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Health Policy

ASH ICB Ready Reckoner

Nov 2023

Update: You can find an abbreviated table of key costs of smoking by ICB here. This table was updated 15/11/23.

The ASH ICB Ready Reckoner is an easy-to-use cost calculator, allowing you to see the costs of smoking to society at ICB level. Costs are in the categories of productivity, social care, healthcare and fire.

The cost total for England is £49.2 billion, which is much larger than in previous versions. This is largely because we have added the following costs:

  • Reduced Gross Value Added (GVA) due to expenditure on tobacco compared to other products (this is the value generated by any unit engaged in production of goods and services)
  • Cost of informal care provided by friends and family (social care)
  • Cost of unmet care needs (social care)Also reported, but not included in the spend total, are green book QALY value of life lost due to smoking, annual spending on tobacco and the tobacco tax income from VAT and excise duty.

For information on the original Ready Reckoner methodology, visit the ASH Ready Reckoner page.


For a short guide (with screenshots) on how to unzip and use this type of calculator, read the instructions on the original Ready Reckoner page.

If the Excel window says at the top that it’s in ‘Preview mode’ or ‘Read-Only’
Make sure you followed the instructions above for downloading the document. Opening an unsaved or zipped document means it may not function properly.

If there’s a red banner across the top of the Excel screen saying SECURITY RISK, or the document isn’t working as expected

The document works using macros, which are pieces of computer code. As it’s difficult to tell automatically whether they are designed to harm your computer, Windows and some IT systems might automatically block macros, which will stop the document from working. Try these tips:

  • Inside the Excel document go to File > Info. If there’s a red shield icon, click on it and set it to making it a ‘trusted document’
  • Close the document and open a new Excel document and try going to File > Options > Trust Centre > Trust Centre Settings > macro settings and select ‘disable all VBAs with notification’ or ‘disable all macros with notification’ (wording depends on excel version), and reopen the document.

The ICB Ready Reckoner may not run properly on versions of Excel older than 2010, and some organisations blanket-block all macro-enabled Excel documents, so it may not be accessible to everyone.

If you’re not able to access the document, please email and we can send you screenshots of the data you need.