Smoking: Is the glass half full or half empty?

Cigarette smoke Smoking rates are hovering just above 20%

It is easy to look at the study produced on the performance of the NHS stop smoking service in its first decade of existence and conclude money has been wasted.

The unofficial target for the service in England is to get half of the people who turn to it for help to quit in the short-term - that is to say to give up for at least four weeks.

Over all the NHS failed to achieve this in any of the years from 2001 to 2011.

In fact, the data published on the British Medical Journal website shows if anything performance deteriorated slightly.

In the first year examined by the study 35% of those who used the service quit, compared to 34% in the most recent year.

But that would do the service an injustice.

In terms of providing value for money, stop smoking is among one of the most "cost-effective" treatments adopted by the NHS in the past decade, according to Martin Dockrell, of the Action on Smoking and Health campaign group.

Each short-term quitter costs the NHS just over £300 (I say NHS because even though smoking is now the responsibility of local government councils get a ring-fenced budget from health to pay for such schemes).

In terms of benefit to health, which is determined by a complex calculation known as quality adjusted life year, the health service would be prepared to pay five times as much.

Not only this, but the reach it has is impressive.

According to the figures for the year up to March 2011, the service made contact with about 8% of the nation's smokers.

New generation of smokers

Of course, only a minority end up quitting in the long term.

About 80% of those who give up for four weeks will relapse at some point.

But, nonetheless, the service is helping make inroads into what was considered only a few years ago to be a hardcore group of smokers which were pretty resistant to stop smoking advice.

Since the mid 1990s the numbers of smokers have been hovering stubbornly above the 20% mark.

However, there are signs that is beginning to fall, albeit slowly.

In recent years the numbers have come down by less than 1% a year.

Some of that is down to smokers dying and the success of health campaigns in discouraging a new generation of smokers from taking up the habit.

But some of it is undoubtedly linked to the success of the NHS stop smoking service - and that is why experts are hailing it as the "jewel in the NHS crown".

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 210.

    People aren't addicted to smoking, they're addicted to the stimulant nicotine which has the same effect on the brain as caffeine and alcohol. (Although alcohol in excess obviously has more detrimental effects.) The hand to mouth action and similarity to 'smoking' without the dangers is available in e.cigarettes, no withdrawal symptoms and no one's died from using one. It's the solution that works

  • rate this

    Comment number 209.

    Sir Richard Doll et al after spending some 40 odd years on painstaking research trying to establish the link between smoking and health once said,
    "...smoking is the single most important preventable CAUSE of ill-health and disease..."! Yes, absolutely.
    Smoking, nothing more than a highly addictive, expensive, misdirected, suspect "pleasure" that tobacco producers would have us believe otherwise?

  • rate this

    Comment number 208.

    205. nehbrown
    I empathise with your plight, however most of the battle against cigs is against the horrid effects of your body repairing itself against tar on your lungs and carbon momoxide in your blood, rather than nicotine addiction. You can keep a nicotine addiction (via tabs etc.) if you find it easier, without smoking, they'll do everything an e-cig does other than the habit of holding a fag

  • Comment number 207.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 206.

    204. Parmenion
    Ah, so you're someone who thinks you enjoy smoking? I guess you're trying to increase the amount of smoking you do, if it's so enjoyable? Assumedly you'll be telling your chirldren/young relatives how good it is to get into at a young age, as most smokers do.

    I smoked for 15 years, even though I realised 5 years into it that it's just a horrid addiction. It's just a drug addiction

  • rate this

    Comment number 205.

    I started smoking aged 18 and smoked for 50 years increasing each year and reaching 60 a day. I retired @ 65 and a few years later decided that £7 a packet x 3 every day didn't work with a pension.
    NHS gave me Champix which, after 6 weeks, drove me nuts.
    Thank God for e-cigs. Sadly tho the govt plan to drive them underground so I'll have to seek out the drug-dealers. That'll be a new experience!

  • rate this

    Comment number 204.

