New ASH report shows increase in support for smokers from local councils

Action on Smoking and Health (ASH) and Cancer Research UK (CRUK) have released the results of their latest annual survey of the UK’s local government stop smoking services. Whilst the report indicates an overall improvement in service provisions compared to before the Covid-19 pandemic, it also warns about the increased pressures on services due to a lack of funding. 

The report praises councils for the welcome improvements in local support, due to their “impressive ability to quickly adapt to the challenges of COVID-19 lockdowns, for example by delivering traditionally face-to-face services remotely.” 

The survey also discusses how the pandemic has highlighted the consequences of years of cuts to public health services, which has led to local authorities having to “make difficult decisions”. Some opted to stop providing a dedicated specialist quit smoking service, relying instead on NHS smoking cessation services in general practices or pharmacies. 

This became a bigger issue as the pandemic piled pressure on the already stretched NHS, resulting in such service providers being the most likely to report negative impacts from the pandemic. “This highlights why it is so important local councils have increased and sustainable funding for tobacco control,” the report concluded. 

The report found that the Covid-19 pandemic has had a range of both positive and negative impacts on local authority stop smoking services. 36% of local authorities surveyed said that the pandemic had a positive impact overall, 34% said it had neither a positive nor negative effect, whilst 30% reported that it had a negative impact overall. 

The positive key findings from the survey include:

• The expansion of remote support (telephone and digital)
• An increase in service accessibility and flexibility
• The development of new modes of providing Nicotine Replacement Therapy (NRT), treatments and e-cigarettes
• An increase in smokers’ motivation to quit

Where they were experienced, the main negative impacts included: 

• The contraction of services
• A decline in primary care support and referrals
• Reduced access to face-to-face support
• A decline in wider tobacco control work

Despite funding cuts and additional pressure, 67% of the local authorities surveyed commissioned a universal specialist stop smoking service in 2021, which is an increase from 62% in 2020. Meanwhile, 9% opted for a restricted specialist service and 7% commissioned a service in primary care only. Just two local councils chose to offer a telephone helpline only, whilst two others (1%) had no service at all. 

Most importantly, the report found that local authorities offering a specialist service were least likely to report negative impacts following the pandemic, compared to those relying on primary care services alone who were most likely to report negative impacts. 

Thankfully, face-to-face support had been restored in most stop smoking services by August 2021, with 83% returning to face-to-face advice by the time the survey was taken. 98% of local authorities were offering telephone advice at the time, whilst 60% provided advice via video call. The increase in telephone advice and the use of video calls has resulted in a more flexible and accessible offering overall, hopefully reaching more smokers who may not be able to travel for face-to-face appointments. 

Local authorities have also engaged with a wide range of advisors to increase support reach, including primary care professionals, midwives, firefighters and, most importantly for our industry, vape shop staff. E-cigarette provision has also increased dramatically, with 40% of local councils now offering smokers this option, whilst a further 15% having plans in place to start this. This is a huge rise compared to 2019, when just 11% of local authorities offered vaping as a recommended alternative. 

The report also made recommendations on both a national and local level. “With serious pre-existing funding pressures unremedied and unknown challenges in the pandemic’s future course, it is unreasonable to expect local governments to continue to adapt without additional resources and support.” It went on to say, “There is a clear need to invest in local government. Not doing so risks not only the viability of local government tobacco control but also the Government’s Smokefree 2030 ambition for England and the lives that depend on achieving it.”

The national action recommendations stated that the Government should implement the recommendations made by the All Party Parliamentary Group (APPG) on Smoking and Health in its forthcoming Tobacco Control Plan, including:

• Funding measures to reduce smoking and to support people to quit through a ‘polluter pays’ amendment to the Health and Social Care Bill, forcing tobacco manufacturers to pay – but without letting them influence how the funds are spent.
• Targeting investment to tackle high smoking rates in communities where smoking does the most damage, including social housing tenants, pregnant women and people with a mental health condition. 
• Introducing tough new regulations to protect children and young people from becoming smokers and help smokers quit, including consulting on raising the age of sale of tobacco from 18 to 21.

The release of the UK’s Tobacco Control Plan has reportedly been delayed once again, despite being initially due for publishing in July 2021. Whenever it’s released, it’s hoped that reports like this will help make sure that additional funding to stop smoking services will be included in the plan, alongside the incorporation of e-cigarettes as a recommended tool for quitting.