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Last Updated: Friday, 12 November, 2004, 17:26 GMT
Who is really dying for a smoke?
Raja Khan
Raja Khan: "Rich people buy four or five packs at once"

More than four out of every 10 people who die above the age of 35 in Tower Hamlets do so because they smoked, according to figures published on Friday.

What is it about this east London borough that has it vying with Merseyside for the uncoveted title of lung-cancer capital of Britain?

To find out, Steve Hawkes from BBC News went looking for smoke signals on Mile End Road.

Like any good investigative journalist, my initial instinct is to start with a search for the source - who benefits from all these coughing cockneys? So my first stop is a tobacconist.

Raja Khan, 28, has been selling cigs to the good people of Tower Hamlets for the past three and a half years - but is he to blame?

"I have to make money - but when people buy my cigarettes, I always show them the health warning on the packet.

"And when a customer tells me they are giving up smoking, I feel happy."

If you are very poor, you cannot afford it
Murtaza Arifou

Dame Yve Buckland, chairwoman of the Health Development Agency, which published Friday's figures, says: "The poorer you are, the more likely you are to smoke."

But, as Mr Khan points out, fags are not cheap, and some of his best customers seem to come from the right side of the tracks.

"The rich people come in and buy four or five packs at once - because they can afford it."

Mr Khan does not smoke himself, nor do any of his staff and there is a strict no-smoking policy in his shop.

But that does not deter his many regulars, and tobacco sales have never been higher - so who is buying?

"The university keeps expanding," Mr Khan tells me between customers.

Richer people have more things to occupy their minds, the working class do not have so many outlets
James Hanshaw

"And those students smoke a lot."

Next stop - Queen Mary college, part of the University of London, where I spot Murtaza Arifou engulfed in a cloud of sweet-smelling cigarillo smoke outside the law department.

At the tender of age 17, Mr Arifou looks like a smoking freshman - but he has been at it since he was 12.

"I started because of school stress and family problems," he tells me between lectures.

"But stress is a very silly reason to smoke - it does not solve your problems."

Nowadays, Mr Arifou smokes because "it relaxes me after very hard lectures".

It has nothing to do with social status - you can be a millionaire and still smoke 60 a day
Lee Brown

Although, paradoxically, he cites a lack of education as the main reason so many of his Tower Hamlets neighbours fail to kick the habit.

The borough's high level of unemployment is also a contributing factor, according to Mr Arifou.

And a lack of the structure that a nine-to-five job imposes could also explain why so many of his class-mates at his hall of residence share his passion for puffing.

Poverty - another thing students have in common with the unemployed - is not to blame, though, Mr Arifou adds.

"If you are very poor, you cannot afford it."

So is there a link between cash on the hip and a fag on the lip?

The poorer you are, the more pressure you are under, and people smoke because they are stressed
Gerry O'Hara

My next stop is that last bastion of the smoking speculator - the betting shop - where ashtrays are built into the furniture.

Frank Hamilton, like many others in Tower Hamlets, lives on 53 a week Income Support.

And smoking is one of the things that "eases the pressure" of living within such a tight budget.

"Every day, I come in here, have a coffee, put a couple of coppers on the horses and light up a fag," he tells me between puffs.

"It eases the nerves, and keeps me calm."

A long-term sufferer from back pain and rheumatism, the 55-year-old sees the 20 roll-ups he has been smoking every day for the past 35 years as "a form of medication".

"Smoking helps with the pain."

James Hanshaw
James Hanshaw: "We got 20 Players for sixpence"

Mr Hamilton's friend, James Hanshaw, 81, started smoking in the Royal Navy during World War II - when servicemen's cigarettes and tobacco were subsidised.

"We got 20 Players for sixpence and a pound of 'baccy for half a crown - everyone smoked," he tells me between races.

After getting through 100 cigarettes every day for almost 40 years, Mr Hanshaw finally gave up - for health reasons - at the age of 55.

But his children and grandchildren still smoke.

And it remains part of working-class culture, according to Mr Hanshaw.

"Richer people have more things to occupy their minds, the working class do not have so many outlets."

Lee Brown
Lee Brown: "If you are out of work, you are less likely to be motivated"

The other side of the counter, Lee Brown, 30, has been taking bets in Tower Hamlets for the past year.

A 20-a-day man for the past 12 years, he puts the borough's high-incidence of smoking-related fatalities down to opportunity as well as motive.

"It has nothing to do with social status - you can be a millionaire and still smoke 60 a day.

"But if you are out of work and stuck in a council flat, you are less likely to be motivated to stay healthy."

And Tower Hamlets is the perfect environment for a smoking culture born of deprivation to flourish, Mr Brown tells me between punters.

"There are a lot of betting shops, pubs and Indian restaurants where you can smoke."

"My previous shop, in Hackney, was bigger, and we had a smoking area at one end and non-smoking at the other."

But is apartheid-style segregation really the answer?

My next stop is a pub - with separate bars for smokers and non-smokers.

And as soon as I go in somebody asks me for change for the cigarette machine.

Gerry O'Hara
Gerry O'Hara: "When I started, everybody I knew smoked"

But sitting in the smoking section and sucking on a cigarette-surrogate nicotine inhaler, is one man determined to buck the Tower Hamlets trend.

Gerry O'Hara's grandparents smoked, his parents smoked, and his daughter smokes

At the age of 51, he had smoked 20 cigarettes every day for more than 30 years.

But after a "cancer scare" and being diagnosed with angina, he has given up - on Tuesday, and "so far, so good".

Unsurprisingly, Mr O'Hara puts the area's high incidence of smoking-related fatalities down to "peer pressure".

But he adds: "The poorer you are, the more pressure you are under, and people smoke because they are stressed.

"When I started smoking, everybody I knew smoked - but it is not just Tower Hamlets, it is working-class areas throughout the country," Mr O'Hara, a caretaker, tells me between sucks.

"If you work in an office, you have to stop smoking for eight hours a day - but if you work on a building site you can carry on."

Working-class culture

My final stop is an office - one attached to the London Independent Hospital, which specialises in treating heart disease.

Marketing manager Malcolm McCoskery, 48, has never smoked, and his parents gave up in their 20s.

He believes smoking has less to do with working-class culture and more to do with the stress caused by economic deprivation and unemployment.

Health campaigns are failing to reach people living in poorer areas, Mr McCoskery tells me between patients.

And, perhaps most worryingly of all, the hospital's heart patients are getting younger and younger.

Scotland smoking ban to go ahead
10 Nov 04 |  Scotland
Smoking ban: What they said
10 Nov 04 |  Scotland
Living in an anti-smoking climate
10 Nov 04 |  Scotland
Timeline: Smoking and disease
22 Jun 04 |  Health

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