The London Health Observatory is the lead Public Health Observatory on smoking for the Public Health Observatories in England. These pages provide some key facts about smoking and tobacco use in London, signposting relevant data and resources.

Local tobacco control profiles for England, produced by London, Eastern region and East Midlands Public Health Observatories on behalf of the Public Health Observatories in England, contain information on a range of smoking indicators for comparison locally, regionally and nationally.

Information, data and other resources about smoking and health in England and the UK can also be found on the LHO's Smoking in England page.

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• An estimated 19% of adults aged 18 and over in London were smokers in 2010, slightly lower than the England average of 21%. However, there was wide variation in the estimated proportion of smokers in each London borough, ranging from 15% in Redbridge to 24% in both Hackney and Greenwich. Overall, there were nine boroughs in London where smoking levels were significantly better than the national average, and two boroughs where they were significantly worse¹.



• Smoking in the routine and manual group was 27% in London in 2010, lower than the national average (30%). No borough in London had a significantly higher proportion of smokers in the routine and manual group compared with the national average¹.



• Over the period 2006-2008, 31% of London’s young people aged 11-15 tried smoking at least once, while 5% smoked regularly. Both of these figures were low compared to other regions of England. Consistent with national findings, girls were more likely to be regular smokers than boys².



• About one in 13 (7.4%) women who gave birth in London in 2009/10 said they smoked during pregnancy. This was half that of the England average at almost 14%. All but three London boroughs have levels of smoking during pregnancy that are significantly lower than the England average¹.



• The London Boost of the 2006 Health Survey for England found that White Londoners were significantly more likely to be current smokers (25%) than people from Black and Black British (14%) and Asian and Asian British (12%)groups. The survey also found that, based on a national ranking of deprivation, the most deprived areas in London had the highest prevalence of smoking in the capital (27%) while the least deprived areas had the lowest (16%). These figures are not directly comparable to other sources on smoking prevalence due to differences in methodologies used ³ .



• Smoking accounts for a significant proportion of inequalities in life expectancy at birth. The London health inequalities forecast estimated that 37% of the difference in life expectancy at birth in males and 30% of the difference in females between the London authorities with the worst health and deprivation indicators and the England average was accounted for by mortality attributable to smoking⁴.

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• Among a sample of London children aged 4-15 in 2006-08 who did not smoke, more than half (51% of boys and 61% of girls) had recently been exposed to secondhand smoke⁵.



• The smoke-free legislation in England has resulted in approximately 1,000 fewer bed days for heart attack admissions in London, with an estimated cost saving of £1 million, in the first year since its introduction in July 2007⁶.

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• Smoking caused almost 8,800 deaths per year amongst Londoners aged 35 and over during the period 2007-09⁷.



• Overall, London’s rate of smoking attributable deaths during 2007-09, at 208 deaths per 100,000 population was significantly better than the England average of 216 deaths per 100,000 population. However, the capital had 11 boroughs where smoking death rates were significantly worse than the national average¹.



• Smoking related harm varies markedly across London. Death rates from smoking-specific causes such as heart disease, stroke, and chronic obstructive lung disease (COPD) in the local authorities with the highest rates in 2007-09 were almost three times higher than in those with the lowest rates¹.



• Worryingly, oral cancer registrations are significantly higher in London than in England overall. In 2006-08, London’s rate of oral cancer registration was 9.8 per 100,000 population, compared to England’s rate of 8.9. The highest rates per 100,000 population were in Tower Hamlets (13.3), Wandsworth (13.3) and Camden (13.2). Registration is a measure of each new diagnosis of cancer¹.

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• In 2009/10, smoking-related health problems lead to about 13 hospital admissions for every 1,000 London residents aged 35 years and over¹.



• The rate of smoking attributable hospital admissions among adults aged 35 and over varies across London boroughs, ranging from 990 per 100,000 population in Redbridge to 2,176 per 100,000 in Islington.¹.



• The London Health Observatory estimated that, if patients admitted for planned surgery were to stop smoking before their operation, there could be as many as 5,300 fewer post-operative complications in London each year. This would save the NHS in London around 4,000 bed days and up to £1.1 million a year⁸.

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NHS Stop Smoking Services (SSS) provide counselling and support to smokers wanting to quit. Monitoring of the NHS SSS is carried out via quarterly monitoring returns and reported in an annual bulletin.

• More than 50,000 people in London reported successfully quitting smoking with NHS Stop Smoking Services at the 4 week follow-up in 2010/11. This figure includes more than 38,000 people whose smoking status was confirmed by carbon monoxide validation⁹.



• Of those Londoners who set a quit date through NHS SSS in 2010/11, 47% had successfully quit at the 4 week follow-up. This proportion is lower than the England average of 49%⁹.



• There were an estimated 4,100 quitters with NHS SSS per 100,000 smokers in London in 2010/11, less than the national average of 4,400 quitters per 100,000 smokers⁹.



• There is limited evidence to suggest that the boroughs with the highest quit rates are also the areas with the highest smoking prevalence. In 2010/11, only one (Tower Hamlets) of the five boroughs with the highest quitting rates per 100,000 people was among the five boroughs with the highest smoking prevalence ¹.

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The Mayor of London has outlined potential action on smoking, and other lifestyle factors, to promote health and reduce inequalities in the London Health Inequalities Strategy¹⁰.

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Further information, data and resources about smoking and health in England and the UK can also be found on the LHO’s Smoking in England webpage.