Statistics on NHS Stop Smoking Services

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1 Statistics on NHS Stop Smoking Services England, th August 2017

2 Key findings Thousands Setting a quit date 2 The number of people setting a quit date fell for the fifth consecutive year to 307,507 in 2016/17. This represents a decrease of 15% on 2015/16 1. The reduction in recent years may be partly due to the increased use of e-cigarettes which are widely available outside of these services. Successful self-reported quitters 2 The number of successful self-reported quitters also fell for the fifth consecutive year to 155,875. This was a decrease of 16% on 2015/16 1. This means that the self-reported quit rate was 51% which has remained fairly stable in recent years. CO validated successful quitters 2 72% (112,823) of self-reported quitters had their results confirmed by Carbon Monoxide (CO) validation 2. 1) Comparison restricted to LAs who submitted data for all quarters in both 2016/17 and 2015/16. 2) See page 5 for details on definitions. For more information: Table 2.1 of Statistics on NHS Stop Smoking Services in England, 2016/17, 2

3 This is an Official Statistics publication This document is published by NHS Digital, part of the Government Statistical Service All official statistics should comply with the UK Statistics Authority s Code of Practice for Official Statistics which promotes the production and dissemination of official statistics that inform decision making. Find out more about the Code of Practice for Official Statistics at This report will be of use to local and central government for assessing performance of these services over time and particularly for comparing between local areas. It is of use to patients of these services and members of the public who wish to see how performance in their area compares to others. ISBN

4 Introduction NHS Stop Smoking Services were first set up in 1999/2000 with the aim of reducing health inequalities and improving health among local populations. Services were rolled out across England from 2000/01 and provide free, tailored support to all smokers wishing to stop by offering a combination of recommended stop smoking pharmacotherapies and behavioural support. This report presents statistics from Stop Smoking Services in England for the period April 2016 to March 2017 and is supplemented by excel tables, data files, technical appendices and data quality information. It supersedes the provisional results previously published for quarters 1, 2 and 3 in 2016/17. Information is presented at national, regional and local authority (LA) level including some time series data for the last 10 years. Information is also shown by age, gender and ethnicity. For this year s report, no data has been received from three LAs who provide Stop Smoking Services and data has only been received for part of the year from a further six LAs. A list of these LAs is available on page 22. No estimation has been made for missing data and therefore national and regional totals which appear in this report will be underestimates. 4

5 Definitions Setting a quit date A quit attempt. The report refers to the number of people setting a quit date but if the same person makes more than one quit attempt during the year then each attempt will be counted. Quit rate The number of people who quit smoking expressed as a proportion of those setting a quit date. In most cases the self-reported quit rate is used but where possible the Carbon Monoxide validated quit rate is also provided see below for more details. Self-reported quitters An individual is counted as having successfully quit smoking at the 4 week follow-up if he/she says they have not smoked at all since two weeks after the quit date. Carbon Monoxide validated quitters Carbon Monoxide (CO) validation measures the level of carbon monoxide in the bloodstream and provides an indication of the level of use of tobacco. 5

6 Quit rates 60% Self-reported quitters CO validated quitters 50% 40% 30% 20% The self-reported quit rate was 51% which has remained fairly stable in recent years. 37% of those setting a quit date were CO validated. 10% 0% For more information: Table 2.1 of Statistics on NHS Stop Smoking Services in England, 2016/17 6

7 Gender Number of quit attempts A higher number of females set a quit date (163,121) than males (144,386). Thousands Male Female Self-reported quit rate Males had a higher quit rate than females (52% and 49% respectively) but CO validated quit rates were similar (73% and 72%). Quitters passing CO validation Quitters failing CO validation 60% 50% 40% 30% 20% 10% 0% Male Female For more information: Tables 2.4 and 3.3 of Statistics on NHS Stop Smoking Services in England, 2016/17 7

8 Age Number of quit attempts There was no clear pattern by age. The largest number of quit attempts came from the year old age group (31% of all attempts). Self-reported quit rate The quit rate increased with age reaching 57% for the 60 and over age group. Thousands Under and over 60% 50% 40% 30% 20% 10% 0% Under and over For more information: Tables 2.4 and 3.4 of Statistics on NHS Stop Smoking Services in England, 2016/17 8

