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3 - THE KNOCK ON EFFECT AND GREATER COST TO SOCIETY
Smoking Poverty in the UK (2026 Update)
By: Dan JuddSmoking Poverty in the UK — At a glance
- Smoking rates in the UK are at record lows overall, but remain heavily concentrated in lower-income communities (29).
- Around 10.6% of UK adults smoked in 2024 — the lowest level since records began in 2011 (29).
- Adults in the most deprived areas are more than twice as likely to smoke as those in the least deprived areas (30).
- When tobacco spending is accounted for, around 1.5 million smoking households are classed as living in poverty (31).
- A pack-a-day smoking habit now typically costs around £6,000 per year (32).
With public health being such an ongoing and important concern, we’re aware first hand of the relationship between smoking and health. It’s more complex than simply becoming an addiction for some people and it’s not just a matter of simply quitting. We also know there are other factors that play into why people pick up a cigarette for the first time (and continue to do so). Vape Superstore did some work with Smokefree Hackney to look at smoking rates and which factors were affecting the prevalence of smoking.
While, collectively, we’re quitting at a pretty impressive rate, we’re not quite on track for the “smokefree” ambition (generally defined as <5% prevalence) (34). Smoking related illnesses are still the leading cause of preventable deaths in the UK and accounts for a high number of cancer diagnoses too (27). It isn’t just smokers who are affected by their habit, second hand smoke also affects the children, friends and relatives around the smoker too. It’s a complex issue to unpack, so let’s start at the beginning.
The Current Statistics:
Smoking is currently at an all time low in the UK. While that’s great news, it doesn’t mean the issues surrounding smoking are gone.
- Around 10.6% of UK adults smoked in 2024, the lowest level since records began in 2011 (29).
- In order to constitute a “smokefree” society, smoking prevalence would need to drop to 5%. Progress remains uneven across socioeconomic groups (30).
- Smoking is responsible for 15% of cancer diagnoses in the UK and remains the leading preventable cause of cancer (1).
- Adults aged 25–34 continue to have the highest smoking prevalence, at around 12.6% (29).
Who’s Still Smoking?
Before we look at why people are smoking, it’s important to understand the demographics where smoking remains most prevalent. Rates increase significantly when individuals fall into more than one of the following categories.
Those with poor mental health, including anxiety, depression, PTSD, bipolar disorder and chronic stress, are significantly more likely to smoke (35).
People who are unemployed or fall below the poverty line. Those in the most deprived areas are more than twice as likely to smoke than those who live in the least deprived areas (30). This includes factors like whether they rent or own their homes, whether they receive benefits and who they’re living with (4).
Another factor relating to work is the nature of their profession. Manual and factory workers with routine jobs are significantly more likely to smoke than those in professional or managerial roles. This pattern remains consistent in the most recent Annual Population Survey data (29).
Individuals with no formal qualifications are around twice as likely to smoke as those with higher educational attainment (4).
Children whose parents smoke are 15–21% more likely to become smokers themselves later in life (3).
Being Born Into And Growing Up In A Poorer Area Sets People Up For Being More Likely To Smoke.
Unpacking the Causes
If we look at income and poverty alone, financial stability has a significant impact on the quality of someone’s life. It can be affected by general economic changes as well as individual factors like family, education and where someone lives. Consider the fact that living in a lower decile area, rented accommodation or council funded accommodation can make someone twice as likely to smoke(30).
Then, add to that the financial strain of sustaining a smoking habit to an already tight budget and breaking free of poverty is going to be even more of a challenge. In many cases, smoking does not just correlate with poverty, it actively deepens it by reducing disposable income (31).
Where You’re From And Who You’re Around Plays A Big Part
Growing up in a poorer area sets people up for being more likely to smoke.
First of all, growing up in a smoking household makes a child significantly more likely to later take up the habit themselves (3).
Even if a child has non-smoking parents, the added stress of living pay-check to pay-check can affect anyone’s life (36).
A study from Scotland found that children in less affluent areas came into contact with shops selling cigarettes on average 149 times in a single week, compared with just 23 times in more affluent areas (8).
Living in poverty has a knock on effect to education. Lower educational attainment is strongly correlated with higher smoking prevalence.
A lower educational level factors into career prospects. Manual labourers and those in routine-oriented jobs continue to show substantially higher smoking rates than professional workers (29).
Adults and children in the lowest income bracket are two to three times more likely to experience poor mental health (10), which in turn increases the likelihood of smoking (35).
Following analysis undertaken by Landman Economics on behalf of ASH, it was found that around three-fifths of smoking households living in poverty are located in the Midlands and North of England, a pattern reaffirmed in later updates (31).
