UK health leaders urge chancellor to invest in a smoke-free UK

Over 200 leading doctors, professional bodies and charities are urging the chancellor to use the budget on 30 October to invest in creating a smoke free UK as quickly as possible, and make the tobacco industry pay.

In an open letter published by The BMJ, they warn that unless smoking is addressed, there is no prospect of delivering on Labor’s manifesto commitment to halve the gap in healthy life expectancy between the richest and poorest regions.

The rationale for investing to end the tobacco epidemic could not be stronger, they explain. The annual cost of smoking to individuals, public services and the wider UK economy is £93 billion, while the direct cost of smoking to the UK public finances in 2023 was £21.9 billion, with a net cost of £13.5 billion.

They recognize that there are acute constraints on spending, but point out that smoking cessation treatment saves £2.37 for every £1 invested, while improving health improves economic productivity.

What’s more, introducing a ‘polluter pays’ levy on tobacco manufacturers “could raise £700 million a year for vital tobacco control activity in a way that would prevent companies from simply passing the cost on to consumers.”

They acknowledge the investment by the previous government, but say the new government needs to go further. “Dedicated long term funding is vital to deliver stop smoking support in hospitals and the community, national marketing campaigns, a robust illicit tobacco strategy, and targeted measures to reduce smoking rates in priority groups,” they write.

Finally, they say the UK must now reestablish its global leadership in tobacco control. They point out that UK funding for the WHO Framework Convention on Tobacco Control is set to expire at the end of 2024/25.

“Committing the UK to contribute at least £2 million a year for a further five years will cement our place as a world leader in tobacco control,” they conclude.

Professor Nick Hopkinson, Professor of Respiratory Medicine, Imperial College London, Hon Consultant Physician, Royal Brompton Hospital, said, “The UK government has set out a bold mission to improve the nation’s health, but this must be backed up by investment. Ending the tobacco epidemic is central to this mission and will also boost the public finances.

“The Tobacco and Vapes Bill will be vital for preventing the next generation becoming addicted to smoking. But we need sustained investment in tobacco control to support the 6.4 million adult smokers in the UK to quit. If the government cannot find the funding needed, then they should impose a levy on tobacco manufacturers to make them pay to fix the damage they have caused.”

Hazel Cheeseman, Chief Executive, Action on Smoking and Health, said, “Investment in reducing smoking pays dividends for the public finances and underinvestment is a missed opportunity.

“ASH analysis shows that cuts of £15m to NHS funding for tobacco-dependence treatment services have cost the health service more than twice as much—£33m a year—in additional savings. Failing to fund efforts to tackle smoking is a false economy.”

Professor Sanjay Agrawal, Special Adviser on Tobacco, Royal College of Physicians, said, “The evidence of the economic impact of smoking on society and the NHS is clear. Tackling the harms of tobacco is central to the government delivering on its manifesto commitment to halve the difference in healthy life expectancy between the richest and poorest.

“The previous government committed increased funding for stop smoking services, mass media campaigns and illicit tobacco enforcement. This funding is vital for driving down smoking rates, especially in our most deprived communities. The budget is an opportunity to set a course for a smokefree country and cement our place as a world leader on tobacco control—government should seize it.”

Dr. Charmaine Griffiths, Chief Executive, British Heart Foundation, said, “It is a scandal that smoking continues to have such a devastating impact on the nation’s health, being linked to 15,000 heart disease deaths in the UK each year. Besides the grief and pain each death causes countless families, ill health caused by smoking also puts a strain on the NHS and our economy.

“The status quo is unacceptable, and we need a bold and far-reaching package of measures to consign smoking to history. Alongside the Tobacco and Vapes Bill, which aims to protect young people from tobacco harm in the future, we need adequate and sustained funding for local stop smoking services so current smokers can quit for good.”