Smoking

We must do more to help people quit smoking and ensure everyone gets the care they need. 

The poorest people are times more likely to smoke than those living in the least deprived areas. This level of inequality isn't fair. Everyone who wants to quit should be able to use a stop smoking service that caters to them. Getting specialist support alongside medication is the most effective way to quit smoking.

We need funding for local stop smoking services.

Quitting through a stop smoking services

What this page tells you

This page gives evidence and information about stop smoking services in England. It looks into smoking rates and people quitting through a stop smoking service. It checks progress against the Taskforce recommendation to: 

Plan and fund effective, high-quality stop smoking services which are accessible to everyone who wants to quit 

This will be measured through the following measures of success: 

  • An increase in the proportion of smokers setting a date to quit through an NHS stop smoking service.  

  • An increase in the proportion of smokers who have successfully quit smoking through an NHS stop smoking service.  

  • A decrease in the total adult smoking rate from 14.9% to 12% or less by 2022, in line with the Tobacco Control Plan for England 

What's the story so far?

Smoking rates are declining but there's still a huge problem and fewer smokers are accessing stop smoking services

The number of adults who smoke has been falling for a decade. This is good news. There are now 1.8 million fewer smokers than there were in 2011. Smoking rates have dropped from 19.8% of adults being recorded as current smokers in 2011 to 14.4% in 2018. 

Despite this, smoking is still the nation’s biggest killer and today nearly 6 million people are still smokers.

Smoking rates have been declining steadily from 2011 to 2018

Progress in smoking rates may be slowing

We're worried because the fall in smoking rates has slowed over the past 2 years. Last year saw the lowest levels of progress since 2011. We must maintain momentum if we are going to hit our 2022 target.

Smoking is still the nation’s biggest killer and today almost 6 million people are smokers.

Year% of population who currently smoketarget smoking rate (%)
201012
201119.8412
201219.3212
201318.3912
201417.8512
201516.9212
201615.5212
201714.8712
201814.4512
201912
202012
202112
202212

Current smoking rate over time against 12% target

Smokers want to quit and stop smoking services are the best way to make that happen

The package of support received through a stop smoking service

Around 60% of smokers want to quit, according to the Opinion and Lifestyles Survey. This means there are more than 3.5 million smokers who want to quit. They need the best advice, support and treatment to do this.

Smokers who get this package of support are up to 3 times more likely to quit successfully than those who try to quit on their own or with over the counter nicotine replacement therapy.

Funding for services has been cut

  • Icon illustrating a decrease in spendingLocal spending has fallen by £41 million from 2014/15 to 2017/18 (down 30%)
  • Icon illustrating cuts to government grantsGovernment cuts to the public health grant are the main reason for the reduction in spending
  • Only 56% of local authorities now offer a specialist stop smoking service to all smokers

Despite stop smoking services being the most effective way to quit, government funding has been cut making it difficult for local authorities to keep stop smoking services open. 

Funding for public health was £850 million lower in real terms in 2019/20 than initial allocations in 2015/16. As a result, many local authorities have had to reduce budgets for smoking cessation.

ASH states that between 2014/15 and 2017/18 local authority spending in England on stop smoking services and wider tobacco control fell by £41 million (30%).

What does this mean for smokers?

Services are less available to smokers

These cuts make services less available to smokers. In 2018, only 65% of local authorities commissioned a specialist stop smoking service, despite these being the most effective. This was down from 74% in 2017. What's more, not all of these were universal services open to all smokers. 56% were universal and 9% were restricted. 

22% of local authorities moved to an integrated lifestyle service, instead of a specialist service; 9% commissioned stop smoking support from professionals in primary care only. 3% did not commission any services.

*See descriptions for the different types of stop smoking services in the footnote below
Stop Smoking Servicerestricted specialist stop smoking servicesuniversal specialist stop smoking servicesintegrated lifestyle serviceprofessional support through primary careno stop smoking support service
Percent of Local Authorities9552293

A breakdown of the different stop smoking services across the country

Footnote - Smoking services definitions:
  • no stop smoking support service:
    Where there is no service available.
  • professional support through primary care:
    Where support is given through GP practices or pharmacies but there is no dedicated stop smoking service.
  • integrated lifestyle service:
    Where support is accessed through a general lifestyle and wellbeing service rather than a dedicated stop smoking service.
 
  • restricted ​specialist stop smoking services:
    Where support is given through a dedicated stop smoking service but it is restricted to only certain smokers, such as pregnant smokers.
  • universal specialist stop smoking services:
    Where support is given through a dedicated stop smoking service but it is restricted to only targeted groups, such as pregnant smokers.

Specialist stop smoking services have fallen from 111 to 85 services in 1 year.

A quarter of specialist stop smoking services became integrated with other services or closed altogether between 2017 and 2018

Specialist stop smoking services offer the most options for support and these have seen a reduction from 111 services to 85 services between 2017 and 2018.

