state of smoking and health in the United Kingdom

This page was last edited on: February 9, 2024 at 1:14 pm

smoking rate (2022)

Tobacco Use and Trends

In 2022, 6.4 million adults aged 18 years old and older are smokers in the UK[1]. This is the lowest proportion of current smokers since 2011.
Smoking prevalence is marginally higher among men (14.6% – around 3.6 million) versus women (11.2%-around 2.8 million).
- Wales has the highest prevalence of cigarette smokers (14.1%) around 340 thousand people), while England has the lowest (12.7%) around 5.3 million people. The prevalence in Northern Ireland is 14% (around 200 thousand) and Scotland is 13.9% (around 590 thousand people). (Figure 1)

As the smoking prevalence is continued to be highest among those between 25 to 34 years old, the largest reduction occur among those age 18-24 years old between 2011 and 2022 (Figure 2).

Source: Annual Population Survey from the Office for National Statistics ONS, 2022 – last accessed in January 4, 2024)

In 2022, 70% female and 68.9% male smokers have quit smoking.
- 27.2% of people use a vaping product in their attempt to quit smoking in the previous 12 months as compared with 15.5% who used NRT.
Demand for cigarettes fell by 54.3% between 2010 from 38.3 packs/capita and 2022 to 17 packs/capita.

Proportion of current smokers, all persons aged 16 years and over UK 1974 - 2017

Source: ONS, 2020

Nicotine Alternatives

Daily e-cigarette use has increased to 5.2% among 16 years old and older population, compared with 3.8% in 2020.
Prevalence of daily e-cigarette use is higher among men (6%) as compared with women (4.4%), and among those aged 25-34 years old (6.8%) while it is the lowest in those aged 60 and over (2.9%). Figure 3.
Among ex- and current smokers, 13.5% and 12.2% are daily e-cigarette smokers in 2022. (Graph 1)
In 2020, 27.2% of adults used vaping products in a quit attempt in the previous 12 months, compared to 15.5% using NRT.

Smoking status of e-cigarette users in UK 2022

12.2%

Cigarette Smokers

13.5%

Ex-Smokers

0.6%

Never Smoked

Source: Office of National Statistics (Last accessed in January 4, 2024)

HEALTH AND ECONOMIC BURDEN FROM TOBACCO USE

In 2019, it is estimated that tobacco is the 1^st highest risk factor that drive the most death and disability combined in United Kingdom.
Tobacco is estimated to account for more than 125 thousand deaths. Smoking accounts for of 120 thousand deaths, secondhand smoke for 8 thousand deaths, and chewing tobacco for 38 deaths.
Ischemic heart disease (IHD), Stroke, COPD and Lung Cancer are the top 4 causes of deaths respectively where:

Tobacco is responsible for 18.9 thousand or 22% of total IHD deaths, 25.7 thousand or 81% of all COPD deaths, 6.1 thousand or 15% of all Stroke deaths and 31 thousand or 83% of all tracheal, bronchus, and lung cancer deaths in 2019.

Tweet

Tobacco use causes an estimated loss of 9 millions disability-adjusted life years (DALYs) – 34% of total DALYs where tobacco accounts for loss of 397 thousanf DALYs for IHD, 580 thousand DALYs for tracheal/bronchus/lung cancer, 545 thousand DALYs for COPD and 133 thousand DALYs for Stroke.

“If current/ex-smokers had never smoked, the difference in the equivalent rates of economic activity would boost the UK economy by £19.1 billion a year or 1.9% of earnings.”

The International Longevity Centre UK Tweet

Source: Up in smoke: The impact of smoking on health and economic activity

regulatory environment & economics

Public Health Commitment

UK ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004 and the WHO Illicit Trade Protocol in 2018.
Implemented Graphical Health Warnings (GHWs) in 2008, and Plain Packaging (PP) on combustible cigarettes (CCs) in 2017.
In 2013, the UK government decided that the Medicines and Healthcare Products Regulatory Agency (MHRA) is responsible for regulating nicotine-containing products (NCPs), such as e-cigarettes, as medicinal products in the UK.
In Oct 2021, the MHRA published an updated “Guidance for licensing electronic cigarettes and other inhaled nicotine-containing products as medicines”.

Diverse Tobacco Market

HTPs and e-cigarettes with or without nicotine are legally available in the UK. HTPs are classified as hand-roll tobacco (HRT).
E-cigarettes are not categorized as tobacco products but are subject to regulations. Product restrictions for e-cigarettes include a maximum nicotine concentration of 20mg/ml, a tank capacity not exceeding 2ml, and refill containers irrespective of nicotine content limited to a maximum of 10ml.
Text health warnings, covering 30% of both package surfaces are required for HTPs as of 2023. PP regulation does not apply to HTPs and e-cigarettes.

Taxation Policy

In 2022, the total tax rate on retail prices of a pack of cigarettes was 83.7%.
HTPs are subject to a specific excise tax of £93/kg, while no tax is imposed on e-cigs as of 2023.
A differential excise tax policy is applied between CCs and HTPs. The excise value for HTPs is GBP1.85/pack with a share (36.96%) of the retail selling price of GBP 5.00/pack while the excise value for CCs is GBP8.00/pack with its share (62.73%) of the retail selling price GBP12.75/pack as of 2023.

Smoking and Advertising Bans

Comprehensive smoking and advertising bans with complete compliance on smoking bans and moderate compliance on advertising bans were enforced on CCs in 2022. E-cigs are not subject to smoking and advertising bans. While HTPs are not subject to smoking ban regulations like CCs, they are under strict advertisement regulations.

Illicit Cigarette Trade

Estimated figures indicate that the illicit trade had a high market share with 15.7% in 2008, falling to 10.3% in 2016 and consistently remaining less than 15% throughout with 14.6% in 2022.

[1] The data of UK comprises four constituent countries: England, Scotland, Wales, and Northern Ireland.

As research findings become available that are inclusive of additional gender identities, the Foundation will update the information presented.