Smoking and Vaping Among Adults

This topic area covers statistics and information relating to adults smoking tobacco and using e-cigarettes in Hull including local strategic need and service provision. Further information relating to Smoking in Pregnancy is given under Pregnancy, Infants and Early Years within Children and Young People, and Smoking and Vaping Among Young People is given under Lifestyle Factors within Children and Young People. Smoking information has been collected within Hull’s Health and Wellbeing Surveys and more recently information relating to the use of e-cigarettes. The full reports are available under Surveys within Tools and Resources.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• Tobacco is a unique product. It is the only consumable that, when used in the intended way, kills half of its users.
• As smoking and deprivation is associated this acerbates the inequalities associated with poverty and deprivation. Smoking is the single greatest cause of inequality, and it also accounts for approximately half of the difference in life expectancy between the lowest and highest deprivation groups.
• The majority of residents of Hull live within a short drive of the nearest tobacconist or vape store with only some areas to the north of the city in Kingswood and North Carr having a slightly longer drive time, although all residents live within an an 11 minute drive of the nearest tobacconist or vape store.
• From the local adult Health and Wellbeing Survey 2019, a high percentage of adults in Hull smoke tobacco currently one in four residents (24.9%) which is much higher than England (13.9%). This equates to 52,050 current smokers in Hull and a further 59,750 ex-smokers. Smoking prevalence is highest among those aged 25-34 years (30.5%), people living in the most deprived fifth of areas of Hull (35.7%), people who are unemployed (45.0%) or not working due to long-term illness and disability (48.1%), and among lone parents (38.8%). Overall, 28.6% were ex-smokers and 46.5% stated they have never smoked.
• From local surveys, the prevalence of smoking has decreased in Hull from 31.7% in 2014 to 24.9% in 2019. Smoking prevalence has decreased across all deprivation groups. Furthermore, around 10% of all adults in Hull smoked 20+ cigarettes per day in 2007 and 2009, but this has fallen to 4.5% in 2019.
• In the national Annual Population Survey 2023, it is estimated that 17.6% of people in Hull smoke compared to 11.6% for England. The prevalence in Hull is the seventh highest among all upper-tier local authorities in England.
• More than four in ten people in Hull with manual and routines occupations smoked in 2011, but this has decreased considerably to around one-quarter in 2023 (26%). Around one-third of people with long-term mental health conditions (2019/20) smoked in Hull in 2019/20, but over half of those with serious mental health illness in 2014/15 (although this is relatively old data now) and more than eight in ten of people admitted to substance treatment services in 2019/20.
• From the local survey in 2019, it was estimated that 4.5% of all adults in Hull are heavy smokers smoking 20+ cigarettes per day, although this was higher at 13.6% among people who were not working due to long-term illness or disability, and higher among people living in Newington & Gipsyville ward (8.4%). However, the percentage had more than halved from 10.1% in 2007 and 2009.
• Overall, in the local Health and Wellbeing Survey 2019, 29% of people were ex-smokers although this was as high as 47% among those aged 75+ years. In the national Annual Population Survey 2023, it was estimated that 32% of people in Hull were ex-smokers.
• Lung cancer registrations for 2016-18 are very high in Hull (73% higher than England and fifth highest out of the 311 lower-tier local authorities in England), and the rate of emergency admissions for chronic obstructive pulmonary disease in Hull for 2022/23 is 1.6 times higher than England (around 80% of lung cancer cases and chronic obstructive pulmonary disease are related to smoking).
• In 2019/20, it is estimated that there were 3,097 hospital admissions among Hull residents that were attributable to smoking (75% higher than England and fifth highest among 150 lower-tier local authorities in England). It was estimated that the cost of hospital admissions attributable to smoking among those aged 35+ years is £43.80 for every person aged 35+ years in Hull (cost per capita for 2016/17).
• Mortality from lung cancer is very high in Hull being 80% higher than England for deaths registered during 2020-22, although the mortality rate has been gradually decreasing over time.
• Mortality from chronic obstructive pulmonary disease is very high in Hull (78% higher than England). Furthermore, prior to the pandemic the mortality rate from chronic obstructive pulmonary disease has been increasing in Hull, particularly so for women. The mortality rate has been increasing very gradually in England, but the increase in Hull has been much greater and dramatic. Over the 17 year period between 2001-03 and 2017-19, the mortality rate from chronic obstructive pulmonary disease decreased by 10% in England and by 9% across the Yorkshire and Humber region, but increased sharply (by 47%) in Hull. In Hull, mortality from chronic obstructive pulmonary disease was the highest for both men and women, and substantially higher than the next highest local authority (13% higher for men and 9% higher for women) for 2017-19. The mortality rate from chronic obstructive pulmonary disease decreased in Hull sharply between 2017-19 and 2020-22 due to the COVID-19 pandemic. People who had chronic obstructive pulmonary disease in Hull still died between 2018-20 and 2020-22, but they were less likely to die from chronic obstructive pulmonary disease, and had a relatively high mortality rate from COVID-19 (16% of all COVID-19 deaths in 2020 and 2021 had chronic obstructive pulmonary disease as a secondary cause of death). Whilst the mortality rate from chronic obstructive pulmonary disease decreased slightly for England during the pandemic, the decrease in Hull was much more dramatic, which suggested that people in Hull with pre-existing chronic obstructive pulmonary disease were more likely to die from COVID-19 than people in England. It is likely that the mortality rate in Hull for COPD will increase sharply for the period 2022-24 once deaths registered in 2020 and 2021 (during the pandemic) are no longer included in the three year period of time.
• In the three year period 2017-19, it is estimated that there were 1,501 deaths to Hull residents attributable to smoking, and Hull had the highest mortality rate (420 deaths per 100,000 population aged 35+ years) among the 150 English upper-tier local authorities and the rate was more than twice as high as England (202 deaths per 100,000 population aged 35+ years). The smoking-attributable mortality rate was second highest for heart disease, highest for stroke and highest for cancer. The difference was particularly noticeable for stroke with the rate in Hull being 37% higher than the local authority which was second highest (22.2 versus 16.2 deaths per 100,000 population).
• Over the three years 2016-18, it is estimated that 8,231 potential years of life prior to the age of 75 years were lost that were attributable to smoking giving a rate of 2,399 per 100,000 population (almost twice as high as England at 1,313 per 100,000 population).
• A new provider of the Stop Smoking Services commenced at the end of 2019 and whilst services were initially disrupted due to the COVID-19 pandemic, the current service is working well with two-thirds of smokers quitting at four weeks among those who set a quit date.
• Action on Smoking and Health (ASH) in their Ready Reckoner 2024 estimate that smoking costs Hull £14.8 million cost to the NHS, £127 million in care (including informal and unmet care) , £2.4 million in fires and additionally the total soct of tonabacco products is £95.2 million.
• Overall, 13.4% of adults in the local survey used e-cigarettes which is an increase from 2014 when it was estimated that 8.4% adults in Hull used e-cigarettes. Nine in ten people who used e-cigarettes used them to stop or cut down tobacco smoking or to prevent them re-starting smoking. One quarter of daily and ex-smokers of tobacco and one-third of occasional tobacco smokers used e-cigarettes. Only 15 people in the survey used e-cigarettes who had never smoked tobacco representing fewer than 0.9% of never smokers. The majority were young males but not exclusively so. It is estimated that around 6.5% of people in England use e-cigarettes, but it is not surprising that usage is much higher in Hull when tobacco smoking prevalence is much higher in Hull and a high percentage of e-cigarette users use them as a quit aid.

