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 the United Kingdom (from 20% in 2011 to 15% in 2018), 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. The number of ‘carbon monoxide validated quitters’ is significantly lower, which indicates that the self-reported data is prone to bias. In 2018/19, 52% 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 37% of service users.
Data for 2016/17 onwards are not directly comparable with previous years because they have been adjusted to estimate for local authorities that did not provide data.
The number of people using NHS Stop Smoking Services who set a quit date has fallen for seven consecutive years, from 816,444 in 2011/12 to 236,175 in 2018/19 (data not comparable, see 'About this data' for more information). Between 2017/18 and 2018/19, the number of people setting a quit date decreased by 14%. 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 6.3% in 2018. The percentage of people who had been an e-cigarette user was higher at 10%, and over 19% of people had tried an e-cigarette.
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 2018, 17.9% of people aged 18 and over in the most deprived areas were current smokers compared with only 9.8% of people in the least deprived areas. Since 2011, the percentage of current smokers has declined at every level of area deprivation. The gap in smoking prevalence between the most and least deprived areas has also decreased, from a 9 percentage point gap in 2011 to an 8.2 percentage point gap in 2018.
The Smoking, Drinking and Drug Use among Young People survey (SDD) asks secondary school pupils in years 7 to 11 in England about their tobacco consumption. Pupils were categorised as regular smokers if they usually smoked at least one cigarette per week. In July 2017, the Tobacco Control Plan for England set a national ambition to reduce the number of 15-year-olds who regularly smoke from 8% to 3% or less by the end of 2022.
Between 2000 and 2018, the proportion of 15-year-old pupils who were regular smokers decreased from 23% to 5.3%. In general, a greater proportion of 15-year-old girls are regular smokers compared to 15-year-old boys. If the 2022 target is to be met, the proportion of young people who smoke must decrease by 2.3 percentage points.
About this data
This indicator uses data from NHS Digital on Stop Smoking Services in England, the Office for National Statistics on e-cigarette use, Public Health England on smoking inequalities, and the Smoking, Drinking and Drug Use among Young People survey (SDD).
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. This 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 NHS Digital data for 2016/17 onwards are not directly comparable with previous years because they have not been adjusted to estimate for local authorities that did not provide any data, or only provided data for some quarters.
Local Tobacco Control Profiles use data from the Annual Population Survey (APS) to calculate smoking prevalence in adults aged 18 and over. The number of respondents is weighted, taking into account survey design and non-response, to improve representativeness of the sample. Deprivation deciles are defined using the Index of Multiple Deprivation 2015 local authority scores.
Smoking patterns among young people:
The SDD survey is a biennial survey of secondary school pupils in years 7 to 11 (mostly aged 11 to 15) in England, published by NHS Digital. The last survey was in 2018. Prior to 2014, the survey was conducted annually.
Pupils were categorised in three ways based on the responses given:
- regular smokers (defined as usually smoking at least one cigarette per week);
- occasional smokers (defined as usually smoking less than one cigarette per week); or
The government's ambition to reduce the number of 15-year-olds who regularly smoke to 3% or less by the end of 2022 will be measured via the SDD survey.