A recent report issued by the Royal College of Physicians says that tobacco smoking could be practically eradicated by 2025, but only if the Government was prepared to take far more radical measures to combat smoking.

In their report "Ending tobacco smoking in Britain: Radical strategies for prevention and harm reduction in nicotine addiction" it says that the conventional approaches to combating smoking that have been at the core of the public health strategy in the UK, such as increasing cigarette tax, advertising restrictions, the smoking ban, public awareness campaigns and cessation programmes are likely to deliver a drop in smoking prevalence of only between 0.5 and 1.0 percentage points per year.

Without any shift in policy it would therefore take between 11 and 22 years for the smoking rates to even halve from the current 22% to 11% or, in absolute terms, from 10 million to 5 million people.

The report argues that much more could and should be done to make smoking as unappealing and unacceptable as possible, and importantly, to make alternative, less hazardous nicotine products as affordable and attractive as possible.

The report therefore calls for the introduction of a wide range of newer and more radical measures on smoked tobacco, existing and new medicinal nicotine products, and non-medicinal smoke-free nicotine products.

The most important measures include:

· Annual increases of tax on tobacco by 10%
· Licensing of tobacco retailers and prohibition of the sale of smoked tobacco products in premises accessible to children
· Crack down on tobacco smuggling, and apply Class A drug penalties for tobacco smuggling and under-age sale
· Protect children from exposure to smoking role models in the media
· Existing medicinal nicotine products: To make this product group as available and attractive to smokers as possible, and to encourage smokers to switch as completely as possible to use of medicinal nicotine instead of smoking
· Encourage sale of low cost single day nicotine packs, available
· Encourage and promote commercial competition to make medicinal nicotine attractive and affordable
· Permanently exempt medicinal nicotine from VAT
· Provide free medicinal nicotine for all smokers on the NHS, not just those on a smoking cessation programme
· New medicinal nicotine products: Encourage development and marketing of new medicinal nicotine products that are more acceptable and satisfying alternatives to smoking than current products
· Encourage development of products that deliver doses of nicotine as quickly as cigarettes
· Remove unnecessary restrictions and regulations that currently inhibit development of new, more effective cigarette substitutes
· Make these products widely available to smokers at competitive prices
· Non-medicinal smoke-free nicotine products: Realise any benefit that smokeless tobacco and other potential nicotine sources might offer as reduced hazard alternatives to smoking, while minimising the hazard to users by:
· Allowing restricted marketing of products for which there is evidence of efficacy as a smoking substitute from randomised clinical trials, and for which potential hazard has been

The report also calls for the establishment of a new Nicotine Regulatory Authority, independent from the tobacco and pharmaceutical industries, to implement these changes, monitor their impact on smoking behaviour, and tasked to reduce the prevalence of smoking as quickly as possible.

Professor John Britton, Chair of the RCP Tobacco Advisory Group, said:
"Smoking is still the biggest public health problem in the UK, and a problem of this magnitude and importance demands radical and effective action to prevent any further avoidable loss of life. Our governments have shown themselves more than willing to react decisively to other public health problems, but despite the progress of the past 10 years, still do not seem willing to take all the actions in their power to prevent children from starting to smoke, or encourage existing smokers to quit. The UK has led the world in many areas of public health in the past; here is our opportunity show the world that tobacco smoking can be driven out of our society."

Professor Ian Gilmore, President of the Royal College of Physicians, said:
"As a country, we have a real opportunity to build on previous steps, and I believe the public are ready for strong action. They would support bold government in resolute steps to attack what remains the number one threat to the nation's health, smoking."

The report is available to download free from the Royal College of Physicians website.