Number of smokers drops by 10%, but prevalence ‘remains high among vulnerable’

The number of smokers in Northern Ireland has dropped from a quarter of the population to 14%, but concern remains around prevalence among the most vulnerable.

The Auditor General Dorinnia Carville also expressed concern at a rise in the numbers who vape – from 5% to 9% of adults in the last 10 years, and an estimated 9% of 11 to 16-year-olds as well as 24% of Year 12 students.

The report, Tackling the Public Health Impacts of Smoking and Vaping, records that an estimated 320,000 people aged 16 and over currently smoke in Northern Ireland.

This is around 14% and has dropped from 24% in 2010-11.

However, Ms Carville’s report finds that challenges remain, particularly with smoking prevalence significantly higher among the most deprived areas – 24% compared to the least deprived at 7%.

It was also found that around 2,200 pregnant women continue to smoke annually, and emerging research suggests a high smoking prevalence amongst people with mental health issues.

In terms of impact on the health service, the report finds that around 15% of deaths in Northern Ireland (2,200) are attributable to smoking, as are around 35,000 smoking-related hospital admissions each year and an estimated £218 million spent on treating smoking-related illnesses.

Meanwhile, the Public Health Agency (PHA) estimates around a £450 million cost to the local economy due to premature deaths and excess sickness absence.

The cost of smoking – for those who smoke 20 cigarettes a day – is put at £4,600.

The report also examined the impact of the “rapid emergence” of vaping.

It found that vaping levels among adults have almost doubled, from 5% to 9% between 2014-15 and 2022-23.

It also noted a Department of Health survey which suggests that 9% of 11 to 16-year-olds in Northern Ireland are vaping, with 6% doing so regularly, and added “underlying this, 24% of Year 12 children currently vape”.

The report finds scope to improve enforcement of tobacco control legislation including spot checks at retailers and businesses, to identify if tobacco or vaping products are being sold to children.

While more than 5,000 tobacco test purchases were made by councils between 2011-12 and 2018-19 (identifying 570 age-of-sale offences), the report notes that targets set by the PHA for the required number of annual visits and test purchases were often not met.

In addition, the report highlights that local businesses stocking vapes do not currently have to register with councils, even though a requirement for tobacco retailers to register has been in place since April 2016.

It recommends the health service reassess the budgetary requirements for delivering a future combined tobacco and vaping strategy, and that it considers quality standards to ensure a more consistent approach to enforcement across councils.

Ms Carville described smoking as “remaining the greatest cause of preventable illness and death”, as well as the cause of some of the largest health inequalities.

“In Northern Ireland, smoking related deaths are 98% higher in the most deprived areas compared with the least deprived,” she said.

“Similarly, lung cancer deaths are 151% higher and women are more than four times as likely to smoke during pregnancy.

“The reduction in overall smoking prevalence over the last decade highlights how progress is achievable in this area, but the issue clearly remains a major threat to public health and a strain on public finances.”

She said she made several recommendations, including a focus on prevention supported by enhanced enforcement of tobacco and vaping regulations.

“A renewed strategic approach, that responds to these changes and emerging challenges, will be vital to sustain the advances made to date and reach those most impacted by smoking and vaping,” she added.