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ASH on the Cost of Smoking

Action on Smoking and Health UK has released a report detailing the cost of smoking on social care in England

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Action on Smoking and Health UK (ASH) has released a report detailing the cost of smoking on social care in England. It is the fourth in the series and details the shocking impact of tobacco use on people’s lives – something that could be alleviated if ASH got behind pragmatic, evidence-based changes to the current legislation.

Deborah Arnott, chief executive of ASH (1), said, “This report reveals the shocking extent to which smoking damages the quality of people’s lives, and of those around them, before going on to kill them prematurely. On average, smokers need social care at 63, ten years earlier than non-smokers, so if the Government truly wants to extend healthy life expectancy by five years by 2035, ending smoking is a priority. However, achieving the Smokefree 2030 target won’t be easy and requires investment at a time when the Government has a massive budget deficit. Tobacco manufacturers, on the other hand, remain extremely profitable and should be made to pay a levy on their sales as they do in the US to help make smoking obsolete.”

The report (2) used data from the English Longitudinal Study of Ageing (ELSA) and the Health Survey for England (HSE). It estimated the rate at which smokers and ex-smokers aged over 50 (in the ELSA    data) and over 65 (in the HSE data) receive care in their home (domiciliary care) and residential social care compared with people who have never smoked.

It found that over one and a half million people in England (1,647,500) require care support as a result of smoking. Of these:

  • 85,000 people are receiving local authority funded care in their home
  • 17,500 people are receiving local authority funded care in a residential care home
  • 1,095,000 people are receiving care from informal sources, such as relatives and friends
  • 450,000 people currently need social care support but receive none

It estimates that if local authorities met the current needs that are being catered for in family homes it would place an additional £14 billion burden on the state, on top of the current £1.2 billion being spent.

Councillor Ian Hudspeth, chairman of the Local Government Association’s (LGA) Community Wellbeing Board, said: “The substantial impact smoking has on council finances and social care costs reinforce the case for urgent investment to reduce smoking and achieve the Government’s ambition of a smokefree country by 2030. Public health funding has not kept pace with funding for the NHS, and this must change if local government is to play a full role in improving the health of the nation. The forthcoming Spending Review must be the moment to put public health and social care on a sustainable footing so that councils can continue their vital work in supporting, promoting and improving people’s wellbeing.”

It could not be clearer, if ASH wishes to reduce the cost of smoking on social care in England then it needs to get behind calls to raise the cap on nicotine concentration in e-liquids and stop demanding ministers restrict the availability of flavours.


  1. Action on Smoking and Health UK -
  2. The costs of smoking to the social care system and related costs for older people in England: 2021 -

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Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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