Smoking is inextricably linked to poverty, according to the campaigning group Action on Smoking and Health (Ash), which today launches interactive maps revealing the close match between cigarette consumption and deprivation.
Derek Wanless, the former chief executive of the NatWest Group who carried out the health trends review for the government, found that 48% of men in the poorest social class died before they reached 70, compared with 22% of men in the richest social group. Half of that difference, he estimated, was accounted for by smoking.
The maps, available online, show how even relatively small areas of deprivation coincide with areas of heavy smoking. In the Princess ward of Knowsley, Merseyside, said to be the most deprived area of England, 52% of the population smoke, compared with a national average of 26%. Three of the other four most deprived wards are in Liverpool and the last is in Manchester. Smoking rates there are between 42% and 46%.
By contrast, in the least deprived ward - Keyworth North, in Rushcliffe in the east Midlands - only 12% of the population smoke. The four other least deprived are in East Hampshire, Chiltern, Eastleigh and Surrey Heath. Their smoking rates are between 12% and 18%. Ash points out that smoking 20 cigarettes a day costs between £1,600 and £1,800 a year, which means that poorer smokers spend proportionately much more of their income on their habit than wealthier ones do.
In 2003, it says, the poorest 10% of households spent 2.43% of their income on cigarettes a week, while the richest 10% spent 0.52%. Among the most deprived groups, which include lone parents on state benefits, three out of four families smoke, says Ash. They spend a seventh of their disposable income on cigarettes.
The mapping project, says Deborah Arnott, director of Ash, "shows the iron chain that links smoking and deprivation. Smoking is the biggest killer in England, and it kills more people in poorer communities than in richer ones.
"This project shows once again why smoking must be top of the list of concerns for everyone who cares about tackling poverty and social exclusion."
Ash says it hopes the legislation to stop smoking in enclosed public places by next summer will help reduce the gap in smoking-related ill-health between deprived and more affluent areas. But it calls for primary care trusts to give anti-smoking initiatives top priority and wants to ensure smoking cessation programmes will not stop because of NHS funding problems.
The data on smoking rates comes from a study by the Institute for the Geography of Health at Portsmouth University for the Health Development Agency. The deprivation index scores are produced by the Department for Communities and Local Government.
The maps are available at www.ash.org.uk/html/mappingproject/mappingproject.html
