Smoking rates have increased in some areas of England for the first time in nearly two decades, according to new research.
A study by University College London (UCL) analysed smoking habits among more than 350,000 adults over 18 years and found that while the overall proportion of smokers has declined, progress has stalled since 2020, with some regions now seeing a rise.
The research, published in the journal Addiction, revealed a 10% increase in smoking rates in southern England between 2020 and 2024, while the north saw a 9.7% decline over the same period.
The South West experienced the sharpest rise, with smoking rates jumping 17% to 18.7%, while the South East and London saw increases of 9% and 8%, respectively.
Extrapolating these figures suggests that around 7.5 million adults in England now smoke, including 3.3 million in southern regions—nearly 400,000 more than in 2020. Meanwhile, the north now has 2 million smokers, 160,000 fewer than four years ago.
Over the last 18 years, smoking rates in the north have nearly halved, dropping from 28.8% in 2006 to 15.8% in 2024. UCL researchers believe this progress is due to the concentration of tobacco control programmes in northern regions.
Lead author Dr Sarah Jackson stressed the importance of equal access to stop-smoking services nationwide, warning that without sustained investment, progress could be lost.
Public health experts are concerned that planned 50% cuts to Integrated Commissioning Boards (ICBs), which fund NHS smoking cessation services, could undermine efforts to reduce smoking rates. Hazel Cheeseman, chief executive of Action on Smoking and Health, highlighted the role of long-term investment in the north’s success.
She warned that without continued funding, England risks reversing its progress towards becoming a smoke-free country.
Dr Ian Walker of Cancer Research UK, which funded the study, echoed these concerns, urging the government to maintain momentum in tobacco control. He warned that budget pressures and NHS restructuring should not compromise efforts to help people quit smoking.
A Department of Health and Social Care spokesperson defended the government’s approach, pointing to the landmark Tobacco and Vapes Bill, which aims to create the first smoke-free generation.
The government has also committed an additional £70 million this year to local stop-smoking services and is expanding NHS ‘opt-out’ smoking cessation programmes in hospitals.
Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, welcomed the overall decline in smoking rates but expressed concern over stagnation and regional increases. She highlighted the devastating health impacts of smoking, from preventable diseases to premature deaths, and stressed the critical role of GPs in helping people quit.
With smoking still a leading cause of illness and death in the UK, experts warn that without continued investment in prevention and cessation programmes, the country’s long-term progress could be at risk.