Quitting smoking improves #mentalhealth even in the short term; it can reduce #depression and #anxiety, improve mood and help to relieve financial stress for those on low incomes: https://t.co/RjjFIrT1iT @GM_HSC #ActOnTobacco
— ASH (@ASH_LDN) September 12, 2019
Why Does Stress Lead To Smoking?
From this trend, we can see that stress is one of the main contributing factors to increasing someone's likelihood of being a smoker. Why is that? Stress causes the release of a hormone called cortisol. There are two kinds of stress, both release cortisol but have different triggers. One form is eustress, which is beneficial in day to day life. Small doses of cortisol boost concentration and productivity and your body will stop producing cortisol once you’ve completed the task that’s causing you stress in the first place. This is the function that helps people focus when they have a tight deadline or need to get something done in a certain timeframe.
The second kind of stress is distress. It’s where there’s no “end trigger” to tell your body to stop producing cortisol so it builds in your system over time. The end result is being in a constant state of agitation and “fight or flight” mode(11). So what’s the correlation between stress and smoking?
Smoking triggers the release of dopamine in the brain(12), the happy molecule that makes you feel calm. When there are a number of stressful factors in your life - including financial strain and mental health issues for example - smoking can become a coping mechanism. However, the more you smoke, the higher your tolerance becomes meaning you need more over time to achieve the same effect(13). Essentially, a smokers brain becomes desensitised to nicotine with more use whilst still craving the same effect. Smoking gives a perceived relaxing effect, even though the withdrawal symptoms then add more stress to their body once the nicotine has been synthesised in their brains.
The Rising Cost Of Smoking, Compared To A Slower Increase In Average Income.
If these factors combine, once you start smoking, it’s that much more difficult to break free of the poverty line. Back in 2009, just a decade ago, the average cost of a 20 pack of premium cigarettes was just £5.45. By late 2024, this had risen to around £16.35, increasing further to around £16.60 in early 2025 (32).
A pack-a-day smoking habit now costs around £6,000 per year (32).
If cigarette prices had risen in line with general inflation, a 20 pack would cost around £10.71 today (6).
Median weekly earnings rose from £488.50 in 2009 to £569 in 2018 (7). More recently, median weekly earnings reached £728 in 2024 and £766.60 in 2025 (37).
A pack-a-day smoker now spends around £115 per week, equating to around 15% of median gross weekly earnings, and a significantly higher proportion for households below the median (32, 37).
According to ASH, around 1.5 million smoking households are pushed below the poverty line once tobacco expenditure is included (31).
Cost Of Smoking Increasing At A Greater Rate Than Inflation
The Hackney Case Study:
Hackney’s smoking rate sits at 21%, higher than the London average of 16% and the UK average of 15%(21). Hackney is also the 11th most deprived local authority in England(14). Hackney typifies many of the factors that contribute to a higher prevalence of smoking even when compared to the rest of London. Essentially - factors like lower education level, more chance of renting, higher unemployment and lower average income are more common in Hackney than elsewhere in London. We can see a correlation between these factors and the 5% higher smoking rate in this borough.
How The Key Factors Affecting Smoking Rate Stack Up:
Employment/Income:
Qualifications/Education:
Housing:
It’s Estimated The Uk Collectively Loses £8.4Bn A Year In Productivity Due To Smoking Breaks Alone.
The Knock On Effect And Greater Cost To Society
Smoking poverty is harmful not only at an individual level, but also to the wider community as far as the illicit tobacco industry goes as well as the cost to the healthcare system.
Smoking reduces productivity and increases sickness absence. The total cost of smoking to society in England is now estimated at over £17 billion per year, including productivity losses, NHS treatment and social care (39).
Rates of mothers smoking at time of delivery have continued to fall, but around 7.4% of women in England were recorded as smokers at time of delivery in 2023–24(40).
Smoking-related illness costs the NHS around £2.5bn a year, with an additional £760m spent on local authority social care services (16).
The Illegal Cigarette Trade:
With such high demand for cigarettes and many people struggling to afford to sustain a habit, the illegal tobacco industry is thriving in the UK. Aside from contributing to people’s addiction as well as making cigarettes more accessible to younger people, it also undermines proper taxation. In recent years, similar patterns have been observed beyond tobacco, with black market vapes emerging as another unregulated route for nicotine products when price pressure and addiction intersect.
For the 2015–2016 period at a mid-range level, HM Revenue and Customs estimated that 13% of all cigarettes and 32% of hand-rolling tobacco in the UK were illicit. What this translates to financially is a collective loss of £3.5bn in tobacco duties and a further £1.3bn in VAT for that period alone (17).
