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Cuts to public health funding are crippling Stop Smoking Services

by Dan Hunt | Analysis

16 November 2016

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Tobacco is still the biggest preventable cause of cancer in the UK. And while smoking rates recently hit a record low in England, around 9 million adults still smoke in Great Britain.

The UK has been making steady progress in tobacco control over recent years, with landmark achievements like standard cigarette packs, alongside making tobacco less affordable.

These measures stop people, particularly children, from starting smoking.

But to help prevent cancers caused by smoking, people also need support to help them quit. And a new report we’ve released today suggests that sadly, all over England, councils are struggling to do this.

And it’s down to deep cuts in the budgets they use to fund vital Stop Smoking Services.

The most effective tool

Evidence shows Stop Smoking Services are the most effective way for a smoker to quit.

This is because they combine behavioural support with access to specific drugs that make it possible to quit. These drugs work by blocking nicotine ‘switches’ in the brain, allowing smokers to manage their cravings.

You might not realise it – many smokers don’t – but you can also bring your e-cigarette with you, something we’ve written about recently.

They are the only structured services that can offer this support. But given they are the most effective way to stop smoking, it might be surprising that they aren’t always available.

A ‘perfect storm’

Unlike GP services or sexual health clinics, councils aren’t required to provide Stop Smoking Services. The same rule applies to alcohol and drug misuse centres, and local efforts to improve nutrition.

And at the same time, the amount of money that is given to councils for public health is being reduced time and again, with more cuts to come.

Despite a supposed ‘ring-fence’ to protect these budgets, there have been cuts of £200m to budgets in 2015, and further annual reductions of more than £100m a year are expected between now and 2020.

The funding for mass media campaigns, which direct people to Stop Smoking Services, has also been stripped back. Evidence shows scaling back these campaigns leads to fewer people reading information about stopping smoking and making calls to a national quit line.

What’s more, the Government’s plan to shift funding for public health from a central pot to using taxes that councils raise may not be the solution smokers need. We’re still waiting for answers on how the poorest parts of the country, which typically have lower rents and higher rates of smoking, will be given the support they need.

These funding pressures are creating a ‘perfect storm’ of cuts that are hindering smokers who want to stop, and councils who are being forced to make very difficult choices.

It also flies in the face of the Government’s most recent Tobacco Control Plan, which commits to:

Supporting local stop smoking services to extend the range of support options for smoking cessation

– Healthy Lives, Healthy People: A Tobacco Control Plan for England, 2011.

To explore what this means for smokers wanting to stop, we’ve worked with Action on Smoking and Health (ASH) to survey the people in charge of tobacco control in councils across England, and understand the impact in their local region.

And their answers are worrying.

Three years, lots of goodwill, no support

This is the third survey we’ve done – we blogged about our concerns last year – and it paints an increasingly bleak picture.

Our headline finding is stark – three in five councils (59%) have been forced to cut their budgets for helping people stop smoking since last year, up from 39% in 2015/16.

For the first time ever, the majority of councils across England are having to reduce the amount of money available to support smokers to quit. No region across England has been spared.

And around half of all local authorities (48%) have had to cut their budgets by more than 5%, meaning there could be significant reductions in the services available to smokers.

A similar proportion (45%) have also had to reduce their funding for broader tobacco control, meaning they will likely need to scale back on enforcing trading standards, working with young people, and tackling tobacco smuggling.

This is even more frustrating when our report also found that Councils want to support smokers properly.

Tobacco control has consistently remained a high or above average priority across the majority of regions in England. It also has strong support among those in charge, such as the Council Leader or lead members for health and wellbeing, with virtually no opposition.

But sadly, it appears that cuts to public health mean their ambitions won’t be realised. And that means the outlook for people wanting to use these services has got worse and worse.

Real world impact

These findings aren’t just numbers on a balance sheet, as Nicky, one of our Cancer Campaigns Ambassadors, describes:

When you see Stop Smoking Services help a loved one to quit, it’s hard to overstate just how important they are.

They’re the most effective way for a smoker to stop, and they save the NHS money in the long run. It can be difficult to go it alone and most smokers want to stop, so why make it more difficult for them?

Her story, which she has blogged about for us, makes the case clear.

And Brian, who also benefitted from using a Stop Smoking Service and filmed his efforts to quit smoking, reinforces this point:

Cutting funds to these services is a false economy; increasing the risk of more people developing cancer because of smoking, and leading to higher costs to the NHS for managing and treating these diseases in the long term.

It shouldn’t have to be a choice that some smokers are supported to quit and others aren’t.

That’s why we’re running our ‘Don’t Quit on Us’ campaign with a simple message: the Government must provide councils with the funds they need to run effective Stop Smoking Services, and the media activity to make sure smokers can find them.

And when councils are under more pressure than ever, the decisions they face can be life-changing.

We want to send a clear message to the Chancellor, Philip Hammond, to show just how important these services are.

You can take action by contacting your local councillor.

Dan Hunt is a policy advisor at Cancer Research UK