Smoking is responsible for nearly twice as many cancer cases in lower-income groups compared to higher-income groups, new estimates by Cancer Research UK show.
Over 11,000 cases of cancer were linked to smoking in the lowest-income group, compared to around 6,000 in the highest.
More than 27,000 cases of cancer a year in England are associated with poverty, Cancer Research UK said.
People living in more impoverished areas are 2.5 times more likely to smoke than those in higher-income areas and find it harder to quit, contributing to major health inequalities.
Experts think this is probably due to a mix of factors such as exposure to cigarettes, tobacco industry targeting, housing and income pressures, access to health and social care, information and education.
The study found that, of the 27,000 cases of cancer, if smoking inequalities were removed and smoking rates were the same for everyone, around 5,500 of these cases could have been prevented each year.
Public health expert Linda Bauld believes public health services have a vital role to play in combating this inequality.
“It’s not a case of just telling people to stop smoking — going cold turkey doesn’t work for everyone. People who smoke shouldn’t be blamed but need support and the right tools to help them quit.”
She said: “Smoking has accounted for more deaths than Covid-19 in the past year.
“Public health and prevention services play a vital role in tackling health inequalities as well as improving health and well-being across England. This has come into even sharper focus since the pandemic, which has exposed where investment in these services has fallen behind.”
The UK government has set a goal for England to become smoke-free by 2030, but there is a clear socio-economic divide that needs to be addressed: the poorest groups are not on track to achieve this goal until the mid-2040s, while the richest are expected to achieve it in 2025.
Despite this, Stop Smoking Services, which give smokers the best chance of quitting, have continuously had their funding slashed, and public health campaigns, which motivate people to stop smoking, have been cut.
Some experts believe one solution could be a Smoke-free Fund — making tobacco companies cover the costs of the damage caused by smoking but without their involvement on how the money is spent — would be a much-needed new source of funding to help people stop smoking.
It would also mean more of the public health budget would be available for use in other important areas of public health. It would also vitally reduce the cost of smoking-related illnesses to the NHS in the future.
“It’s very concerning that smoking causes more cancer cases in more deprived groups. The upcoming tobacco control plan for England is a key opportunity for the government to tackle smoking rates as well as the long-standing, unacceptable health inequalities that exist across the country,” said Cancer Research UK’s chief executive, Michelle Mitchell.
“But this can only be achieved if there is sufficient additional investment into tobacco control. A Smoke-free Fund — using tobacco industry funds, but without industry interference — could pay for the comprehensive measures needed to reduce smoking rates across all socio-economic groups.”