Smoking costs Councils £600m+ a year for social care

Wednesday 03 September 2014

New figures from Action on Smoking and Health (ASH) show that Councils in England face a bill of more than £600m a year to help people with smoking-related illness stay in their own homes (domiciliary care). The true figure may be much higher because of lack of information on some costs. There are no figures at all for what Councils are spending to support people aged under 50. [1]

Individuals also face a bill of about £450 million to cover the cost of their own care. This means that more than £1 billion is spent on domiciliary care every year in England because of smoking.

For the first time the new research has estimated the cost of smoking to the social care system. It reveals that current smokers over 50 are twice as likely to need help with day-to-day living and on average need care nine years earlier than non-smokers. [2]

The study shows that every year 47,000 more people need social care as a result of smoking. However, smoking means that 846,000 people are receiving unpaid care from friends or family.

For every person who dies from smoking, 20 are living with a smoking-related illness. The research shows that smokers need care on average 9 years earlier than non-smokers.

The costs of smoking to the social care system in England also shows that local authorities spend more as a proportion of their total care budgets on smoking-related care than does the NHS. [3]

Peter Hunt, 67 from London, has COPD (chronic obstructive pulmonary disease) and a heart condition caused by smoking:

“I’ve received support from the council for two years and the care is vital – I really couldn’t do it without them. My carer comes in every morning to help me with washing, shaving and changing and my wife helps out too – she has to, I can hardly do anything for myself. I can make a cup of tea myself but I can’t carry it anywhere. I also have a walk-in shower and a ramp to help me get into the house. I pay for as much of my care as I can and the local authority provides what’s left.”

Deborah Arnott, Chief Executive of ASH, commented:

“From next April, when the Care Act 2014 becomes law, Councils will have to meet the extra social care costs of preventative measures to help reduce the need for care in people’s homes – at a time when they face even deeper cuts to their budgets.

“Investing in tobacco control and supporting smokers to quit will have to be high on the list of preventative measures, if Councils are to cut their social care bills in the future. We have published estimates for every top tier English Council to help them plan and cost local services more effectively.

“Local authorities are facing a financial squeeze that makes effective and targeted spending on preventative services all the more important.”

Paul Burstow MP and Chair of the All Party Parliamentary Group on Smoking and Health said:

“Smoking remains by far the biggest single cause of preventable deaths in the UK and a major cause of disability and illness. Councils now lead on both public health and social care. Smoking brings both together. By helping people to quit smoking, not only will their health improve but they will need less paid-for care in the future.

“This report makes a powerful case for investing in smoking cessation now to save money on social care in the future.”

The President of The Association of Directors of Adult Social Services, David Pearson said:

“Local authorities currently face real difficulties with a growing need for social care at a time of shrinking resources. The number of people who, as a result of smoking, need care from the state or from family members is very high.

“Reducing smoking can help to address funding challenges and make a real difference to those who may otherwise need years of care. Working with colleagues in public health to encourage people to stop smoking could make an important contribution to reducing pressures on adult social care in the future.”



[1] The costs of smoking to the social care system in England has cost estimates for every top tier English local authority. The full report with the detailed estimates can be found online at The study was conducted by economist Howard Reed from Landman Economics for ASH. The report excludes costs borne by the national government such as the payment of welfare benefits.

[2] The 2014 version of the total cost of smoking for local areas will be available here.
Local breakdown of social care costs and need will also be available at this link on Wednesday morning.

[3] The NHS budget for 2012/13 was £109bn. It is estimated that England local authorities’ social care budget for the over 50s in 2012/13 was £9.5bn. It is estimated that local authorities spend 6% of their care budgets on smoking related care while the NHS spends 2%.

[4] Recent analysis by Community Care illustrates how the overall budget for councils in England continues to fall, predicting a real term reduction in spending on adult social services this financial year of 4%.

[5] Local authorities took on responsibility for public health with the Health and Social Care Act in 2012. The Care Act 2014 becomes law in April 2015.