Services across England have been cut or restricted at a time when they must be maintained as we work towards a smoke-free generation. 

Fewer smokers are accessing stop smoking services

While some areas do better than others, the trend across England is that fewer and fewer people are accessing stop smoking services with numbers falling each year. 

Stop smoking services have remained just as effective across this period, there are just fewer people using them.

To achieve the target of more smokers successfully quitting through stop smoking services we need improve the availability and accessibility of these services and continue to encourage smokers to use them through public health campaigns.

 

Stop smoking services between 2008 - 2018

Year% of smokers setting a quit date% of smokers successfully quitting (self-reported)% of population who currently smokes
20087.713.8720.79
20098.634.2620.66
20109.004.3819.62
20119.514.6719.84
20128.704.4919.32
20137.293.7418.39
20145.742.9217.85
20155.092.6016.92
20164.432.2515.52
20174.122.0814.87
20183.611.8914.45

The number of smokers using stop smoking services has been in decline since 2011 and with that, the number of people quitting through the services has fallen too.

We need to put this right.  

P-Smok-SRSSS-SSS OT No SQ% of smokers setting a quit date
20087.71
20098.63
20109.00
20119.51
20128.70
20137.29
20145.74
20155.09
20164.43
20174.12
20183.61

2011 was the high point for stop smoking services, with almost 100 out of every 1,000 smokers getting help from a stop smoking service. Now just under 40 out of every 1,000 smokers get help.

This was still 236,000 people last year, but it is not enough. 

Year% of smokers setting a quit date% of population who currently smokes
20087.7120.79
20098.6320.66
20109.0019.62
20119.5119.84
20128.7019.32
20137.2918.39
20145.7417.85
20155.0916.92
20164.4315.52
20174.1214.87
20183.6114.45

There are now less than half as many people getting help from smoking services than there were in 2011. That marks a 60% drop. Smoking rates have only fallen by 27% in that period. 

The decline in the use of stop smoking services is happening at a much faster rate than the decline in smoking. 

This rate of decline is not sustainable.  

 

Year% of smokers setting a quit date% of smokers successfully quitting (self-reported)
20087.713.87
20098.634.26
20109.004.38
20119.514.67
20128.704.49
20137.293.74
20145.742.92
20155.092.60
20164.432.25
20174.122.08
20183.611.89

The proportion of successful quit attempts has stayed roughly the same across the decade. This means the number of smokers successfully quitting has dropped in tandem with those setting a quit date. Put simply, the services are still just as effective but with fewer people setting a quit date fewer people quitting are ultimately quitting. This is why the focus area must be on getting more people through the doors of stop smoking services.  

Stop smoking services are now a postcode lottery

Access to stop smoking services now depends on where you live. This is wrong. Everyone who smokes should be able to count on specialist stop smoking support, but this isn’t the case. The government should fund local stop smoking services, across the whole country.

If you or someone you know wants to quit smoking, find out where your local stop smoking service is. You can also speak to your GP or a local pharmacist who will be able to provide support and advice on stopping smoking.

Explore how your area is performing

Explore how your area is performing

A detailed analysis

Nearly 1 million more smokers could have quit through a stop smoking service had services maintained their accessibility and impact

Stop smoking services are not reaching their full potential. In 2011, 9.5% of smokers set a quit date using a stop smoking service and 4.7% successfully quit. Since then these rates have more than halved. If access and standards had been maintained at 2011 levels from 2012 - 2018 then an extra 1.97 million smokers would have set a quit date and nearly 1 million more smokers would have successfully quit. While this is a simplification it highlights how smokers are paying the price of the decline in funding and services.

There are fewer people quitting as part of their new year’s resolution

Each year we see a spike in the number of smokers setting a quit date in the first quarter of the year. This is likely due to smokers finding inspiration in new year’s resolutions and the national January quit smoking campaigns.

Smokers swap cigarettes for party blowers as part of their new year's resolution

However, this pattern is changing. Previously, throughout 2009 – 2012, January, February, and March saw an average of 1.5x the number of smokers through the door of a stop smoking service than in the previous 3 months. Now it’s just 1.2x the number of people (2016 – 2019).  

This is possibly due to a reduction in services and national campaigns as well as the overall downturn in stop smoking services. However, it should be a focus area to re-inspire these quitters.  

However, there has been a decline in new year's quitters

The older you are the better your chances of successfully quitting – why don't services work as well for younger smokers?

Generally, the older you are the more likely you are to successfully quit using these services. Stop smoking services should be doing more for young people. The chart to the right describes how successful different age groups are at quitting through a stop smoking service. Percentages refer to the proportion of people who successfully quit through a stop smoking service after setting a quit date.

