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Page last updated: Mon, 11 Feb 2013 13:20:35 GMT

Smoking in London


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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Smoking and tobacco use in London
  • An estimated 19% of adults aged 18 and over in London were smokers in 2011/12, slightly lower than the England average of 20%. However, there was wide variation in the estimated proportion of smokers in each London borough, ranging from 14.6% in Harrow to 25.2% in Hackney. Overall, there were five boroughs in London where smoking levels were significantly better than the national average; only in Hackney were they significantly worse.1


  • Smoking in the routine and manual group was 27.5% in London in 2011/12, lower than the national average (30.3%). Only the borough of Bexley had a significantly higher proportion of smokers in the routine and manual group (about 38%) compared with the national average.1


  • 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 boys.2


  • About one in 16 (6%) women who gave birth in London in 2010/11 said they smoked during pregnancy. This was less than half that of the England average at 13%. Havering is the only London borough with levels of smoking during pregnancy that are significantly higher than the England average (14.7%).1


  • 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 smoking.4


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Secondhand smoke exposure
  • 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 smoke.5


  • 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 2007.6

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Smoking related harms
  • Smoking caused almost 8,550 deaths per year amongst Londoners aged 35 and over during the period 2008-10.7


  • Overall, London’s rate of smoking attributable deaths during 2008-10, at 199 deaths per 100,000 population was significantly better than the England average of 211 deaths per 100,000 population. However, the capital had 10 boroughs where smoking death rates were significantly worse than the national average.1


  • Smoking related harm varies markedly across London. Death rates from smoking-specific causes such as heart disease, stroke, lung cancer and chronic obstructive lung disease (COPD) in the local authorities with the highest rates in 2008-10 were at least twice those with the lowest rates. Trend data show a decrease in death rates from these causes in London overall in the last few years.1


  • In 2008-10, London’s rate of lung cancer registration was 44 per 100,000 population, compared to England’s rate of 45.8. The highest rates per 100,000 population were in Barking and Dagenham (68.5), Tower Hamlets (67.2) and Islington (66.2). Registration is a measure of each new diagnosis of cancer.1

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Hospital treatment and costs of smoking related illness
  • In 2010/11, smoking-related health problems led to about 13 hospital admissions for every 1,000 London residents aged 35 years and over.1


  • The rate of smoking attributable hospital admissions among adults aged 35 and over varies across London boroughs, ranging from 909 per 100,000 population in Harrow to 2,223 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 year.8

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Stopping smoking

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 53,000 people in London reported successfully quitting smoking with NHS Stop Smoking Services at the 4 week follow-up in 2011/12. This figure includes more than 37,600 people whose smoking status was confirmed by carbon monoxide validation.9


  • Of those Londoners who set a quit date through NHS SSS in 2011/12, 49% had successfully quit at the 4 week follow-up, the same as the England average.9


  • There were an estimated 4,300 quitters with NHS SSS per 100,000 smokers in London in 2011/12, less than the national average of 4,660 quitters per 100,000 smokers.9


  • There is no evidence to suggest that the boroughs with the highest quit rates are also the areas with the highest smoking prevalence. In 2011/12, only one (Islington) 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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London context

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 Strategy.10

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Lifestyle & behaviour – Smoking – London – LHO resources
Date Title Format
27 Oct 2010 £134m annual cost of smoking for London hospitals: Local tobacco control profiles London press release Icon representing a pdf filetype Download resource icon
27 Oct 2010 Local tobacco control profiles: main findings for London Icon representing a pdf filetype Download resource icon
9 Jun 2010 Heartsavers: cost savings from a reduction of emergency admissions for heart attacks following smoke-free legislation in England. London PCT and sector data Icon representing a xls filetype Download resource icon
9 Sep 2009 Commissioning for equity. Stop gaps: equity of access to London's stop smoking services Icon representing a pdf filetype Download resource icon
9 Sep 2009 Commissioning for equity. Stop gaps: equity of access to London's stop smoking services. Data tables Icon representing a xls filetype Download resource icon
23 Jun 2009 Health Survey for England 2006 London Boost - Smoking Tables Icon representing a xls filetype Download resource icon
30 Nov 2007 Commissioning for equity. Are London's stop smoking services equitable? A review of age, gender, ethnic group and area based deprivation data: a progress report Icon representing a pdf filetype Download resource icon
16 Nov 2006 The London health inequalities forecast: a briefing on inequalities in life expectancy and deaths from cancers, heart disease and stroke in London Icon representing a pdf filetype Download resource icon
23 May 2006 Stop before the op: a briefing on the short term benefits of preoperative smoking cessation in London Icon representing a pdf filetype Download resource icon
17 Feb 2005 Choosing health. A briefing on tobacco in London Icon representing a pdf filetype Download resource icon
18 Mar 2004 Tobacco in London: The Preventable Burden [data tables for local authorities] Icon representing a pdf filetype Download resource icon
18 Mar 2004 Tobacco in London: The Preventable Burden [data tables for parliamentary constituency] Icon representing a pdf filetype Download resource icon
18 Mar 2004 Tobacco in London: The Preventable Burden [data tables for SHAs and PCTs] Icon representing a pdf filetype Download resource icon
18 Mar 2004 Tobacco in London: The Preventable Burden [Executive summary] Icon representing a pdf filetype Download resource icon
18 Mar 2004 Tobacco in London: the preventable burden. Full report Icon representing a pdf filetype Download resource icon

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Lifestyle & behaviour – Smoking – London – Other resources

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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.


References