A study found that smoking rates in the North of England have declined faster than in other regions, narrowing the gap in smoking prevalence across the country.
Researchers at University College London (UCL) say that smoking rates in the North are now as low as in the South. They found that regions such as the North East, which had ‘sustained tobacco control activity’ programmes encouraging people to quit, saw the greatest reductions in smoking.
The findings are published in Addiction. The observational study, funded by Cancer Research UK, used data from nationally representative monthly cross-sectional household surveys, which were part of the Smoking Toolkit Study, conducted between November 2006 and July 2024. All 368,057 participants were 16 years of age or older.
Using statistical methods such as logistic regression, the researchers could determine time trends in current smoking by region and test findings against occupational social grade to explore differences between more and less advantaged groups.
The North of England experienced the most significant and fastest reduction in smoking rates, nearly halving from 28.8 per cent to 15.8 per cent over the 18-year study period. This is compared to a fall of 25.2 per cent to 16.0 per cent in the Midlands and from 22.7 per cent to 17.3 per cent in the South. The observed reductions helped to narrow differences between regions.
The researchers also found a reduction in the gap in smoking prevalence between the more and less advantaged social grades. In Yorkshire and the Humber, the gap in smoking prevalence between higher and lower social grades shrank from 17.9 percentage points to 3.7, and in the West Midlands, the gap decreased from 16.1 percentage points to 3.0.
Regions with the highest sustained tobacco control activity, such as the North East, saw the largest decline in smoking prevalence, falling by -13.3 per cent, compared with -9.3 per cent in regions with no programmes operating. The East Midlands, West Midlands, East of England, and South East had no dedicated tobacco control activity across the study period.
Dr Sarah Jackson, lead author of the study from UCL, said: ‘Until recently, smoking rates were highest in the North of England, but our study shows that regional differences have narrowed considerably over the past 18 years. Smoking rates fell most in northern regions, where dedicated regional tobacco control programmes have been largely concentrated.’
The researchers, however, note that other factors, such as changing levels of deprivation, could also have contributed to the shift in smoking habits.
Despite the long-term changes occurring in the North of England, the researchers found that the smoking decline had slowed more recently, between 2020 and 2024, and that smoking appeared to rise in some regions, including the South of England.
Dr Jackson cautioned: ‘Across England, progress has stalled in recent years, and in some regions, smoking rates appear to be increasing. It’s vital that stop smoking services are made easily and equally available across the country so that everyone – wherever they live – can access the right tools to quit for good.’
Cancer Research UK’s executive director of policy and information, Dr Ian Walker, said he hoped budget pressures and changes to NHS England would not compromise funding of programmes that help people quit smoking. He added: ‘A future free from the harms of tobacco is in sight, but we can’t afford to lose any momentum. The world-leading Tobacco and Vapes Bill is a crucial opportunity for the UK Government to shield society from the devastating effects of smoking.’
