Smoking is the primary cause of preventable illness and premature death in the United Kingdom, accounting for approximately 100,000 deaths a year. Reducing the number of people who smoke is therefore a key priority in improving the health of the population, and Stop Smoking Services are a key NHS intervention to reduce smoking.
Although smoking prevalence has fallen in Great Britain (from 27% in 2000 to 17% in 2017), the health consequences of smoking continue to present a major public health challenge. NHS Stop Smoking Services offer intensive group therapy or one-to-one support to help people quit smoking. Their effectiveness can be measured by the percentage of people who self-report that they have successfully quit smoking at the four-week follow-up, if he/she says they have not smoked at all since two weeks after the quit date.
The percentage of people using NHS Stop Smoking Services who self-reported that they were successful in quitting at four weeks has remained relatively steady over time, fluctuating at around 50%. However, to gain an indication of the level of tobacco use we can also measure the level of carbon monoxide in the bloodstream, and the number of ‘carbon monoxide validated quitters’ is significantly lower, which indicates that the self-reported data is prone to bias. In 2017/18, 51% of people using NHS Stop Smoking Services self-reported that they had quit at four weeks, but this was only confirmed by carbon monoxide validation among 36% of service users.
The number of people setting a quit date has fallen for six consecutive years, from 816,444 in 2011/12 to 274,021 in 2017/18 (data not comparable, see ‘About this data’ for more information). Between 2016/17 and 2017/18, the number of people setting a quit date decreased by 11%. The reduction in recent years may partly be due to the increased use of e-cigarettes, which are widely available outside stop smoking services. According to the Opinions and Lifestyle Survey, the percentage of people in Great Britain aged 16 and over who currently use e-cigarettes increased from 3.7% in 2014 to 5.5% in 2017. The percentage of people who had been an e-cigarette user was higher at 13.3%, and over 19% of people had tried an e-cigarette.
The absolute number of people setting a quit date gradually increased from 2003/04 to a peak of over 800,000 in 2011/12. Since then, the number has plummeted, hitting roughly 450,000 in 2014/15. Anecdotal evidence suggests that people increasingly smoke e-cigarettes in lieu of quitting. The declining prevalence of smoking may also contribute to the decreasing number of quitters, although this trend outlasts the period of decline.
NHS Stop Smoking Services were first set up in 1999/2000 with the aim of reducing health inequalities and improving the health of local populations. This indicator shows the extent to which smoking varies by deprivation. In 2016, 27.2% of people aged 18 and over in the most deprived areas were current smokers compared with only 7.9% of people in the least deprived areas. Over time, the percentage of current smokers has declined at every level of area deprivation.
About this data
This indicator uses data from NHS Digital on Stop Smoking Services in England and the Office for National Statistics on e-cigarette use and smoking inequalities.
NHS Stop Smoking Services:
- Successful quitter (self-reported): a person is counted as having successfully quit smoking at the four-week follow-up if he/she says they have not smoked at all since two weeks after the quit date.
- Successful quitter (confirmed by carbon monoxide validation): measuring the level of carbon monoxide in the bloodstream provides an indication of the level of tobacco use. It is a motivational tool as well as a validation of smoking status. It should be attempted on all people who self-report as having successfully quit at the four-week follow-up, except for those who are followed up by telephone.
The data for 2016/17 onwards are not directly comparable with previous years because they have not been adjusted to estimate for local authorities who did not provide any data or only provided data for some quarters.