Concerns over care home ratings

27 October 2012 Last updated at 20:28 ET By Hannah Barnes Reporter, 5 live Investigates

Care homes with five-star ratings are receiving premium fees despite not meeting essential standards set out by the care regulator.

Local authorities pay higher fees to care homes awarded top ratings.

But critics say this is a "cheque book system" open to any home prepared to pay for a rating.

The Care Quality Commission advises people to visit homes and check their most recent CQC inspection report before making a decision on care.

Care regulator the Care Quality Commission (CQC) stopped issuing its own star ratings in 2010 and now some homes pay independent ratings companies and consultants to assess them instead.

Gwenda Dunn was surprised to find that her aunt's care home had been awarded five stars by such a company.

"This is not a complaint against the home - it's a complaint as to how the home could be given five stars when it patently was not," she told the BBC's 5 live Investigates.

5 star failures

Mrs Dunn says her aunt's room was often cold and calls from her aunt for a commode during the night were sometimes ignored by staff.

Continue reading the main story

"Start Quote

People who aren't in the know would take it as face value, not recognising the reality"

End Quote Gwenda Dunn Niece of care home resident

Also, her aunt was frequently disturbed by another patient with dementia who often entered her room uninvited.

"I was there when the inspection was done. I spoke to the inspector and raised a fair amount of issues and then we found out within a week that the home had got five stars again," says Mrs Dunn.

"People who aren't in the know would take it as face value, not recognising the reality."

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Find out more

Listen to the full report on 5 live Investigates on BBC 5 live on Sunday, 28 October at 21:00 GMT or download the programme podcast.

The home was rated by David Allen, an independent consultant who trades under Prestige Quality Ratings (PQR).

Mr Allen says the issues raised with him lacked substance and were misplaced. He also says other people at the home spoke very highly of the care provided and he saw no reason to downgrade the home.

PQR is one of three independent ratings companies recognised by Sefton Council. The others are RDB Star Rating Limited and Assured Care.

With the top five-star rating attached, families might believe a home is providing an outstanding level of care.

But the BBC has found that out of 80 homes given a four or five-star rating in the Sefton area, 14 are failing to meet one or more of the essential standards set out by the CQC.

This includes standards of staffing, standards of treating people with respect and standards of caring for people safely and protecting them from harm.

All of the homes had been rated by either RDB Star Rating, Assured Care or PQR.

The CQC is taking action against two of the highly-rated homes, demanding immediate improvements be made - although it is not known which company provided their rating.

All three ratings companies have defended their awards system.

"I always take account of what the CQC have to say… but the CQC doesn't have to be right every time," says Frank Watts of Assured Care.

David Allen of PQR insists that his company's ratings are "accurate reflections of the quality of the care provided at care homes at the time of the assessment".

RDB Star Rating told the BBC its assessments were "comprehensive and reliable".

Higher fees for homes

Sefton Council pays a quality premium to homes given a high rating by the companies - a residential or nursing home with five stars receives an additional £40 per week on top of the basic fee paid for each person in its care.

A spokesman for Sefton Council said: "All the companies providing quality ratings use assessment criteria linked to outcomes in care home provision.

"We work closely with the CQC to ensure quality standards are closely monitored. If either party feel standards have reduced, through their own monitoring activity or inspections, we will decline or even suspend a particular rating and work with CQC in relation to this."

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"Start Quote

We maintain it is the responsibility of CQC as the regulator to assess the quality of care home"

End Quote Nadra Ahmed National Care Association

Sefton council is not the only one to pay a quality premium to homes awarded a four or five-star rating.

Redcar and Cleveland Borough Council says that since it introduced the RDB rating scheme in 2001, standards of care homes across the borough have improved.

But the BBC has learned that a quarter of its highly rated homes are failing to meet all the essential standards set out by the CQC.

"The council does feel that a new quality assessment tool would help to continue the drive to improve the quality of provision and therefore the RDB scheme will cease to be used at the end of this financial year," a council spokesperson said.

While the old Care Quality Commission rating system did have problems, critics say it was at least a system which was nationally recognised, independent, and easy for the public to understand.

"We maintain it is the responsibility of CQC as the regulator to assess the quality of care homes," says Nadra Ahmed, chair of the National Care Association which represents care homes.

"When the star rating system was scrapped by the CQC they consulted on the introduction of a system whereby assessments would be carried out by organisations independent of the CQC, which would be selected through a tendering process.

"The process was voluntary, so providers would pay to be assessed. The National Care Association felt strongly that this would be a cheque book rating system which enabled those who could afford it, to purchase a rating."

