The government has pledged to cut the smoking rate among adults in England by almost a quarter, nearly halve the smoking in pregnancy rate and cut the proportion of teens who smoke regularly even more dramatically within just five years under its new Tobacco Control Plan
To achieve these goals, all health professionals will have access to training on how to help patients — especially patients in mental health services — to quit smoking. And NHS trusts will encourage smokers using, visiting and working in the NHS to quit, with the goal of creating a smoke-free NHS by 2020.
Links to stop smoking services will be promoted across the health and care system, and there will be full implementation of all relevant NICE guidelines by 2022.
Smokers who do not quit will be encouraged to use less harmful nicotine products such as e-cigarettes, including in the workplace and public places. In line with this, Public Health England has produced guidance for employers and organisations emphasising that e-cigarette use is not covered by smoke-free legislation and should not routinely be included in the requirements of an organisation’s smoke-free policy.
While stop smoking services have proved very effective in supporting quitting — since 2011–2012 the number of people setting a quit date has fallen — repeated cuts to local authority public health budgets have seen provision of stop-smoking services slashed, and a recently published King’s Fund analysis has said they are likely to be cut by a further 10–20% this year.
Specifically, the Tobacco Control Plan commits to cutting the smoking rate among adults from 15.5% to 12% by 2022, cutting the smoking in pregnancy rate from 10.5% to 6% or less, and reducing the number of 15-year-olds who smoke regularly from 8% to no more than 3% to create what the Department of Health calls the ‘first smoke-free generation’.
No extra funding
But it does not come with any promise of additional funding. The government says it wants to see “local areas working together to explore if regional and cross-regional approaches could offer a greater return on investment”.
The public health budget in England is held by local authorities, and the Local Government Association’s chair, Izzi Seccombe, said financial cuts will make the plan difficult to implement.
“This is made all the more difficult by the Government’s reductions to the public health budget, which councils use to fund smoking cessation services,” she said.
The Pharmaceutical Services Negotiating Committee (PSNC) does not hold comprehensive data on locally commissioned smoking cessation services, but it said it was aware of 32 active nicotine replacement and/or Champix voucher schemes and 91 active stop smoking services commissioned from pharmacies.
PSNC director of NHS Services, Alastair Buxton, said: “Within the past year, we have noticed an increase in the number of public health services being decommissioned by local authorities, with smoking cessation services being the most affected. The squeeze on local government budgets is clearly having a detrimental impact on the provision of public health services to local communities, including those provided by pharmacy teams.
Areas where pharmacy services have been decommissioned since autumn last year include Lewisham, Leicestershire and Rutland, South Staffordshire, and Cheshire and Wirral.
 GOV.UK. Towards a smoke-free generation: tobacco control plan for England. 18 July 2017. Available at: https://www.gov.uk/government/publications/towards-a-smoke-free-generation-tobacco-control-plan-for-england (accessed July 2017)