We have known for some time that chronic ill health caused by smoking can have a catastrophic impact on individual lives. But, the significant impact on local authority social care budgets across England has only now been estimated by ASH (Action on Smoking and Health) – and the figure is over £600m every year.
This is a considerable sum for cash-strapped councils, and our research shows how smoking will place an increasing burden on our already stretched social care system. Not only are local authorities across England spending an additional £600m on social care as a result of smoking-related illness, but also a further £450m is being spent by individuals on their own care. That means that at least £1bn is spent every year on social care support. And the figures are almost certainly an underestimate. The only data that is available is for the over 50s, and even then not for all the costs a local authority picks up when a person is too ill to care for themselves.
One in two life time smokers will die from smoking and many more will suffer from years of ill health. The new research throws further light on the impact of smoking on the lives of individuals and on the health and social care system. The research found that smokers need care on average nine years earlier and that over 800,000 people need care from friends or family as a result of smoking.
The research also shows that smoking is placing a significant burden on our already stretched social care system. Across England an additional £600 million a year is being spent by local councils on social care as a result of smoking-related illness – a further £450 million is being spent by individuals on their own care.
These figures are almost certainly an underestimate because only data for the over 50s is available, and even then not for all the costs a local authority picks up when a person is too ill to care for themselves.
ASH estimates that this £600m equates to 6% of social care spending on the over 50s. At a time of squeezed budgets these avoidable costs are something which local authorities can’t afford not to do something about. The investment in high quality prevention services can make a real difference to long term social care costs. The research indicates that there are benefits not only from preventing people from ever smoking but also in getting people to quit, with ex-smokers having lower care needs than current smokers.
England has some of the best services in the world to help people to quit smoking. These are services which must be maintained in the future if we are to have a chance of avoiding these unnecessary costs.
The social care costs of smoking are a fraction of the total costs. Across England ASH new analysis estimates that smoking costs society in the region of £17.8bn. This includes the cost to the NHS (£2bn) lost productivity (£8bn) and the costs of smoking related fires (£610m). The £17.8 billion is also likely to be an underestimate with costs such as smoking related litter (6,395 tonnes nationally) better quantified locally than nationally.
We have spoken to those ill from smoking and receiving care. David, 63, lives in Bath and has needed support from the local authority for the last six years as a result of a smoking related illness. He pays for part of the care himself and the local authority pays the remainder. 'I started smoking when I was 12 or 13 and carried on for the best part of 50 years, smoking up to 40 cigarettes a day. I was diagnosed with severe COPD in 2005. I had lung reduction surgery two years ago and while I was in hospital I also had a stroke. It’s depressing not being able to do the things I used to be able to do as a matter of course. I currently have an hour a day personal care, which includes help with a shower or washing and help with dressing. I also get an hour a week domestic help, so that’s things like changing the bed and hoovering.'
There is a strong financial case for continued investment in tobacco control by local authorities – reducing smoking prevalence won’t only improve the bottom line though it will also reduce health inequalities and improve the wellbeing of the whole community.
To see the costs of smoking for your local authority visit www.ash.org.uk/localtoolkit. Costs are also available at ward level.
Hazel Cheeseman, is director of research and policy at Action on Smoking & Health