The Population Affected – Why Is It Important?

The following video from The Office for Health Improvement & Disparities (previously Public Health England) explains how we can prevent ill health from both alcohol and tobacco.

https://youtu.be/dEVguE2yOj4

Tobacco is a unique product. It is the only consumable that, when used in the intended way, kills half of its users. This makes it one of the biggest causes of death and illness in the UK. Smoking causes around 80% of lung cancers, but can also cause cancer in many other parts of the body. Smoking also increases the risk of developing heart and circulation problems such as coronary heart disease, stroke, peripheral vascular disease and cerebrovascular disease. It also damages the lungs increasing the risk of bronchitis, emphysema and pneumonia, and other chronic obstructive pulmonary disease. Smoking can also cause or exacerbate numerous other health problems, and there are further risks caused by smoking in pregnancy and breathing in second hand smoke. In 2015/16, there were approximately 474,000 smoking related hospital admissions with smokers seeing their GP 35% more than non-smokers. Every year, there are around 64,000 deaths attributable to smoking in England. Smokers who die prematurely lose on average about 10 years of life.

There are also specific serious risks to the baby if their mother smokers during pregnancy (further specific details are given within Smoking in Pregnancy under Pregnancy and Maternal Health under Children and Young People). Second-hand smoke is very dangerous for anyone exposed to it, but it is particularly dangerous for children (further specific details are given within Smoking Among Young People under Lifestyle Factors under Children and Young People).

As smoking and deprivation are associated this acerbates the inequalities associated with poverty and deprivation. Smoking is the main contributor to health inequalities. Marmot in his original report in 2010 stated that smoking accounts for approximately half of the difference in life expectancy between the lowest and highest deprivation groups. Furthermore, as stated in Marmot’s ’10 years on’ report, it is more difficult for individuals to change unhealthy behaviours such as smoking when they are under stress caused by factors such as debt or poor housing.

Action on Smoking and Health (ASH) have produced a Ready Reckoner to calculate the cost of tobacco in a single year at local authority level. For the 2022 edition of their Ready Reckoner, for England, ASH estimate that:

• There are 5,666,400 adult (aged 18+ years) smokers in England (12.7%).
• The total cost to society is around £17.0 billion every single year.
  • Healthcare: It is estimated that the smoking-related cost to the NHS is around £1.89 billion each year.
  • Economy / productivity: It is estimated that the cost to the economy is around £18.3 billion each year in terms of lost productivity (people who are economically inactive due to smoking-related illnesses, people who die prematurely due to smoking-related illnesses, and lost productivity through smoking-related absenteeism and smoking breaks).
  • Social care: It is estimated that the additional social care costs are £1.23 billion per year (relating to additional care costs that are additional to or earlier in life, because of smoking-related conditions). Furthermore, it is estimated that smoking-related ill-health means social care is being provided informally by friends and family for over one million people and if this care was replaced with formal paid care it would cost the social care system an additional £8.41 billion.
  • House fires: It is estimated that house fires related to smoking cost £347 million per year (cost of deaths and injuries, property damage and costs to Fire and Rescue Services).
  • In addition to the £46 billion cost per year, it is estimated that smokers in England spend around £13.7 billion on tobacco products each year (£2,486 per smoker).

Health benefits of quitting tobacco smoking are:

• immediate after quitting smoking;
• within 2-13 weeks circulation improves and lung function increases;
• within 1-9 months coughing and shortness of breath decreases and people start to regain lung function;
• after one year excess risk of coronary heart disease is half that of a continuing smoker’s;
• after 2-5 years stroke risk falls to that of a non-smoker’s;
• after five years the risk of cancer of the mouth, throat, oesophagus and bladder are cut in half, and cervical cancer risk falls to that of a non-smoker;
• after 10 years the risk of dying from lung cancer is about half that of a person who is still smoking, and risk of cancer of the larynx and pancreas decreases; and
• after 15 years the risk of coronary heart disease is that of a non-smoker’s.

The Hull Picture

Drive Times to Nearest Tobacconist or Vape Store

The Access to Healthy Assets and Hazards which includes drive times to nearest tobacconist or vape store was updated in 2024.

The Access to Healthy Assets and Hazards (AHAH) index is designed to allow policy and decision makers to understand which areas have poor environments for health, and to help move away from treating features of the environment in isolation.

The Access to Healthy Assets and Hazards index is comprised of four domains: access to retail services (fast food outlets, gambling outlets, pubs/bars/nightclubs, off licences, tobacconists), access to health services (GP surgeries, A&E hospitals, pharmacies, dentists and leisure centres), the physical environment (green and blue spaces) and levels of air pollution (nitrogen dioxide (NO2), particulate matter smaller than 10 microns (PM₁₀) and sulphur dioxide (SO₂)).

In 2024, the Access to Healthy Assets and Hazards Index is very high in Hull with 44.7% of Hull’s population residing in the bottom fifth of areas nationally in relation to the Access to Healthy Assets and Hazards Index. The percentage nationally is 20.9% and across the other 14 lower tier local authorities in the region the range is from 1.3% to 32.6%.

Despite the very high levels in Hull, the index has decreased considerably since 2016 when nine in ten residents lived in the worst fifth of areas of England in relation to the index, although there was a large decrease between 2016 and 2017 to 46% with only relatively minor changes to 2022 and 2023.

In 2024, it is estimated that 120,220 residents in Hull live within areas defined as the bottom fifth of areas nationally based on the Access to Healthy Assets and Hazards Index.

Information relating to version 4 of the Access to Healthy Assets and Hazards index is available at lower layer super output area geographical level. There are 33,755 lower layer super output areas in England, and the percentile score has been calculated for each of the 168 lower layer super output areas in Hull. The index was updated in July 2024, and information on the individual components is available.

