30 May 2018
New data published for World No Tobacco Day 31st May, by Action on Smoking Health shows that smoking costs communities in England £12.6 billion a year .
The figures show the additional pressure that smoking is putting on the NHS and social care services including annual costs of £2.5 billion to the NHS, and over £760 million to local authorities from smoking-related social care needs . Local authorities can use an easily accessible web tool to break the data down to local level so they can see the impact on their communities .
Smoking remains the largest cause of preventable death in England. However, a 2016 audit found that more than 1 in 4 hospital patients were not asked if they smoke and 50% of frontline staff are not given routine smoking cessation training .
ASH Chief Executive Deborah Arnott said:
“The Five Year Forward View calls for a ‘radical upgrade in prevention and public health’ but this has not been followed through and smokers are not getting the support they need to quit from the NHS. In some areas, Local Authority Stop Smoking Services have been reduced due to cuts in local authority funding. Cuts to public health budgets need to be reversed and the NHS needs to step-up and play a larger role in supporting smokers to quit.”
Given the enormous burden tobacco places on society, ASH argues that the tobacco industry should be forced to pay to address the harm it causes in line with the ‘polluter pays’ principle . It is estimated that tobacco companies in the UK make a collective annual profit of around £1 billion . ASH calls for the Government to place a levy on the tobacco industry with the money raised used to fund support for the recurring costs of tobacco control measures to reduce smoking prevalence, such as mass media campaigns, cessation services and local authority enforcement to prevent illicit trade and underage sales.
The theme of World No Tobacco Day this year is tobacco and heart disease. The British Heart Foundation has been award the World No Tobacco Day medal for their long standing work tackling the harm caused by tobacco.
Simon Gillespie, Chief Executive of BHF said:
“Smoking kills over 16,000 people in England every year from heart disease; a total of 20,000 across the UK. Many more people continue to live with smoking related heart problems. It is vital that tobacco control is properly funded, giving smokers the best chance to quit and preventing people from taking up smoking. A levy on tobacco companies would ensure there is sustained funding for tobacco control thus crucially help to drive down smoking rates.”
 Action on Smoking and Health (ASH). Local Costs of Tobacco Tool. 2018. http://ash.lelan.co.uk/
 Agrawal S and Mangera Z. Smoking Cessation Audit Report: Smoking cessation policy and practice in NHS hospitals. British Thoracic Society. 2016. https://www.brit-thoracic.org.uk/media/315359/BTS-Smoking-Cessation-Audit-Report-7-December-2016-final.pdf
 Smoking Still Kills, 2015 – this report produced by ASH and funded by Cancer Research UK and endorsed by 129 organisations, set out the case for making the ‘polluter pay’ and placing a levy on the tobacco industry to fund work to reduce the number of people who smoke. https://ash.org.uk/information-and-resources/reports-submissions/reports/smoking-still-kills/
 Branston JR, Gilmore AB. The extreme profitability of the UK tobacco market and the rationale for a new tobacco levy. University of Bath. 2015. http://opus.bath.ac.uk/43061/
18 August 2016.
Figures published today show a further significant 15% decline in the number of smokers seeking help to quit from the Stop Smoking Services in England. The services are as effective as ever, increasing smokers’ chances to quit by up to fourfold over cold turkey but they are reaching fewer smokers. Of particular concern is the decline in smokers who need the services most, such as pregnant smokers who find it particularly difficult to quit unaided. 
The NHS England Five Year Forward (FYFV) view forecast a £22 billion shortfall in funding for the NHS by 2020 which could only be plugged if there was “a radical upgrade in prevention and public health”.  Smoking kills more people than the next six causes of preventable premature death put together, so tackling smoking is core to a successful prevention strategy. However, government funding cuts to public health budgets have led to cuts in stop smoking services, making it increasingly difficult for them to deliver. 
Between April 2015 and March 2016 68,082 fewer smokers set a quit date with the Stop Smoking Services in England, compared with the previous year. This is the 4th consecutive year to show a fall in the number of people using the services. At the 4-week follow-up 195,170 people – 51% – reported that they had successfully stopped smoking. 
Stop Smoking Services remain effective and incredibly cost-effective. A review found that over ten years of operation, the English Stop Smoking Services increased their reach and impact threefold. In 2010/11 it is estimated that they helped more than 20,000 people to achieve long term abstinence. 
Services offer the best way of helping people to quit and to stay smokefree. With proper investment they can be very successful in attracting smokers from lower socio-economic groups where smoking prevalence is highest. 
Dr Andy McEwen, Executive Director of the National Centre for Smoking Cessation and Training (NCSCT) said:
“The Stop Smoking Services provide a vital lifesaving service for smokers addicted to tobacco and the real difference they make to hundreds of thousands of people each year is shown by the latest figures. They are proven to be effective and cost-effective, and it’s therefore very worrying that some local authorities are downgrading or even decommissioning their services. Such an approach is short-sighted and will end up costing lives and harming communities.
We need a fresh approach to measuring the success of the services with a focus on quality of care rather than simply the number of people they see, which is largely not under the control of the services.”
Deborah Arnott, chief executive of health charity ASH said:
“Smoking is responsible for half the difference in life expectancy between the richest and poorest in society. Stop smoking services provide the support smokers need to quit successfully, but they are under threat from local authority budget cuts.
The government needs to ensure that local authorities continue to be funded to provide specialist stop smoking services targeted at those with greatest need if they are to succeed in reducing health inequalities. The obesity strategy has not delivered, the government promised a new tobacco control strategy this summer which we await with interest. It needs to deliver if the Prime Minister is to succeed in her ambition to improve the life chances of the poorest in society.” 
Notes and Links:
 Five Year Forward View NHS England, 2015
 Reading between the lines. Results of a survey of tobacco control leads in local authorities in England. ASH/Cancer Research UK, 2016
 West, R. et al. Performance of English stop smoking services in first 10 years: analysis of service monitoring data. BMJ2013;347:f4921 doi: 10.1136/bmj.f4921
 Statement by the new Prime Minister, Theresa May 13 July 2016
A briefing for local councillors on the importance of the Stop Smoking Services is available from our Local Resources section.