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expert reaction to study showing that the decline in smoking in England has stalled since the pandemic

A study published in BMC Medicine looks at the decline in smoking in England since the pandemic.


Prof Caitlin Notley, Professor of Addiction Sciences, Norwich Medical School, University of East Anglia, said:

“This research report indicates a slowing in the decline of smoking prevalence in England. The smoking toolkit study is a robust and invaluable source of epidemiological data and is one of our key indicators of population trends. The study reveals some interesting findings, such as an increase in smoking quit attempts during the pandemic, but little change in smoking prevalence overall. This may be due to increased uptake of smoking by younger adults during the pandemic, off-setting increases in quitting behaviour by older adults. 

“This is a concern. In this generation we have seen cuts in funding to public health anti-smoking campaigns, but intense media focus on other nicotine containing products such as e-cigarettes, and some alarmist reporting. Unfortunately this may be contributing to inaccurate harm perceptions, such that approximately half of people who continue to smoke incorrectly believe vaping is at least as harmful as smoking. Young people may incorrectly believe smoking and vaping to be equivalent in harm.

“To drive down rates of tobacco smoking we must invest in public health campaigns to inform people accurately that vaping is an effective smoking cessation aid and substantially less harmful than smoking tobacco. New government proposals to increase funding for anti-smoking campaigns, increase the age of sale, and a pledge to make a million vape kits available to support people who smoke to switch, are welcome and needed to meet the smokefree 2030 target.”


Dr Leonie Brose, Reader in Addiction Education and Nicotine Research, King’s College London, said:

“This is a very well-conducted analysis of changes in smoking and cessation in England between 2017 and 2022, looking particularly at changes coinciding with the COVID pandemic. It found that while cessation increased among adults who smoked, smoking increased among young adults. When attempting to explain the reasons behind this increase, earlier findings from the same survey1 are useful. They showed that mental health, particularly in young adults, has deteriorated substantially. By the end of 2022, 20% of 18–24-year-olds reported a level of distress serious enough to suggest mental health treatment was needed. Poorer mental health is closely associated with increased smoking; addressing the causes of the high and increasing levels of poor mental health among young people is crucial and could also be expected to help reduce smoking prevalence.”

1 of which I am an author


Have there been sustained impacts of the COVID19 pandemic on trends in smoking prevalence, uptake, quitting, use of treatment, and relapse? A monthly population study in England, 2017–2022’ by Sarah E. Jackson et al. was published in BMC Medicine at 1am UK TIME on Thursday 14 December 2023.





Declared interests

Caitline Notley has received an honorarium from Vox media company for filming a ‘nicotine explainer’ on the role of nicotine in addiction.

Leonie Brose: no conflicts


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