The 2011 General Lifestyle Survey Overview report marks 40 years of results from a continuous household survey.
The General Household Survey (GHS) and General Lifestyle Survey (GLF) have been monitoring smoking prevalence for over 35 years. The 2011 survey included questions on cigarette consumption, type of cigarette smoked, how old respondents were when they started smoking, and dependence on cigarettes.
How the data are used and their importance
Smoking is the leading cause of preventable illness and premature death in Great Britain; therefore reducing its prevalence has been a key objective of Government policy on improving health. There have been a number of policy initiatives (including new legislation) aimed at reducing the prevalence of cigarette smoking, which are outlined below. Such initiatives have been informed by GHS/GLF statistics on smoking.
In December 1998 Smoking Kills – a White Paper on tobacco was released, which included targets for reducing the prevalence of cigarette smoking among adults in England to 24% by 2010. In 2004 the Department of Health (DH) agreed a Public Service Agreement (PSA) which revised the target downwards: to reduce the prevalence of cigarette smoking among adults in England to 21% or less by 2010. In 2010 the white paper Healthy Lives, Healthy People set out the Government’s long term policy for improving public health and in 2011 a new Tobacco Control Plan was published. The plan sets out national ambitions to reduce smoking prevalence in England. For Scotland, the 2008 Smoking Prevention Plan: Scotland’s Future is Smoke-free also detailed a programme of measures designed specifically to encourage children and young people not to smoke.
The GHS/GLF time-series statistics are used to understand the impact that legislative changes have had on smoking. Legislation came into force in February 2003 banning cigarette advertising on billboards and in the press and magazines in the UK, restrictions on advertising at the point of sale were introduced in December 2004, and regulations came into force in 2011 banning tobacco displays. Legislation prohibiting smoking in enclosed work and public places came into force in Scotland during the spring of 2006 with similar legislation introduced in England and Wales in 2007. On 1 October 2007 it became illegal in Great Britain to sell tobacco products to anyone under the age of 18.
As outlined above, the GHS/GLF smoking estimates are mainly used to inform Government policy with respect to health; however, there are some other important uses. For example, Her Majesty’s Revenue and Customs (HMRC) uses GLF data for its estimates of the illicit tobacco market. These estimates are used to calculate the overall indirect tax gap to inform HMRC’s contribution to the Treasury’s fiscal policy decisions. HMRC also use GLF data for developing and measuring its tobacco fraud strategy.
This chapter presents data on the prevalence of cigarette smoking in Great Britain in 2011, as well as information on trends in smoking over time.
The reliability of smoking estimates
It is likely that the survey underestimates cigarette consumption and, perhaps to a lesser extent, prevalence (the proportion of people who smoke). For example, evidence suggests (Kozlowski, 1986) that when respondents are asked how many cigarettes they smoke each day, there is a tendency to round the figure down to the nearest multiple of 10. Underestimates of consumption are likely to occur in all age groups. Under-reporting of prevalence, however, is most likely to occur among young people. To protect their privacy, particularly when they are being interviewed in their parents’ home, young people aged 16 and 17 complete the smoking and drinking sections of the questionnaire themselves, so that neither the questions nor their responses are heard by anyone else who may be present2.
Notes to this section
Kozlowski L T, Pack size, reported smoking rates and public health, American Journal of Public Health, 76 (11) pp1337–8 November 1986.
See Chapter 4, General Household Survey 1992, HMSO 1994. This includes a discussion of the differences found when smoking prevalence reported by young adults on the GHS was compared with prevalence among secondary school children.
Respondents to the GHS aged 16 and over were asked questions about smoking behaviour in alternate years from 1974 to 1998. Following the review of the GHS carried out in 1997, the smoking questions became part of the continuous survey and have been included every year from 2000 onwards. Note however, that in order to keep the tables in this report to a manageable size they only show data from each fourth year from 1974 to 1998.
The prevalence of cigarette smoking has fallen over the last four decades. In 1974, 45% of the adult population of Great Britain were cigarette smokers compared with 20% of adults in 2011.
