England: Cost of premature care for smokers puts strain on local services

A new one report published by Action on Smoking and Health (ASH)[1] shows that on average, smokers in England need care 10 years earlier than non-smokers, placing a considerable burden on local health and social services.

Smoking is the leading cause of premature and preventable death in the country. In 2019, the estimate of tobacco-attributable mortality in the country represented 74,600 deaths. For every person who dies from smoking, at least 30 others suffer serious illness and disability related to their smoking. On average, smokers in England require care at the age of 63, ten years earlier than non-smokers. The analysis, conducted by Landman Economics for ASH, establishes that 1.6 million people need help in their daily lives due to a smoking-related illness.

To measure the impact of smoking on social services, Landman Economics updated previous analyses of social care costs from 2014, 2017, and 2019. To do this, the economists considered the English Longitudinal Study on Ageing (ELSA) and Health Surveys for England (HSE) data. They were able to estimate the number of smokers and ex-smokers in the country, aged over 50 (for the ELSA survey data) and over 65 (for the HSE data), requiring care and social support at home and in residential care. They compared these data with the population of people who have never smoked.

The high cost of smoking to the UK welfare system

An estimated 102,500 people are receiving care funded by UK local authorities for smoking-related illness (85,000 at home and 17,500 in residential care). Nearly 1.1 million people receive care through other channels, such as care from relatives, such as parents and friends. Finally, 450,000 people currently need social care but are not receiving it. This high level of local authority support has a significant impact on their budgets: £1.2 billion a year, or 8% of the country's social services budget, is spent on adult home and residential care.

If all the care currently provided by other providers (e.g., relatives, etc.) were provided by the public sector, it would cost an additional £8.16 billion each year. And if the currently unmet care of those in need were covered, the additional cost would be £5.91 billion each year. In total, the value of the necessary care is over £14 billion.

The importance of pursuing comprehensive actions to reduce the burden of tobacco use

The study emphasizes that the cost of smoking estimates provided here are only those derived from the social care needs of adults aged 50 and over for home care and 65 and over for residential care. This means that the true impact of smoking could be much higher than indicated in the study. This analysis reinforces the need for national, regional, and local action to tackle smoking through comprehensive strategies. The aim is to improve the health and quality of life of the population and reduce pressure on an overburdened social care system while also providing opportunities for social care in England. In 2018, the UK government announced its target of increasing healthy life expectancy by 5 years by 2035, while reducing the life expectancy gap between the richest and poorest groups. For Deborah Arnott, Chief Executive of ASH, "Ending smoking is a priority to achieve this goal by 2035 »

The United Kingdom, particularly England, has made significant progress in combating the tobacco epidemic through comprehensive policies combining tax increases, the introduction of plain packaging, the development of smoke-free areas, the removal of stalls in retail outlets and, more recently, a ban on smoking in vehicles around children. These public policies are having results: the smoking rate among adults in England has continued to fall in recent years and is getting closer to the government's target of a tobacco-free generation by 2030.