9 Ethnicity Self-reported quit rate The quit rate was highest for the Asian or Asian British group (56%) and lowest for Mixed (46%) and Black or Black British (47%) groups. 60% 50% 40% 30% 20% 10% Male/female split by ethnicity Almost 80% of the Asian or Asian British group attempting to quit were male. In the White group 45% were male. 100% 80% 60% 40% 20% Female Male 0% White Mixed Asian or Black or Asian British Black British Other ethnic group 0% White Mixed Asian or Asian British Black or Black British Other ethnic group For more information: Tables 2.5 and 3.5 of Statistics on NHS Stop Smoking Services in England, 2016/17 9

10 Socio-economic Number of quit attempts The largest number of quit attempts came from the Routine and manual occupations group (81,469). Routine and manual Never worked or long-term unemployed Retired Managerial and professional Unable to work Intermediate Home carers (unpaid) Full time students Prisoners Thousands Self-reported quit rate The quit rate was highest amongst Retired (58%) and lowest for Never worked or long-term unemployed (43%). Routine and manual Never worked or long-term unemployed Retired Managerial and professional Unable to work Intermediate Home carers (unpaid) Full time students Prisoners 0% 10% 20% 30% 40% 50% 60% 70% For more information: Tables 2.6 and 3.6 of Statistics on NHS Stop Smoking Services in England, 2016/17 10

11 Region Number of quit attempts London had the highest number of quit attempts (51,945) and Yorkshire and the Humber had the lowest (23,124). Thousands Self-reported quit rate The quit rate was highest in Yorkshire and Humber (61%) and lowest in North East (46%), North West (46%) and South West (45%). 70% 60% 50% 40% 30% 20% 10% 0 North East North West Yorks. & Humb. East Mids West Mids East of Eng. London South East South West 0% North East North West Yorks. & Humb. East Mids West Mids East of Eng. London South East South West For more information: Table 3.1 of Statistics on NHS Stop Smoking Services in England, 2016/17 11

12 Local Authority Quit attempts Self-reported quit rate Among Local Authorities, Westminster had the highest number of quit attempts (11,248) and the highest number of quitters (5,529) per 100,000 smokers. Stockton-on-Tees had 11,177 quit attempts per 100,000 smokers while Central Bedfordshire had 5,518 quitters per 100,000 smokers. For more information: Table 3.2 of Statistics on NHS Stop Smoking Services in England, 2016/17 12

13 Pregnant women Number of quit attempts 15,219 pregnant women set a quit date continuing a steady decline in quit attempts amongst pregnant women since the peak in 2011/12. Quit rate Both quit rates remained similar to previous years with a self-reported quit rate of 46% in 2016/17 and a CO validated quit rate of 28%. Thousands 30 Quit attempts Quit (self-reported) Quit (CO validated) 60% Quit (self-reported) Quit (CO validated) 25 50% 20 40% 15 30% 10 20% 5 10% 0 0% For more information: Tables 2.7 of Statistics on NHS Stop Smoking Services in England, 2016/17 13

14 Intervention type Number of quit attempts The majority of quit attempts were made via Oneto-one support (248,847). Self-reported quit rate Telephone support had the highest quit rate (59%), and Closed Group the lowest (46%). One-to-one support Drop in clinics Telephone support Open (rolling) group One-to-one support Drop in clinics Telephone support Open (rolling) group Other Closed group Couple/ Family group Thousands Other Closed group Couple/ Family group 0% 10% 20% 30% 40% 50% 60% 70% For more information: Table 4.1 of Statistics on NHS Stop Smoking Services in England, 2016/17 14

15 Intervention setting Number of quit attempts General practice had the highest number of quit attempts (115,460). General practice Community Pharmacy Other Hospital Prison Maternity Workplace School Children s centre Psychiatric hospital Military base Community psychiatric Dental Thousands Self-reported quit rate Psychiatric Hospital had the highest quit rate (62%) and Pharmacy the lowest (45%). General practice Community Pharmacy Other Hospital Prison Maternity Workplace School Children s centre Psychiatric hospital Military base Community psychiatric Dental 0% 10% 20% 30% 40% 50% 60% 70% For more information: Table 4.1 of Statistics on NHS Stop Smoking Services in England, 2016/17 15

