New survey shows Councils welcome growth in NHS support to smokers
The annual Action on Smoking and Health (ASH) survey of local government public health teams, funded by Cancer Research UK, finds NHS investment in new inpatient treatment for smokers strongly supported by local government. [1]
NHS investment is welcomed as an opportunity to help more smokers to quit, by creating a more integrated service that can reach more smokers. Additionally, many places have NHS Targeted Lung Health Checks, an initiative to improve early lung cancer diagnosis. These NHS-funded checks target those with a smoking history and direct them to support. Of those local authorities with these Targeted Lung Health Checks in place, 73% report an increase in demand for local authority stop smoking services.
However, councils are worried that funding cuts in local authority public health grant since 2015/16 [2] have left them short of the capacity to provide sufficient follow up support in the community to maximise successful quitting outcomes. These concerns have intensified recently as public health grant allocations have still not been given to local authorities, leaving them little time to prepare for the forthcoming financial year (2023-24). [3]
Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board said:
“Council public health teams work hard to help reduce smoking rates and it is testament to their efforts that smoking rates continue to fall.
“However, as this report reveals, this work is becoming increasingly challenging, as local public health budgets have been reduced by over £1 billion since 2015 and we’re still in the dark about our funding for the forthcoming year which starts in April.
“Councils can help the Government to achieve its ambition of eliminating smoking in England by 2030, through their tobacco control and other public health and support services, but they must have long term certainty over their public grant in order to do this.”
Despite the concerns over budgetary pressures, local government is broadly positive about the future of working in partnership with the NHS, including through Integrated Care Systems. Most local authorities are closely involved in supporting the NHS to develop new services (86%). In places where they were not involved there were risks to the system, such as smokers not being picked up when discharged from hospital or unproven models being implemented.
ASH, Cancer Research UK and others have joined the APPG on Smoking and Health and the Independent Khan Review [4] in a call for additional funding for tobacco control to be generated through a levy on the tobacco manufacturers. This would easily raise the additional £125 million a year The Khan Review said was the minimum amount needed to meet the government’s ambition for England to be smokefree by 2030.
Malcolm Clark, Senior Prevention Policy Manager, Cancer Research UK
“It’s time the tobacco industry, not the taxpayer, pays for the harm it causes to our nation's health, and our health service.
“The UK Government must implement a Smokefree Fund, making tobacco companies foot the bill – without them having any influence on how the money is spent. This funding should go towards the vital measures and services that help people who smoke to stop, like local stop smoking services.
“If Steve Barclay took bold action on tobacco control in this way, this would have a significant impact on relieving pressure on an NHS already buckling under huge demand.”
Last week ASH also published a new analysis of the impact of smoking on public finances and the economy. It showed that investing the £125m called for in the Khan review could create a net benefit to public finances of £5.3bn by 2030. [5] They called on the Chancellor to recognise the value of addressing smoking to the economy and invest to secure the smokefree 2030 target.
Hazel Cheeseman, Deputy Chief Executive, Action on Smoking and Health:
“The lack of funding for local government is not sustainable and risks undermining the chance to help thousands more smokers quit. This funding should come from big tobacco companies whose massive profits come at the price of ordinary people’s health and wealth.”
Key findings from the survey:
- Most surveyed local authorities (86%) were involved in the planning and roll-out of new NHS tobacco dependence treatment services, though some local authorities were much more engaged than others. In some areas, local authorities were leading the implementation process.
- Many survey respondents were optimistic about the opportunity of the roll-out of NHS tobacco dependence treatment services to reach more smokers and to create a more integrated service across the NHS and community. However, some expressed concern that new NHS services could place a burden on community services that local authorities would struggle to meet.
- The impact of the NHS tobacco dependence treatment services on local authority stop smoking services is likely to be complex and variable across the country. Some local authorities reported an increase in demand, others a decrease. In most areas, impacts were yet to be felt.
- In the areas where lung health checks have been implemented, 73% of local authorities reported an increase in demand on community stop smoking services. None reported a decrease in demand.
- A majority of surveyed local authorities (52%) offered vapes or e-cigarettes to users of stop smoking services. They were provided directly or via vouchers or other arrangements with vape shops.
- One third of surveyed local authorities (33%) do not commission a universal specialist stop smoking service and two authorities no longer commission any support for smokers.
ENDS
For additional information, contact press@ash.org.uk
References
[1] ASH. New Paths and Pathways. Feb 2023: https://ash.org.uk/uploads/New-paths-and-pathways.pdf
[2] The Health Foundation. The Public Health Grant. October 2022 https://www.health.org.uk/news-and-comment/charts-and-infographics/public-health-grant-what-it-is-and-why-greater-investment-is-needed
[3] https://www.local.gov.uk/about/news/local-public-health-services-risk-amid-funding-uncertainty
[4] The Khan review: Making Smoking Obsolete. Independent review into Smokefree 2030 policies. 9 June 2022. https://www.gov.uk/government/publications/the-khan-review-making-smoking-obsolete