How can we better support people to stop smoking and vaping?
The Government wants to create a smoke-free generation. Included in their policy package is proposed legislation to stop young people from starting to smoke, a ban on single-use vapes, as well as a ban on the marketing of nicotine products to children.
The NHS is also investing more in services and initiatives to help people who already smoke or vape to stop. However, if we are to reduce the number of current and future smokers radically, policymakers must learn from people's experiences of existing stop-smoking support.
Feedback people have shared with us about smoking, vaping and stop smoking services highlights that while good work is being done to support people to quit, promotion of these services and general attitudes towards smokers and their health could be improved.
What has the Government committed to?
The Tobacco and Vapes Bill, introduced by the Government in November 2024 proposes:
- Creating a smoke-free generation, gradually ending the sale of tobacco products across the country.
- Strengthening the existing ban on smoking in public places to reduce the harms of passive smoking in specific outdoor settings, particularly for children and vulnerable people.
- Banning vapes and nicotine products from being deliberately branded, promoted and advertised to children to stop the next generation from becoming hooked on nicotine.
The impact of smoking
One in eight adults in the UK smokes, and the habit costs the UK economy and wider society an estimated £21.8 billion a year.
It is the leading preventable cause of death, taking approximately 74,600 lives a year. Reducing the pressure on the NHS associated with smoke-related health issues like lung cancer, chronic obstructive pulmonary disease, and coronary heart disease is just one of the aims of the Tobacco and Vapes Bill.
Treatment of Smokers
People who smoke have told us that they've had their health concerns dismissed because they smoke. This can mean patients don't feel listened to, or health issues can go unnoticed if they are equated with the side effects of smoking.
"I went to the doctors on many occasions with various complaints and each time, I was told I am too fat, and I smoke. One time, I was told it was all in my head. Turns out I have terminal cancer." - Story shared with Healthwatch Liverpool
We also heard about patients being told to quit smoking at check-ups, even if seemingly unrelated to their condition, leading them to feel discriminated against or as though they cannot trust the doctor.
Stop smoking services
When recommended to stop smoking, the quality of support varied. People told us it wasn't always clear how to access stop-smoking services. Several local Healthwatch who've researched this topic within their communities heard that although stop-smoking services were available, these were poorly promoted.
Healthwatch Blackburn and Darwin examined local pharmacies offering the smoking cessation service. They found little promotion of the service within the pharmacies.
They also found that the level of signposting by both GPs and dentists to the local stop-smoking service provision is poor and does not meet NICE guidelines.
Healthwatch Islington spoke with people experiencing health inequalities about stop-smoking services. They found that the lack of awareness of these services was concentrated among Somali men, 93% of whom didn’t know how to access the support available to quit smoking. This indicates that targeted promotion is needed to increase access to stop-smoking programmes.
Those who were able to access the services often gave negative accounts of their ability to help them stop smoking.
We heard some reports that services were impersonal and didn't make a huge impact. One person felt the support worker they spoke with followed a script, and another said the advisor wouldn't let them speak.
"The advisor was very unhelpful. Just talked at me. Wouldn't let me speak. Kept talking about vapes that I tried to explain I couldn't use. Made me feel that it's not possible to give up smoking. I'll never approach any service for help and advice again. And that's any health service. Not just the stop smoking service." – Story shared with Healthwatch Darlington
Tackling the rise of vaping
As well as improving stop-smoking services for current smokers, our insight also shows that more needs to be done to help tackle the rise in young people vaping.
E-cigarettes and vaping
E-cigarettes are a common alternative to smoking offered by the NHS. Although smoking legal e-cigarettes is less harmful than smoking, vaping can come with its own issues and is not free of risk.
There is particular concern about the rise in vaping among young people. Healthwatch Blackpool's "Children and Young People’s Vaping Report" revealed that 31% if young people in their area vaped. Their work reached parliament and was influential in highlighting the dangers of rising vape and e-cigarette use among children and young people. We reported on this last February.
Several other local Healthwatch have also researched young people's vaping habits.
Healthwatch Trafford found that almost a fifth of children and young people had either tried vaping or did so regularly. While a large proportion of those who do vape said they’re either planning to cut down or quit, there was a lack of information on where to seek support to stop vaping.
While these reports highlight that young people understand vaping is unsafe, their feedback reveals there is a lack of support or education to explain precisely why it is unsafe and what the impacts on their health will be.
Another focus of these discussions was not knowing what support was in place to quit vaping. Young people noted that a more open discussion was needed to move forward.
"It is a huge issue that schools do not talk about, all we get is vaping is bad, we need more information" - Story shared with Healthwatch Bath and North East Somerset and Swindon.
We heard from one person they were turned away from NHS Stop Smoking Service as they wanted help to stop vaping, which is the alternative that the service endorses.
How will people receive support to stop smoking?
The Government is allocating an extra £70m in 2025-26 to local authorities to ensure local stop-smoking services are in place. Areas with higher smoking rates, such as Blackpool, Kingston upon Hull, and Sandwell, will be eligible for more funding per smoker.
According to guidance sent to local authorities about how to spend this budget, people who quit with the support of these services have at least three times the success rate compared to those who have no support.
This guidance adds that while councils should make stop-smoking services available to all, the "scale and intensity of support "must be proportionate to the most disadvantaged" This includes people living in social housing, people with mental health conditions and those experiencing homelessness.
Hospitals will also encourage people to give up smoking before they have planned operations under a new NHS Elective Reform Plan published in January 2025.
What can be done
While steps by the Government to create a smoke-free generation are welcome, more support for current smokers trying to quit is needed. We're calling for:
- Local authorities and the NHS to provide accessible, clear and prominent information to their communities about how people can access local stop-smoking services and the variety of support on offer (e.g. switching to vapes or nicotine replacement patches, alongside group or one-to-one behavioural support).
- Services should be promoted in ways that are tailored to lower literacy levels, different languages, and the communication needs of groups more likely to smoke.
- Hospitals to work with local public health services to ensure they can seamlessly arrange support for smokers to give up before planned operations.
- NHS staff across a range of settings to be trained to give brief opportunistic stop-smoking messages or to signpost to stop-smoking services.
- Local authorities and integrated care systems to report yearly on the progress they have made towards cutting local smoking rates, broken down by the most disadvantaged groups.
- Local authorities to report regularly on actions they've taken against retailers to ensure vapes are not sold to under-18s.
- Public health services to work with schools to educate children and young people about the risks of vaping.
- The Government to measure and report on the impact of the proposed legislation once it becomes law.
