Smoking

Smoking

If you’re ready to quit smoking, there’s lots of free support available. Choose how you’d like to stop via this link: Stopping smoking

This page summarises key facts and the latest available data on smoking and e-cigarettes (vapes) and smoking-related harm in Southampton, with links to support and services.

At a glance

• Tobacco is the leading cause of preventable death and disease in the UK.
• Tobacco smoke contains thousands of harmful chemicals; the harms come mainly from burning tobacco.
• Tobacco-related harm contributes to large inequalities in health and healthy life expectancy.
• Quitting improves health at any age, and support can make quitting easier.

Health harms
Tobacco is the leading cause of preventable death and disease in the UK and the leading factor for disability-adjusted life years. Every year around 78,000 people in the UK die from tobacco, with many more living with debilitating tobacco-related illnesses. Tobacco use increases the risk of developing more than 50 serious health conditions including cancer, heart disease, other vascular diseases and Chronic Obstructive Pulmonary Disease (COPD). Ischemic Heart Disease, COPD, cancer and a stroke are 4 of the top 6 conditions causing the greatest disease burden with smoking as an upstream factor.

Pregnancy and tobacco
In England, 1 in 9 pregnant women still smoke. Quitting at any stage of pregnancy can be a benefit to both mother and baby. Quitting smoking reduces risks of miscarriage, premature birth, still birth, low birth weight and neonatal complications.

Inequalities
Tobacco is the largest contributor to years of life lost for both males and females. Tobacco-related harm remains the leading cause of premature death and disability, accounting for half the gap in healthy life expectancy between the most and least deprived communities.

Costs to Southampton
Action on Smoking and Health (ASH) estimates that, for Southampton, tobacco costs society approximately £229m per year. This includes £9.3m to the NHS, £166m potential wealth lost from lost productivity, £51.9m in social care costs linked to tobacco-dependence and £1.8m in costs to fire and rescue services responding to house fires caused by cigarettes (ASH 2025).

Why tobacco is so harmful – and why it’s hard to stop
When tobacco is smoked, people inhale a toxic mixture of 7,000 chemicals, around 70 of which are known to cause cancer (PHE 2018). Tobacco can be smoked in pre-rolled or hand-rolled cigarettes, as well as in cigars or pipes. Some people smoke shisha (waterpipe tobacco), others chew smokeless tobacco. All tobacco products harm health regardless of how they are used. 

People who use tobacco products can find it hard to stop because nicotine is highly addictive. Nicotine is not risk-free, but it is the smoke from burning tobacco, and the chemicals it contains, that causes the most serious harms. Tobacco smoke can also harm other people through the exposure to second-hand smoke. Tobacco advertising is restricted or banned in public places and tobacco companies are not allowed to advertise on TV, radio, or in magazines and newspapers.

Benefits of quitting
Quitting smoking is the single most beneficial thing a person can do to improve their physical and psychological wellbeing, with significant financial benefits too. Today, there are many tools available to help people successfully quit.

If you would like to quit smoking or know someone who would like to quit, local help and support is available: Stopping smoking

Vapes

At a glance

• Vapes (e-cigarettes) deliver nicotine in a vapour rather than smoke.
• Nicotine vaping is substantially less harmful than smoking and can help people to quit.
• Vaping is recommended as short term quitting aid for adults who already smoke.
• Vaping is not risk-free and is not recommended for people who do not smoke.
• Single use vapes are illegal to sell in the UK.
• All vapes (including rechargeable devices) and batteries should be disposed of safely by returning them to a vape retailer or taking to a dedicated recycling point. (Do not put them in household waste or recycling bins).

Terminology: “E-cigarettes” and “vapes” refer to the device. “Vaping” refers to using an e-cigarette. We use both terms because some data sources use “e-cigarettes” while others use “vaping”.

What vapes are
Vapes (also called e-cigarettes) are electronic devices that allow people to inhale nicotine in a vapour rather than smoke. They work by heating an e-liquid solution that typically contains propylene glycol, vegetable glycerine, flavourings and nicotine. Nicotine has been used safely for many years in medicines to help people stop smoking, including in nicotine replacement therapy (NRT).

Most vapes contain a refill container (often called a tank or pod), and a battery which can be recharged. Vapes and their batteries should be disposed of safely by returning them to a vape retailer or taken to a dedicated collection point at your local Household Waste Recycling Centre. They should not be thrown in household waste or recycling bins.

Vaping and quitting smoking
Nicotine vaping is substantially less harmful than smoking. It's also one of the most effective short term tools for quitting smoking and is recommended by NICE. Other effective options include NRT (such as patches or gum), and medication such as varenicline and cytisine. These products are most effective when used alongside behavioural support. Nicotine has been used in licensed stop smoking medicines for decades with a well-established safety record.

