Hospital Stop Smoking Service cuts ‘abandoning’ vulnerable patients to a deadly addiction, health leaders warn

Health leaders have sounded the alarm over the threat of cuts to NHS tobacco dependence treatment services, as a new survey indicates that these vital, lifesaving programmes are at risk across the country due to budget uncertainty.

According to new data from Action on Smoking and Health (ASH), six acute hospital trusts and two mental health trusts have begun decommissioning their tobacco dependence treatment services, while 83% of services face uncertain futures due to lack of secure funding.[1]

Writing in the BMJ,[2] senior representatives from medical organisations including the Royal College of Physicians and the British Medical Association warn: “If these services are lost, it will set the NHS prevention agenda back five years and result in tens of thousands of vulnerable patients being abandoned to a deadly addiction.”

Since 2019, the NHS has been rolling out dedicated stop smoking support for patients in hospital and pregnant women. These services are already delivering significant results and supported over over 160,000 people between April 2024 and March 2025.[3] Most notably, smoking during pregnancy has fallen by 41% since 2019/20 (from 10.4% to 6.1%), after years of stagnation.[4] This progress translates into fewer stillbirths, miscarriages, and low birthweight babies – improving outcomes while easing pressure on maternity services.

In the BMJ article, health leaders say dismantling these services will reverse hard-won progress and derail the government’s plans to shift the health service towards prevention, laid out in the new 10-Year Health Plan for England. The Plan reaffirms the government’s commitment to embedding opt-out smoking cessation interventions into all hospital care.

Hazel Cheeseman, Chief Executive of ASH said:

“Tobacco treatment in the NHS is one of the rare interventions that saves lives, cuts costs, and reduces inequalities – yet it’s under threat just at the point when the NHS wants to ‘shift to prevention’. We’ve made real progress, but without sustained funding and leadership we risk turning a public health success story into a missed opportunity. Strategic sanity demands we protect what works.”

Alizée Froguel, prevention policy manager at Cancer Research UK, said:

“Tobacco is the biggest cause of cancer in the UK and if you smoke, stopping completely is the best thing you can do for your health. But this report reveals worrying funding uncertainty for NHS stop smoking services in England. It’s vital that everyone can access the support they need to quit – it can help to save lives, reduce pressure on the NHS and tackle health inequalities.

“Alongside the world-leading Tobacco and Vapes Bill, we urge the UK Government to prioritise long-term funding for stop smoking services as our health services evolve. Tobacco is a toxic product that should have no place in our future.”

The NHS bears a heavy cost from smoking – £1.8 billion annually,[5] with one person admitted to hospital nearly every minute due to smoking-related disease. Up to 75,000 GP appointments each month are linked to smoking - more than 100 every hour.[6]

ASH’s yearly survey of ICBs shows variation in NHS commitment to tobacco dependence treatment across Integrated Care Boards (ICBs).[1]

• 50% of ICBs have expanded provision beyond NHS Long Term Plan commitments, including in A&E, outpatient, and paediatric settings.
• In contrast, three ICBs have begun decommissioning services, affecting six acute and two mental health trusts.
• Tobacco control remains a high or above-average priority in 59% of ICBs.
• Implementation rates are strong: 80% in secondary care, 71% in mental health, and 91% in maternity services.
• Community-based provision is limited, with only 21% of ICBs offering services outside hospital settings.
• 83% of ICBs cite financial instability as a major threat to sustaining services, despite active efforts to maintain progress.

ASH is calling for protected, long-term funding for NHS tobacco dependence treatment services and clear accountability for Integrated Care Boards to deliver them. It is also urging investment to expand services beyond core settings and to embed tobacco treatment within wider NHS prevention and health inequality strategies.

For interviews or more information, contact press@ash.org.uk


Notes to Editors

The ASH ICB survey was conducted using Survey Monkey and was available online in April and May 2025. Tobacco control leads in ICBs were emailed and asked to complete the survey. Complete responses were received for 32 of 42 the ICBs in England, a 76% response rate. Most of the data reported are at ICB level. However, respondents to the survey provided trust-level data on the implementation of tobacco dependence treatment services.

Action on Smoking and Health (ASH) is a health charity working to eliminate the harm caused by tobacco use. For more information, visit ash.org.uk. ASH receives funding for its program of work from Cancer Research UK and the British Heart Foundation.


References

1. Action on Smoking and Health (ASH), Cancer Research UK (CRUK), At risk? Tobacco dependence treatment in the NHS: Findings from a survey of Integrated Care Boards in England, August 2025.
2. Protect NHS tobacco dependence treatment services from funding cuts—a call from health leaders to NHS England. BMJ 2025;390:r1730
3. From correspondence with NHS England
4. NHS Digital. Statistics on Women's Smoking Status at Time of Delivery: England, Q4 2024/25. 19 June 2025
5. ASH. ASH Ready Reckoner January 2025: Costs of smoking to society
6. Cancer Research UK. Ending smoking could free up 75,000 GP appointments each month. March 2023