Significant progress has been made in tackling smoking in recent years, with prevalence (or rates of smoking) in England now at the lowest level for 50 years, at 17%. 1 Despite this, smoking remains a leading cause of preventable disease and death and is one of the most significant factors contributing to health inequalities.

Every year, smoking kills more than 100,000 people in the UK and almost 80,000 people in England. 2 Smoking causes lung cancer, respiratory disease and heart disease as well as numerous cancers in other organs including lip, mouth, throat, bladder, kidney, stomach, liver and cervix. 3

For every death caused by smoking, approximately 20 smokers are living with a smoking-related disease. 4 These include Alzheimer’s disease, angina, asthma, Crohn’s disease, gastric and duodenal ulcers, gum and tooth disease, osteoporosis, rheumatoid arthritis, cataracts, macular degeneration, psoriasis, reduced fertility, impotence, depression, sight loss, hearing loss, multiple sclerosis and diabetes. 5

Tobacco smoking harms others too, through second hand smoke,6 while smoking in pregnancy impairs foetal growth and development and increases the risk of stillbirth and infant mortality. 7 8 9

Not all groups are affected by smoking in the same way. Some are at greater risk of harm (such as pregnant women) and others find it harder to give up (such as people living with a mental illness). In some communities, smoking appears to be promoted through cultural norms.

It is estimated that, in England, every year smoking costs society as much as £13.9 billion; annual costs in Hackney and the City are estimated at £68 million. 10 These costs are spread across health services, businesses, local government and the fire service.

It is for these reasons that tobacco control remains a priority in both Hackney’s and the City’s Joint Health and Wellbeing Strategies.


  1. Office for National Statistics, Social Survey Division, “Annual Population Survey, April 2014 – March 2015,” UK Data Service, 2016. Office for National Statistics, Social Survey Division.

  2. Health & Social Care Information Centre, “Statistics on Smoking: England 2015,” 2015.
  3. ASH, “Smoking statistics: Illness and death,” 2014. [Online]. Available:
  4. US Department of Health and Human Services, “How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General,” 2010.
  5. American Council on Science and Health, “Cigarettes: what the warning label doesn’t tell you,” 2003. [Online]. Available:
  6. Second hand smoke or ‘passive smoking’ is the inhalation of smoke that comes from someone else smoking.
  7. Royal College of Physicians, “Smoking and the young,” London, 1992.
  8. Tobacco Advisory Group of the Royal College of Physicians, “Passive smoking and children,” London, 2010.
  9. Tobacco Advisory Group of the Royal College of Physicians, “Going smoke-free: the medical case for clean air in the home, at work and in public places,” London, 2005.
  10. ASH, “Ready reckoner: the local cost of tobacco,” 2015. [Online]. Available: [Accessed 31 October 2016].