The majority of residents of Hull live within a short minute drive of the nearest tobacconist or vape store with only some areas to the north of the city in Kingswood and North Carr having a slightly longer drive time, although all residents live within an an 11 minute drive of the nearest tobacconist or vape store.

Information on the other indicators is available under Geographical Area under Place.

Smoking Tobacco

Current Prevalence and Trends Over Time

Current Smokers (General Population)

From Hull’s Health and Wellbeing Survey 2019, 24.9% of adults smoked tobacco in Hull. One in five adults smoke daily and a further 4.9% smoked but not every day. The prevalence was slightly higher among men compared to women, and differed by age with 26.5% of 16-24 year olds smoking which increased to 30.5% of 25-34 year olds before falling to 28.5% among those aged 35-54 years and decreasing to 9.0% among those aged 75+ years. More than four in ten people who were unemployed or not working due to long-term illness or disability smoked tobacco, and there was a strong association with deprivation. Over one third (35.7%) of people living in the most deprived fifth of areas of Hull smoked compared to 13.2% of those who lived in the least deprived fifth of areas of Hull. Rates of smoking were also high among lone parents and people under 65 years who lived alone. Among survey responders aged under 65 years, the single person households had a higher percentage of males aged 35-64 years (42% versus 24% for all other households type where the survey responder was aged under 65 years) and females aged 55-64 years (19% versus 8% for all other households types where the survey responder was aged under 65 years). So it appears that this group could include people who are separated or divorced as well as single individuals.

It is estimated that there are 52,050 current smokers in Hull with 41,700 smoking daily and 10,300 smoking but not every day. There are a further 59,750 people who are ex-smokers.

There were large difference in the prevalence of smoking across Hull’s 21 wards ranging from 9.9% in Kingswood to 41.7% in St Andrew’s and Docklands. The prevalence of smoking was strongly linked to deprivation. St Andrew’s & Docklands was the most deprived ward in Hull followed by Orchard Park, Central, Marfleet, North Carr, and Newington & Gipsyville. The prevalence of smoking was surprisingly low in the survey for North Carr, but all the other wards had high levels of current smokers. In contrast, Kingswood is the least deprived ward, followed by Holderness, Bricknell, and Boothferry, and these four wards has the lowest prevalence of smoking.

Health and Wellbeing Surveys have been completed in Hull for a number of years, and it is possible to compare the prevalence of smoking over time among survey responders. The prevalence has been consistently higher than 30% but fell in 2019 to just under one-quarter. The recent decrease occurred for both men and women, and across all deprivation groups particularly people living in the most deprived areas of Hull. The estimate for 2019 differs slightly to the figure quoted above as the percentages in the trend chart have been adjusted for age.

The Office for Health Improvement & Disparities’ Fingertips also presents the prevalence of smoking from the Annual Population Survey (ASP) for local authorities in England, although a couple of local authorities do not have data because of recent boundary changes, and the numbers are too small for two local authorities (City of London and Isles of Scilly). They also present smoking prevalence from the GP Patient Survey (GGPS) as well as the prevalence from the Quality and Outcomes Framework (QOF) which is the primary care payment system where practices’ funding is based on achieving specific indicators around care (e.g. recording patients who have specific diseases and medical conditions and the care those patients receive). Within the Quality and Outcomes Framework, there is an indicator relating to recording smoking prevalence, and the prevalence of smoking can be estimated from this at practice level and at Clinical Commissioning Group level. Both measures from the GP Patient Survey and Quality and Outcomes Framework will be based on a slightly different population compared to the Annual Population Survey as the former two are based on patients registered with Hull GPs whereas the latter is based on the resident population.

The local surveys have involved a much larger number of people (at least 4,000) and are much more representative of Hull’s population, whereas the national Annual Population Survey involve far fewer people who participate in Hull (often around 500 people) and due to the way they are approached or selected to participate in the survey, they are not necessarily representative of Hull’s population. So prevalence estimates from the local survey have been used and are the best ones to use when estimating smoking prevalence in Hull. The GP Patient Survey involves a larger sample, but it is possible (with all surveys) that there is a difference between those who responded and those who did not, so it is not known how representative the sample is in relation to Hull’s overall population. For the GP Patient Survey in 2024, 9,842 questionnaires were sent out with 2,537 returned (26%), although the number of questionnaires returned and the response rate have reduced over recent years (for instance, in 2001, 12,458 questionnaires were sent out with 4,224 (34%) returned). The Quality and Outcomes Framework data is recorded for all patients registered with Hull GPs, but this does not necessarily mean the data is accurate. It is possible that the smoking status may not be recorded for all patients, and for some patients their smoking status could have changed and the change has not been reflected in their GP record (especially if the patient has not attended the practice for some time and/or their GP did not ask or was not told if there had been a change to the patient’s smoking status).

From the Annual Population Survey 2023, it was estimated that 17.6% of people aged 18+ years in Hull smoked compared to 11.6% for England. The rate in Hull was second highest across the Yorkshire & Humber region (after Doncaster) and seventh highest of the 147 upper-tier local authorities in England. In 2021, the prevalence was 22% for Hull and the rate was the highest across all upper-tier local authorities in England so there has been a considerable decrease in the estimated prevalence of smoking in the last two years, although the rate in 2021 was higher than in 2020 and might not have represented the overall trend but a ‘blip’ of who was surveyed in Hull during 2021.

Over the three year period 2021-23, the smoking prevalence in Hull is second highest among upper-tier local authorities at 19.6% just below Blackpool at 20.0%.

For 2022/23, it is estimated that the prevalence of smoking is 19.5% for patients registered with Hull GPs compared to 13.6% for England from the GP Patient Survey, and 21.8% for Hull and 14.7% for England from the Quality and Outcomes Framework.

So whilst all these surveys are slightly different, there is not too much difference between the different measures of smoking prevalence for Hull.

From the national survey, the prevalence of smoking in Hull has decreased from 30.5% in 2011 to 17.6% in 2023 which is a decrease of 42% and a very similar percentage decrease as England (41%) over the same time period.

There has also been a fall in prevalence as measured by the GP Patient Survey falling from 25% in 2013/14 to 20% in 2022/23.

A similar decrease in smoking prevalence among Hull patients has occurred as measured by Quality and Outcomes Framework falling from 27% in 2013/14 to 23% in 2021/22.

Current Smokers (People Working in Routine or Manual Occupations)

From the Annual Population Survey 2023, the prevalence of smoking among people who work in routine and manual occupations is estimated to be 26.0% in Hull which is higher than England (19.5%).