16 Pharmacotherapy Number of quit attempts Combination of licensed NCPs 1 concurrently had the highest number of quit attempts (104,666). Self-reported quit rate Licensed medication and an unlicensed NCP 1 consecutively had the highest quit rate (69%). Combination of licensed NCPs concurrently Varenicline only Single NCP only Did not use any licensed medication or unlicensed NCP Pharmacotherapy not known Combination of a licensed medication and an unlicensed NCP concurrently Licensed NCP and/ or Bupropion and/ or Vareniciline concecutively Unlicensed NCP Licensed medication and an unlicensed NCP consecutively Bupropion only Combination of licensed NCPs concurrently Varenicline only Single NCP only Did not use any licensed medication or unlicensed NCP Pharmacotherapy not known Combination of a licensed medication and an unlicensed NCP concurrently Licensed NCP and/ or Bupropion and/ or Vareniciline concecutively Unlicensed NCP Licensed medication and an unlicensed NCP consecutively Bupropion only 0% 10% 20% 30% 40% 50% 60% 70% 80% 1) Nicotine Containing Product For more information: Table 4.4 of Statistics on NHS Stop Smoking Services in England, 2016/17 16

17 Free prescriptions Number of quit attempts 174,678 people eligible to receive free prescriptions set a quit date in 2016/17. This has been steadily declining since the peak in 2011/12. Thousands Self-reported quit rate The quit rate was 49% in 2016/17 which has remained fairly stable in recent years. 60% 50% 40% 30% 20% 10% 0% For more information: Table 4.6 of Statistics on NHS Stop Smoking Services in England, 2016/17 17

18 Prescription items Millions All Pharmacotherapies NRT 1 Varenicline Bupropion The number of prescription items dispensed in England in 2016/17 was 1.0 million, compared to 2.1 million ten years ago. Prescription items dispensed peaked at 2.6 million in 2010/11. In 2016/17, 542 thousand items of NRT were dispensed, down from 644 thousand in 2015/16, and around a quarter of the total of ten years ago in 2006/07 (1.9 million). 411 thousand items of Varenicline were dispensed in 2016/17, compared with a peak of 987 thousand items in 2010/11. Bupropion is the least common item, with 22 thousand dispensed in 2016/17, with little change in the level over the last few years. 1) Nicotine replacement therapies. For more information: Table 4.8 of Statistics on NHS Stop Smoking Services in England, 2016/17 18

19 Prescription items Prescription items dispensed by Clinical Commissioning Group, per 1,000 England rate: 22 per 1,000 population NHS Bradford City had the highest rate of items dispensed, with 59 per 1,000 population. NHS Bracknell & Ascot, NHS North Tyneside, NHS Rotherham and NHS North & West Reading all recorded rates of 2 items or below per 1,000 population. For more information: Table 4.8a of Statistics on NHS Stop Smoking Services in England, 2016/17 19

20 Cost of prescription items Total cost of prescription items dispensed The Net Ingredient Cost (NIC) 1 of all prescription items used to help people quit smoking was 28.5million in 2016/17. This is less than half of the total in 2010/11 when the NIC of all items peaked at 65.9 million. Average NIC per item The average NIC per item for all pharmacotherapy items was 29. The average per item was 38 for Bupropion, 35 for Varenicline and 25 for NRT 1. Millions All Pharmacotherapies NRT Varenicline Bupropion Varenicline Bupropion Nicotine Replacement Therapies (NRT) All pharmacotherapies ) The Net Ingredient Cost (NIC) is the basic cost and does not take account of discounts, dispensing costs, fees or prescription charge income For more information: Table 4.8 of Statistics on NHS Stop Smoking Services in England, 2016/17 20

21 Data Quality Proportion of unknown data items The proportion of quit attempts where the outcome is unknown has remained fairly stable since 2008/09. 40% Quit outcome Intervention type Ethnic group The data quality of the socio-economic codes has shown a large improvement over the same time period. 40% Socio-economic Intervention setting Pharmacotherapy 30% 30% 20% 20% 10% 10% 0% 0% For more information: Table 5.2 of Statistics on NHS Stop Smoking Services in England, 2016/17 21

22 Data Quality Non-submitting local authorities Three LAs did not submit any data for 2016/17 even though they are still running Stop Smoking Services: Bradford, Enfield and York. A further six LAs did not submit data for at least one quarter: Birmingham, Trafford, Tameside, Havering, Sefton and West Sussex. Two LAs did not submit data but have stopped running Stop Smoking Services so are effectively a nil return: Isle of Wight and Manchester. For more information: Table 5.3 of Statistics on NHS Stop Smoking Services in England, 2016/17 22

23 Author: Stats Team, NHS Digital Responsible Statistician: Paul Niblett This publication may be requested in large print or other formats. Published by NHS Digital, part of the Government Statistical Service Copyright 2017 Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. You may re-use this document/publication (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence v3.0. To view this licence visit or write to the Information Policy Team, The National Archives, Kew, Richmond, Surrey, TW9 4DU; or psi@nationalarchives.gsi.gov.uk

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