Smoking costing NHS GBP2.7 billion a year

New Report Calls for Action to Protect Young People and Curb Tobacco Marketing

07 October 2008

The annual cost of smoking to the NHS in England has soared from £1.7 billion a year in 1998 to £2.7 billion this year. Presented at the NCRI conference today the figures are included in a major new report, ‘Beyond Smoking Kills’ published by Action on Smoking and Health (ASH), in collaboration with the British Heart Foundation, Cancer Research UK and endorsed by over 100 health and welfare organisations (1). The cost of smoking to the NHS would have risen even more – to more than £3 billion a year – if Government action, health education and changing social attitudes had not led over the last decade to a fall in the total number of smokers from nearly 12 million to just over 9 million (2).

The report also finds that tobacco manufacturers are misleading smokers and young people about the safety of cigarettes and calls for radical new legal steps to protect young people from inheriting the smoking habit and to curb tobacco marketing. The Government is now considering what action to take in a new Health Bill, to be included in the Queen’s Speech in December.

“Beyond Smoking Kills” was produced by an editorial board of scientific and medical experts, chaired by Peter Kellner, President of YouGov. It will be launched today at a parliamentary reception with the Minister of State for Public Health, Dawn Primarolo MP.

The report calls on the Government to introduce a comprehensive tobacco control strategy which could help a further 4.5 million smokers to quit by 2015 by:
• Requiring plain packaging for all tobacco products
• Prohibiting the display of tobacco products in shops
• Clamping down on smuggling
• Giving smokers access to safer non-tobacco alternatives to smoking

New research from the University of Nottingham, also published in the report, shows that tobacco branding and packaging sends misleading ‘smoke signals’ to young people. Although it has been illegal for manufacturers to use trademarks, text or any sign to suggest that one tobacco product is less harmful than another since 2003, this research shows that products bearing the word ‘smooth’ or using lighter coloured branding mislead young people into thinking that these products are less harmful to their health.

The research also reveals that young people are between 3 and 4 times less likely to pick a plain pack as a branded one if they were trying smoking for the first time, supporting calls for plain packaging and countering industry claims that plain packs would be more attractive to young people. (3)

One in seven fifteen year olds regularly smokes (4) and two thirds (66%) of regular smokers start before they are 18 (5). Strategies to reduce the attractiveness of smoking and reducing accessibility of cigarettes to young people would have a dramatic influence on take up rates of smoking among young people.

Tackling the stark health inequalities caused by smoking and smoking related disease is also a focus of Beyond Smoking Kills. Smoking rates in the wealthiest parts of England can be as low as 12% and in the most deprived wards as high as 52% (6). Tackling tobacco smuggling is particularly important as the report reveals that less well off smokers are much more likely to buy cheap illicit tobacco.

The report recognises the great progress made with tobacco control in the ten years since the Government published its last tobacco strategy “Smoking Kills” in 1998. However, it concludes that much more needs to be done to protect children and reduce inequalities caused by England’s largest cause of preventable death.

Chair of the Editorial Board Peter Kellner said:

“There is a terrible gap in life expectancy between the richest and poorest in British society. Smoking is by far the biggest single factor, accounting for half the difference. A child born today who never smokes will live, on average, ten years longer than a child who takes up smoking. The younger a smoker starts, the harder it is for them to quit.

Our report sets out a comprehensive strategy for Government action to protect children from exposure to smoke and smoking, to support smokers to quit and to help smokers who are not yet ready to quit to reduce the harm they cause themselves. Smoking remains the greatest public health problem in our society – but we now have a great opportunity to stop the next generation from inheriting this lethal habit.”

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(1) A full copy of Beyond Smoking Kills is available at A copy of the executive summary is available at
(2) Research conducted for Beyond Smoking Kills
(3) Hammond D, Dockrell M, Arnott D, Lee A, Anderson S, McNeill A. The impact of cigarette pack design on perceptions of risk among UK adult and youth: evidence in support of plain packaging regulations
(4) Drug use, smoking and drinking among young people in England in 2007. The Information Centre for Health and Social Care, 2007
(5) Office for National Statistics. Smoking and drinking among adults, 2006 (General Household Survey). ONS, London 2008.
(6) Major Online Mapping Project Shows “Iron Chain” Between Smoking and Deprivation