The prevalence of smoking among people who work in manual and routine occupations has been decreasing in Hull although there has been some year-on-year variability. The prevalence was estimated to be around 42% for 2011 and 2012 but fell to 23% for 2022, with an increase to 26% for the latest year 2023.

The rate in 2021 was particularly high in relation to current trends and it is possible that there were some problems with the sampling / participation in the survey among Hull residents, and potentially other years too. The numbers surveyed in Hull was generally 400-500 people in total and only a subset of these survey responders will be in routine and manual occupations.

Current Smokers (People With Mental Health Conditions)

The prevalence of smoking is also given on Fingertips for different groups who have mental health conditions which tend to have a higher prevalence of smoking.

From the GP Patient Surveys, in Hull, it was estimated that 27% of people with a long-term mental health condition smoked in 2022/23 and 32% of people with anxiety or depression smoked in 2016/17, both of which are statistically significantly higher than England where around one-quarter smoked. The GP Patient Surveys are regularly undertaken and are mainly used to collect information relating to patient satisfaction. The information relating to medical conditions from this survey is self-reported, so those who report they have a long-term mental health condition or that they have anxiety or depression.

From the Quality and Outcomes Framework, in 2014/15, it was estimated that over half (52%) of people with a serious mental illness registered with Hull GPs smoked which was statistically significantly higher than England (41%). This included patients identified as having schizophrenia, bipolar affective disorder or other psychoses in their electronic health record (and their latest mental health diagnosis was not in remission).

Both the GP Patient Surveys and information collected as part of the Quality and Outcomes Framework are collected through GP practices. Around 10% of patients registered with Hull GPs live in East Riding of Yorkshire, and the smoking prevalence estimates relating to mental health will include these patients. The prevalence of smoking is generally much lower in East Riding of Yorkshire (particularly in the villages to the west of Hull where many of these patients will live) and thus it is likely that the prevalence would be slightly higher if only patients who live in Hull were to be included.

It was estimated that almost half of adults with a long-term mental health condition smoked in 2013/14, but this fell steadily to 32% until 2019/20, before increasing in 2020/21 and increasing more sharply for 2021/22. However, in the last year, there has been a substantial decrease to a low of 27% for 2022/23.

In 2014/15, there were 2,487 patients registered with Hull GPs with a serious mental health illness. There were 924 patients with a serious mental health illness who smoked and with the prevalence being 52.3%, this works out to be out of 1,767 patients (presumably this means that smoking status was not recorded for all 2,487 patients and perhaps this is why the indicator has not been updated since 2014/15).

The prevalence of smoking among adults who have anxiety or depression has also been decreasing in Hull from 41% in 2013/14 to 32% in 2016/17. The rate of decrease in Hull has been greater than England (-23% versus -10%) but similar to the decrease across the Yorkshire and Humber region (-21%). So the inequalities gap between Hull and England has decreased over time.

Current Smokers (People in Drug Treatment Services)

Over 80% of people admitted to substance treatment services in 2019/20 smoked.

The number of adults admitted to services who smoked has increased over time in Hull, but it is possible that this increase is due to better recording of smoking status.

Heavy Smokers – 20+ Cigarettes Per Day

From Hull’s Health and Wellbeing Survey 2019, 4.5% of Hull’s total adult population smoked the equivalent of 20 or more cigarettes per day (or equivalent), and this was highest among people aged 45-64 years, people living in the most deprived areas of Hull and people who were unemployed or not working due to long-term illness and disability. It is estimated that across all of Hull, around 9,300 adults usually smoke 20+ cigarettes per day.

People living in Newington and Gipsyville had the highest prevalence of smoking 20+ cigarettes per day with 8.4% of all adults doing so. In contrast, fewer than 1% of all adults participating in the survey who lived in Kingswood usually smoked 20+ cigarettes per day.

The percentage of heavy smokers who usually smoke 20+ cigarettes per day has shown a large decrease over time. In 2007 and 2009, around one in ten of all adults in Hull usually smoked 20+ cigarettes per day, but this has decreased gradually over time and currently around 4.5% of Hull’s total adult population aged 16+ years usually smoke 20+ cigarettes per day.

It is useful to examine the percentage of people who smoke 20+ cigarettes per day out of those people who were current smokers. Among all current smokers surveyed, 17.9% stated that they usually smoked 20+ cigarettes per day, but this was over one-quarter of those aged 55-64 years and who were not working due to long-term illness or disability. People aged 16-24 years who smoked were the least likely to smoke heavily and as a consequence the percentage was also low among students.

Around one-third of current smokers who lived in Longhill & Bilton Grange, and Pickering wards smoked 20+ cigarettes per day. Fewer than 7% of current smokers in Kingswood were heavy smokers.

Ex-Smokers

From the local survey, 28.6% of adults aged 16+ years are ex-smokers. Perhaps unsurprisingly, as age increases the percentage of ex-smokers increases sharply. Almost a half of survey responders aged 75+ years stated they were ex-smokers. There were only small differences in the percentage of men and women who were ex-smokers, and perhaps surprisingly there were only small differences by local deprivation fifth. The differences in the percentage of ex-smokers by working status and household composition were those expected given that there were considerable differences in age among the survey responders by working status. However, the exception to this was the very low prevalence of ex-smokers among those who were unemployed, and this may be because such a higher percentage of people were unemployed still smoked (45%). This was not the case for people who were not working due to long-term illness and disability though which had an even higher prevalence of current smokers (48%) because 30% of this group were also ex-smokers. So the differences here also lie within the differences in the percentages who had never smoked which differs between people who are unemployed and people who are not working due to long-term illness or disability (see below for information in the percentages who have never smoked).

Survey responders living in Pickering (38%), Derringham (38%), Longhill & Bilton Grange (36%), Marfleet (33%), Orchard Park (33%), Bricknell (32%), Avenue (32%) and Boothferry (31%) had the highest percentage of ex-smokers.

The length of time the person had quit smoking was not collected in the 2019 survey so it is difficult to assess the level of risk to health previous smoking may have on the estimated 60,000 adults aged 16+ years who are ex-smokers. It is also complex as the level of risk reduces over time at different rates depending on the disease or medical condition, and will be dependent on other factors such as the length of time the person was a smoker and the quantity they smoked. It is possible that some, or even most or many, of the people who were 75+ years in the survey, quit smoking a long time ago.

From local Health and Wellbeing Surveys, approximately one-quarter of survey responders stated they were ex-smokers (25.7% in 2007, 22.2% in 2009 and 26.3% in 2011) although this was slightly higher in 2014 (27.1%) and in 2019 (28.6%) perhaps due to slightly fewer people being current smokers in those particular surveys.

