Progress towards the Government’s smokefree ambition, House of Commons, 26 April 2022

Certainty over long-term funding is needed to meet the 2030 ambition. Local authorities’ public health grant has been cut by 24 per cent on a real-terms per capita basis since 2015/16 (equivalent to a reduction of £1 billion). This has had an adverse effect on councils’ ability to invest in services and functions that prevent ill health, reduce health inequalities and support a sustainable health and social care system. This includes smoking cessation and tobacco control.


Key messages

  • Smoking is the single largest cause of preventable death and the biggest cause of cancer worldwide. As well as impacting upon health, smoking places a significant burden on the public purse – to the tune of £12.6 billion each year. Beyond the significant cost to the health and social care system, it also impacts the local economy through sick days and lost productivity.
  • The LGA welcomes the Government’s ambition to be smoke free by 2030. Councils can help the Government achieve its ambition of eliminating smoking in England by 2030 through their tobacco control and other public health and support services. Proactive support for routine and manual workers, pregnant women, those with long-term health and mental health conditions and those in more deprived areas continue to be a priority for local government.  
  • Council public health teams work hard to help reduce smoking rates in their areas, alongside local charities and community groups, and it is testament to their efforts that smoking rates continue to fall. Councils commission integrated lifestyle service that can support all smokers. It includes face-to-face support, specialist support for pregnant women, Nicotine Replacement Therapy (NRT), support from local pharmacies and in some places their own digital apps, including specialist text helpline for young people. Trading Standards’ Tobacco Control Survey for England 2019/20 found that 99 per cent of councils are undertaking at least one type of tobacco control activity.
  • Since its launch in May 2013, over 100 councils across the country have signed the Local Government Declaration on Tobacco Control. Developed by Newcastle City Council, the Declaration is a statement of a council’s commitment to ensure tobacco control is part of mainstream public health work and commits councils to taking comprehensive action to address the harm from smoking.
  • To support councils in their work to reduce smoking, the LGA, in partnership with Cancer Research UK, produced a report Tobacco control: How do you know that your council is doing all it can to reduce smoking-related harm? which lays out the importance of tobacco control and what councillors can do to reduce smoking-related harm. The report also includes examples of good practice across councils, who have led the way for many years in tackling the harmful effects of smoking.
  • Although the UK is a world leader in tobacco control, the current rate of decline in smoking is insufficient to deliver the 2030 ambition. New analysis by epidemiologist Professor Sir Richard Peto has found that smoking has killed nearly eight million people in the UK in the last 50 years, with an estimated two million more expected to die in the next 20 years unless current smoking rates decline.
  • Certainty over long-term funding is needed to meet the 2030 ambition. Local authorities’ public health grant has been cut by 24 per cent on a real-terms per capita basis since 2015/16 (equivalent to a reduction of £1 billion). This has had an adverse effect on councils’ ability to invest in services and functions that prevent ill health, reduce health inequalities and support a sustainable health and social care system. This includes smoking cessation and tobacco control. Councils currently spend around £75 million on Stop Smoking Services and £11 million on Tobacco Control. Councils also fund some activity through trading standards. Due to reductions in funding, research by The Health Foundation showed that spending on stop-smoking services fell by a third between 2015/16 and 2022/22.
  • In addition to sufficient funding for public health services, the LGA supports a ‘polluter pays’ levy for tobacco control. The APPG for Smoking has said that a levy on tobacco manufacturers could raise £700 million in year one alone without the costs being passed on to smokers.
  • Local government remains committed to tackling the harm caused by smoking. Every pound invested by government in council-run services such as public health helps to relieve pressure on other services like the NHS, criminal justice and welfare. Councils can help the Government to achieve its ambition of eliminating smoking in England by 2030 through their tobacco control and other public health and support services, but need certainty over their long-term funding.

Improved co-ordination between the NHS and local government

Local authorities must retain their role in co-ordinating local public health strategies. NHS England has made commitments through the NHS Long Term Plan to tackle causes of poor health and a renewed focus on prevention. This role could be further strengthened by pooling budgets, improved coordination and we see there being a key role for Health and Wellbeing Boards and Integrated Care Systems (ICSs).

