If people on benefits are struggling to quit smoking, then the cost-effective, compassionate solution is cessation support

This week, the Conservative Party announced plans to change benefits so that recipients get pre-paid cards that can’t be used for certain goods and services, including tobacco. In this blog, ASH Senior Policy Officer Noah Traill explains why the best solution is targeted quit support and access to free and cheap alternatives for those on low incomes or benefits.

Proposals to withdraw benefits or control what they are spent on for people who drink, gamble or smoke have been put forward in the past. The initial appeal is clear. Taxpayers may be happy to support those who aren’t in work or are on low incomes to buy food, but not these unhealthy products. The Conservative Party seems to be suggesting that this measure will motivate those on benefits to get back into work.

However, there is a reason that no party of government has ever followed through on a proposal like this. That’s because it is impractical, probably very expensive, and extremely punitive. The money that would be spent setting up a pre-paid card system in an attempt to control behaviours would be much better spent supporting smokers to quit, eliminating the problem altogether.

I work closely with smokers with lived experience of deprivation, and they often say to me that they don’t think they should be able to spend taxpayer money on these products. They don’t want to be buying tobacco at all, but the addiction is so strong. What they need is support.

Smoking is an addiction; it is not a lifestyle choice. Most people who smoke regret ever starting and want to quit. It can take, on average, up to 36 attempts to quit smoking.

People on benefits are more likely to be smokers because smoking is not spread equally across our society. Smoking rates are around 2.5 times as high in the most deprived communities as in the least deprived. In Blackpool, England’s most deprived local authority, smoking rates are double the national average. People who smoke are also more likely to experience food insecurity, skip meals and attend food banks.

Smoking also causes poverty. It pushes hundreds of thousands of households into poverty and deepens financial stress. As a lethal addiction, it requires care, support and sustained effort to overcome.

Smoking stops people from working. Working-age smokers are nearly three times more likely to be out of work for health reasons than non-smokers (roughly 11.3% of smokers versus 3.3% of non-smokers).

It seems like the one thing we can all agree on is that smoking is bad for individual health and wealth, and bad for the economy. So, what is the best way to motivate and support those on benefits to quit?

ASH’s recent report, Ending Smoking Inequality, sets out practical measures that can reduce smoking rates while tackling poverty. These include delivering support in settings that people already use - in emergency departments, food banks, lung screenings, and in-patient pathways. When support is accessed, practitioners need to have the tools to help people quit. Vapes, lozenges, chewing gum, and other nicotine replacement therapy (NRT) should be free in every stop smoking service so that people can find the right option that works for them as well as access to medications such as varenicline which help to suppress cravings.

Support needs to work around people’s lives. For those who cannot easily attend a clinic or waiting room because of work, childcare, transport or other barriers, digital programmes can extend the reach of services and offer flexible help at the point people need it.

Interventions of this kind are remarkably good value for money. ASH analysis shows that if we invested an additional £97 million to support smokers to quit, this would yield £894 million of benefits in 2030 through reduced burden on public finances – delivering a ninefold return on investment.

We know what works to truly eliminate this issue. If political leaders are serious about reducing smoking and poverty, they must invest in proven support – not punish people for needing it.

For further information read Ending smoking inequality: An action plan to reduce poverty and improve health