Bupa, the UK's second-largest care home group, is also critical of the CQC for abolishing its rating system:

"We would like to see them [star ratings] back so people can identify excellent care homes," said a company spokesperson.

"Other organisations, such as local councils and independent companies, are creating their own systems - but this could be confusing because there is no consistency."

The CQC warns people not to rely on ratings from outside companies when choosing a home.

"We do not endorse any external ratings systems," CQC operations director Amanda Sherlock told the BBC.

"We would recommend people look at a range of information including our website to get the latest reports into care homes, nursing homes, hospitals and other care providers."

Listen to the full report on 5 live Investigates on Sunday, 28 October at 21:00 GMT on BBC 5 live.

Listen again via the 5 live website or by downloading the 5 live Investigates podcast.

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'More violence' after riots push

27 October 2012 Last updated at 21:25 ET

The response to last year's riots has led to more violence among some gangs, an independent think tank has said.

A Centre for Social Justice (CSJ) report, to be published on Monday, said the arrest of leading gang members led to chaos in some areas after younger, wilder youths filled the power vacuum.

It calls on the authorities to focus on preventing youngsters joining gangs.

Ministers say a £10m fund is helping to stop the next generation of gang members and targeting current ones.

Although the government set aside millions of pounds to target the problem of street gangs, the report says many charities have been unaware that funding was available following the riots.

Continue reading the main story

"Start Quote

The alarming fact is that many streets across the country are besieged by anarchy and violence"

End Quote Centre for Social Justice report

And it accuses the authorities of a lack of follow-up work with junior gang members.

The think tank's research also revealed a marked increase in the number of girl gang members and a rise in sexual violence within gangs.

Prime Minister David Cameron promised an "all-out war on gangs and gang culture" following the riots which took hold of many English cities - including London, Manchester and Liverpool - in the summer of 2011.

Police responded by arresting many of those associated with criminal groups.

But the CSJ report finds that the removal of established gang leaders has led to the breakdown of criminal codes of behaviour and a "marked increase" in violence.

'No control'

It says: "Many in Whitehall regard the riots as a random one-off, and mistake the quashing of the disorder as control of the streets. They could not be more wrong.

"The alarming fact is that many streets across the country are besieged by anarchy and violence. There is no control in such neighbourhoods."

People researchers spoke to in riot-hit areas are said to have reported a "marked increase" in the violent behaviour of some gangs as the result of the removal from the streets of "elders" who had previously imposed a code of behaviour.

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Rioting by numbers

• Of the 3,051 people brought before the courts by 8 June 2012 for offences related to the England riots, 89% were male and 11% were female
• Of those 27% were aged 10-17 (juveniles) and a further 26% were aged 18-20
• Only 6% of those appearing before the courts for the disorder were aged 40 or over

"There was a consensus that the current gangs neither have such a code nor cohesive leadership, which is resulting in increased chaos, violence and anarchy," states the report.

Christian Guy, of the CSJ, which was founded by Work and Pensions Secretary Iain Duncan Smith, says: "Gangs played a significant role in the riots and it is dangerous to pretend otherwise.

"In London at least one in five of those convicted was part of a gang."

The report recommends "addressing the drivers of gang culture, not just the symptoms".

It says: "The surest way of eliminating gangs is to try to ensure that children and young people never want or feel the need to join them. To do this we need to tackle deeper issues in our society and seek to nurture and support ever-strong families and stronger communities."

A government spokesman said the coalition's strategy on violence and gangs made clear this problem could not be tackled through police enforcement alone.

He pointed to a new network of Young People's Advocates to provide direct support to victims of gang-related sexual violence and the introduction of gang injunctions for 14-17 year olds.

The spokesman said: "There are no quick fixes but we are seeing results. The Crime Survey for England and Wales shows that crime is down by 6%, and police figures show knife crime is down by 9%."

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Events to back charged marines

27 October 2012 Last updated at 22:17 ET

Events are planned across the country later in support of five Royal Marines charged with murder over an incident in Afghanistan last year.

The unnamed five have been released from custody back to their unit, with restrictions on their movements.

The "show support" events are being organised in several cities including Edinburgh, Swansea, Norwich and London.

The Ministry of Defence says it would be inappropriate to comment further on the ongoing investigation.

Green lapel ribbons - some bearing the words "Free the 5" - will be worn by those who say the charges are unjust.

The ribbons will also raise money to pay for any costs to their families.