E-cigarettes

The LGA has called for VAT on e-cigarette sales to be reduced from 20 to 5 per cent to bring it in line with sales on nicotine gum and patches. Current legislation allows a 5 per cent rate to be applied to “pharmaceutical products designed to help people stop smoking tobacco”. 

There is growing evidence that using e-cigarettes can help people quit smoking, with a recent study suggesting that people who use vaping products such as e-cigarettes are twice as likely to stop smoking than those who use nicotine patches. Councils argue that making legal vaping products more affordable and treating them equally with other cessation methods, will incentivise more people to quit smoking by making them cheaper to purchase.

Whilst open to the idea of vaping products on prescription, we would need to ensure that strict conditions are attached, to ensure that it is time limited and only available to those that do not currently vape. Whilst take-up of e-cigarettes is not high amongst children, we remain concerned that the sale of certain flavours are being marketed at young people.

Smokefree 2030 levy

As well as reducing VAT on e-cigarettes, councils are calling on the Government to impose a Smokefree 2030 Levy on tobacco manufacturers. The revenue generated from this could be targeted in geographical areas, occupational groups and communities where the need for cessation services are most needed. Last year, around 13 per cent of the UK population smoked, with smoking-related illness such as lung cancer still being one of the leading causes of preventable death in the UK. As well as impacting upon health, smoking places a significant burden on the public purse – to the tune of £12.6 billion each year. Beyond the significant cost to the health and social care system, it also impacts the local economy through sick days and lost productivity.

Reducing smoking rates among the remaining 5.7 million smokers in England will reduce cardiovascular disease, respiratory conditions and cancer, meaning people can live longer in better health.

Funding

Local authorities’ public health grant has been cut by 24 per cent on a real-terms per capita basis since 2015/16 (equivalent to a reduction of £1 billion). This has had an adverse effect on councils’ ability to invest in services and functions that prevent ill health, reduce health inequalities and support a sustainable health and social care system. This includes smoking cessation and tobacco control. Councils currently spend around £75 million on Stop Smoking Services and £11 million on Tobacco Control. Councils also fund some activity through trading standards. Due to reductions in funding, research by The Health Foundation showed that spending on stop-smoking services fell by a third between 2015/16 and 2022/22.

The research also found that during the same period, spending on mass media anti-smoking campaigns in England declined by 90 per cent and the number of adult smokers trying to quit in the previous year fell by a quarter. Local government expenditure on resources that support people to be active – including parks, recreation and leisure centres – has also declined over the past decade due to councils’ having to prioritise their statutory services (such as adult social care and housing).

Polluter pays levy

In addition to providing local authorities with sustainable public health funding, the LGA supports a ‘polluter pays’ levy. The levy would provide, at no cost to the public purse, the funding needed to eradicate the social and geographical inequalities in smoking, and deliver a Smokefree 2030. According to the APPG for Smoking, such a levy could raise around £700 million a year from tobacco manufacturers to pay for stop smoking services, mass media campaigns like Stoptober, and work to stop the sale of illegal tobacco.

Raising age of sale

The LGA is not supportive of raising the age of sale of tobacco products as enforcement would be challenging. For instance, would someone be able to tell the difference between someone who is 18 versus someone who is 21. We request for the Department of Health and Social Care to liaise with other Government departments dealing with other age-restricted products and align their policies/messages to stop confusion with consumers and businesses. Instead, we feel that mandatory Challenge 25 would be helpful for all Age Restricted products and try to encourage retailers to introduce this voluntarily.

Sanctions

Sanctions are not sufficient to stop retailers supplying to underage people or breach other smoking regulations. Higher fines and stronger sentences available to the courts are required to be more of a deterrent. There should be an option of issuing a fixed penalty notice instead of the resources it takes to prosecute, leaving someone with a criminal record. It should be dealt with quickly and the fines on a scale in accordance with the number of sales etc. Access to the HMRC Track and Trace system have been mentioned as matters that would assist Trading Standards tackle this issue.

Contact

Laura Johnson, Public Affairs and Campaigns Adviser

Laura is the LGA’s public affairs lead on local government finance issues including business rates and fair funding. Laura also leads on education, children’s social care and children’s mental health as well as community wellbeing, which includes adult social care, public health, mental health, health systems and supported housing, including refugees and unaccompanied children. Laura joined the LGA in April 2019, having previously worked for a political monitoring organisation.

[email protected]