Smokers forced to quit on their own after funding cuts

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Thousands of smokers are being left without the support they need to quit after prescriptions of products to help them stop plummeted by 75% over the last decade, according to a report.

GPs are the most common first port of call for smokers who want to beat their addiction in England – 38% of smokers choose this route.

However, primary care prescriptions of nicotine replacement patches and gum and the smoking-cessation drugs bupropion and varenicline fell by three-quarters in England between 2005-06 and 2016-17.

In Scotland there was a 40% drop, while in Wales prescription rates fell by two-thirds. This is despite the fact that a combination of support and medication has been shown to be the most effective way to help smokers quit – increasing the chance of successfully beating their addiction threefold compared with going “cold turkey” – and is recommended by the National Institute for Health and Care Excellence (Nice).

The analysis of NHS prescribing data, which will be published in full on Monday in a report by the British Lung Foundation (BLF), called Less Help to Quit: What’s happening to stop-smoking prescriptions across Britain, also reveals wide regional variations in the prescribing of such products.

Alternative routes to getting help such as specialist clinics are also declining in some areas, it finds.

In Worcestershire, for example, where 15% of the population smokes, the local authority decommissioned its stop-smoking services, and local clinical commissioning groups advised GPs not to prescribe stop-smoking aids for new patients in April 2016, the report reveals.

As a result, just 98 people last year were helped to quit successfully across the Worcestershire council area compared with 2,208 the previous year, and there were no recorded attempts to quit through GPs and only one in a hospital setting.

The BLF says smokers are bearing the brunt of government budget cuts and are being discriminated against.

Packet of anti-smoking drug Varenicline tablets
Primary care prescriptions for smoking-cessation drugs such as varenicline fell by three-quarters in England between 2005-06 and 2016-17. Photograph: Getty

Stephen Spiro, professor of respiratory medicine and medical adviser at the charity, said in a foreword: “Many smokers cannot get the medication they need to quit because of the decisions made by their local health services.

“These decisions are of course not taken lightly or, in some cases, willingly. They are the result of the erosion of government funding for stop-smoking support. In England, the national cuts in public health funding will total over £600m by 2021.

“This report shows that we’re reaping the very real effects of sustained cuts to funding. It also shows how decisions are being taken by a growing number of clinical commissioning groups to stop GPs from prescribing clinically effective and appropriate medication for smokers. This is a travesty.”

Smoking is the main cause of preventable illness and death in England, costing the NHS £2.5bn a year and the economy £11bn. Figures from the NHS and the Office for National Statistics published this month revealed that 200,000 people gave up smoking last year in England: 14.9% of adults smoked, the equivalent of 6.1 million people.

While the fall in smokers is encouraging – and may in part explain decreasing prescription rates – the drop in prescriptions is “greatly outpacing the decrease in the size of the smoking population”, the report says, leaving a gap for many smokers who want to quit.

According to the report, while smoking rates in England fell by 22% between 2010-11 and 2016-17, prescription rates fell by 60%.

Furthermore, it warns that the increasing popularity of e-cigarettes, which are not available on the NHS and have to be purchased, cannot be guaranteed to fill the gap created by the drop in prescribed products.

Updated Nice guidance published earlier this year recommended smoking-cessation services be targeted at high-risk groups.

A stop-smoking session in Middlesbrough
Alternative routes to getting help such as specialist clinics are also declining in some areas. Photograph: Christopher Thomond for the Guardian

However, the BLF says all smokers should be able to expect their GP to provide access to stop-smoking medication, either by prescribing themselves or referring smokers – even if they are not in a priority group – to specialist services. The charity is calling on the government to reverse the cuts to public health funding for local authorities and remove restrictions on the prescription of stop-smoking products.

Alison Cook, director of policy for the charity, said: “[Clinical commissioning groups] should immediately retract all guidance to GPs which withdraws their right to prescribe stop-smoking medications. We are making a big mistake as these services could potentially save an NHS immersed in difficulties millions.”

A spokesperson for the Department of Health and Social Care said: “There are now fewer smokers in this country than ever before thanks to our bold and effective plans, including standardising packaging for cigarettes and covering up tobacco products in shops.

“However, 78,000 people still die from smoking in England each year, which is why we recently launched a new tobacco control plan and will give councils £16bn to provide public health services for their communities.”

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