Meanwhile, thousands of people have joined a Facebook group in support of the marines.

All five marines - who have been granted anonymity - are charged with the murder of an unknown Afghan national.

The incident happened when 3 Commando Brigade were based in Helmand, on their fourth tour of duty in Afghanistan.

The marines were arrested by the Royal Military Police after suspicious video footage was found on a laptop by civilian police in the UK. A plea hearing is due to take place in December.

It is believed to be the first time UK servicemen have been arrested and charged with such an offence during the Afghanistan conflict.

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Storm threat to key US poll week

28 October 2012 Last updated at 02:11 ET

Hurricane Sandy is swirling towards the US, forcing presidential candidates to adjust schedules and cancel events.

President Barack Obama has held a conference call with emergency chiefs to discuss preparations for the storm, which could hit as early as Monday.

Its sustained winds of 75mph (120km/h) are set to intensify as it merges with a wintry storm from the western US.

A number of states key to the election could be hit by a storm that may affect up to 60 million Americans.

At 20:00 EDT (00:00 GMT on Sunday), the eye of the storm was about 330 miles south of Cape Hatteras in North Carolina, according to the National Hurricane Center.

Craig Fugate, director of the Federal Emergency Management Agency, said: "This is not a coastal threat alone. This is a very large area."

Sandy has already killed 60 people in the Caribbean during the past week.

Political storm

Republican candidate Mitt Romney cancelled an event scheduled for Sunday in Virginia, a key election state, because of the weather, and was instead heading to Ohio.

President Obama will head to Florida on Sunday rather than Monday, and has cancelled a campaign stop with former President Bill Clinton in Virginia on Monday and a rally in Colorado on Tuesday to monitor the storm from the White House, said White House spokesman Jay Carney.

Vice-President Joe Biden also cancelled a rally in coastal Virginia to allow for disaster preparations.

Early balloting in Maryland saw lines of voters stretching for a number of blocks at some polling stations on Saturday.

But despite concerns about Sandy's impact, with some polls suggesting the contest is a virtual dead heat, both Mr Romney and Mr Obama pressed ahead with campaigning in key swing states on Saturday.

Nine states are thought to be too close to call.

In New Hampshire, Mr Obama urged his supporters to encourage people to vote early and allow him to finish the job he started.

"We've still got a lot of work to do, but New Hampshire and the country has come too far to go back to the policies that got us into this mess," he said.

"All he's offering is a big rerun of the same policies," Mr Obama said of his opponent.

In Florida, Mr Romney said he stood for "big ideas" that would get America going again, compared to what he called Mr Obama's "shrinking agenda".

"The president doesn't have a plan, he's out of ideas, he's out of excuses and this November, Florida is going to make sure we put him out of office," Mr Romney said to cheers from the conservative crowd in Pensacola.

How Mr Obama handles the weather emergency and how far Mr Romney tries to make political capital out of it could enhance or harm their chances, says the BBC's Bridget Kendall, on the election trail.

'Prepare for the worst'

While the East Coast is used to extreme weather, Sandy is concerning meteorologists who fear it could mutate into a "Frankenstorm" as it merges with a winter storm in the run-up to Halloween.

It is only moving north-east at 13mph, meaning it could hover for 36 hours over as many as 12 states, bringing up to 10in (25cm) of rain, 2ft of snow, extreme storm surges and power cuts.

States of emergency have been declared in Maryland, New York, Pennsylvania, Virginia, Washington DC and a coastal county in North Carolina.

Tropical storm warnings are in effect in both South and North Carolina, as well as Pamlico and Albemarle Sounds.

The NHC said further strengthening was possible on Sunday, before Sandy touched down anywhere between Virginia and southern New England late on Monday.

In New Jersey, Governor Chris Christie pleaded with residents not to be complacent.

"I know everyone's saying this isn't going to happen… that the weathermen always get it wrong," he said.

He urged people to stock up on essentials in case they were trapped at home for a few days.

"We have to be prepared for the worst here. I can be as cynical as any of you but when the storm comes, if it's as bad as they're predicting it will be, you're gonna wish you weren't as cynical as you might otherwise have been."

Delaware has ordered a mandatory evacuation of 50,000 people from coastal areas.

New York has not yet ordered evacuations.

Mayor Michael Bloomberg said: "This is a dangerous storm. But I think we're going to be OK."

Earlier in the week, Sandy caused havoc as it ploughed across the Caribbean, killing at least 44 people in Haiti, 11 in Cuba and four more in the Dominican Republic, Jamaica and the Bahamas.