Risks and guidance
Vaping has not been around for long enough to know the risks of long-term use. Nicotine vaping is not completely harmless and is recommended for adults who smoke tobacco as a short-term way to quit smoking and to stay quit (Cochrane Library - Electronic cigarettes for smoking cessation by Hartmann-Boyce, J, et al. - 2022). The Chief Medical Officer for England advises that people who do not smoke should not start vaping (Chief Medical Officer for England on vaping – GOV.UK).

Tobacco products and e-cigarette (vape) products can also contribute to wider harms, including litter, fire and environmental pollution. An illicit market can add to these harms and may be linked to organised crime.

Adult vaping (Great Britain)
Action on Smoking and Health (ASH) monitors vaping in Britain through the ASH Smokefree GB Survey of 11 to 18 year olds and ASH Smokefree GB Adult Survey (for ages 18+).

In 2025, 10.4% of adults 18+ reported current vaping (around 5.5 million people in Great Britain), a drop of 3% since 2024. If the prevalence is similar in Southampton, this suggests around 22,000 people aged 18+ currently vape in the city.

In Great Britain, 55% of people who currently vape are ex-smokers (up 2.0 percentage points from 2024), 40% are dual users (they vape and also smoke tobacco) and 5% have never smoked (a decrease from 8% in 2024). Use of single-use (non-rechargeable) vapes increased from 2.3% in 2021 to 31.0% in 2023, driven mainly by adults aged 18-24, and has since stabilised at 24% in 2025.  (ASH - Use of e-cigarettes (vapes) among adults in Great Britain).

Since 1 June 2025, it has been illegal to sell single-use vapes in the UK.

Vaping among young people (Great Britain)
In 2025 current vaping was reported by 5% of 11-15 year olds and 12% of 16-17 year olds in Great Britain. If rates are similar to Southampton, this suggests around 730 young people aged 11-15 and 675 people aged 16-17 currently vape in the city. Current vaping in older teenagers has decreased (16-17yrs: 12%; 18yrs: 15%), while it has remained stable for 11-15 year olds. Most 11-17 year olds report they have never tried vaping or are unaware of e-cigarettes (79% in 2025). (ASH - Use of e-cigarettes (vapes) among young people in Great Britain).

 Estimates assume Southampton prevalence is similar to Great Britain.

The information below summarises some of the key issues relating to smoking prevalence and smoking ill-health in Southampton. More detail is available in the Southampton Smoking Needs Assessment, Smoking dashboard and Smoking presentation available in the resources section.

Who is at risk and why?

Tobacco-related harm contributes to health inequalities. People in more deprived areas, people living with severe mental illness, people experiencing homelessness, and people who are dependent on drugs or alcohol are more likely to use tobacco.

The Tobacco Control Plan (2017), set out the Government’s strategy to reduce smoking prevalence among adults and young people, and reduce inequalities in smoking prevalence by focusing on groups at higher risk. Key groups highlighted include:

• People in routine and manual occupations: there are nearly 1.7 times as many people who smoke among lower earners compared to higher earners.
• Smoking during pregnancy: tobacco use in pregnancy increases the risks of miscarriage, stillbirth and complications for the baby, and contributes to child health inequalities. Nationally, 1 in 9 pregnant women smoke.
• People with long-standing mental health conditions: smoking is around twice as high among people with long-standing mental health conditions compared with the general adult population. The plan aims to give equal priority to people with mental ill health as much as those with physical ill health.

In 2019, the government set an ambition for England to be smokefree by 2030, meaning no more than 5% of the population would smoke. The government commissioned an independent report on achieving the ambition. The subsequent Khan Review: making smoking obsolete in June 2022 reported that “without further action, England will miss the smokefree 2030 target by at least 7 years, and the poorest areas in society will not meet it until 2044”. The report suggested 15 recommendations with 4 “critical must dos”.

The Government is now progressing a Tobacco and Vapes Bill through Parliament, designed to reduce supply and demand for tobacco.

Why tackling smoking is important

At a glance

• Tobacco smoke causes serious long-term illness and premature death, including most lung cancers.
• Tobacco harm also affects mental health and wellbeing and can reduce fertility.
• Smoking has major economic impacts, including lost productivity.

Health impacts
Tobacco smoke damages nearly every organ. It causes about 70% of lung cancers and can cause cancers in other parts of the body including lip, mouth, throat, bladder, kidney, stomach, liver and cervix. Smoking tobacco damages the heart and circulation, increases the risk of heart disease and other vascular diseases. It also damages the lungs, contributing to conditions such as COPD and pneumonia. Smoking can reduce fertility and is associated with impotence, and it can worsen anxiety, depression and other mental health conditions (NHS website).

