It's harder to stop than to start!

There have been many indications from central government that schools are expected to play a major part in improving children’s health. The White Paper on Public Health, November 2004, set out action for supporting children and young people to attain good physical and mental health and ensuring that children understand the opportunities and risks in choices that have an impact on their health. Every Child Matters has Being Healthy as one of its five core messages.

So schools cannot duck the issue. Quite apart from the health dimension, there may also be some link to academic performance. Although there are clearly some individuals who are smokers but who perform well, in general young people who smoke do less well at GCSE. Statisticians point out, of course, that this may not mean that the actual act of smoking reduces academic performance but rather that there is an underlying cause of children smoking and doing less well at school, for example, poverty, domestic upset, peer group pressure etc. In other words, the link may be correlational but not causal.

Another worrying fact is that, at 15, more girls are smoking than boys. (This is about the only area in which boys emerge in a better light than girls at this age!) Girls who are addicted smokers find it difficult to give up when they become pregnant in spite of all the best efforts of the ante-natal staff in hospitals. In general, smoking mothers produce smaller babies which are less likely to do well in school and are more likely to become smokers later on in their lives. The cycle of health deprivation linked to smoking is extremely depressing.

• 43% of pupils who had truanted in the past 12 months had smoked in the past week compared with 7% of pupils who had not missed school

On top of all that, cigarette smoking is often the gateway to other more immediately harmful drugs. Only 2% of those taking hard drugs have not previously been cigarette smokers.

The case for delaying the onset of smoking is overwhelming. Schools have an important part to play: they set standards, enforce constraints (for example, punishing not only a smoker caught in flagrante but also anybody standing with them, in order to challenge the peer group effect), they give out messages to parents and work with local enforcement agencies (usually Trading Standards) to identify shops that sell to under-age smokers.

It has to be recognised that there are people who believe quite sincerely that putting concerted pressure on a minority only serves to reinforce their activity. It is as though ‘persecution’ hardens commitment to a cause. A number of my former secondary school headteacher colleagues used to say that they preferred a softer approach. High profile blitzes, powerful assemblies, extensive poster campaigns, gruesome carcinogenated lungs in jars, harsh punishments – all these, they said, only served to add kudos to the rebellious minority.

There are also concerns among primary teachers of a too heavy-handed approach to the topic in the classroom with younger pupils. Giving the message that smoking is bad for you is hard to take for a seven-year-old from a home where the parents and older siblings smoke regularly. Some hard-liners unashamedly say that it is a good way to put pressure on smoking parents. Other more sensitive souls worry about creating tensions within young minds about the mismatch between what they are told at school and what they experience at home.

We should not mislead ourselves into thinking that this change in the law, if indeed it comes about, will solve the entire problem. It is going to take many more measures (increase in taxation, no publicity at point of sale, no smoking in films or television plays, for example) before we can get the proportion of the smoking population down further from its current 25%.

Surveys show that 75% of people who smoke wish they didn’t and want to give up. But giving up is more difficult than starting. Logically therefore, we must direct our efforts at dissuading people from starting in the first place. Government can’t do it alone; schools must play their full part too.

Peter Downes was a comprehensive school headteacher for 21 years. He is now a school governor of an infant school and a special school and is a county councillor in Cambridgeshire. The opinions expressed are personal.

The statistics on these pages are taken from the survey Drug Use, Smoking and Drinking Among Young People in England in 2005, carried out for the Information Centre for Health and Social Care by the National Centre for Social Research and the National Foundation for Educational Research.

Strategies to support raising the minimum age for buying cigarettes

• Enhanced levels of government support for proof of age schemes ensuring that every young person receives a standard proof of age card that is recognisable by retailers across the country.
• Mass media campaigns to raise awareness of the reasons for raising the minimum age, addressing the needs of three different audiences: the general population, retailers and young people – especially those caught in the 17-18 age range who will be directly hit by the new law.
• School and community based education schemes, designed to explain very clearly the reasons for the change. Without this there could be the likelihood of violence against retailers who refuse sales to hardened smokers of 16 and 17.
• Appropriate cessation support for young people who want to give up smoking. This provision must be targeted and specific; using the same method as with adults is not effective. Young people centred services are available for support with alcohol, illegal drugs and sexual health. The lack of these services for smoking cessation further undermines the message that smoking tobacco is the largest preventable cause of death in the UK. Many do not believe it is a real and immediate heath risk as cessation provision is not available to them.
• Regular compliance checks will need to be in place, ie test purchasing.