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Tsunami hits Hawaii after quake

28 October 2012 Last updated at 05:25 ET

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Dr Charles McCreery, Pacific Tsunami Warning Center: "Readings were larger than we had expected"

A tsunami triggered by a 7.7 magnitude earthquake thousands of miles away in Canada has hit the island chain of Hawaii, with no damage reported so far.

Emergency sirens sounded late on Saturday to alert residents around the islands that make up Hawaii.

The first waves were reported to be up to 2.5ft (76cm) in one area.

Wave heights of three to six feet were predicted in some areas, as "urgent action" was advised to protect lives.

There were no immediate reports of damage on the Canadian coast following the earthquake.

Tsunami alerts that were issued for coastal areas of Alaska and British Columbia were swiftly downgraded.

The quake hit 125 miles (200km) south-west of the Canadian mining town of Prince Rupert at a depth of 11 miles (18km), said the US Geological Survey.

Initially, the Pacific Tsunami Warning Center said it did not expect a threat beyond the immediate area.

But later it said: "A tsunami has been generated that could cause damage along the coastline of all islands in the state of Hawaii."

First waves had been predicted to hit the archipelago around 22:30 local (08:30GMT).

"Urgent action should be taken to protect lives and property," the warning said.

After the first wave struck, Hawaii's Lt Governor, Brian Schatz, tweeted that water was now receding in Hilo Harbour, on Hawaii or 'Big Island'.

He also reminded people that the first wave was not usually the biggest, and that surges could continue for six to seven hours.

Initial local media reports from around the islands suggested that wave heights recorded so far had generally been about six inches, with 2.5ft in one place.

Hawaii is made up of hundreds of islands, spread over some 1,500 miles.

People living in areas considered to be at risk were urged to move to higher ground.

Wave heights of three to six feet have been predicted in some areas, with the biggest waves expected in Hilo, Kahului, Haleiwa and Hanalei, local media reported.

'Everything moving'

The quake struck the coast of western Canada at around 03:00 GMT and was followed by a 5.8 magnitude aftershock.

People in coastal areas of Canada's Haida Gwaii archipelago - formerly known as the Queen Charlotte Islands - were reportedly being moved to higher ground as a precaution.

Urs Thomas, operator of the Golden Spruce hotel in Port Clements, close to the epicentre, said the initial quake lasted about three minutes.

"It was a pretty good shock," he told Associated Press. "I looked at my boat outside. It was rocking. Everything was moving. My truck was moving."

A resident of the mainland town of Prince Rupert, Grainne Barthe, told AP: "Everything was moving. It was crazy. I've felt earthquakes before but this was the biggest. It was nerve-wracking. I thought we should be going under a table."

Following the quake, small waves measuring 69 cm (27 inches) were reported on the north-east tip of Haida Gwai, while parts of the north-east coast of Vancouver Island saw waves up to 55cm high.

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Bomb attack hits Nigeria church

28 October 2012 Last updated at 05:38 ET

Several people have been killed or injured in an explosion during mass in a Catholic church in northern Nigeria, officials say.

The attack happened in the town of Kaduna, scene of many sectarian attacks.

The church was surrounded by soldiers and police after the blast.

No-one has claimed responsibility, but Islamist group Boko Haram has been involved in several recent attacks in the area.

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Glitter arrested by Savile police

28 October 2012 Last updated at 05:44 ET

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The BBC's Tim Reid said police have confirmed they "have today arrested a man in his 60s in connection with the investigation"

Former pop star Gary Glitter has been arrested on suspicion of sex offences by police investigating Jimmy Savile abuse claims.

He has been taken from his home into custody at a London police station.

Glitter, whose real name is Paul Gadd, was jailed in Vietnam in 2006 for child sex offences.

Police are investigating allegations that the late TV presenter Savile sexually abused some 300 young people over a 40-year period.

Met Police confirmed that officers from Operation Yewtree had "arrested a man in his 60s in connection with the investigation".

"The man, from London, was arrested at approximately 7:15 BST on suspicion of sexual offences. The individual falls under the strand of the investigation we have termed 'Savile and others'."

Scotland Yard has said it is following about 400 lines of inquiry as part of the operation - which is looking into claims Savile, who died last year aged 84, abused hundreds of young girls and some boys.

Police described former BBC DJ Savile as a "predatory sex offender".

Karin Ward - a former pupil at Duncroft approved school for girls in Surrey - told the BBC she had once seen singer Glitter having sex with a schoolgirl in Savile's dressing room at the BBC. Glitter has denied the allegations.

