Radical plans to clamp down on the way cigarettes are sold are being considered by the government in an effort to tackle historically high levels of smoking among teenagers.
The blueprint for making cigarettes harder to buy, particularly for young people, have been drawn up by leading doctors and will now be evaluated by the Department of Health.
The sale of packs of 10 cigarettes - attractive to teenagers because they are cheaper - would be banned and cigarettes kept out of sight in shops.
A fifth of teenagers are described as 'regular smokers', a number that has remained stubbornly high despite government public health campaigns.
The proposals, contained in a report from the British Medical Association, also include plans to compel retailers to obtain licences to sell tobacco, to outlaw tobacco vending machines and impose regular and above-inflation price increases to try to cut demand.
'We want to maintain the momentum brought about by the ban on smoking in public places in England coming into force on 1 July and initiatives like this we would want to look at,' said a senior source at the Department of Health last night.
The far-reaching suggestions from the BMA's board of science are intended to reduce the harm which adult smoking does to children. Its report, 'Breaking the Cycle of Children's Exposure to Tobacco Smoke', stresses that parental smoking has a profound impact on the health of offspring, through inhalation of second-hand smoke, house fires caused by cigarettes and encouraging youngsters to regard smoking as normal. Having parents who smoke increases the chance of young people smoking.
In addition, doctors, nurses, health visitors and midwives should do more to warn parents who smoke of the risks their habit pose for their children, it says. 'Parents who smoke should be encouraged and helped to quit smoking and to adopt smoke-free homes if they continue to smoke,' the report says.
The measures are intended to reduce what the Treasury has estimated is the 80 billion cigarettes bought in the UK every year and, over time, cut the annual toll of about 112,000 deaths - 70,000 in men and 42,000 in women - linked to smoking. About 1,000 people a day are admitted to hospital in England alone suffering from smoking-related diseases such as cancer, heart disease and respiratory problems.
Although only a quarter of British adults smoke, almost half the country's children are exposed to tobacco smoke at home, according to research by Cancer Research UK, the leading cancer charity. The Royal College of Physicians estimates that more than 17,000 children under five are admitted to hospital every year because of passive smoking.
Dr Vivienne Nathanson, the BMA's head of science and ethics, said: 'Cigarettes must be made more inaccessible to children. By banning 10-pack cigarettes and vending machines, and making tobacco more expensive, fewer children will be able to buy them.
'It's essential we break the tobacco trap. Young smokers will become tomorrow's parents who smoke and they will continue the cycle of smoking-related ill-health and premature death.'
France, the Republic of Ireland, Canada and Australia have already banned the sale of 10-packs, while Norway and New Zealand are considering compelling shops to adopt a 'total non-public display' policy for cigarettes.
Four Australian states operate the scheme advocated by the BMA, under which places that sell cigarettes must be licensed. The Department of Health will study evidence about those places, the source added.
Nathanson said: 'Forcing shops selling cigarettes to have a licence, the way off-licences to do to sell alcohol, would be a public recognition of the dangers of tobacco. Cigarettes aren't like milk or bread, where anyone can and should be able to sell them. Cigarettes aren't as dangerous as guns, but they kill more people than alcohol or guns in the UK and we need to change the culture of cigarette-buying by recognising that.'
Cancer Research UK last night endorsed the broad thrust of the BMA's proposals. Elspeth Lee, its tobacco control manager, welcomed the report as a useful contribution to the debate about smoking after 1 July.
The board of science considered making recommendations aimed at parents who smoke at home or in their cars, potentially opening itself up to charges of undue interference in family life, but instead limited itself to calls for greater help for smokers wishing to give up.
This week the Action on Smoking and Health pressure group will highlight what it claims are the dubious and unethical ways in which cigarette manufacturers market their products. It intends to picket Thursday's annual meeting of British American Tobacco, the world's second largest tobacco firm, to draw attention to allegedly unscrupulous practices and flouting of agreements on marketing techniques through, for example, using the design of cigarette packets to entice buyers.