The difference in smoking prevalence between men and women has decreased considerably since the 1970s. In 1974 there was a ten point difference between men and women, 51% of men smoked cigarettes compared with 41% of women, whereas in 2011 there was only a two point difference between them (21% of men compared with 19% of women).
Over the last 30 years there have been falls in the prevalence of smoking in all age groups. Since the survey began, the GHS/GLF has shown considerable fluctuation in smoking prevalence among those aged 16 to 19, particularly if young men and young women are considered separately. However, this is mainly because of the relatively small sample size in this age group and occurs within a pattern of overall decline in smoking prevalence in this age group from 31% in 1998 to 18% in 2011.
In 2011 the prevalence of cigarette smoking varied according to marital status. Smoking prevalence was lower among married people (15%) than among those who were single (25%); cohabiting (32%); widowed, divorced or separated (21%). This is not explained by the association between age and marital status, as in every age group (with the exception of those aged 16-24 years), married people were less likely to be smokers than other respondents.
The socio-economic status of the household reference person (HRP) is also a factor by which cigarette smoking varies. The socio-economic classification (NS-SEC) used in this report is based on information about people’s occupation and employment status (please see Appendix A, Definitions and terms for further information). In 2011 smoking prevalence was highest in households where the HRP was in the routine occupation category (31%) and lowest in households where the HRP was in the large employers and higher managerial and the higher professional occupation categories (10%).
Estimates comparing adults in employment with those who are unemployed and those who are economically inactive are shown in Table 1.22. Smoking prevalence among unemployed adults was 35 % compared with 18% of adults who were economically inactive and 19% of adults who were in employment. The low figure among the economically inactive is due to the high proportion of this group who are aged 60 or over. Among those aged less than 60 in this group, smoking prevalence was higher than it was among those in employment except for those aged 16-24.
Smoking was more common in Wales and in Scotland in 2011 than it was in England; prevalence in England was 19%; in both Wales and Scotland prevalence was 24%. Smoking also varied by region of England. For example, smoking prevalence was higher in Yorkshire and the Humber and the North West (both 21%) than it was in London (16 %).
The overall fall in smoking prevalence in Great Britain since the mid 1970s has been due to a fall in the proportions of both light to moderate smokers (defined as fewer than 20 cigarettes per day) and heavy smokers (20 cigarettes or more per day). The proportion of adults smoking heavily fell between 1974 and 2011, from 26% to 6% among men and from 13% to 4% among women. Over the same period the proportion of light to moderate smokers fell from 25% to 15% for men and from 28% to 15% for women.
In all age groups in 2011, respondents were much more likely to be light to moderate than heavy smokers, the difference was most pronounced among those aged under 35. For example, 22% of men and 18% of women aged 25 to 34 were light to moderate smokers in 2011 and only 4% and 3% respectively were heavy smokers.
The average number of cigarettes smoked by men and women has changed little over the last 40 years. Consistently, men have smoked more cigarettes, on average, per day than women: in 2011 men smoked an average of 13 cigarettes a day compared with 12 for women. The average number of cigarettes smoked per day by men has slowly declined since the early 1980s, from 17 in 1982 to 13 in 2011. Among women the average number of cigarettes consumed per day has remained constant, since 1974, staying between 12 and 14 cigarettes. Among both men and women smokers, cigarette consumption varied by age. The highest average was 16 cigarettes per day among men in the 50 to 59 age group.
In 2011 smokers in households where the HRP was in a routine or manual occupation smoked an average of 14 cigarettes per day compared with 11 per day for households where the HRP was in the managerial or professional occupation. This is unchanged from 2010.
Cigarette smokers were asked whether they mainly smoked filter-tipped, plain or hand-rolled cigarettes. Filter cigarettes continue to be the most widely smoked type of cigarette, especially among women (74% of women and 59% of men smokers smoked filter-tipped cigarettes). There has been a marked increase since the early 1990s in the proportion of smokers who smoke mainly hand-rolled cigarettes. In 1990, 18% of men smokers and 2% of women smokers smoked hand-rolled cigarettes. In 2011, 40% of men and 26% of women smokers said they smoked mainly hand-rolled cigarettes, the highest levels recorded on the GHS/GLF.
