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Support for smokers trying to quit falls sharply

Third of local authorities have cut smoking cessation

Adrian O'Dowd

Monday, 15 January 2018

The support available for people trying to stop smoking has fallen sharply as a result of cuts to the public health budget nationally, claims a report* published today.

The report by charities Cancer Research UK and ASH (Action on Smoking and Health) is based on a survey of tobacco control leads at local authorities across England and shows that cuts to the public health budget nationally have led to changes in services for smokers.

Responses from 117 local authorities showed that 39% of local authorities had stopped offering all local smokers access to evidence-based support in line with NICE guidance.

Half (50%) of local areas reported budgets for stop smoking services were cut in 2017 and only 4% said they had increased this budget. These changes follow budget cuts in 59% of local authorities in 2016 and cuts in 39% of local authorities in 2015.

There is now at least one local authority in England where there is a zero budget for addressing smoking.

Overall, 57% of local authorities said they commissioned GPs to provide stop smoking support and 69% commissioned pharmacies to provide this support. In some cases, this service was subcontracted through a specialist service.

Only 9% of local authorities commissioned stop smoking support solely through primary care.

Although some local authorities said they had decommissioned specialist services to leave stop smoking services in primary care only, elsewhere it had been primary care provision that has been lost to protect specialist services.

One unnamed local authority said in its survey response: “We had engagement of all our GP practices and 14 local pharmacies but these were decommissioned from 1 April 2017 due to mandatory cost savings - public health responsibilities that were not mandated (such as smoking cessation) took the biggest hit.”

The survey of local authorities also found that one in nine areas reported that GPs were no longer prescribing nicotine replacement therapy (NRT), such as patches or gum, to smokers.

In addition, one in 10 GPs did not provide access to the prescription-only medication to help smokers quit – varenicline.

However, the report authors said these findings on GP prescribing should be treated with caution as local authority tobacco control leads did not always have full knowledge of the prescribing practice of their local GPs.

George Butterworth, senior policy manager for Cancer Research UK, said: “National decisions to cut public health funding are having an impact on the ground. A growing number of local areas no longer have treatment available for all smokers that meets the necessary standards.

“On top of this, smokers in many areas can no longer access stop smoking medications from GPs. We are deeply concerned that the erosion in support will hit disadvantaged smokers hardest. We urge government at every level to ensure smokers have the support they need to stop smoking.”

Deborah Arnott, ASH chief executive, said: “Thousands of people every year die from smoking with many more living with disabilities and disease. Shrinking public health budgets make it tougher to provide smokers with quit services while tobacco companies pocket a billion in profit every year in the UK. The government should place a levy on the industry to fund the support smokers need.”


* Feeling the Heat: The Decline of Stop Smoking Services in England. A report prepared by Action on Smoking and Health, commissioned by Cancer Research UK, 2018.

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