Matthew Evison, consultant in respiratory medicine at Wythenshawe Hospital, explains why he’s grateful for the work of the NHS, councils and other partners across Greater Manchester to keep illegal tobacco out of our communities.

The hardest part of being a doctor is undoubtedly seeing illness so close first-hand. Every day, I see the damage smoking causes to every organ in the body. Smoking causes heart attacks, strokes, diabetes, 16 different types of cancer and lung disease.

2020 has been a tough year for my colleagues, as it has for many people; COVID-19 has brought some very intense pressures and demands like we have never seen before. However, even without a pandemic, every day across our city region, we know that 14 people die too soon from a smoking related illness. That’s over 4,780 deaths to date in 2020. And for every smoking death there are 30 times as many people living with smoking related diseases.

I would say the hardest part of my job is the awful moment when I tell patients they have a disease caused by smoking, like lung cancer, which may shorten their life. You see the fear and desperation in that person and their fear for what it means for their loved ones. Their first thought is often how they are going to tell their children or loved ones.

Most smokers will have tried to quit before, and possibly resisted when someone advised them to quit. I worry whether the health care system has provided them with enough help to stop smoking, whether that person has had the opportunity to try the many different highly effective treatments we have. But what tends to go through both our minds is remembering those missed opportunities and wishing it hadn’t reached this moment. It’s devastating.

I think you would struggle to find many families in Greater Manchester who have not lost a loved one or seen someone’s health suffer because of smoking. I’m pretty confident that if tobacco was invented today, people would ask why something that eventually kills one in two British customers would be allowed onto the market. Its is the ONLY consumable product that when taken directly as instructed and intended, leads to your death. However, tobacco products are legal and I will be working with colleagues across the region to help people break the addiction.

Quitting smoking is the single best thing you can do for your health and quitting is worth it even if you’ve been diagnosed with a smoking-related illness because it can improve your outcomes hugely.

It’s clear that all tobacco kills – whether legal or illegal, hand rolled or cigarette sticks. It’s all the same – toxic and cancer causing. But a common theme I see is the role illegal (smuggled or fake) tobacco has to play in getting people started on smoking and undermining smokers’ attempts to quit. This is because illegal tobacco sellers will sell to children under 18, and illegal tobacco’s cheaper price means smokers find it harder to stop a habit they can afford.

I don’t care what people say about illegal sellers and dealers fulfilling a demand, or getting one up on the taxman. At the end of the day, they are just making money from an addiction that will end in misery and disease for thousands of people.

You might not have given much thought to illegal tobacco or realised that the issue is about so much more than lost duty. NHS and councils across the region are working together to keep illegal tobacco out of our communities because it is a route into smoking for many and because it prevents many people from quitting. The human cost of these ‘cheap’ products is also high with links to human trafficking and wider crime across our city region and beyond.

Greater Manchester organisations are working to protect our neighbourhoods from the harms of illegal tobacco. I think back to those moments of telling people they have lung cancer. It is hard but I use it as motivation to prevent the next person being in that room with me. That’s why I’m encouraging anyone who cares about local families to anonymously get in touch with any information about where illegal tobacco is being sold. Please report illegal tobacco at or via the Crimestoppers line, 0800 555 111.

Smokers can visit to find information and details of stop smoking services and support across all ten boroughs of Greater Manchester or call the NHS Stop Smoking helpline free on 0300 123 1044.





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