The Annual Population Survey and GP Patient Survey also includes information on the prevalence of ex-smokers, but estimates are slightly higher with over three in ten classified as ex-smokers for 2023 and 2022/23.

From the Annual Population Survey, the percentage of ex-smokers was around a third between 2011 and 2015 in Hull but fell to around one-quarter between 2016 and 2022, although has increased to 31.5% for 2023. It is possible that the fluctuations are due to the relatively small number of people surveyed in Hull.

The percentage of ex-smokers from the GP Patient Survey has remained relatively constant between 2013/14 and 2020/21 at around 27-28% for Hull, but increased for both 2021/22 and 2022/23 to reach a high of 30% for 2022/23.

Never Smoked

Within the local adult Health and Wellbeing Survey 2019, the percentage of survey responders who had never smoked was 46.5% although it was considerably higher among those aged 16-24 years (60.0%) and students (69.6%). There was a strong association with deprivation with 37% of people living in most deprived fifth of areas of Hull having never smoked compared to 59% among people living in the least deprived fifth of areas of Hull. Only around one in five people who were not working due to long-term illness or disability had never smoked.

There were also considerable differences in the percentages who had never smoked across Hull’s 21 electoral wards which ranged from 68% in Kingswood to 33% in St Andrew’s & Docklands.

From local Health and Wellbeing Surveys, the percentage who had never smoked was relatively consistent over time (42.6% in 2007, 44.4% in 2009, 39.7% in 2011 and 42.3% in 2014 although this was slightly higher in 2019 at 46.6%).

The Annual Population Survey and GP Patient Survey also includes information on the percentage who have never smoked. The percentages are higher in both these national surveys compared to the local Health and Wellbeing Survey 2019 with just over half stating they had never smoked. This is around 10 percentage points higher than in the local surveys.

From the Annual Population Survey, the percentage of adults who have never smoked was around 40% between 2011 and 2015, but has increased to around 50% between 2016 and 2019, and has further increased to around 54% for 2021 and 2022, although decreased back to just over 50% for 2023.

The percentage of adults who have never smoked from the GP Patient Survey has increased gradually over time from 47.4% for 2013/14 to 51.4% for 2018/19, but has remained around 50-51% until 2022/23.

Smoking Related Cancer Registrations

The Office for Health Improvement & Disparities’ Fingertips also provides information on the number of cancer registrations from lung and oral cancers, a high percentages of which are due to smoking.

The Office for Health Improvement & Disparities (formerly Public Health England) state that “In England in 2017/18, 47% of hospital admissions for cancers that can be caused by smoking, and 39% of admissions for respiratory diseases that can be caused by smoking, were estimated to be attributable to smoking in persons aged 35 and over. Lung cancer registration is therefore a direct measure of smoking-related harm.”

The rate of lung and oral cancer registrations is given as the directly age-standardised registration rate for lung and oral cancer per 100,000 population standardised to the European Standard Population.

During 2017-19, the rate of lung cancer registration for Hull was 72% higher than England (132 versus 77 per 100,000 population), and the highest across the Yorkshire and Humber region.

The rate of oral cancer registration for Hull was 12% higher than England, and the rate of cancer registrations for oesophageal cancer is 22% higher than England and the highest across the region.

The rate of lung cancer registration declined slightly in Hull from 148 registrations per 100,000 population in 2007-09 to 124 registrations per 100,000 population in 2010-12, but has gradually increased to 139 per 100,000 population for 2014-16 before decreasing slightly to 132 registrations per 100,000 population during 2017-19. The rate in England has remained relatively unchanged over this period, and has decreased marginally across the Yorkshire and Humber.

In the latest three year period 2017-19, there were 802 cancer registrations for lung cancers in Hull.

The rate of oral cancer registrations in Hull has been relatively variable but the rates appear to have increased between 2007-09 and 2015-17, and although there has been a fall between 2015-17 and 2017-19, but the latest rate in 2017-19 is considerably higher than the rate in 2007-09. The increase over time is not unique to Hull as the rates across both England and the region have increased between 2007-09 and 2017-19.

In the latest three year period 2017-19, there were 113 cancer registrations for oral cancers in Hull.

There has been relatively large year-on-year variation in the rate of cancer registrations for oesophageal cancer, but for the six of the 11 periods the rate has been statistically significantly higher in Hull compared to England.

Further information relating to cancer incidence can be found in Cancer under Health Factors within Adults.

Hospital Admissions Due to Smoking

Around 80% of cases of chronic obstructive pulmonary disease (COPD) are caused by smoking, and given Hull’s high prevalence of smoking, the emergency admission rate for COPD is 1.7 times higher in Hull (03F) compared to England (318 versus 191 emergency hospital admissions per 100,000 population) for 2022/23.

The rate is given as a directly age-standardised admission rate per 100,000 population standardised to the European Standard Population.

The number of emergency hospital admissions for COPD in Hull steadily increased from 400 admissions per 100,000 population in 2013/14 to a high of 525 admissions per 100,000 population during 2017/18. Whilst the rate decreased between 2017/18 to 2019/20, the rate in Hull is twice as high as England.

The rate fell sharply in 2020/21 with admissions halving due to the COVID-19 pandemic, although increased for 2021/22. The rate remained relatively unchanged for 2022/23. The latest rate is currently significantly below pre-pandemic admission rates, with the change in the rate of admissions for Hull since 2020/21 very similar to those changes observed nationally and for the region.

The inequalities gap between Hull and England decreased between 2019/20 and 2020/21 and has remained at that slightly lower difference for 2022/23. However, despite the inequalities gap narrowing slightly the admission rate in Hull is 1.7 times higher than England for 2022/23.

Overall, in 2022/23 there were 815 emergency admissions for COPD which is much lower than the peak of 1,245 in 2017/18 or 1,125 in 2019/20 prior to the pandemic.

Further information relating to hospital admissions from chronic obstructive pulmonary disease can be found under Respiratory Diseases under Health Factors within Adults.

Fingertips also provides information on hospital admissions attributable to smoking. Each hospital admission is assigned a primary diagnosis code using the International Classification of Diseases which relates to the main reason or cause for the hospital admission. The Office for Health Improvement & Disparities (formerly Public Health England) have assigned a smoking attributable fraction for each diagnosis code based on research. Each smoking attributable fraction is between 0 and 1. Most smoking attributable fractions will be zero in that smoking is not implicated in any way for that specific primary diagnosis of admission, but admissions with a primary diagnosis for a smoking-related condition will have a smoking attributable fraction higher than zero and that fraction is likely to differ for men and women, and for different age groups.

