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£44m social care bill to North East councils from smoking (ASH press release)

NEW figures show that smoking is adding to England's social care crisis, with at least £80.5m in the North East and £1.4 billion a year nationally spent on social care required because of smoking-related illness.


The problem is set to get worse, because the local authority public health grant which pays for stop smoking services is being cut by central government, and a growing number of NHS commissioners are now refusing to pay for GP prescriptions for stop smoking medicines.


Research published today by Action on Smoking and Health shows that local authorities in England face a bill of £760m a year, up from £600m in 2012, to help people with smoking-related illness stay in their own homes (domiciliary care). Individuals also face a bill of about £630 million to cover the cost of their own care.  This is on top of the estimated cost to the NHS of around £2 billion.


In the North East the figures for 2015/16 show:

  • The total additional spending by local authorities on social care as a result of smoking for adults aged 50 and over was approximately £44 million.
  • Individuals across the region aged 50 and over also faced a bill of over £36.6 million to cover the cost of their own care.
  • In addition, a further 13,595 individuals receive informal care from friends and family.


As well as killing 1 in 2 long term smokers, tobacco causes a range of diseases which can result in long term disability, including chronic obstructive pulmonary disease.


The new figures are included in an All-Party Parliamentary Group on Smoking and Health Report published today following an Inquiry convened by Bob Blackman MP, Chair of the APPG and former leader of Harrow Council. The Inquiry report highlights the need for national leadership to ensure smoking rates continue to fall and urges the Government to publish the new tobacco control plan for England - now over a year overdue - without further delay. 


The report also highlights the faster decline in smoking rates in the North East, where smoking fell by 9.1% between 2005 and 2014 compared to a 6% fall nationally, with strong and continued commitment by local authorities to tackling smoking after responsibility for public health was transferred from the NHS.


Bob Blackman MP, Chair of the All Party Parliamentary Group on Smoking and Health said:

"Evidence presented to the APPG on Smoking and Health shows that smoking is contributing to the current social care crisis. The situation will worsen if funding to local stop smoking services continues to be cut. Smoking is the leading cause of health inequalities in the UK so this puts at serious risk progress towards the Prime Minister's ambition to reduce the burning injustice caused by inequality.


The new Tobacco Control Plan for England, published without further delay, will be crucial to ensuring that Government, the NHS and local Councils work together effectively to continue to tackle the harm caused by smoking."


The Inquiry heard evidence that funding cuts to local authority stop smoking services and tobacco control work are being made worse by a lack of commitment from some parts of the NHS to helping smokers quit, with serious impacts on the health and social care system. The LGA has predicted that local authorities face a funding gap for social care provision of £2.6 billion by the end of the decade. 


John Pearce, Corporate Director for Children, Adults and Health for South Tyneside Council and Chair of the North East Regional Group for Directors of Adult Social Services, said:


"There is not only rising demand for care but also increasing costs. It is not just hospital budgets that are affected. In a region like the North East with very high smoking rates in previous decades and an ageing population, we are seeing a high burden placed on social care.


"Preventing people from needing care in the first place is vital and reducing smoking can make an important contribution both to reducing the costs of care to councils and improving the quality of life for many who may otherwise need years of care.


"Though the Government has taken short term steps to try and relieve the serious strain being placed on individuals, councils and the NHS, without urgent action, the situation will only worsen."


After being diagnosed with smoking-related Chronic Obstructive Pulmonary Disease (COPD) in his mid-fifties, Denham Thomas, from Hartlepool, has had to rely on the caring support of his wife, Debbie. Now 64-years-old, Denham's health has continued to deteriorate. For Debbie, 52, she no longer has a life outside of caring for Denham. 


"I first met Denham when he'd just been diagnosed with COPD. It's been heart-breaking to watch him get worse over the years and when I look at him sat in his wheelchair struggling to breathe through his oxygen tank, it's hard to believe that he was once this strong young man who loved sports. He gets really depressed sometimes and I can see in his eyes how angry he is with what smoking has done to him.


It's really sad to say because I wouldn't want anyone else to take care of him, but I'm not his partner anymore - I'm his carer and I've got to look after his every personal need."


Deborah Arnott, Chief Executive of ASH, commented: "Smoking places an enormous pressure on our over stretched health and social care system, not to mention the many thousands of carers who spend their lives looking after loved ones.


"We know that most local authorities remain committed to reducing smoking but key services are under threat from public health funding cuts. In some areas this is being made worse by a lack of engagement from NHS partners. Local and national action is urgently needed to ensure the continuity of support to help smokers quit."


Ailsa Rutter, Director of Fresh, said: "Smoking kills, but it also leaves thousands of people with years of life-limiting disability which can leave people housebound and requiring care.

"By helping more people to quit smoking now, not only will it improve their health but it will reduce social care costs and hospital re-admissions for people with long term conditions.

"We welcome this report and the recognition of North East local authorities to reduce the death toll and impact of smoking. We believe our biggest priority now is ensure that every time someone who smokes sees their GP or visits hospital, they are offered the support they need to quit."



[1] Cutting Down: The Reality of Budget Cuts to Local Tobacco Control ASH/CRUK, Nov. 2016

[2] ASH is surveying all the CCGs in England through Freedom of Information requests. The following CCGs have are now not providing funding for GP prescriptions to patients seeking to stop smoking:

  • Medicines Commissioning News: Wyre Forest CCG, South Worcestershire CCG, Redditch and Bromsgrove CCG, March 2016
  • East Kent Prescribing Group. Information for practices.  April 2016
  • Mailing from Windsor, Ascot & Maidenhead CCG to GP practices, 12th May 2016
  • NHS Vale of York CCG Practice Communication, 14th March 2016

[3] The costs of smoking to the social care system in England has cost estimates for every top tier English local authority. The full report with the detailed estimates can be found online on Monday morning at The study was conducted by economist Howard Reed from Landman Economics for ASH. The report excludes costs borne by the national government such as the payment of welfare benefits.  

Local costs will be available under embargo at [LINK] from Thursday morning.

[4] Local Costs of Smoking Tool ASH, July. 2016

[5] Burning Injustice - reducing tobacco driven harm and inequality: Recommendations to the g7overnment, local authorities and the NHS APPG on Smoking & Health, Jan. 2017

[6] Smoking cessation: policy and practice in NHS hospitals British Thoracic Society, Dec. 2016

[7] LGA responds to the Local Government Finance Settlement. LGA media release.15 December 2016

[8] For a more detailed case study and photos please contact the ASH office on 020 7404 0242.