Bar titleIcon filenameValueRange-minRange-maxTargetLeft is goodLine of peopleScale-minScale-maxUnitRange-min-labelRange-max-label
Under 1837.21%63%Yes
18 - 3447.44%63%Yes
35 - 4451.81%63%Yes
45 - 5953.75%63%Yes
60 and over57.56%63%Yes

Who uses stop smoking services

45 - 59 year olds make up the biggest group of service users with young males behind on numbers

The biggest group of quitters are 45-59 year olds. In 2018 over 39,000 females and over 36,000 males set a quit date through a stop smoking service. The next biggest group was 18-34-year old females. In comparison, males aged 18-34 years old were a much smaller cohort, the smallest cohort over the age of 18. This highlights a potentially neglected group that could be a focus area for engagement.  

Default OrderName OrderAge and genderNumber of quittersSucess rate
17Female: 45 - 5939,95552%
28Male: 45 - 5936,83855%
33Female: 18 - 3435,27446%
49Female: 60 and over26,44055%
510Male: 60 and over24,54660%
65Female: 35 - 4424,29150%
76Male: 35 - 4423,25154%
84Male: 18 - 3422,41749%
91Female: Under 181,68633%
102Male: Under 181,47742%

A breakdown of who uses stop smoking services based on age and gender

Some of the most at risk in our society find it hardest to quit

The biggest group of quitters are those with a routine or manual occupation. In 2018 over 63,000 routine and manual workers set a quit date through a stop smoking service. This group does also represents a large proportion of the smoking population, 40%. 

Smokers who are classified as 'sick/disabled and unable to return to work', 'never worked or are unemployed for over 1 year' or 'students' have some of the worst quit success rates. Sick or disabled people may need tailored interventions and support to quit smoking for good, as they are likely to be living with competing health issues and priorities. It is important that services are tailored to each person's individual needs as with specialised stop smoking services in order to provide the best level of care.

Default OrderName OrderSocio-economic classificationNumber of quittersSucess rate
38Retired32,17659%
41Managerial and professional occupations25,47158%
62Intermediate occupations19,68156%
97Prisoners2,58156%
13Routine and manual occupations63,39155%
75Home carers (unpaid)10,34148%
59Sick/disabled and unable to return to work22,60148%
1010Unable to code21,16747%
26Never worked or unemployed for over 1 year33,55645%
84Full time students5,21043%

A breakdown of who uses stop smoking services based on socioeconomic classification

Men are under-represented in stop smoking services

Only 3% of male smokers access stop smoking services compared to 5% of female smokers.

Of those using stop smoking services, 54% are female and 46% are male. This is despite the fact that there are more male smokers than women smokers according to ONS data.   

We know that only 3 in every 100 male smokers, compared to nearly 5 in every 100 female smokers use stop smoking services. Men are generally not engaging with these services as much as women, despite being the slightly larger smoking population.  

This ties in with the fact that generally, men are less likely than women to seek advice from their doctor. Is there more to be done to encourage men into a stop smoking service?  

 

Our asks

What do we need?

  • We need sustainable funding for services from central government
  • We need well-funded national stop smoking campaigns
  • We need more services
  • We need all services to be accessible to all smokers
  • We need equal care for all people
  • We need consistent and quality data on smoking and stop smoking services - see data issues below

Data issues

Missing data

Each year a number of local authorities fail to submit or only partially submit data on stop smoking services. In 2018, 9 local authorities either did not submit any data or only submitted partial data. This can be seen on the map with areas shaded in grey. We need reliable data in order to ensure the best level of care for the public. 

Data consistency

The way data on smokers and stop smoking services are recorded makes it difficult to know if any demographic groups are being underrepresented for both age and socio-economic classifications. We want to know this to ensure everyone is receiving an equal level of care and no-one is missed during outreach, marketing or campaigning. By knowing what the problem is we can put it right.   

There are a number of examples of support for smokers with low socioeconomic status to quit which really work. These include services that offer a financial incentive or are tailored to match literacy levels.

A comparison between smoking rates and smoking services data

The tables outline the difference between the number of current smokers is recorded (smoking prevalence) and how the number of people using stop smoking services is recorded. Until these are consistent it is impossible to know if groups are being missed. 

Smoking prevalence: age cohorts are as follows: Smoking services: age cohorts are as follows:
  Under 18
18 to 24
25 to 34
18 - 34
35 to 44 35 to 44
45 to 54
55 to 64
65 and over
45 - 59
60 and over
Smoking prevalence: socio-economic classifications are as follows: Smoking services: socio-economic classifications are as follows:
Never worked, long term unemployed, and n.e.c2 Never worked or unemployed for over 1 year
Managerial and professional occupations Managerial and professional occupations
Intermediate occupations Intermediate occupations
Routine and manual Routine and manual occupations
 

Full-time students
Home carers (unpaid)
Prisoners
Retired
Sick/disabled and unable to return to work
Unable to code

Help and more info

If you would like more help and information on smoking please visit our website or find out more through the NHS website on stop smoking services

Data sources

All data sources can be found on our data sources page