Economic impact in Southampton
Tobacco also negatively affects earnings and employment prospects. ASH estimates a total productivity loss for Southampton of £166 million, made up of: smoking related lost earnings (£53.3 million or 32.1%), smoking-related unemployment (£53.7 million or 32.3%), smoking-related early deaths (£6.1 million or 3.7%) and reduced GVA due to expenditure on tobacco (£53.1 million or 31.9%). (ASH 2025)

Tobacco-dependency in Southampton

At a glance

• Estimates of how many adults (18+) smoke in Southampton range from 12% (from national survey estimates) to 17.9% (42,171 adults recorded as current smokers in local GP records).
• Smoking is more common in more deprived areas and among people with long-term mental health conditions. (These patterns can overlap and are shaped by wider social, economic and health factors.)
• Smoking is also common among adults in treatment for alcohol and other drugs.

Two main data sources are used to estimate how many adults (18+) smoke in Southampton. Each uses different methods, so figures are not expected to match exactly.

Estimate 1: National Annual Population Survey (weighted)
The national Annual Population Survey is conducted and is used to calculated how many adults smoke in Southampton based on the age and sex profile of the local population. In 2024, an estimated 12% of adults in Southampton smoked (around 1 in 8). This is lower than 2023 (meaning fewer adults smoked), and much lower than 2014 (20%). Southampton’s 2024 estimate (12%) is higher than the average for England (10.4%) and Hampshire (7.7%), although the differences are not statistically significant. Southampton is the 9^th lowest in our CIPFA comparator group of 16 authorities.

Estimate 2: GP records (recorded smoking status)
GP data estimates that 17.4% of adults aged 18+ are recorded as current smokers (40,873 people). This estimate is higher and may reflect more complete local recording and/or that smoking status is not always updated promptly when someone quits smoking. 

From GP records, 51.0% of people recorded as current smokers have two or more additional health risk factors, such as obesity, low physical activity, or alcohol use.

Differences across the city (from GP records)
GP records also help show how smoking varies across Southampton, including by deprivation, age and ward. These figures are most useful for understanding local patterns and targeting support.

Deprivation: In the most deprived areas, 24.2% of adults are recorded as current smokers, compared with 8.4% in the least deprived areas (around 2.8 times higher).

Change over time: GP records show that the number of adults recorded as current smokers has decreased across all areas in Southampton. Between January 2022 and January 2026, this fell by 17.5% in the least deprived areas and by 11.3% in the most deprived areas.

Age: Recorded smoking varies by age group. Adults aged 50-64 have the highest recorded rate (22.1%), followed by ages 25-49 (19.7%) and 65-74 (15.9%).

Ward: By ward, Thornhill and Redbridge have the highest smoking prevalence (24.5% and 23.3% respectively).

Smoking and other needs
In Southampton, 32.3% of adults with a long-term mental health condition are recorded as current smokers (tobacco dependent). This is significantly higher than England (24%) and is the second highest among comparators (2024/25).

Smoking tobacco is also common among adults in treatment for substance use. Of the adults admitted for alcohol use, 62.5% were tobacco dependent. Among adults in treatment for non-opiate drug use, 82.1% are recorded as current smokers. Both are higher than England (43.9% and 62.0% respectively) and Southampton is the highest amongst comparators.

In Southampton, smoking is more common in groups facing disadvantage, including people on lower incomes, people renting, and some communities with higher reported smoking prevalence. These are population-level patterns and do not describe individuals. They often reflect wider social and economic factors, including stress, housing status and access to support.

Smoking and maternity

Supporting women who are pregnant to stop smoking helps protect an unborn baby from tobacco harms, and supports a healthy start in life. Smoking during pregnancy increases the risk of complications, including miscarriage, premature birth, stillbirth, low birth weight and sudden infant death syndrome (NHS - Smoking in pregnancy). Quitting at any stage of pregnancy can improve outcomes and support can help. If you would like to quit smoking or know someone who would like to quit, local help and support is available: Stopping smoking

In Southampton, 6.1% of people are recorded as smoking at time of delivery (2024). This is statistically similar to England (6.1%) and is the 6^th lowest amongst comparators. Southampton was significantly higher than England until 2020/21, when Southampton made a significant decrease and continues to do so.

At Ward level in 2024, Woolston had the highest recorded rate of smoking at delivery (15%) and Bassett (one of the least deprived areas) had the lowest (3.1%).