What Would Make The Difference?
While it may not be possible to quickly counteract all the factors affecting smoking rates - like employment, education and living conditions - there are a few things that would make a difference. The first of which is to try and prevent a new generation from picking up cigarettes in the first place.
Underage Smoking:
Typically, most people will take up smoking before they’re 20 years of age (28). Part of preventing a new generation of smokers is addressing the current smoker population. They directly influence the younger generation both through second hand smoke exposure and making cigarettes more readily available. Aside from offering quit services in lower income areas, reducing the accessibility and visibility of cigarettes can help. Even if a child lives in a low decile area with non-smoking parents, they’re more likely to encounter shops selling cigarettes and other tobacco products than those in higher decile areas.
However, a recent study looked at perceptions of 11 - 16 year olds regarding smoking since legislation changed regarding how cigarettes can be displayed. Displaying cigarettes was banned in larger stores in 2012 and the full ban including smaller stores like off-licenses came into effect in 2015. Since then, smoking has become less appealing to teenagers. The study interviewed 3,791 young people, including 2,953 who had never smoked and tracked their perceptions of smoking before, during and after the legislation change. The results showed a drop in susceptibility to smoking - going from 28% pre-ban to 23% mid-ban and 18% post ban. Noticing cigarettes at all dropped significantly from 81% pre-ban to just 28% post-pan(19). It also made smoking unappealing to 70% of the participants interviewed.
New research from @ASH_LDN suggests 418,000 UK households could be lifted out poverty if they quit smoking: https://t.co/J2ukSuStMj
— BHF (@TheBHF) October 28, 2015
Quit Smoking Services And Support:
When it comes to addressing the adult population, in recent years we’ve seen a significant increase in quit smoking services for current smokers. Things like Stoptober, Vapril and quit services provided by the NHS and local organisations including the likes of Smokefree Hackney are all offering people the support they need. NHS hospitals are set to start offering quit assistance for all patients who come through their facilities - regardless of whether it’s for a smoking related illness or not. While smoking is still prevalent in the UK, the volume of cigarettes people are smoking is dropping and the number of quit attempts is rising all the time.
A new study from Cancer Research UK indicates the UK is smoking a billion less cigarettes a year. Part of this is due to a smaller smoking population but can also be attributed to the fact that those who continue to smoke are smoking less cigarettes on average a day. Smokers trying to quit are in good company as on average, someone makes a quit attempt every 80 seconds in the UK(22). The current smoking rate is at an all time low too. The government are predicting the existing smoking rate of 15% will have dropped to just 5% by 2030, a significant fall when as recently as 2011 it was 19.8% in England(24).
Why Quit Services Are Important
The importance of quit smoking services is clear. Campaigns like Stoptober, run by Public Health England, find that smokers who stop for 28 days are five times more likely to quit for good. Those who use face to face services and smoking aids like nicotine replacement therapy are four times more likely to quit (25).
Not only does quitting improve the health of the individual smoker, it also significantly impacts their quality of life, mental health, financial independence and the health of those around them. Access to practical, evidence-led support such as the guide to quit smoking can help make quitting more achievable and immediately reduce the financial burden of tobacco addiction. Were the existing smokers in the UK enabled to quit, many would be elevating themselves above the poverty line. This positively benefits the health and mental wellbeing of smokers’ children. By removing both parental smoking influence and the financial strain caused by smoking, future generations stand a better chance of escaping poverty.
The talks from the #ecigsummit are now online.
— Centre for Addictive Behaviours Research (@CABR_LSBU) November 17, 2018
Here is CABR's Sharon Cox delivering the keynote on 'Smoking & Poverty &...', discussing why we need a change in thinking if we are ever going to engage with the UK's most deprived smokershttps://t.co/XDD1z7xTkZ
WITH THANKS TO SMOKEFREE HACKNEY
Sources:
- Tobacco Statistics - cancerresearchuk.org
- Turning the tide on tobacco: Smoking in England hits a new low - publichealthmatters.blog.gov.uk
- Parent and Child Cigarette Use: A Longitudinal, Multigenerational Study - ncbi.nlm.nih.gov
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- Recognition and Alleviation of Distress in Laboratory Animals - ncbi.nlm.nih.gov
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- L&B: Smoking: Comparisons Hackney adults - hackneyjsna.org.uk
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- Statistics on women’s smoking status at time of delivery – nhs.uk
- Measuring tax gaps – Tobacco duties – gov.uk
- Tobacco: treating dependence (QS207) – nice.org.uk
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