Smoking: How the NHS Aims to Help You Quit, and Why

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Note: The information in this article is taken (largely) word-for-word from this government web page.

Smoking and tobacco: applying All Our Health

Updated 5 April 2022

13.9% of adults in England still smoke. This equates to over 6 million people in 2019.

Smoking is the leading preventable cause of illness and premature death, killing around 74,600 people in England in 2019. US data indicates that for every death caused by smoking, at least 30 smokers are living with a serious smoking-related illness.

In England in 2019 to 2020, there were an estimated 506,100 smoking-related admissions to hospital, equating to almost 1,400 each day. One in 4 patients in a hospital bed is a smoker. Smokers also see their GP 35% more than non-smokers.

The benefits of quitting smoking

Quitting smoking has many benefits, including:

  • shorter hospital stays
  • lower drug doses
  • fewer complications
  • lower drug doses
  • fewer complications
  • higher survival rates
  • better wound healing
  • decreased infections
  • fewer re-admissions after surgery

Smoking is now considered a dependency requiring treatment and the government is committed to making the country smoke-free as soon as possible. In fact, it is the stated aim of the government to achieve a smoke-free society in England by 2030.

The harm caused by smoking

Smoking harms nearly every organ of the body. It causes lung cancer, respiratory disease and cardiovascular disease, as well as many cancers in other organs including lip, mouth, throat, bladder, kidney, stomach, liver and cervix. Smoking reduces fertility and significantly raises the risk of developing type 2 diabetes, eye disease and dementia. It leads to decreased bone mineral density and is associated with increased risk of osteoporosis, bone fractures, back pain and degenerative disc disease.

Smoking is also harmful to mental health and wellbeing. National data shows that smokers score worse than the population as a whole on every mental wellbeing indicator.

Smoking during pregnancy

Smoking is the most important modifiable risk factor in pregnancy. Smoking is associated with a range of poor pregnancy outcomes including:

  • miscarriage
  • stillbirth
  • premature birth
  • neonatal complications
  • low birth weight
  • sudden infant death syndrome

Around 1 in 10 babies in England is born to a mother who smoked throughout her pregnancy.

The effects on mental health

People with mental health problems are almost 2½ times as likely to smoke as the general population. Smoking rates increase with the severity of mental illness. Among adults with a serious mental illness, 40.5% smoke. The high smoking rate among people with mental health conditions is the largest contributor to their 10 to 20 year reduced life expectancy.

People with a mental health condition are just as likely to want to stop smoking as those without, but they are more likely to be addicted to smoking and more likely to think it will be difficult to quit.

Quitting smoking

Over half (52.7%) of smokers say they want to quit, and 1 in 5 intends to do so within 3 months. Currently, around half of all smokers in England try to quit with no help (i.e. just using willpower alone), despite this being the least effective method.

How the NHS aims to help

The NHS Long Term Plan sets out the commitment that by 2023 to 2024, all people admitted to an acute or mental health hospital who smoke will be offered NHS-funded tobacco dependency treatment (based on the Ottawa Model for Smoking Cessation). NHS staff will deliver stop smoking support during and after the hospital stay and refer the patient into community stop smoking support when they are discharged.

There is a wide range of stop smoking aids available, including:

  • nicotine replacement therapy (NRT) products such as patches, sprays, lozenges and gum
  • e-cigarettes (vapes)
  • prescription tablets Varenicline (Champix) and Bupropion (Zyban)

Using a stop smoking medicine prescribed by a healthcare professional doubles a smoker’s chances of quitting.

The really harmful substances in cigarettes

The evidence shows that while nicotine is the addictive substance in cigarettes, it is relatively harmless. In fact, almost all the harm from smoking comes from the thousands of other chemicals in tobacco smoke, many of which are toxic. Despite this:

  • 4 in 10 smokers and ex-smokers incorrectly think nicotine causes most of the smoking-related cancer
  • only a third of smokers know that NRT is much less harmful than cigarettes

Conclusion

To sum up, the government is committed to achieving a smoke-free society in England by 2030.
The aim, therefore, is to make smoking in England a thing of the past in the next decade or two.
Over recent years, smoking has been banned in various places, e.g. shops, bars, restaurants, theatres, buses, trains, etc. The aim is to extend this ban so that soon it will be illegal to smoke virtually anywhere in England in public.

Smoking is dangerous to the individual (see above), and it’s costly to the nation. The government is determined to do everything possible to encourage people to quit smoking once and for all.

Today, 9th June 2020, the government announced new measures, including increasing the age at which it is legal to buy tobacco products by one year, every year. It’s now legal to buy cigarettes at 18 years of age. If this plan goes ahead it will be increased to 19 next year, 20 the year after, and so on. This will continue until it’s illegal for anyone, of any age, to buy tobacco products.

The use of vapes, in preference to cigarettes, will be promoted. And there will be a mass media campaign to encourage smokers to quit.

Dr Javed Khan OBE, who led the independent review into tobacco, said:

“A smokefree society should be a social norm – but to achieve this, we must do more to stop people taking up smoking, help those who already smoke and support those who are disproportionately impacted by smoking. My holistic set of recommendations for government will deliver this, whilst saving lives, saving money and addressing the health disparities associated with smoking.”

“My proposals are not just a plan for this government, but successive governments too. To truly achieve a smoke-free society in our great country, we need to commit to making smoking obsolete, once and for all.”

For further information, see this page, and this page.

If you’re interested in quitting smoking (and improving your life in several other ways), see this page.