'Reputation on the line'

Meanwhile the deputy leader of the Labour Party Harriet Harman has reiterated Labour's call for an overarching inquiry to look into the Savile allegations.

She told BBC One's Andrew Marr Show there should be a judge-led inquiry to look into what went on at the range of different organisations involved.

Meanwhile, the chairman of the BBC Trust, Lord Patten, has expressed his determination to deal with the sexual abuse scandal surrounding Savile.

Writing in the Mail On Sunday, he says the corporation's reputation is on the line and it must face up to the truth, warning the BBC "risks squandering public trust" and its "reputation is on the line" because one of its stars was apparently a sexual criminal.

Ms Ward was interviewed for the BBC's Newsnight programme in November, but the interview was only shown on Panorama this week as the Newsnight investigation was shelved.

Mr Patten told the paper: "Like many who work for the BBC, I feel a sense of particular remorse that abused women spoke to Newsnight, presumably at great personal pain, yet did not have their stories told as they expected."

Elsewhere, ex-BBC director general Mark Thompson has also denied ever being told about the Savile abuse claims.

The Sunday Times reports that his office was alerted on at least two occasions while he was still director general.

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Berlusconi to appeal in tax case

26 October 2012 Last updated at 21:15 ET

Lawyers for former Italian Prime Minister Silvio Berlusconi are to appeal against his jail sentence for tax fraud, media reports say.

The appeal will be lodged by 10 November, reports said, and could take several years.

Mr Berlusconi and others were convicted of inflating the price of distribution rights bought by his Mediaset group to avoid paying taxes.

On Friday a Milan court sentenced him to four years but later cut it to one.

The media mogul was also barred from holding office for five years.

A furious Mr Berlusconi later went on national television to condemn the sentence as "intolerable judicial harassment".

He has long complained that he is being persecuted by left-leaning judges in Milan.

"It is a political, incredible and intolerable judgement," Mr Berlusconi said on Italia 1 - one of the TV stations he owns.

"It is without any doubt a political verdict just as all the cases invented against me are political."

Continue reading the main story

• Accused of having paid for sex with an underage prostitute and of abuse of power for asking police to release her when she was arrested for theft
• Convicted of tax fraud in case focusing on the purchase of the TV rights to US films by his company, Mediaset
• Two other corruption cases - involving alleged tax evasion by his Mediaset company and the alleged bribing of British lawyer - expired under statute of limitations

Mr Berlusconi has faced a number of trials but it is the first time he has been sentenced for any crime concerning his business activities.

He has in the past either been cleared, or cases have run beyond the judicial time limit.

In 1997 he received a suspended sentence for false book-keeping but that conviction was reversed on appeal.

In the latest case, prosecutors said that part of the money declared for the purchase of US film rights was skimmed off to create illegal slush funds, reducing tax liabilities for Mr Berlusconi's Mediaset group.

The court handed Mr Berlusconi a longer sentence than the three years and eight months requested by prosecutors. However, it later announced that the sentence would be cut to one year due to a 2006 amnesty law aimed at reducing prison overcrowding.

It ordered him and his co-defendants to pay 10m euros (£8m) in damages.

Both the jail term and the ban from holding office will only take effect if the sentence is upheld by a higher court.

Sex case

The BBC's David Willey in Rome says Mr Berlusconi is unlikely ever to serve his sentence as the conviction first has to be confirmed by two successive courts of appeal.

Those appeals could take years, he adds.

In February a court threw out a corruption case against him after the statute of limitations had expired.

He is also currently on trial charged with paying for sex with an underage girl and trying to cover it up. He denies any wrongdoing.

Mr Berlusconi, 76, was forced to resign as prime minister of a centre-right coalition last November, and recently said he had no plans to stand again in elections due next year.

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Tree import ban to halt disease

27 October 2012 Last updated at 01:01 ET

A ban on the import of ash trees will come into force on Monday in an attempt to halt the spread of a deadly disease, the environment secretary has said.

The Chalara fraxinea fungus, which causes Chalara dieback, has already killed 90% of ash trees in Denmark and has been found in East Anglia.

Owen Paterson has denied that ministers were slow to react to the outbreak.

He said 50,000 ash trees had already been destroyed to try to prevent the spread of the disease.

Until earlier this week, the disease had only been recorded in a few nursery specimens.

Ash trees suffering with C. fraxinea have been found across mainland Europe, with Denmark reporting the disease has wiped out about 90% of its ash trees.

