Statistics on Smoking: England, 2008 16/10/2008 Copyright © 2008, The Health and Social Care Information Centre. All rights reserved. The NHS Information Centre is England’s central, authoritative source of health and social care information. Acting as a ‘one-stop-shop’ for high quality, national, comparative data, we deliver information for local decision makers, to improve the quality and efficiency of care. Copyright © 2008, The Health and Social Care Information Centre. All rights reserved. Summary This statistical report presents a range of information on smoking which are drawn together from a variety of sources. The report aims to present a broad picture of health issues relating to smoking in England and covers topics such as smoking habits, behaviours and attitudes among adults and school children, smoking-related ill health and mortality and smoking-related costs. This report combines data from different sources presenting it in a user-friendly format. It contains data and information previously published by the NHS Information Centre, Department of Health, the Office for National Statistics and Her Majesty’s Revenue and Customs. The report also includes new analysis carried out by the NHS Information Centre. Main findings Smoking among adults Among adults aged 16 and over, in England, in 2006: • Results from the General Household Survey show, overall smoking prevalence has decreased. In 2006, 22% of adults reported smoking, compared to 24% in 2005 and 39% in 1980 • Those aged 20 to 24 and 25 to 34 reported the highest prevalence of cigarette smoking (31% and 29% respectively) while those aged 60 and over reported the lowest (12%) • As with previous years, smoking was higher among men than women (23% and 21% respectively) although this gap is narrowing • Current smokers smoked an average of 13.5 cigarettes a day • Those in the routine and manual groups reported the highest prevalence of smoking (29%). • There has been a marked increase in the proportion of smokers who smoke mainly hand-rolled tobacco. In 1990, 18% of men and 2% of women who smoked said they smoked mainly hand- rolled cigarettes, but by 2006 this had risen to 34% and 17% respectively • Two-thirds of current smokers and ex smokers who had smoked regularly at some point in their lives started smoking before they were 18. • In 2004-2006, 26% of adults in Scotland were smokers, a significantly higher proportion than in England and in Wales (23% and 22% respectively) Smoking among children For pupils aged 11 to 15 in England, in 2007: • Two-thirds of pupils reported they had never smoked. The proportion who had never smoked rose from 47% in 1982 to 67% in 2007. • Six per cent of children reported that they were regular smokers (smoked at least once a week) • Regular smokers smoked on average 6 cigarettes a day • Girls were more likely to have ever smoked than boys (36% compared to 31%) and to smoke regularly (8% compare with 5%) • Since 1990 there has been an increase in the number of pupils being refused cigarettes at point of sale, from 37% in 1990 to 53% in 2006 Copyright © 2008, The Health and Social Care Information Centre. All rights reserved. Behaviour and attitudes to smoking Among adults in Great Britain in 2007: • Almost three-quarters of current smokers reported wanting to give up smoking, with almost 8 in 10 current smokers reported trying to give up smoking at some point in the past • Two-thirds (67%) of adults report that they do not allow smoking at all in their home, an increase from 61% in 2006 • Four in five people agree with the smoking ban in public places. Smoking-related ill health and mortality In England in 2006/07 among adults aged 35 and over: • There were approximately 1.4 million hospital admissions with a primary diagnosis of a disease that can be caused by smoking. This figure has been steadily rising each year and is around 309,300 more than it was in 1996/97 • Around 445,100 hospital admissions are estimated to be attributable to smoking. This accounts for 5% of all hospital admissions among this age group. Around a quarter 26% (107,600) of all admissions with a primary diagnosis of respiratory diseases, 16% (139,600) of all admissions with a primary diagnosis of circulatory diseases and 13% (163,200) of all admissions with a primary diagnosis of cancer are attributable to smoking In England in 2007 among adults aged 35 and over: • Around 82,900 deaths (18% of all deaths of adults aged 35 and over) were estimated to be caused by smoking with a larger proportion of men (23%) estimated to die from smoking- related diseases than women (14%) • Around 37,200 (29%) cancer deaths, 22,300 (35%) deaths from respiratory diseases, 22,000 (14%) deaths from circulatory diseases and 1,400 (6%) of deaths from diseases of the digestive system were attributable to smoking. Smoking costs and economics In 2007: • Tobacco was nearly 17% less affordable than it was in 1980 • UK households spent an estimated £16.6 billion on tobacco Copyright © 2008, The Health and Social Care Information Centre. All rights reserved. Contents 1. Introduction ........................................................................................................... 1 2. Smoking among adults.......................................................................................... 3 2.1 Introduction................................................................................................ 3 2.2 Smoking prevalence, patterns and trends................................................. 3 2.3 Smoking and demographic characteristics................................................ 5 2.4 Geographical comparisons........................................................................ 8 Summary ................................................................................................................. 10 List of tables ................................................................................................................. 13 3. Smoking among children..................................................................................... 29 3.1 Introduction.............................................................................................. 29 3.2 Smoking behaviour and habits ................................................................ 29 3.3 Smoking among different groups and other factors................................. 30 3.4 Obtaining cigarettes and school policies ................................................. 32 3.5 National Comparisons............................................................................. 32 Summary ................................................................................................................. 33 List of tables ................................................................................................................. 35 4. Behaviour and attitudes to smoking .................................................................... 47 4.1 Introduction.............................................................................................. 47 4.2 Adults’ behaviour and attitudes to smoking............................................. 47 4.3 Children’s behaviour and attitudes to smoking........................................ 51 Summary ................................................................................................................. 53 List of tables ................................................................................................................. 55 5. Smoking related ill-health and mortality .............................................................. 77 5.1 Introduction.............................................................................................. 77 5.2 Smoking-related ill-health........................................................................ 77 5.3 Smoking-attributable deaths.................................................................... 79 Summary ................................................................................................................. 80 List of tables ................................................................................................................. 81 6. Smoking-related costs......................................................................................... 87 6.1 Introduction.............................................................................................. 87 6.2 Costs to the NHS..................................................................................... 87 6.3 Availability and affordability of tobacco.................................................... 88 6.4 Spending on tobacco............................................................................... 90 Summary ................................................................................................................. 91 List of tables ................................................................................................................. 93 Appendix A: Key sources.............................................................................................. 103 Appendix B: Logistic regression.................................................................................... 113 Appendix C: Estimating smoking-attributable deaths and hospital admissions ............ 115 Appendix D: Government policy and plans................................................................... 123 Appendix E: Editorial notes..........................................................................................