It should be noted that this increase in the proportion of smokers smoking mainly hand-rolled tobacco coincides with a fall in the prevalence of cigarette smoking from 30% in 1990 to 20% in 2011. Therefore, the proportion of all adults who smoke hand-rolled tobacco has not increased quite so sharply: it rose from about 3% to about 6% over this period (no table shown).
The White Paper Smoking Kills noted that people who start smoking at an early age are more likely than other smokers to smoke for a long period of time and more likely to die from a smoking-related disease. Two-thirds (66%) of adults who were either current smokers or who had smoked regularly at some time in their lives had started smoking before they were 18 years of age. Two-fifths (40%) had started smoking regularly before the age of 16 even though it has been illegal to sell cigarettes to people aged under 16 since 1908 and has recently become illegal to sell cigarettes to people under 18 years of age. Men were more likely than women to have started smoking before they were 16 years of age (43% of men who had ever smoked regularly compared with 37% of women in 2011).
Since the early 1990s there has been an increase in the proportion of women taking up smoking before the age of 16. In 1992, 28% of women who had ever smoked started before they were 16 years of age; in 2011 the corresponding figure was 37%. Since 1992, the proportion of men who had ever smoked and had started smoking regularly before the age of 16, has stayed constant at approximately 40%.
In 2011, as in previous years, there was an association between age started smoking regularly and the socio-economic classification of the HRP. In managerial and professional households, 31% of smokers started smoking before they were 16 years of age compared with 45% of those in routine and manual households.
Current heavy smokers (20 or more cigarettes a day) were more likely than current moderate (10 to 19 cigarettes a day) or light smokers (fewer than 10 cigarettes a day1) or ex-smokers to have started smoking at an early age. Among current heavy smokers, 58% started smoking regularly before they were 16 years of age compared with 44% of current moderate smokers and 35% of current light smokers.
Since 1992, the GHS/GLF has asked three questions relevant to the likelihood of a smoker giving up. First, whether they would like to stop smoking, and then two indicators of dependence: whether they think they would find it easy or difficult not to smoke for a whole day and how soon after waking they smoke their first cigarette. There has been little change since 1992 in any of the three measures.
In 2011, 63% of smokers said they would like to stop smoking altogether and 60% of smokers felt that it would be either very or fairly difficult to go without smoking for a whole day. Not surprisingly, heavier smokers were more likely to say they would find it difficult; 81% of those smoking 20 or more cigarettes a day did so compared with only 32% of those smoking fewer than 10 cigarettes a day7.
Smokers in routine and manual households were more likely than those in managerial and professional households to say they would find it difficult to go without smoking for a whole day (63% compared with 52%). However, once amount smoked was taken into account (smokers in the routine and manual group smoke more on average than smokers in other social classes) the pattern of association is less clear.
Among adult smokers, 16% had their first cigarette within five minutes of waking up. Heavy smokers were more likely than light smokers to smoke within five minutes of waking up: 35% of those smoking 20 or more cigarettes did so, compared with only 3% of those smoking fewer than 10 a day.
Overall, smokers in managerial and professional households were less likely than those in routine and manual households to have had their first cigarette within five minutes of waking than those in routine and manual households (10% compared with 18%).
Women aged 16 to 49 where asked whether or not they were pregnant at the time of interview. Pregnant women were less likely to be smokers than women who were not pregnant or unsure if they were pregnant. For example, among women aged 16 to 49, 8% of pregnant women were smokers compared with 23% of women who were not pregnant or unsure if they were pregnant. Among women aged 16 to 49, pregnant women were more likely than women who were not pregnant or unsure if they were pregnant, to be ex-smokers (34% compared with 17%) suggesting that many women give up smoking when pregnant.
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