More information can be found on the Births page and in the resources section below.

Adult smoking cessation and quit rates

• Service reach: In 2023/24, a higher proportion of people who smoke in Southampton set a quit date through commissioned services than in England (5.9% vs 3.3%)
• Quit outcomes (service users): The self-reported quit rate in Southampton’s stop smoking services was lower than England (40.7% vs 53.8%)
• Stop smoking support increases the chance of quitting compared with trying without support.

Quit attempts and outcomes (commissioned services)
(Commissioned services are local stop smoking support services funded by Southampton City Council for people in Southampton who smoke.)

In 2023/24, 5.9% of people in Southampton aged 16+ who smoke set a quit date through commissioned support services, significantly higher than England (3.3%). The (self-reported) quit rate in Southampton’s commissioned services for the same year was 40.7%, lower than England with 53.8%.

Many people also quit using NHS self-help resources or on their own. Evidence shows that people who use stop smoking support are at least three times more likely to successfully quit as those who try without support.   

Who is using services in Southampton
In Southampton’s commissioned tobacco dependence treatment services for 2024/25, 22.4% of quit dates were set by people in routine and manual occupations, compared with 7.1% in managerial and professional occupations. 22.0% of those setting a quit date reported that they had never worked or were unemployed for over one year.

Quit rates by group (4-week quit rates, 2024/25 Q4)
Four-week quit rates for people using Southampton tobacco dependence support services in 2024/25 Q4 were:

• 8% for routine and manual occupations
• 6% for people who have never worked or were unemployed for over 1 year
• 8% for managerial and professional occupations.

Quit rates by age groups in 2024-25 Q4 [January to March 2025] were reported as:

• 18-34 years: 44.6%
• 35-44 years: 47.2%
• 45-59 years: 41.6%
• 60+: 50.3%.

People aged 45-59 set the most quit dates (37.9%), but this group also had the lowest quit rate at 4 weeks after starting their quit attempt (41.6%) when compared to other age groups.

Further stop smoking service data can be explored on the OHID Stop Smoking Service Data Explorer.

Experian Mosaic data indicates people who have tried to quit smoking in the last 12 months are more likely to be single, council tenants, unemployed, have school aged children and very low income. (These are population-level patterns and do not describe individuals.)

Smoking ill-health and mortality

At a glance

• Tobacco use accounts for 1 in 6 of all deaths in England.
• In 2022/23, 408,700 hospital admissions were attributable to smoking (4% of all admissions).
• In 2023, there were 112 lung cancer deaths in Southampton (22.9% of cancer deaths)
• Southampton’s smoking-attributable hospital admissions and mortality are higher than the England average.

Tobacco smoke is a major cause of early death and long-term illness. In this section, “smoking-attributable” means admissions or deaths estimated to be caused by smoking.

Lung cancer and COPD
Tobacco use accounts for 1 in 6 of all deaths in England and is responsible for over 70% of lung cancer cases. In 2023, there were 112 lung cancer deaths in Southampton, out of 489 cancer deaths (22.9%).

Three million people in the UK suffer from COPD, and tobacco smoke is the biggest modifiable risk factor. COPD is the third biggest killer in the UK and 86% of these deaths are caused by tobacco.

Hospital admissions attributable to smoking
In England in 2022/23, an estimated 408,700 hospital admissions were attributable to tobacco (4% of all hospital admissions). This is an 8% decrease from 2019/20 (446,400). An estimated 25% of hospital admissions for respiratory disease and 19% of admissions for cancers linked to tobacco are attributable to smoking.

In Southampton there were 1,901 per 100,000 smoking-attributable hospital admissions in 2019/20, a 26% increase since 2017/18, and significantly higher than England (1,398 per 100,000). COPD hospital admissions in the city are also significantly higher than the England average.

LSOA level GP data shows a strong relationship between areas with higher recorded smoking (current or former) and higher COPD prevalence. Among people diagnosed with COPD, 94.6% are recorded as people who currently smoke or used to smoke, further highlighting the impact of tobacco on COPD.

Smoking-attributable mortality
In 2019, an estimated 15% of all deaths in England were attributable to tobacco. This included 52% of cancer deaths, 47% of respiratory disease deaths and 43% of digestive system deaths. Smoking-attributable deaths are higher among males than females (Statistics on Public Health - NHS England Digital)

In Southampton, smoking-attributable mortality in 2017-19 was 260.6 per 100,000, significantly higher than England and the 4^th highest amongst comparators. Deaths from lung cancer and other smoking-attributable conditions have remained significantly higher than the England average since 2010-11. More information can be found on our mortality page.