For instance, a hospital admission would be assigned a smoking attributable fraction of 0.7 if it has been found that 70% of admissions with that primary diagnosis code were related to smoking among men or women of a specific age.

Every admission in Hull for the specified period has been assigned a smoking attributable fraction, and then these have been summed over all admissions to estimate the total number of hospital admissions that are attributable to smoking.

In 2019/20, it is estimated that there were 2,440 hospital admissions attributable to smoking in Hull per 100,000 population which is 75% higher than England, and the highest across the Yorkshire and Humber region. The rate in Hull is also fifth highest across all upper-tier local authorities in England behind Blackpool (3,071 per 100,000 population), Sunderland (2,868), Stoke-on-Trent (2,593) and South Tyneside (2,511).

The rate is given as a directly age-standardised admission rate per 100,000 population standardised to the European Standard Population.

It is estimated among people aged 35+ years in Hull that there were 3,097 admissions to hospital during 2019/20 that were attributable to smoking. There has been some year-on-year variability in Hull over time, but the rate has remained relatively unchanged between 2015/16 and 2019/20 at around 2,500 per 100,000 population. In contrast, the rate for England and across the Yorkshire and Humber region has decreased over this time.

Information relating to the cost of hospital admissions attributable to smoking is given below in the section entitled Cost of Smoking in Hull.

Deaths from Smoking

Information relating to deaths attributable to smoking is also available from Fingertips as well as mortality rates from diseases where a high percentage of the cases are due to smoking. Action on Smoking and Health (ASH) estimated in their October 2023 Smoking Statistics Factsheet that 85% of male lung cancer deaths and 69% of female lung cancer deaths were due to smoking, and that 88% and 81% of chronic obstructive pulmonary disease (COPD) deaths among men and women respectively were due to smoking. These are the two diseases where more than three-quarters of the deaths from these causes are attributable to smoking, although similar conditions such as cancer of the larynx (79% for men and 71% for women) and chronic airway obstruction (77% for men and 74% for women) also have high rates of mortality linked to smoking.

Further and more detailed information on individual diseases such as COPD, cancer, heart disease and stroke is available within Health Factors under Adults.

The mortality rate from oral cancer, lung cancer and from COPD is high in Hull due the current and historically high levels of smoking in Hull.

The mortality rate from oral cancer in Hull is lower than England for deaths registered between 2020 and 2022.

Mortality rates from lung cancer in Hull are the second highest in England (Liverpool with 88.7 deaths per 100,000 population had the highest rate) and 83% higher than England for death registered during for 2021-23.

Mortality from chronic obstructive pulmonary disease in Hull was the highest in the region, and ninth highest across lower-tier local authorities in England for deaths registered during 2021-2023 (Knowsley with 94.4 deaths per 100,000 population had the highest rate). The rate in Hull was 77% higher than England.

There were 30 deaths from oral cancer among Hull residents registered during the three year period 2020-22. As the numbers are relatively small there has been year-on-year variability, but the numbers for the most recent two years are the lowest they have been in Hull since 2008-10.

There were 565 deaths from lung cancer among Hull residents that were registered during the three year period 2021 to 2023. There has been a steady decrease over time in the mortality rate in Hull.

There were 496 deaths to Hull residents from chronic obstructive pulmonary disease that were registered during the three year period 2021 to 2023. There has been a steady increase over time in the mortality rate in Hull until 2017-19. Among all deaths from COVID-19 during 2020 and 2021, 16.1% had an underlying cause of chronic obstructive pulmonary disease. So whilst the total number of people who died directly from chronic obstructive pulmonary disease during the COVID-19 pandemic was lower as shown by the sharp decrease between 2017-19 and 2020-22, it would appear that the mortality rate among Hull residents with chronic obstructive pulmonary disease was high; it was just that they were dying of COVID-19 rather than chronic obstructive pulmonary disease itself. Further information is given within the Causes of Death in Hull under Population.

Whilst the mortality rate did decrease between 2017-19 and 2020-22 in England, the reduction did not appear particularly marked. This could suggest that people with chronic obstructive pulmonary disease in Hull were more susceptible to COVID-19 than people in England. There are many reasons why people in Hull might be more likely to catch COVID-19 and die from COVID-19. These could be associated with the age profile of the people with chronic obstructive pulmonary disease in Hull, their working status (employed or not working or retired), likelihood of going out and catching COVID-19 (living alone, less support to collect medicines and food, less ability to shop online, perception of risk, compliance with wearing masks, etc), differences in access to care and hospital treatment, and higher mortality rate (more at risk due to progression or severity of chronic obstructive pulmonary disease or number, severity and complexity of other co-morbidities). It is not known which, if any, of these might be more or less likely among Hull residents, but these are simply examples of potential reasons for the differences in the COVID-19 mortality rate among people with chronic obstructive pulmonary disease.

The mortality rate from chronic obstructive pulmonary disease increased in the last year but only marginally, and the mortality rate in 2021-23 is 33% lower than it was in 2017-19 prior to the pandemic.

The trends in the mortality rate from lung cancer were not affected as much by the COVID-19 pandemic as those from chronic obstructive pulmonary disease as the mortality rate from lung cancer is higher with one year survival rates for lung cancer lower than those for chronic obstructive pulmonary disease.

Fingertips also present the mortality rate attributable to smoking.

The Royal College of Physicians in 2018 assigned a smoking attributable fraction for each International Classification of Diseases code. Each smoking attributable fraction is between 0 and 1. Most smoking attributable fractions will be zero in that smoking is not implicated in any way for that underlying cause of death, but deaths with an underlying cause for a smoking-related condition (such as lung cancer or COPD) will have a smoking attributable fraction higher than zero and that fraction is likely to differ for men and women, and for different age groups.

For instance, a death would be assigned a smoking attributable fraction of 0.7 if it has been found that 70% of deaths that underlying cause were related to smoking among men or women of a specific age.

Every death in Hull for the specified period has been assigned a smoking attributable fraction, and then these have been summed over all deaths to estimate the total number of deaths that are attributable to smoking.

The rates are presented as directly age-standardised mortality rates per 100,000 population aged 35+ years, and rates in Hull are more double that of England for 2017-19.

The overall mortality rate from deaths attributable to smoking was the highest in Hull among the 150 upper-tier local authorities. The smoking-attributable mortality rate in Hull is second highest after Manchester (out of 149 upper-tier local authorities) for heart disease, highest for stroke (out of 147) with a rate substantially higher than Blackpool which has the second highest rate (22.2 versus 16.2 per 100,000 population), and highest for cancer (out of 148).

For heart disease and stroke specifically, the rates are also twice as high in Hull compared to England.

