Smoking Rate Decline Stalls in Some Areas of England

Smoking rates in the North of England have fallen more rapidly than in other regions over the past 18 years, helping to narrow regional gaps, according to a new study.

Researchers from University College London (UCL) analysed data from 2006 to 2024 and found that smoking rates in the North nearly halved, dropping from 28.8% to 15.8%. In the Midlands, rates fell from 25.2% to 16%, while in the South, they declined from 22.7% to 17.3%.

The study, funded by Cancer Research UK and published in the journal Addiction, suggested that smoking prevalence in the North is now as low as in the South.

Despite the long-term decline, progress has slowed in recent years, and smoking rates have even increased in some areas, according to lead author Dr Sarah Jackson, PhD, principal research fellow at UCL’s Institute of Epidemiology and Health Care.

Regional Differences Narrowing

The observational study analysed data from 368,057 adults aged 16 and older using the Smoking Toolkit Study. Researchers used statistical methods to estimate trends in smoking by region and differences by occupational social grade.

The national average for smoking prevalence fell from 25.3% to 16.5% over the study period. In the Northwest, rates dropped from 28.3% in 2006 to 15.7% in 2024, while in Yorkshire and the Humber, they fell from 30% to 16%. The Northeast saw a similar decline from 27.4% to 16%.

Socioeconomic disparities in smoking prevalence also decreased. The gap between more and less advantaged social grades narrowed most in Yorkshire and the Humber (17.9% to 3.7%) and the West Midlands (16.1% to 3%). 

Impact of Tobacco Control Measures

Regions with sustained regional tobacco control measures saw greater declines in smoking prevalence than regions without, with reductions of 13.3 % versus 9.3%, respectively. The researchers noted that other factors, such as demographic shifts, may have contributed to these changes.

However, the study also found increases in smoking rates in the Southwest, rising from 16% to 18.7%, in the Southeast from 15.4% to 16.8%, and in London from 15.8% to 17%.

“Until recently, smoking rates were highest in the North of England, but our study shows that regional differences have narrowed considerably over the past 18 years,” highlighted Jackson. “Smoking rates fell most in northern regions, where dedicated regional tobacco control programmes have been largely concentrated,” she added.

Call for Continued Action

Smoking remains the leading cause of cancer and death in the UK. According to the Office for National Statistics’ Annual Population Survey, an estimated six million adults smoked cigarettes in the UK in 2023, the lowest proportion since records began in 2011.

Between 2006 and 2024, smoking rates in the North of England fell faster than the national average, narrowing the geographic disparities in prevalence. By July 2024, there was little difference in rates between the North, Midlands, and South.

Dr Ian Walker, executive director of policy and information at Cancer Research UK, stressed the need for continued action. “A future free from the harms of tobacco is in sight, but we can’t afford to lose any momentum,” he said.

Jackson added: “It’s vital that stop smoking services are made easily and equally available across the country, so that everyone – wherever they live – can access the right tools to quit for good.”

Dr Rob Hicks is a retired NHS doctor. A well-known TV and radio broadcaster, he has written three books and has regularly contributed to national newspapers, magazines, and online. He is based in the UK.