That being poor is bad for your health has become almost a truism, this week the Office for National Statistics reminded us there is an uncomfortable reality behind the cliché.
Figures released by the ONS to coincide with National No Smoking Day (14th March) show that people in deprived areas are more likely to smoke than in more affluent areas of England.
In fact, the more deprived the area, the more likely people living there are to smoke. Out of England's 6.3million smokers one in six live in deprived areas, for example in Hastings 25.7% of people are smokers, the national average for England is 15.5%%. Other deprived areas including Blackpool Bradford and Manchester also have high rates of smoking.
At the opposite end of the spectrum just 4.9% of people living in Epsom and Ewell are smokers, Wokingham in Berkshire and Chiltern in Buckinghamshire also have low levels of smoking; all of which are leafy, affluent areas.
Smoking is a major contributing factor in 85% of cases of lung cancer and chronic obstructive pulmonary disease treated by the NHS, conditions that people living in deprived areas are twice as likely to suffer from.
This can be linked to factors including living in insecure or temporary housing, having few formal qualifications and being in a low skilled occupational group. All of which can make individuals three times more likely to be smokers than people in skilled or managerial roles.
High levels of smoking, along with other risky behaviours, can be seen as contributing to the disparity in life expectancy between affluent and deprived areas, with gender further skewing the figures.
A boy born in Kensington and Chelsea can expect to live for 83.3 years, girl for 86.7 years; in Blackpool and Middlesbrough life expectancy falls to 74.4 years for boys and 79.8 years for girls.
The inequality in life expectancy between affluent and deprived areas has widened over the past two decades.
Overall the trend for the number of people in deprived regions of England who smoke is falling, dropping from 32.7% in 2012 to 27.2% in 2016. In more affluent areas it has fallen over the same period from 10.0% to 7.9%.
The figures cited in this article were produced by the ONS using data from the Annual Population Survey and apply to England only, the other UK nations conduct their own health surveys and publish separate data on inequality.
The government and the NHS aim to reduce the number of adults in England who smoke from 15.5% to 12.0% by 2022.
Statistics say only so much about why levels of smoking are so persistently high in deprived areas. To get close to the truth you must look past the quantitative analysis to the qualitative story behind.
In the 1930's George Orwell wrote about working class people numbing themselves against the hardships of their lives with cheap pleasures, picture shows, football, beer and cigarettes mostly being their poisons of choice. Pleasures the comfortable but concerned upper middle classes neither understood nor approved of.
The world has moved on, but if you are poor much has stayed the same, work is still dull drudgery, expectations and horizons are limited; sometimes a cigarette or a bag of chips is the closest thing to comfort you are going to get. A salad and a brisk walk will, for sure be better for you in the long run, but forward planning is often another luxury out of reach of the poor.
If the government want the poor to smoke less, then they need to help people in areas that have been left behind for decades feel the future is something worth living to see.
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