The mortality rate for cancers attributable to smoking is very high and an outlier in relation to the Yorkshire and Humber region, but it is not quite double the rate in England.

Across the Yorkshire and Humber region, North East Lincolnshire has the second highest mortality rate attributable to smoking with 282 deaths per 100,000 population for 2017-19. However, the rate in Hull at 420 deaths per 100,000 population is almost half as much again as North East Lincolnshire (49% higher). This illustrates the magnitude of Hull’s relative position across the region in terms of deaths attributable to smoking. The mortality rate in Hull is substantially and statistically significantly higher than the local authority with the second highest mortality rate.

In the three year period 2017-19, it is estimated that 1,501 deaths among those aged 35+ years in Hull were attributable to smoking, thus averaging 500 per year or over 40 per month.

A similar pattern occurs for deaths from heart disease that are attributable to smoking with 61.2 deaths in Hull compared to 44.6 deaths in North East Lincolnshire per 100,000 population aged 35+ years which has the second highest mortality rate in the region (37% higher in Hull).

It is estimated that there were 224 deaths over the three year period 2017-19 which occurred to Hull residents aged 35+ years which were from heart disease which was attributable to smoking.

The mortality rate from stroke that was attributable to smoking was 22.2 deaths per 100,000 population aged 35+ years in Hull which was almost two and a half times as high as England, and more than double that of the region. North East Lincolnshire had the second highest mortality rate from stroke that was attributable to smoking, but the rate in Hull was 55% higher than North East Lincolnshire.

It is estimated that there were 76 deaths in Hull from stroke that were attributable to smoking over the three year period 2017-19 among those aged 35+ years.

Whilst the difference in the mortality rate attributable to smoking between Hull and England was not as high for cancer as for cardiovascular disease, it was very high. The rate was 88% higher in Hull compared to England, and 61% higher than the region. Doncaster had the second highest rate in the region but the rate in Hull was 35% higher than this.

It is estimated that there were 614 deaths in Hull from cancer that were attributable to smoking over the three year period 2017-19 among those aged 35+ years which equates to more than 200 per year or around 17 per month.

Based on the modelled estimate of the number of deaths attributable to smoking, the rate fell by 8% between 2013-15 and 2014-16, but has increased by 4% between then and 2017-19. Thus whilst the mortality rate in 2017-19 is lower than it was in 2013-15, there has been an increasing trend over the last three years. In contrast, the rate across England and the region has reduced over this time period.

Whilst the deaths from heart disease attributable to smoking fell from 69.8 to 58.7 deaths per 100,000 population aged 35+ years between 2013-15 and 2014-16, the rate has remained around 60 since and has been slightly higher than 60 deaths per 100,000 population in the last two years. In contrast, the mortality rate has decreased across England and the region.

The same pattern is evident for stroke with an initial fall in the mortality rate between 2013-15 and 2014-16 followed by a small increase or relatively small changes in the intervening period. For stoke, there has been a decrease in the mortality attributable to smoking for both England and Hull.

Whilst the cancer mortality attributable to smoking has decreased slightly over the period 2013-15 to 2017-19 in Hull (-9%), the mortality rate has increased by a greater margin for both the region (-14%) and England (-16%). Thus the inequalities gap between Hull and England has increased.

Years of Potential Life Lost Due to Smoking

The years of life lost due to smoking have been presented on Fingertips. Premature mortality is generally defined as a death which occurs prior to the age of 75 years, and years of life lost is the differences between 75 and the age at death for deaths which occurred prior to the age of 75 years. Deaths which occur at 75 years or older do not contribute to the years of life lost (zero years). For example if a death occurs at age 70 then this would contribute five years to the years of life lost calculation.

The number of years of life lost is calculated for each death which occurs between the ages of 35 and 74 years, and the number is multiplied by the smoking attributable fraction to give an estimate of the number of years of life lost attributable to smoking.

For instance, if a person died of cancer at age 64 years then their years of life lost due to smoking would be 11 years (75-64) multiplied by the smoking attributable fraction for smoking relating to cancer (around 26% or 0.26) giving a contribution of 2.86 years to the years of life lost calculation. If a person died of a respiratory disease at age 70 years then their years of life lost due to smoking would be five years (75-70) multiplied by the smoking attributable fraction for respiratory disease (around 37% or 0.37) giving a contribution of 1.85 years to the years of life lost due to smoking calculation, and if another person died of respiratory disease at age 80 years their contribution would be zero (no years contributed above the age of 75 years). In these three cases, the total years of life lost would be 4.71 years for the three individuals.

The estimate of the number of years of life lost is presented as a directly age-standardised rate per 100,000 population.

The number of years lost is 2,399 per 100,000 population aged 35+ years in Hull for 2016-18 which is 83% higher than England and 56% higher than the region.

The rate is highest in Hull across the Yorkshire and Humber region at 2,399 per 100,000 population, and the rate in Hull is substantially higher than all other local authorities in the Yorkshire and Humber region.

It is estimated that the total numbers of years of life lost over the three year period 2016-18 in Hull among those aged 35+ years was 8,231 equating to an average of 2,744 years of life lost attributable to smoking each year among Hull residents.

The rate of years of life lost which was attributable to smoking increased between 2012-14 and 2014-16, the rate has decreased in the two years subsequently, but despite the recent decrease the rate in 2016-18 is still higher than the rate in 2012-14. The trend over time in Hull followed a similar pattern for England and across the region.

In 2016-18 for Hull, there were an estimated 1,514 deaths attributable to smoking with an estimated total 8,231 years of life lost, which averages out as 5.4 years per person (under the age of 75 years). The average was also 5.4 years for England (1,056,032 years of life lost with a total of 197,153 deaths) and across the Yorkshire and Humber (122,993 years of life lost with a total of 22,668 deaths). However, this only measures the years of life lost prior to the age of 75 years so it might not count all potential years of life lost due to smoking. This potential years of life lost does not include people who died after the age of 75 years who might have lived even longer if they had not smoked.

Stop Smoking Services

The Office for Health Improvement & Disparities’ Fingertips also presents information relating to the Stop Smoking Services. However, it gives a relatively misleading picture to examine the Stop Smoking Service data for Hull for 2019/20 (which is currently the latest data on Fingertips). A new provider of Stop Smoking Services in Hull commenced at the end of 2019, and whilst services were initially disrupted due to the COVID-19 pandemic, the current service is working well with two-thirds of smokers quitting at four weeks among those who set a quit date.

The performance figures for Hull for 2019/20 on Fingertips show a relatively poor performance as the old provider was winding their service down and the new provider had not yet commenced. So these figures are not shown here as they are not up-to-date and do not reflect the performance of the current service provider.

