People living in the most deprived areas of England were more than four times more likely to smoke in 2016 than those living in the least deprived areas.
A person’s likelihood of smoking increased in line with the level of deprivation in their neighbourhood2, according to new analysis by Office for National Statistics (ONS) and Public Health England.
On national No Smoking Day, the analysis highlights a clear link between smoking and inequality; one which the Government plans to address by cutting the proportion of adults who smoke in England from 15.5% to 12.0% or less by the end of 2022.
Out of several measures of inequality, area deprivation – which combines factors such as income, employment, health and education within an area – had the greatest impact on someone’s likelihood of smoking.
The next most important factors were someone’s housing tenure and their occupational group.
People living in rented accommodation were more than three times more likely to smoke than those who weren’t renting.
Meanwhile, people in routine and manual jobs were three times more likely to smoke than those in managerial and professional jobs.
A person was also more likely to smoke if they reported having no qualifications, receiving benefits or having a health problem which severely limited their activity.
Smoking more common in deprived areas Around 6.3 million people aged 18 and over in England smoked in 2016. These people were more concentrated in the most deprived areas than the least deprived areas.
Around one in six (16.0%) lived in the 10% most deprived neighbourhoods, compared with just 1 in 20 (5.2%) in the least deprived neighbourhoods.
It’s therefore no coincidence that many of the local authorities with the highest proportions of smokers in 2016 ranked among the most deprived in England.
More than one-quarter of people (25.7%) in Hastings smoked, the highest percentage in England, compared with a nationwide average of 15.5%.
Blackpool, Bradford and Hull in the North of England also ranked near the top for both smoking and deprivation.
In particular, Manchester and surrounding areas were home to a high percentage of smokers. As well as Manchester itself, at least one in five people smoked in Rossendale, Tameside, Knowsley and Salford.
At the opposite end of the smoking scale, just 4.9% of people smoked in Epsom and Ewell in Surrey (the lowest in England). Fewer than 1 in 10 people smoked in many of England’s least deprived areas, including places like Wokingham in Berkshire, Chiltern in Buckinghamshire and Waverley in Surrey.
Smoking contributes to health inequality As smoking is more widespread in deprived areas, it’s not surprising that associated diseases like lung cancer and respiratory disease are more common too.
In 85% of cases where a patient has lung cancer, smoking is the biggest risk factor. Both men and women in England’s most deprived areas are roughly twice as likely to die from lung cancer compared with those in the least deprived areas.
Similarly, the NHS estimates that smoking is responsible for 9 out of 10 cases of a type of respiratory disease called chronic obstructive pulmonary disease (COPD). Deaths from respiratory diseases, including COPD, are more than twice as common in the most deprived places in England as the least deprived places.
But is it a declining habit?
Between 2012 and 2016, smoking declined at every level of area deprivation.
In 2016, 27.2% of adults living in England’s most deprived areas were smokers, down from close to one-third (32.7%) in 2012.
Meanwhile, just 7.9% of adults in the least deprived neighbourhoods smoked in 2016, compared with 10.0% in 2012.