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Health Policy

ASH Ready Reckoner

Nov 2023

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

The ASH Ready Reckoner is an easy-to-use cost calculator, allowing you to see the costs of smoking to society in local authorities, combined authorities, regions, and England. Also find estimates for wards and constituencies. 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.

To see the full set of costs for your area, follow the steps to download the ready reckoner below.

Below is a short guide on how to download and run the calculator.

Unzip and save the file

Once you’ve downloaded it, right click on the file and select ‘Extract All…’ or something similar. Choose a place to save the unzipped document (not your downloads folder). You may want to delete the zipped version so you don’t accidentally open that in future.

Unblock the file

Navigate to the folder the file is saved in, right click on the file and select ‘properties’. In the box that comes up there might be a section at the bottom (underneath ‘Attributes: Read only, Hidden’) that says: ‘Security: This file came from another computer and might be blocked to help protect this computer’ with a tickbox labelled ‘unblock.’

If there is, tick the unblock box > click 'Apply' > then click 'OK'. Then open the Excel file.

Enable all content

If prompted by a yellow banner across the top of the Excel screen saying SECURITY WARNING, click the button on it called ‘Enable Content’.

Enable macros

If a box comes up asking you to confirm you want to enable macros, select ‘Yes’.

Similarly, if there’s a yellow banner across the top of the Excel screen saying it’s in PROTECTED VIEW, select the button on it called ‘Enable Editing’ and If a box comes up asking you to confirm you want to enable macros, select ‘Yes’.


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.

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