Changes to the provider of Stop Smoking Services in Hull has not been the only change over time. The budget has been cut substantially over time. For instance, the budget in Hull for Stop Smoking Service was around £1.2 million in 2013/14 but had halved by 2018/19.

Other changes have also occurred over time. The rate of prescriptions for nicotine replacement is much lower for Hull than elsewhere, but this reflects the way different local Stop Smoking Services are run. The Stop Smoking Service in Hull offers e-cigarettes as an alternative method for people to quit smoking tobacco. This is not common practice across local authorities and this will impact on the numbers using nicotine replacement therapy in Hull.

Cost of Smoking in Hull

Information was previously displayed on Fingertips which related to the estimated cost of smoking-related admissions to hospital for people admitted to hospital who were aged 35+ years. The cost per person for Hull was estimated to be £43.80 for 2016/17. So the total cost of all hospital admissions attributable to smoking was estimated to be £43.80 for every single person aged 35+ years living in Hull in 2016/17. This was the third highest after Blackpool (£45.50) and Hartlepool (£45.10) out of the 122 lower-tier local authorities with data. The cost was not calculated for 192 lower-tier local authorities, but nevertheless, given Hull’s high current and historical prevalence of smoking, it is likely that the ranking would remain high even if these local authorities had been included.

Action on Smoking and Health (ASH) have produced a Ready Reckoner (2024 edition) to calculate the cost of tobacco at local authority level.

In their 2024 edition of their Ready Reckoner, ASH estimate that there are 39,236 adult smokers aged 18+ years living in Hull (18.9% of the adult population) and that the total cost of tobacco in Hull is £162.9 million each and every year.

Further information can be found at https://ash.org.uk/resources/view/ash-ready-reckoner

The costs due to smoking in Hull are made up of the following:

• Healthcare: total cost to the NHS of £14.8 million each year.
• Economy / productivity: total cost £135 million each year.
• Total care cost (including informal and unmet care) of £127 million each year.
• House fires: total cost £2.4 million each year.
  • It is estimated that Humberside Fire and Rescue service will attend around 15 smoking-related house fires each year.
  • It is estimated that the cost of fatalities in Hull costing an average of £1.12 million.
  • It estimated that cost of non-fatal injuries each year would further increase the cost by £499,000 per year.
  • It is estimated that the cost of property damage would be £731,000 each year.
  • It is estimated that the cost to Humberside Fire and Rescue for responding to these fires would be £61,000 per year.
• Total cost to smoker of tobacco products: total annual cost £95.2 million.

Use of E-Cigarettes

Overall, 13.4% of adults in the local survey used e-cigarettes either daily (8.5%) or occasionally (4.8%). The prevalence was highest among the groups where smoking prevalence was the highest. More than one-third of all people who occasionally smoked tobacco used e-cigarettes, and just under one-quarter of all daily tobacco smokers and ex-smokers used e-cigarettes. In total, this equates to around 27,950 adults across all of Hull who currently use e-cigarettes.

In contrast only 15 people in the survey, had used e-cigarettes among people who had never smoked tobacco. Whilst these were mainly younger people (six aged 16-24 and five aged 25-34 years) there was a spread across the age groups up to 65-74 years, although there was a different between genders (11 men and four women).

Whilst around half of e-cigarette users, were using e-cigarettes to quit tobacco smoking, reduce tobacco smoking and/or prevent them restarting smoking tobacco, when combining all the responses nine in ten were using e-cigarettes for one or more of these three reasons.

The prevalence of using e-cigarettes in Hull at 13.4% is higher than England (6.5%). However, this is not surprising given Hull’s high prevalence of tobacco smoking and that the nine in ten of the people who currently used e-cigarettes were doing so because they were current or ex smokers of tobacco and were using e-cigarettes to help them stop or cut down their tobacco or they had quit smoking tobacco and didn’t want to re-start.

The prevalence of using e-cigarettes has increased from 8.4% in 2014 to 13.4% in 2019.

Strategic Need and Service Provision

The aims of SmokeFree Hull are to actively promote a smoke-free City, support quit attempts through pharmacotherapies and behavioural support and harness the wider public health workforce to deliver very brief advice to people they have contact with (“make every contact count”). The service works with other health care providers to access existing networks ensuring access to information and support is widely available.  The Service uses a variety of methods to meet the needs of smokers and their families.

The current adult SmokeFree Hull Service has a priority focus on people living in the most deprived wards (where smoking prevalence is the highest), pregnant women, and people with chronic obstructive pulmonary disease, coronary heart disease and mental health illness. Preventing children and young people smoking is an important element of reducing prevalence and improving their health, and there is a dedicated service for children and young people in Hull.

Hull Alliance on Tobacco is a multi-agency Alliance working collaboratively to reduce smoking prevalence. Helping smokers quit is one strand of the Alliance’s Plan which recognises other aspects of tobacco control are needed. This broader approach is supported by the Tobacco Plan for England, World Health Organisation, National Institute of Health and Care Excellence (NICE) and the Regional Tobacco Control Group.

In practice this means that in addition to helping people quit, Hull has effective regulation and enforcement through Trading Standards to reduce the availability of illicit tobacco, underage sales and enforcement of smokefree laws, work in partnership with the NHS as they become smokefree and support all areas through multi-media communication.

The core areas for HALT partners include mental health (parity of esteem), illicit tobacco, e-cigarettes, marketing, and children and young people (denormalising smoking). We want not smoking to be seen as the norm in all local communities. The HALT plan has three key priorities: smoking in pregnancy, supporting a smoke free NHS and health inequalities.

Resources

Hull’s Health and Wellbeing Surveys

The Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

NHS Digital. Health Survey for England 2018: https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2018

Office for National Statistics: Annual Population Survey 2018 – Smoking habits in the UK and its constituent countries. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/datasets/smokinghabitsintheukanditsconstituentcountries

Official Labour Market Statistics. Annual Population Survey: https://www.nomisweb.co.uk/

Action on Smoking and Health: https://ash.org.uk/home/

Action on Smoking and Health: Ready Reckoner. https://ash.org.uk/resources/view/ash-ready-reckoner

SmokeFree Hull: https://www.changegrowlive.org/smoke-free-hull/home

Bump the Habit: www.bumpthehabit.org.uk

Diary of a Chimney Kid. https://chimneykid.co.uk/

National Institute of Health and Care Excellence (NICE) Guidance NG29. https://www.nice.org.uk/guidance/ng209

Health Equity in England: The Marmot Review 10 Years on. https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on

Updates

This page was last updated / checked on 8 November 2024.

This page is due to be updated / checked in March 2025.