Smoking Rates Rise in Parts of England for the First Time Since 2006

For the first time in nearly two decades, smoking rates in parts of England have increased, reversing years of steady decline. A comprehensive study conducted by researchers at University College London (UCL) has shed light on this alarming trend, highlighting regional disparities in smoking habits and the potential consequences of funding cuts to tobacco control programs.

While the overall proportion of adults who smoke has dropped significantly since 2006—from 25.3% to 16.5% in 2024—the progress made since 2020 has stalled, and in some areas, smoking rates are once again on the rise. This resurgence is particularly concerning given the well-documented health risks associated with tobacco use, including cancer, respiratory diseases, and cardiovascular conditions.

A Regional Divide: Smoking on the Rise in the South, Declining in the North

The study, published in the journal Addiction, examined smoking data from more than 350,000 adults across England over an 18-year period. The findings revealed a striking contrast between different regions:

• In southern England, smoking rates increased by 10% between 2020 and 2024.
• The south-west experienced the largest rise, with a 17% increase, bringing the total smoking rate in the region to 18.7%.
• The south-east and London also saw increases of 9% and 8%, respectively.
• Meanwhile, the north of England saw a 9.7% decrease in smoking rates over the same period.

These findings suggest that while progress has been made in reducing smoking overall, certain regions are now experiencing a troubling resurgence. Extrapolating these figures to the entire population suggests that approximately 7.5 million adults in England are smokers, with an estimated 3.3 million residing in London, the south-east, and the south-west—nearly 400,000 more than in 2020. In contrast, the number of smokers in the north has fallen to 2 million, a decrease of 160,000.

Why Is Smoking Increasing Again?

Several factors may be contributing to the rising smoking rates in parts of England:

1. Increased Relapses Among Former Smokers – While more people have attempted to quit in recent years, some have relapsed, leading to stagnation or even an uptick in smoking rates.
2. Gender and Age Disparities – Previous research suggests that smoking rates among women have risen, while younger adults are quitting at higher rates than older adults.
3. Unequal Access to Smoking Cessation Programs – The north of England has seen significant investment in tobacco control programs, whereas these services may be less accessible in the south.
4. Financial and Social Stressors – Economic uncertainty and lifestyle changes following the COVID-19 pandemic may have driven some individuals back to smoking as a coping mechanism.

Impact of Tobacco Control Programs

One of the key reasons for the decline in smoking rates in the north is the sustained investment in stop-smoking services. The study’s lead author, Dr. Sarah Jackson of the UCL Institute of Epidemiology and Health Care, emphasized the importance of equal access to these services across the country:

“It’s vital that stop smoking services are made easily and equally available across the country, so that everyone—wherever they live—can access the right tools to quit for good.”

However, experts are warning that planned cuts to integrated commissioning boards (ICBs), which fund smoking cessation programs, could jeopardize future progress. Hazel Cheeseman, chief executive of Action on Smoking and Health (ASH), expressed concern that budget reductions might hinder efforts to reduce smoking rates:

“The accelerated progress on smoking in the north compared with the south is because of sustained investment over many years. If cut, the country risks going backwards and failing to deliver on the vision of a smoke-free country.”

Calls for Government Action

With smoking rates rising in some regions and stagnating in others, public health experts are urging the government to maintain and expand funding for anti-smoking initiatives. Dr. Ian Walker, executive director of policy and information at Cancer Research UK, warned that the country cannot afford to lose momentum:

“A future free from the harms of tobacco is in sight, but we can’t afford to lose any momentum. Budget pressures and changes to NHS England can’t compromise funding for programs that help people quit—tackling smoking must be a key priority as our health services evolve.”

The Role of the NHS and Local Authorities

The UK government has pledged to tackle smoking through initiatives such as the landmark tobacco and vapes bill, which aims to create a “smoke-free generation.” A Department of Health and Social Care spokesperson reaffirmed the government’s commitment to reducing smoking rates:

“We are also committed to supporting current smokers to quit. We’re investing an additional £70m for local stop smoking services this year, and we are working to ensure that all NHS hospitals offer ‘opt-out’ smoking cessation services.”

However, health professionals remain concerned that without sustained investment, these efforts may not be enough to counteract rising smoking rates in some areas.

The Devastating Impact of Smoking

Smoking remains one of the leading causes of preventable death in the UK, contributing to numerous serious health conditions, including:

• Lung cancer – Smoking is responsible for more than 70% of lung cancer cases.
• Heart disease – Smokers are at a significantly higher risk of heart attacks and strokes.
• Chronic obstructive pulmonary disease (COPD) – Smoking damages the lungs, leading to long-term breathing problems.
• Weakened immune system – Smokers are more susceptible to infections and illnesses.

Prof. Kamila Hawthorne, chair of the Royal College of General Practitioners, highlighted the role of GPs in encouraging patients to quit smoking:

“GPs see the devastating consequences of smoking every day in our surgeries. We see patients facing years of ill health, preventable conditions, and early death because of smoking. We also know how incredibly hard it can be to give up smoking once it becomes an addiction, and many of our patients do try very hard to stop.”

The Path Forward: Combating Smoking Through Policy and Prevention

To effectively combat smoking and ensure continued progress, experts recommend the following steps:

1. Sustained Investment in Smoking Cessation Programs – Government and NHS funding should remain consistent to ensure equal access to quit-smoking services.
2. Targeted Public Health Campaigns – Raising awareness of the dangers of smoking and promoting evidence-based quitting methods can help reduce smoking rates.
3. Support for High-Risk Groups – Providing tailored support for older adults and individuals at risk of relapse can help address rising smoking rates.
4. Stronger Regulations on Tobacco and Vaping Products – The government’s proposed tobacco and vapes bill should be implemented effectively to prevent future generations from becoming smokers.
5. Continued Research and Data Collection – Monitoring smoking trends across different demographics and regions will help policymakers make informed decisions.

 A Critical Moment for Tobacco Control

The rise in smoking rates in parts of England is a concerning development that underscores the need for continued vigilance in tobacco control efforts. While progress has been made, the recent increase in smoking in the south highlights the risks of complacency and funding cuts.

By maintaining investment in cessation programs, strengthening public health campaigns, and implementing strong policies, England can work towards a smoke-free future and ensure that the gains made over the past two decades are not lost.