Smoking is the leading cause of health inequalities and accounts for half of the difference in life expectancy between the most and least affluent communities in England.

Smoking is associated with most indicators of disadvantage. While smoking prevalence at England level continues to decline each year, the gap in prevalence between the most and least deprived has increased. This means that prevalence is reducing more slowly in more deprived communities than in our more affluent communities.

One group of particular concern is those in routine and manual occupations, which is why the profiles include several measures monitoring prevalence among them. On the contrary, smoking rates are lower amongst homeowners and those in managerial and professional occupations. Therefore, the burden of smoking today is concentrated amongst the poorest and most disadvantaged in our society.

Smokers from our more deprived communities are just as motivated to quit as other smokers. However, they tend to be more heavily addicted and face greater barriers to quitting, such coping with multiple risk factors and greater stress produced by poverty, relative and absolute. As a result, they are less likely to be successful quitters.

Smoking and mental health

People with mental health conditions are more likely to smoke and that smoking rates increase with the severity of illness.

People smoking more than 15 cigarettes a day are more likely to experience a common mental health disorder than those who smoke fewer cigarettes or do not smoke at all. People with a mental health problem consume 40% of cigarettes smoked in England.

One of the four key ambitions of the Tobacco Control Plan (2017) is parity of esteem for those with mental health conditions.

Stopping smoking

Smoking cessation is one of the most effective public health interventions.

Until recently, the main tools for smoking cessation were behavioural support, nicotine replacement therapy, or oral bupropion or varenicline.

However, e-cigarette use is becoming more popular and is currently considered one of the most effective quitting aids in England.