In an open letter published by The BMJ, health professionals have warned that unless smoking is addressed, there is no prospect of delivering on Labour’s manifesto commitment to halve the gap in healthy life expectancy between the richest and poorest regions.

The annual cost of smoking to individuals, public services and the wider UK economy is £93bn, while the direct cost of smoking to the UK public finances in 2023 was £21.9bn, with a net cost of £13.5bn.

Alongside the letter, Action on Smoking and Health (ASH) has published an impact calculator allowing local NHS services to assess the value to their local systems of supporting smokers to quit as part of services established in the ‘NHS Long Term Plan’. Nationally, they estimate that if NHSE was investing in these services at the original planned level, the NHS could avoid a further £33m in costs from reduced admissions and other benefits of smokers quitting.

Nick Hopkinson, professor of Respiratory Medicine at Imperial College London, honorary consultant physician at Royal Brompton Hospital and chair of ASH, said, “The UK government has set out a bold mission to improve the nation’s health, but this must be backed up by investment. Ending the tobacco epidemic is central to this mission and will also boost the public finances.

“The Tobacco and Vapes Bill will be vital for preventing the next generation becoming addicted to smoking. But we need sustained investment in tobacco control to support the 6.4m adult smokers in the UK to quit. If the government cannot find the funding needed, then they should impose a levy on tobacco manufacturers to make them pay to fix the damage they have caused.”

The letter acknowledged that while money is tight, funding action to reduce smoking provides a health return on investment. A ‘polluter pays’ levy on tobacco manufacturers “could raise £700m a year for vital tobacco control activity in a way that would prevent companies from simply passing the cost on to consumers.”

The letter also acknowledged the investment by the previous government but has said the Labour government needs to go further. The letter said, “Dedicated long term funding is vital to deliver stop smoking support in hospitals and the community, national marketing campaigns, a robust illicit tobacco strategy, and targeted measures to reduce smoking rates in priority groups.”

The professionals said the UK must re-establish its global leadership in tobacco control. They point out that UK funding for the WHO Framework Convention on Tobacco Control is set to expire at the end of 2024/25.

They conclude, “Committing the UK to contribute at least £2m a year for a further five years will cement our place as a world leader in tobacco control.”

Charmaine Griffiths, chief executive of the British Heart Foundation, said, “It is a scandal that smoking continues to have such a devastating impact on the nation’s health, being linked to 15,000 heart disease deaths in the UK each year. Besides the grief and pain each death causes countless families, ill health caused by smoking also puts a strain on the NHS and our economy.

“The status quo is unacceptable, and we need a bold and far-reaching package of measures to consign smoking to history. Alongside the ‘Tobacco and Vapes Bill’, which aims to protect young people from tobacco harm in the future, we need adequate and sustained funding for local stop smoking services so current smokers can quit for good.”

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