Smoking-related hospital admissions in England increased by nearly 5% in 2022-23, compared to the previous year, but remain lower than before the Covid pandemic.

Latest statistics from NHS England show that in 2022-23 there were an estimated 408,700 hospital admissions due to smoking, a rise from 389,800 in 2021-22 (an increase of 4.8%).

The newly published figures in NHS England’s Statistics on Public Health, 2023 report also cover 2020-21, when there were 314,100 admissions attributed to smoking, which was consistent with fewer hospital admissions overall that year.

Smoking-related admissions in each of the past three years were lower than in 2019-20, prior to the pandemic, when there were 446,400.

Around one in six (16%) of all hospital admissions for respiratory diseases in 2022-23 were estimated to be related to smoking, while it also caused 8% of all admissions for cancers and 7% of admissions for cardiovascular diseases.

A new study published earlier this week also suggests a decades-long decline in smoking prevalence in England has stalled since the start of the pandemic.

The study, led by UCL researchers, funded by Cancer Research UK and published in the journal BMC Medicine, looked at survey responses from 101,960 adults and found the rate of decline has slowed to 0.3%.

Matt Fagg, NHS England’s Director for Prevention and Long-Term Conditions, said: “We have seen great progress in prevention and tackling smoking-related ill health in recent years, with smoking rates falling significantly in the UK and remaining below most of our peers internationally, but it is clear there is still more to do to help save and improve more lives.

“Quitting smoking is the best way to improve health and to prevent over 50 serious smoking-related illnesses from developing, but we know it can be very difficult to overcome an addiction. That is why the NHS is rolling out dedicated support for patients in hospital to tackle their tobacco dependency, in addition to traditional Stop Smoking Services.

“Being in hospital is a significant event in someone’s life and people can be more open to making healthier choices. The tobacco dependence treatment offered by the NHS can significantly improve the health and wellbeing of the person smoking and their family.”

The NHS is backing the government’s ambition for a smoke-free generation by 2030, with a focus on stopping people from starting to smoke.

The NHS also offers dedicated support for pregnant women to stop smoking. The Saving Babies’ Lives Care Bundle is a clinical guide for maternity service providers to help reduce stillbirth and pre-term birth rates, which are a greater risk for pregnant women who smoke.

Public Health Minister Andrea Leadsom said: “No other consumer product kills up to two-thirds of its users, which is why we have set out plans to stop children who turn 14 this year and younger from ever legally being sold cigarettes – the most significant public health intervention in a generation.

“We are doubling funding for stop smoking services, helping 360,000 people quit, and providing local authorities with one million free vapes via our world-first ‘Swap to Stop’ programme.”

This autumn, the NHS rolled out its biggest ever programme to improve early lung cancer diagnosis, which is caused by smoking in 72% of cases. More than a million current or former smokers have so far been invited for lung cancer checks in community locations through the Targeted Lung Cancer Health Check initiative.

The checks have also identified thousands of people with other undiagnosed respiratory conditions, allowing them to get treatment much quicker and prevent potential hospitalisations.

Hazel Cheeseman, Deputy Chief Executive of Action on Smoking and Health (ASH), said: “Smoking is the leading cause of premature death responsible for half the difference in life expectancy between the most and least advantaged in society.

“The provision of tobacco dependence treatment by the NHS is playing a vital role in improving the health and wellbeing of the nation and reducing health inequalities across society.

“When sick smokers quit they improve both their quality and length of life and free up NHS capacity at a time when, more than ever, this is sorely needed.”

Henry Gregg, Director of External Affairs at Asthma + Lung UK, said: “Smoking remains the biggest cause of lung disease deaths in the UK and there is a direct link between it and preventable lung conditions like Chronic Obstructive Pulmonary Disease (COPD).

“Smokers are also at a higher risk of getting chest infections, including flu, pneumonia and Covid-19, and experiencing more severe symptoms.”

The new Statistics on Public Health, 2023 report also covers:

• hospital admissions with obesity as a primary or secondary diagnosis, which means obesity was a contributory factor, as well as data on bariatric surgery procedures
• hospital admissions with a primary diagnosis for poisoning by drug misuse and for drug-related mental and behavioural disorders
• previously published data on deaths from smoking as well as statistics on prescription items to treat alcohol dependence, obesity and to help people stop smoking
• data on affordability of and expenditure on alcohol and tobacco.

Information on NHS services to help people to stop smoking is available on the NHS.uk website.

Notes to editors

1. This is a press statement that refers to official statistics which have been issued separately from it.
2. Admissions’ means Finished Admission Episodes (FAEs) – the first period of inpatient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year.
3. Smoking-related hospital admissions data is taken from the latest available Hospital Episode Statistics (HES) and is based on the primary diagnosis, or main reason for the admission. Figures presented relate to people aged 35 and over because this age group is most likely to be affected by smoking-related ill health.
4. There has been a methodology change for hospital admissions attributable to smoking – the publication of hospital admissions attributable to smoking for years up to 2019/20 used the relative risk ratios from diseases used by Hughes and Atkinson in the report “Choosing Health in the South East: Smoking”, which was published in 2005 and based on an update of a 1996 epidemiological study. The new publication, and future publications, use a more contemporary methodology based on the Royal College of Physician’s Report “Hiding in Plain Sight“, that was published in 2018 and agreed as part of PHE’s “Consultation on proposed changes to the calculation of smoking-attributable mortality and hospital admissions” from 2020. This methodology has been used to back date the time series within this latest publication.
5. A primary diagnosis indicates the primary reason a patient is being treated. However, secondary diagnoses can also be recorded for contributory reasons for treatment or to provide clinicians with information pertinent to a patient’s care. Therefore, admissions with a primary and secondary diagnoses only reflect the number of admissions where one of the codes were noted, not the number of people admitted specifically for those codes.
6. The NHS Long Term Plan, published in 2019, set out ambition to offer NHS-funded tobacco dependency treatment, as well as an aim to save thousands more lives each year by dramatically increasing the number of people diagnosed with cancer at stages one and two, when cancer is easier to treat.
7. A secondary diagnosis of obesity does not necessarily indicate obesity as a contributing factor for the admission but may instead indicate that obesity is a factor relevant to a patient’s episode of care.
8. Statistics on adult and children’s weight management services are published in the National Obesity Audit.
9. NHS initiatives to tackle obesity include specialist clinics across the country to support children and young people who are severely obese – more information is here https://www.england.nhs.uk/2023/06/nhs-to-open-new-specialist-clinics-for-obese-children-and-young-people/
10. Statistics on drug-related hospital admissions cover admissions with a primary diagnosis of poisoning by drugs listed as controlled under the Misuse of Drugs Act 1971 (includes both intentional and unintentional poisoning).