Smoking Prevalence Drops in England

Smoking prevalence in England has dipped below 20 percent for the first time since World War II, according to data from the Smoking Toolkit Study.

The Smoking Toolkit Study consists of monthly surveys of the adult population in England and has been running since November 2006.

It shows trends in prevalence and in smoking cessation activity.

It also provides key information that can help understand how smokers stop and the effects of events and policies.

Important findings include:

  1. Raising the age of sale from 16 to 18 was linked with an immediate reduction in prevalence among 16 and 17 year olds. This reduction was greater than in older age groups.
  2. The annual ‘No Smoking Day’ event in March is associated with a significant increase in quitting. Conservative assumptions lead to an estimated cost-effectiveness ratio of less than £100 per life year gained.
  3. Ratings of urges to smoke on a normal smoking day may be a better measure of cigarette dependence than the Fagerstrom Test for Cigarette Dependence (FTCD) or Heaviness of Smoking Index (HSI), predicting the success of subsequent quit attempts better than these two measures.
  4. Introduction of a ban on smoking in indoor public areas in 2007 was followed by a sharp increase in the rate of decline in smoking prevalence for about nine months. However, since then smoking prevalence has declined more slowly – but it has been below 20 percent in five of the past six months – for the first time since World War II.
  5. There is no social gradient in England in the rate at which smokers try to stop but only in the rate of success of those quit attempts.
  6. Offers of help with quitting by general practitioners are associated with a higher rate of attempting to quit than is simple advice to quit.
  7. Almost half of all smokers report that they are trying to cut down. About one in eight of all smokers report using nicotine replacement therapy (NRT) to help them cut down. This figure has not changed during the past five years. Those who use NRT help them cut down are more likely to go on to quit than those who cut down without NRT.
  8. Use of electronic cigarettes has increased sharply with approximately five percent of quit attempts involving their use. About five percent of smokers use them to cut down or for periods of temporary abstinence.
  9. There has been a significant decline in average cigarette consumption over the past five years but no decrease in saliva cotinine concentrations.
  10. Use of behavioural support and medication in the most recent quit attempt is associated with a threefold increase in odds of remaining abstinent once potential confounding factors such as cigarette dependence are controlled for.
  11. Even non-daily smokers have a very low probability of succeeding when they try to quit.

These findings are just a sample of all the information that has emerged from the Smoking Toolkit Study.  More details are available at the Smoking Toolkit Study website.