Smoking across England costs local government £1.2 billion in social care costs every year

14th July 2021

New analyses [1] funded by the public health charity Action on Smoking and Health (ASH) shows the impact of smoking on social care need and the associated costs for each region and local authority in England. Around 1.5 million people have everyday social care needs, such as needing help with dressing, walking across a room and using the toilet, due to illnesses caused by smoking. As a result, local authorities are funding care for 85,000 people across England in their homes and a further 17,500 people in residential care [1]. Together this costs English councils £1.2 billion a year [1].


Smoking is the leading cause of premature death in England, killing 74,600 people in 2019 alone [2]. However, smoking is also a leading cause of preventable illness – for every person killed by smoking, at least another 30 are estimated to be living with serious smoking-related disease and disability [3]. ASH analysis found that, on average, smokers in England need care when they are 63 years old, ten years earlier than never-smokers, and still of working age [4].

However, the significant sums spent by councils across England on social care needs caused by smoking each year are not enough. Over one million people across England are estimated to be receiving care from unpaid carers such as friends and family, while a further 450,000 people have care needs which are not met by paid or unpaid care [1]. Stretched budgets prevent councils from being able to cover the additional £14 billion it would cost to meet the full demand for care in England [1].

Deborah Arnott, Chief Executive of Action on Smoking and Health (ASH), said:

“Smoking has a devastating impact on our communities far beyond the tens of thousands of lives it takes every year. It profoundly undermines the quality of many people’s lives, often placing heavy demands on family and friends.

“Securing the Government’s vision of a smokefree country by 2030 will make all the difference. It will ease pressure on the social care system and build resilience in our communities, enabling people to live longer, healthier lives.

“Local authorities have a key role to play in ending smoking, but they cannot do it without additional funding. ASH backs calls on the government to introduce a ‘polluter pays’ levy on tobacco manufacturers to pay for the support needed to end smoking in this country.”


Notes to the Editor
Action on Smoking and Health is a health charity working to eliminate the harm caused by tobacco use. For more information see:
ASH receives funding for its programme of work from Cancer Research UK and the British Heart Foundation.

ASH staff are available for interview. For more information send an email to or ring Deborah Arnott (Chief Executive, ASH) on 07976 935 987 or Hazel Cheeseman (Director of Policy, ASH) on 07754 358 593.

Regional versions of this press release are available.

[1] ASH. The costs of smoking to the social care system in England calculator. July 2021.
[2] NHS Digital. Statistics on smoking, England 2020. December 2020.
[3] U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. 2014.
[4] ASH. The cost of smoking to the social care system, 2021. March 2021.