still …