24 November 2004

S2M-2003 Lung Cancer

Scottish Parliament

Wednesday 24 November 2004

[THE DEPUTY PRESIDING OFFICER opened the meeting at 14:30]

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Lung Cancer

The Deputy Presiding Officer (Trish Godman): The final item of business is a members' business debate on motion S2M-2003, in the name of Irene Oldfather, on lung cancer awareness month. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes that November is Lung Cancer Awareness Month, the Macmillan Cancer Relief and the Roy Castle Lung Cancer Foundation's month-long campaign to raise awareness of lung cancer and highlight the message that early diagnosis saves lives; recognises that lung cancer is now the United Kingdom's biggest cancer killer with 94 people a day dying from the disease; recognises that people are 40 times more likely to survive if the disease is detected early on; congratulates NHS Ayrshire and Arran on its innovative Smoking in Schools scheme whereby health advisers visit secondary schools across North Ayrshire to educate them on the dangers of tobacco smoke and to offer cessation services for young people who have already taken up the habit; recognises the importance of educating our young people on the dangers of tobacco smoking; looks forward to the future development of this scheme, and welcomes the Scottish Executive's plans to increase support for those wishing to stop smoking and to ban smoking in public places, which will help reduce cases of lung cancer in Scotland.


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Stewart Stevenson (Banff and Buchan) (SNP): I thank Irene Oldfather for providing the opportunity for members to speak on such an important subject.

I want to tell members about an ambition that I have, which I think that we would say that we all share, if we were being honest. I have an ambition to die healthy. That means that I want to go suddenly and to live an absolutely healthy life up to the end. I knew a 80-year-old lady who had had barely a day's illness in her life. She was climbing a Munro with a group of friends and dropped dead from her first illness in a couple of decades—she had not even had a cold in that time. That was a perfect way to go. People who are afflicted by the addiction that is tobacco can rarely choose when to die.

I have made some positive choices. I do not smoke now, although, like many others, I used to do so. When I was 51, my blood pressure was 140 over 90. Earlier this month, at age 58, it was 128 over 60, which is not too bad and is heading the right way. Coming to the Parliament has therefore been good for me, if not necessarily for anyone else. I also eat lots of fruit, as the Executive implores me to do.

When I was 17 and 18 and between school and university, I worked in a psychiatric hospital. I worked in the hospital ward, where the physically ill psychiatric patients came. During that time, I sat with someone who was dying of lung cancer. Believe me, there can be no greater spur to wanting to die healthy than my experience of 40 years ago.

Lung cancer in Scotland is, of course, a continuing concern. According to the statistics, its incidence is decreasing in males—we are slowly starting to get the message. The incidence of smoking and, with it, the incidence of lung cancer is falling over time. However, the statistics for females are rising. I think that that is partly because young females are beginning to act like young males used to act. They are beginning to be more assertive and to challenge the norms more, and they are more prepared to ignore warnings and make their own decisions.

The statistics also show that, although there have been improvements in one-year survival rates for younger patients, survival rates at five years have remained relatively unchanged over the past decade. Of course, Scotland's health record is among the worst in Europe.

Mike Rumbles referred to his constituency. There is little doubt that an element of deprivation is involved in the figures. Of course, it might be that the amount of tobacco smoking by smokers also varies as the number of smokers varies, but I do not think that there are good numbers on that matter—that is, there are some numbers, but it is not clear whether we can trust them. However, there is a good correlation between a person smoking more and their being more at risk.

I looked up the general numbers for health for my constituency and for a Glasgow constituency that has a lot of deprivation—I will not name it, as that is not the point. Using a standardised population, my constituency has a quarter of the alcohol-related admissions to hospital of the Glasgow constituency and under a quarter of its drugs misuse admissions. The figure for the percentage of data zones in the most deprived decile of the health domain in my constituency is 0 per cent. The figure for the other constituency is 66.23 per cent. The difference that deprivation makes can be seen.

The international comparisons that I have almost invariably show Scotland at the top of the table. Only Belgium beats our lung cancer incidence rates for males and nobody beats our rates for females. Sweden's figure is approaching a quarter of our figure. We are also at the top for mortality rates. Even countries such as Spain—or Greece, which is not normally thought of as a particularly wealthy country—are doing much better than we are. Factors other than deprivation are therefore at work. In addition, we can see that the issues arise in the Greater Glasgow NHS Board, Lanarkshire NHS Board, Argyll and Clyde NHS Board and, to a lesser extent, Lothian NHS Board areas.

I have one or two slightly off-the-wall comments to make to close my remarks. One of the poorest countries in the world is Bhutan. In Bhutan, only 1 per cent of the population smoke. Because of that, Bhutan was able to make tobacco illegal about 10 years ago, and the incidence of lung cancer there is almost nil. However, we must be cautious about drawing conclusions from that, as the diagnostic facilities are more limited there than they are here.

I have quoted James VI in other debates on smoking, and I shall do so again. James VI got it absolutely right 400 years ago when he took over the Crown and raised the tax on tobacco to a rate that today would be £30,000 per pound of tobacco. The fiscal option is certainly one that I would like the Executive ministers to encourage their colleagues at Westminster to rack up to an even greater extent.

Some years ago in India, I saw an advertising poster for a local brand of tobacco that used a slogan that encapsulates the problem. I do not think that the manufacturer saw the irony of the slogan, which was "The final choice". For too many people, smoking is the final choice.

I close with one suggestion that the Executive might take up. We had the finest medical schools in the world in Edinburgh because of the huge morbidity in the cess pit that was the old town. We may have a similar opportunity, because of our poor health and our high lung cancer rate, to invest more in understanding the problem not only for our own benefit, but for the creation of an industry related to that and for delivering a benefit through improved health care for people who suffer from lung cancer in countries throughout the world. That would be to our economic benefit, to our social benefit and to the benefit of everyone around the world.


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