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Press Release

Smokers develop social care needs a decade earlier than those who’ve never smoked

26 Sep 2019

26 September 2019

The average age of smokers with a social care need is 62, compared to 72 for never-smokers, according to a research report published today by Action on Smoking and Health (ASH).[1]

The report, Social care costs: Going up in smoke, also found that the cost of smoking-related social care to local authorities is £720 million a year and the cost of smoking-related social care to individuals who pay for their own care is £160 million a year.

Last year, smoking killed 78,000 people in England alone.[2] But the costs of smoking don’t stop there - for every person killed by smoking, at least 30 people live with a serious smoking-related illness.[3]

670,000 people over 50 have care needs as a result of smoking and though 55% of these adults receive the support they need, 45% (300,000) have unmet care needs.

Informal carers, friends and family members who help with tasks at no cost, provide care for 345,000 of the total due to smoking which would cost an additional £10.6 billion if it were provided by paid carers.

The report findings are based on multi-wave analysis of the English Longitudinal Study of Ageing (ELSA) by Landman Economics for ASH. Of respondents over 50, one in four (23.5%) current smokers need help with at least one of six activities of daily living (ADLs), compared to never smokers, who were almost half as likely (12.1%) to need help.

Ciaran Osborne, Director of Policy at ASH said:

“Disease and disability caused by smoking leads people to need social care a whole decade sooner than if they had never smoked. Not only is this severely detrimental to their quality of life, it also puts avoidable strains on England’s creaking social care system. Local authorities should support smokers in their communities to make an annual quit attempt as stopping smoking will help them maintain their quality of life as they age.”

Smokers who quit by 30 can avoid almost all the long-term health consequences of smoking,[4] as well as reducing the likelihood they’ll need social care.

Key recommendations:

Local authorities should set a local smoking prevalence target and work to reduce prevalence rates locally by:

  • Denormalising smoking
  • Promoting an annual quit attempt
  • Providing diverse stop smoking support

Central Government should commit to extending and enhancing tobacco industry regulation to ensure delivery of its ambition of ending smoking by 2030 to include:

  • Imposing a ‘polluter pays’ charge on the tobacco manufacturers to fund tobacco control including anti-smoking campaigns, enforcement and targeted support for smokers to quit.
  • Stricter regulation of tobacco marketing including, for example, requiring retailers to have a licence, raising the age of sale and requiring pack inserts which promote quitting.

Helping people to quit smoking today will mean lower social care costs in the future for both local authorities and smokers. It will also mean fewer people relying on informal care or having to live with unmet care needs.


Notes to the editor:

About Action on Smoking and Health:

Action on Smoking and Health is a health charity working to eliminate the harm caused by tobacco use. For more information see:

ASH receives funding for its programme of work from Cancer Research UK and the British Heart Foundation.

Media contacts:

ASH staff are available for interview and have an ISDN line. For more information send an email to or ring 020 7404 0242. Out of hours contact Deborah Arnott (Chief Executive, ASH) on 07976 935 987 or Ciaran Osborne (Director of Policy, ASH) on 07921 502181.


[1] Social care costs: Going up in smoke, 2019 also see Technical report 2019

[2] Statistics on Smoking, England – NHS Digital, 2019

[3] U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014

[4] NCBI, Mortality in relation to smoking: 50 years' observations on male British doctors, 2004