Continue reading the main story

I have already prepared the legislation and we're ready to go"

End Quote Owen Paterson Environment secretary

Experts say that if the disease becomes established, then it could have a similar impact on the landscape as Dutch elm disease had in the 1970s.

This outbreak resulted in the death of most mature English elm by the 1980s. Elms have recovered to some extent but in some cases only through careful husbandry.

The East Anglia outbreak has been confirmed by plant scientists from the Food and Environment Research Agency (Fera) at the Woodland Trust's Pound Farm woodland in Suffolk, and Norfolk Wildlife Trust's Lower Wood reserve, in Ashwellthorpe.

Mr Paterson said: "We will bring in a ban on Monday. I have already prepared the legislation and we're ready to go. The evidence is clearly there."

The disease has the potential to devastate the UK's ash tree population.

Visible symptoms include leaf loss and crown dieback in affected trees and it can lead to tree death.

In Europe, affected trees are not just in woodlands but are also being found in urban trees in parks and gardens and also nursery trees.

Chalara dieback of ash has been listed as a quarantine pathogen under national emergency measures and the Forestry Commission has produced guidance, including help on how people can identify possible signs of infection.

Experts are urging people to report suspected cases of dieback in order to prevent the spread of the disease to the wider environment becoming established.

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Women who quit smoking 'cut risk'

27 October 2012 Last updated at 02:36 ET By James Gallagher Health and science reporter, BBC News

Women who give up smoking by the age of 30 will almost completely avoid the risks of dying early from tobacco-related diseases, according to a study of more than a million women in the UK.

The results, published in the Lancet, showed lifelong smokers died a decade earlier than those who never started.

But those who stopped by 30 lost, on average, a month of life and if they stopped by 40 they died a year younger.

Health experts said this was not a licence for the young to smoke.

Continue reading the main story

'I started aged 11'

Angela started smoking when she was 11.

"Before I knew it, I was addicted," she said.

She used to hide her habit by taking the dog out for a walk. At one point she was smoking 10 cigarettes a day and more if she was going out.

After several attempts to quit she was successful: "I had a bit of a health scare and that really gave me the motivation to finally kick the habit."

She is now 29 and says it is "brilliant" news that quitting before the age of 30 could make a big difference to her health.

"It's amazing, I can feel it already actually."

The study followed the first generation of women to start smoking during the 1950s and 60s. As women started smoking on a large scale much later than men, the impact of a lifetime of cigarettes has only just been analysed for women.

"What we've shown is that if women smoke like men, they die like men," said lead researcher Prof Sir Richard Peto, from Oxford University.

He told the BBC: "More than half of women who smoke and keep on smoking will get killed by tobacco.

"Stopping works, amazingly well actually. Smoking kills, stopping works and the earlier you stop the better."

Early death

The records from 1.2 million women showed that even those who smoked fewer than 10 cigarettes a day were more likely to die sooner.

Sir Richard said that it was exactly the same picture as for men.

The British Lung Foundation said the prospects for long-term health were much better if people stopped smoking before they were 30, but cautioned that this was not a licence to smoke "as much as you want in your 20s".

Continue reading the main story

Smoking

• Smoking is responsible for more than five million deaths worldwide every year
• Smoking tobacco is a known or probable cause of around 25 diseases
• Cigarette smoke contains 4,000 chemicals that can damage the human body
• Eighty of which are known to cause cancer

Source: BBC Health

Its chief executive, Dr Penny Woods, said: "Stopping smoking can also be difficult to do - an estimated 70% of current smokers say they want to quit, so you shouldn't start and just assume you'll be able to quit smoking whenever you want to.

"The best thing for your health is to avoid smoking at all."

Prof Robert West, from the health behaviour research unit at University College London, said it was important to remember that smoking had more effects on the body than leading to an early death, such as ageing the skin.

"Around your mid-20s your lung function peaks and then declines. For most people that's fine - by the time you're into your 60s and 70s it's still good enough. But if you've smoked, and then stopped there is irreversible damage, which combined with age-related decline can significantly affect their quality of life.

"Obviously there is an issue around smoking if they want to get pregnant because it affects fertility and then there are the dangers of smoking during and after pregnancy."

The chartered health psychologist, Dr Lisa McNally, who specialises in NHS stop smoking services, also emphasised other factors.

Speaking to BBC News, she said: "There's the danger isn't there that people could almost take permission to continue to smoke to 30 or even to 40, but actually in my experience younger women quit smoking for other reasons other than life expectancy.

"They're more concerned about the cosmetic effects."

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