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Home > Many ways forward. Stop smoking services and tobacco control work in English local authorities, 2019.

Action on Smoking and Health, Cancer Research UK. (2020) Many ways forward. Stop smoking services and tobacco control work in English local authorities, 2019. London: Action on Smoking and Health and Cancer Research UK.

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Many opportunities exist for local authority commissioners of tobacco control and stop smoking services to build on their past successes and improve their local offer. These include joint working with colleagues in other local authority services, partnering with the NHS (now newly engaged in smoking cessation thanks to the Long Term Plan), and pursuing population approaches within Sustainability and Transformation Partnerships and Integrated Care Systems.


Key findings

  • In 2019, 69% of surveyed local authorities in England offered a specialist stop smoking service to local smokers and 59% offered a service to all smokers, compared to 56% of local authorities offering a universal specialist stop smoking service in 2018.
  • Among the local authorities that still had a budget for stop smoking services, 35% had cut this budget between 2018/19 and 2019/20. This was the fifth successive year in which more than a third of local authorities had cut their stop smoking service budgets.
  • Pressure on budgets remains by far the biggest threat to stop smoking services and wider tobacco control work in local authorities in England. Almost three quarters (74%) of respondents said pressure on budgets was a threat to local tobacco control, including ongoing cuts to local authority budgets, further cuts to the public health grant and uncertainty about the future of the grant after March 2021.
  • In the four years from 2014/15 to 2018/19, total local authority spending on stop smoking services and tobacco control in England fell by 36% from £135.9m to £87.3m.
  • Respondents highlighted the opportunities offered by partnerships and alliances locally, with the NHS and with other local authority services, and at wider strategic level. Most (92%) Sustainability and Transformation Partnerships or Integrated Care Systems had identified smoking as a priority.
  • Despite the cuts, 98% of surveyed local authorities still offered some or all local smokers face-to-face support to quit and 97% were engaged in some form of wider tobacco control activity.
  • Smokers in disadvantaged groups were less likely to receive targeted support in areas where specialist support had been replaced by integrated lifestyle or primary care-based services.
  • Specialist stop smoking advisers received more training in smoking cessation on average (3.2 days) than heath trainers (2.2 days) and intermediate advisers (1.6 days), but in a fifth (21%) of local authorities with specialist stop smoking advisers, these advisers received 1.5 days training or less.
  • Only 65% of local authority stop smoking services offered smokers a full 12-week course of dual Nicotine Replacement Therapy (NRT). 


  • Government must reverse cuts to public health funding and deliver new investment in local tobacco control by imposing a ‘polluter pays’ charge on the tobacco industry. This charge would raise £300m - £500m per year and could fund stop smoking services, enforcement against the illicit tobacco trade, and mass media public health campaigns to help reduce smoking.
  • The NHS and local authorities should work together to ensure that new NHS services developed in response to the Long Term Plan are integrated with wider community stop smoking support, including targeted lung health checks.
  • Local authorities should ensure that all smokers have access to behavioural support to help them quit smoking alongside a choice of a full 12-week course of dual NRT or a full course of Champix (varenicline).
  • Directors of Public Health, NHS senior leaders and their colleagues in tobacco control should ensure that the priority given to smoking in Sustainability and Transformation Partnerships and Integrated Care Systems is followed through in comprehensive strategic planning involving all local and regional partners.
  • Local authorities that have decommissioned specialist stop smoking services in favour of integrated lifestyle services or primary care-based support should ensure that these approaches are effective in reaching smokers in high prevalence groups.
  • Commissioners should ensure that advisers employed to deliver behavioural support are trained to National Centre for Smoking Cessation and Training (NCSCT) standards and undertake refresher training at least annually to stay up to date with the latest developments in smoking cessation.
  • Local authorities which do not currently provide e-cigarette starter packs as part of their cessation offer should consider doing so to give local smokers the best possible chance to quit.
Item Type
Publication Type
International, Report
Drug Type
Tobacco / Nicotine
Intervention Type
Harm reduction
January 2020
31 p.
Action on Smoking and Health and Cancer Research UK
Corporate Creators
Action on Smoking and Health, Cancer Research UK
Place of Publication

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