Towards a Smokefree Future: Supporting Social Housing Tenants to Quit in Sheffield

By Sarah Hepworth
Health Improvement Principal
Sheffield Tobacco Control Strategy Lead
Associate Director of South Yorkshire Tobacco Control Alliance
Public Health
Sheffield City Council

Although smoking rates are declining, smoking remains the leading cause of preventable ill-health and premature death in the UK. Around 64,000 people die each year in England from smoking and many more suffer with debilitating health conditions that harm their quality of life. The burden of smoking is not shared equally across society. Those from more deprived backgrounds typically have above-average smoking rates and as a result bear the brunt of the death and disease from smoking. 

This is especially true for people living in social housing, where smoking rates are more than double the national average (26% compared to 11.6%). Children living in social housing are much more likely to be exposed to secondhand smoke. One in five adults living in social housing with children under 18 report that someone smokes inside most days, compared with one in ten in owner occupied housing (21% vs 11%).[i] The Royal College of Physicians has estimated that exposure to secondhand smoke was responsible for between 5,000 and 11,000 hospital admissions for children in 2015/16.

Despite this, in 2024 only 67% of surveyed local authorities said that people living in social housing were target groups for stop smoking services. As the UK moves towards a smokefree future, we must ensure that social housing tenants do not fall even further behind.

Quitting smoking brings immediate and long-term benefits for tenants, local authorities, housing providers and communities. Helping more tenants to quit reduces preventable diseases like cancer and heart disease, while tackling health inequalities. Stopping smoking also improves people’s mental health and wellbeing by breaking the cycle of stress and addiction. 

For tenants, quitting means more money in their pockets: the average smoker spends £2,338 a year on tobacco, equivalent to around 10% of average disposable income. For social housing tenants – who are more likely to be on lower incomes and less likely to be in employment – quitting can ease financial strain, reduce rent arrears, and help balance household budgets during the cost-of-living crisis.

Local authorities and housing providers also benefit when tenants quit. Fewer people smoking means reduced fire risk and lower refurbishment costs, with less property damage from tobacco smoke when tenancies change. 

By supporting tenants to quit, public health and housing teams can improve wellbeing, increase disposable income, cut housing costs, and make homes and communities safer.

In Sheffield we have been working with social housing providers (within the council and wider housing associations) to raise awareness and uptake of the Smokefree Sheffield service with tenants. For example, we have worked with Sheffield City Council housing team to support housing officers to raise the topic of smoking, including incorporating questions on smoking status with tenants during initial conversations and annual reviews. We have worked with a number of different teams (such as income maximisation and new tenancies), recognising the importance of providing consistent messaging for tenants as well as multiple opportunities to be referred to Smokefree Sheffield.

We have worked with housing associations, specifically focusing on supporting those experiencing homelessness. For example, in collaboration with The Guinness Partnership, we have delivered staff training, held a wellbeing event for tenants, and set up an in-house clinic with a Smokefree Sheffield advisor. Residents have also been offered an incentive scheme to support them to quit, and we have seen good engagement with this to date.

From our work so far, we have learnt that it's important to support engagement across the whole of the partnering organisation rather than relying on a single champion, as this helps to get staff on board. Whist this has required more input from staff within our team, we think it has been worth the time and has led to better outcomes. We will also be reviewing this work in due course to better understand its impact.

• Ask new tenants about their smoking status during onboarding so that those who smoke can be offered targeted support.
• Include quit messaging in communications to tenants e.g. newsletters or posters in communal areas. Communications from social landlords should focus on financial savings messaging whereas public health outreach should focus on health harms.
• All housing providers should have a clearly defined referral pathway to their local stop smoking service that all resident-facing staff are familiar with.
• Tenant facing staff should be trained in how to deliver Very Brief Advice (VBA), a fast and opportunistic intervention that is proven to boost quit attempts.
• Consider introducing a digital offer for tenants in addition to referral to the local stop smoking service.
• Consider introducing a financial incentive offer for tenants in addition to a referral to the local stop smoking service.
• Consider providing vapes as part of the government Swap-to-Stop scheme encouraging residents to switch from smoking to vaping by giving out free vape starter kits, alongside some form of behavioural support.
• Join the smoking and social housing working group, coordinated by ASH. 

Action on Smoking and Health coordinates a smoking and social housing working group which brings together professionals focused on reducing smoking among social housing tenants. Members can share learning and best practice, get feedback, and connect with peers across England and Wales. Email noah.traill@ash.org.uk to request to join.