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Care needs come earlier for smokers

Help needed a decade earlier for people who smoke

Adrian O'Dowd

Thursday, 26 September 2019

People who smoke appear to develop social care needs a decade earlier than those who have never smoked, claims a report published today by charity ASH (Action on Smoking and Health).

The research report Social care costs: Going up in smoke says that the average age at which smokers develop a social care need for the first time is 62, compared to 72 for never-smokers.


It also found that the cost of smoking-related social care to local authorities is £720m a year and the cost of smoking-related social care to individuals who pay for their own care is £160m a year.

ASH said that last year, smoking was responsible for the deaths of 78,000 people in England, but for every person killed by smoking, at least 30 people were living with a serious smoking-related illness.

The report findings are based on multi-wave analysis* of the English Longitudinal Study of Ageing (ELSA) carried out by Landman Economics for ASH.

Of respondents over the age of 50, almost a quarter (23.5%) of current smokers needed help with at least one of six activities of daily living (ADLs), compared to never smokers, who were almost half as likely (12.1%) to need help.

The charity’s analysis says that 670,000 people over the age of 50 have care needs as a result of smoking and though 55% of these adults receive the support they need, around 45% (300,000) have unmet care needs.

Informal carers, friends and family members who help with tasks at no cost, were providing care for 345,000 of the total due to smoking, which would cost an additional £10.6bn if it were provided by paid carers.

The report says that helping people to quit smoking now will mean lower social care costs in the future for both local authorities and smokers.

The authors said that smokers who stopped by the age of 30 could avoid almost all the long-term health consequences of smoking, as well as reducing the likelihood that they would need social care.

They recommended that local authorities set a local smoking prevalence target and work to reduce prevalence rates locally by:

  • denormalising smoking
  • promoting an annual quit attempt
  • providing diverse stop smoking support.

In addition, central government should commit to extending and enhancing tobacco industry regulation to ensure delivery of its ambition of ending smoking by 2030.

Ciaran Osborne, ASH director of policy, said: “Disease and disability caused by smoking leads people to need social care a whole decade sooner than if they had never smoked.

“Not only is this severely detrimental to their quality of life, it also puts avoidable strains on England’s creaking social care system. Local authorities should support smokers in their communities to make an annual quit attempt as stopping smoking will help them maintain their quality of life as they age.”


*The costs of smoking to the social care system and related costs for older people in England: 2019 revision. Landman Economics, 2019.

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