In a press release, NICE notes that oral health in England has improved greatly over the last 30 years, but tooth decay (in approximately a third of people) and gum disease are still widespread, despite being largely preventable. In addition, the incidence of oral cancer, caused by alcohol, tobacco use and the HPV virus has increased by around a third in the UK in the past decade, with over 7000 new cases in 2012 alone. Each year the NHS in England spends around £3.4 billion on primary and secondary dental services.