    Antismokers tell us that people only smoke because they are ‘addicted to nicotine’, and that most smokers actually want to quit. But most smokers enjoy smoking, and few people want to quit
    something they enjoy. Nag and frighten them enough though, and you can certainly get them to believe that they should.

  • rate this

    Comment number 203.

    I don;t want to sound bitter, but with regards to the negative ratings on my comments here - what is it people disagree with? I don't understand.

  • rate this

    Comment number 202.

    My mother started smoking in the late 1920's at her GP's suggestion as a way of calming her nerves. She smoked upward of 20 plain (untipped) cigs a day for the next 60 years. Presumably no-one told her body it was meant to get lung cancer, but she stopped aged 81 as cigs were 'getting a bit expensive.' She lived for a further 15 years.

  • rate this

    Comment number 201.

    @ 198. OldWoodman "The suggestion that the service retains any credibility is absurd."

    Ermmmm. No. That's just not true. There's not a single basis for your assertion. It's wrong. Untrue. Mis-leading. A plain deceit. A clear absurdity, to use your nomenclature. The government is there to improve the lives of all, not to make some money.

    It's not an attack to offer help to those who ask for it.

  • rate this

    Comment number 200.

    The fact that hundreds of thousands gave up once the smoking ban came into place just proves that most smokers want help (e.g. not being subject to the drug they are trying to withdraw from) to give up. There's no more rational arguement for smoking than for any other addiction - in fact less - at least one gets a reasonable high from other drugs - smoking is rubbish until you're addicted.

  • rate this

    Comment number 199.

    In 2008 the Dutch government looked into the cost of treating people from age 20, till death. They had three categories, the healthy, obese and smokers. The results were not what the health gurus were looking for.

    The lifetime costs were in Euros:

    Healthy: 281,000

    Obese: 250,000

    Smokers: 220,000

    It's totally dishonest of the anti smokers to say that smoking is a burden on society

  • rate this

    Comment number 198.

    The suggestion that the service retains any credibility is absurd. The government must now cease its relentless attack on smokers and lift the ban on smoking in public places in favour of licencing premises which wish to allow smoking. That would boost the economy. The 'Quit' service is a drain on the economy which has little or no effect on public health.

  • rate this

    Comment number 197.

    190. corncobuk

    The government is right to place tax smoking. Were it cheaper, I'd still be smoking, allowed in confined public spaces, hundreds of thousands of others would be too. Not a Labour supporter, but both measures (tax and ban) are the finest public health measures since the NHS. Governments aren't there to make money, they are there for the public good. This is the best of government.

  • rate this

    Comment number 196.

    Speed of Dark (189 &191);

    If you don't like breathing near smokers - stop breathing.
    I am an ex-smoker (24 years without), but still have regard to the freedom of others.

  • rate this

    Comment number 195.

    After being a 40 a day smoker, I used this service after trying various other means of stopping, I can honestly say it was the best thing ever and after 3 separate attempts I finally quit, and so did my husband, that was 5 years ago and I will NEVER touch a cigarette again.

  • rate this

    Comment number 194.

    189. speed_of_dark

    You actually read the article yesterday on retrospective morality and thought it said it was ok to judge people from the past, or even future moral standards? Wow.

  • rate this

    Comment number 193.


    It is now accepted by open-minded civilised people and societies that someone who has an addiction of any kind is suffering from a mental illness.

    Self-righteous angry people who are incapable of feeling empathy toward other human beings are called psychopaths and are considered to be a danger to others but they are also suffering from a mental illness.

  • rate this

    Comment number 192.

    Many attitudes have seriously changed over 5 years or so. Smokers are fundamentally the same except sharing outdoor spaces more, but non smokers have become more pompous, self righteous and indignant

    Funny how the same non smokers then want to bum a cigarrette after a couple of drinks

  • rate this

    Comment number 191.

    Smokers stink, there's no way to avoid that truth, and worse they make non-smokers who have to pass through their fumes while they cluster in public doorways stink too. It's filthy, antisocial, how anyone can defend being an addict is beyond belief. People on trains making rollups 30 mins before their station and lighting up as they exit the train shows the level of the addiction.


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