Author: Nick Hopkinson

World No Tobacco Day – how to get where we need to be?

Nick HopkinsonThe path to a smokefree generation demands decisive action and innovative strategies. To mark World No Tobacco Day, Professor Nick Hopkinson from the National Heart & Lung Institute (NHLI) offers his insights, drawing on years of dedicated research to suggest ways in which we can achieve this. 

Smoking is the leading preventable cause of premature disability and death; two out of three people who continue to smoke will die from a smoking-related disease. Ending this requires two things: First, ensuring that people don’t start to smoke in the first place; and second, supporting the more than six million people in the UK who still smoke to quit.

‘Stopping the start’ involves making smoking less appealing,less affordable, and less available to children and young people. A key step to creating a smokefree generation will be steadily raising the age of sale, ensuring that tobacco products can never legally be sold to people born on or after 1 January 2009. The General Election has paused the progress of this legislation, but the policy has enjoyed cross-party support, so is almost certain to become law. We can be confident that it will be effective – youth smoking rates fell when the age of sale in the UK was increased from 16 to 18 in 2007, and similarly where it has been increased to 21 in the US. The year-on-year increase will also prevent the tobacco industry from addicting people later in life.

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COVID and lung health: patient experience and what comes next?

The pandemic has been a huge challenge for people with lung disease – Dr Nick Hopkinson outlines what needs to change to provide them with the required support.

The COVID-19 pandemic has had a double impact on people with lung disease – both the impact of the condition itself as well as measures to avoid it on individuals and the impact on access to healthcare. COVID-19 is a respiratory infection, with people with COPD and severe asthma among those who are the most vulnerable. Many people with these conditions have spent a year shielding to avoid it.

Data from patient surveys by the Asthma UK and British Lung Foundation Partnership early in the pandemic found high levels of anxiety, with four key themes emerging from survey responses:

  • Individuals’ vulnerability to COVID-19,
  • Worrying what the experience of contracting COVID-19 would be like,
  • Uncertainty about the future,
  • The inadequacy of government response.

Many patients reported that their care had been disrupted, with reduced support available and face to face appointments replaced by remote options. (more…)

A smoke-free country: how will we get there?

The Government recently announced plans to create a smoke-free society by 2030 – Dr Nick Hopkinson outlines some of the steps towards achieving this ambition.

Tobacco smoking remains a huge public health issue. Although population smoking rates continue to fall – now down to 14.4% of adults – smoking is still responsible for around 100,000 deaths per year in the UK, and for around half the difference in life expectancy between rich and poor. Smoking rates are high in areas of deprivation, in people with mental health problems and among people who identify as LGBT.

The Government’s recent green paper, Advancing our health: prevention in the 2020’s, although in many areas light on detail, funding, delivery and ambition, does set out some important markers on smoking and some potentially interesting developments around funding tobacco control. (more…)

Can we trust the tobacco industry?

Image credit: Stanford Medical School

Originally published on Dr Nick Hopkinson’s blog and reproduced here with permission, this post looks at the Tobacco Industry’s dark history of appropriation and subversion of science.

“It ain’t no new thing” sang Gil Scott Heron in 1972, condemning the appropriation of black culture by white recording artists. A recent research paper published in Tobacco Control throws light on Tobacco Industry appropriation and subversion of science. Their goal, to prevent or delay measures which reduce their ability to market products that are among the leading causes of death worldwide (1). (more…)

How COPD patients can sing their way to better health this Christmas

COPD singing

Carol Singers (CC BY 2.0)

In this post, Dr Nicholas Hopkinson looks at the benefits of singing for people with respiratory conditions such as COPD.

Singing carols is a big part of Christmas cheer, but not many people realise that singing can also be helpful for people with lung disease. COPD is an extremely common condition – there are 1.3 million people with this diagnosis in the UK. Existing treatments help to some extent, but do not reverse the underlying pathology, meaning that even with optimal care many patients remain breathless with activity limitation and poor quality of life. This symptom burden represents a major area of unmet need. Singing for Lung Health (SLH) groups are a potential way for patients to gain skills to improve control of their breathing and posture, reducing symptom burden and enhancing wellbeing. (more…)

Lung volume reduction – new hopes and missed opportunities in COPD


COPD, chronic obstructive pulmonary disease, has traditionally been thought of as an irreversible and somewhat hopeless condition. Many patients with COPD may be missing out on the possibility for a dramatic improvement in their condition. They deserve better.

COPD, is a common and important condition. There are 1.3 million people with a diagnosis of COPD in the UK and it’s now the third leading cause of death worldwide. The main symptoms are breathlessness, cough and sputum production.

The term COPD encompasses a range of pathological processes, usually caused by smoking or inhaling other noxious materials. It includes chronic bronchitis – inflammation and damage to airways as well as emphysema – destruction of the lung tissue itself and damage to the blood vessels in the lung. In emphysema the walls of the alveoli (air sacs) break down. The lung tissue loses its elasticity and becomes baggy, and air gets trapped in the lungs making breathing uncomfortable. In some people the condition is caused by alpha one antitrypsin (A1AT) deficiency; the inherited lack of a defensive enzyme, which makes their lungs much more vulnerable. (more…)