Tobacco

The current Wirral Smoke Free Plan has been developed through a review of local need, national policy and evidence-based best practice. It builds on the foundations established in the Wirral Smokefree Strategy 2015-2020, which recognised smoking as the single largest preventable cause of ill health, premature mortality and health inequalities in the borough. The earlier strategy focused on four core areas: communicating the risks of smoking, supporting people to quit, creating smokefree environments, and tackling illegal tobacco.

The refreshed approach has been informed by implementation of the National Institute for Health and Care Excellence (NICE) Guideline NG209: Tobacco - Preventing Uptake, Promoting Quitting and Treating Dependence, which provides comprehensive recommendations across the life course. The guideline emphasises early prevention, reducing smoking uptake among children and young people, strengthening smokefree environments, improving access to evidence-based cessation support, embedding tobacco dependency treatment within healthcare settings, and addressing inequalities in smoking prevalence.

Development of the plan was further strengthened through a local assessment against the recommendations contained within the Khan Review: Making Smoking Obsolete (2022), which set out actions required to achieve England's ambition of becoming smokefree. Wirral undertook a formal review of the Khan recommendations, identifying local opportunities for implementation. These included strengthening stop smoking support across the health and care system, increasing efforts to prevent youth smoking and nicotine addiction, expanding smokefree places, enhancing enforcement activity relating to illicit tobacco and underage sales, and improving communications and public engagement.

A local quality assurance process, including completion of the NICE NG209 self-assessment and review of existing tobacco control arrangements, identified areas of good practice and opportunities for further development. This work highlighted the importance of adopting a whole-system approach involving local authority services, NHS providers, primary care, schools, communities, housing providers, trading standards and the voluntary sector. The resulting Smoke Free Plan aligns local priorities with national ambitions to reduce smoking prevalence, prevent uptake among children and young people, protect residents from second-hand smoke and ensure that all smokers are routinely offered effective support to quit.

The plan is structured around five interconnected priorities:

1. Targeted communications and social marketing that amplify national campaigns and increase awareness of the harms of tobacco use.
2. Creating smokefree places, workplaces and outdoor environments that protect people from second-hand smoke and help denormalise smoking.
3. Developing a health and care system that consistently identifies smokers and provides effective quit support.
4. Preventing uptake among children and young people, including reducing access to tobacco and addressing emerging nicotine products.
5. Tackling illicit tobacco and underage sales through intelligence-led enforcement and partnership working.

Together, these priorities provide a comprehensive framework for reducing smoking prevalence, narrowing health inequalities and contributing to the wider ambition of a smokefree generation in Wirral.

• Wirral’s Stop Smoking Service, is provided by A Better Life- ABL

  • People who smoke can access free 12 week quit support with expert advisors who can support you with a range of methods to help you quit , at a location close to where they live.  

  • They can provide you with information, advice, counselling and 12-weeks of free Nicotine Replacement products or vapes.

  • Acces ABLs website here How we support you - ABL Wirral

•  The NHS Better Health Quit Smoking website provides trusted, evidence-based advice, tools and support to help people stop smoking, manage cravings and access free quitting resources- Quit smoking - Better Health - NHS

• Report to Wirral Trading Standards Team, Citizens Advice Consumer Service Contact the consumer service - Citizens Advice  or

• Report the sale of illegal tobacco or under ages sales anonymously Anonymous Reporting | Keep It Out

• Smoking remains the leading cause of preventable illness and premature death in England, responsible for 61,439 smoking-attributable deaths per year in England during 2022-2024 [1], and 1,470 deaths in Wirral for the same time period [2]

• Adult smoking prevalence in Wirral is estimated at 10.7% (APS 2022-2024), slightly below the England average of 10.9%. Despite continued declines in smoking prevalence, significant inequalities remain, particularly among routine and manual workers and people with long-term mental health conditions.

• Smoking prevalence among adults in routine and manual occupations in Wirral: 21.7%, Odds of smoking among routine and manual workers: 2.42 times higher than for those in other occupations. Adults with long term mental health conditions the smoking prevalence  in Wirral is 25.7% which is 3.4 times higher than adults without a long term mental health condition

• The four wards with the highest 18+ smoking prevalence rates are also the four most deprived wards in Wirral according to the Index of Multiple Deprivation (IMD) 2019; Birkenhead and Tranmere, Seacombe, Bidston and St. James, and Rock Ferry.

• 7.8% of mothers in Wirral were recorded as smokers at the time of delivery in 2024/25, equating to 207 births affected by maternal smoking. Wirral's smoking at time of delivery is 1.7 percentage points higher than England rate at 6.1%. (Please note - Most recent data published November 2026).

• Smoking continues to have a substantial economic impact on Wirral, with an estimated annual cost of £240 million [3].

• The largest component of the economic burden is reduced productivity, accounting for £136 million per year (56.8% of total costs). This includes smoking-related lost earnings, unemployment, premature mortality and reduced economic output.

• Smoking-related social care costs are estimated at £91million annually, representing almost two-fifths (37.9%) of the total cost burden in Wirral.

• Healthcare costs attributable to smoking are estimated at £10.7 million each year through smoking-related hospital admissions and primary care activity.

• Smoking-related fires are estimated to cost £2.12 million annually in Wirral.

• Within the productivity burden, reduced Gross Value Added (GVA) associated with tobacco expenditure accounts for £51.1 million, while smoking-related lost earnings (£45.8 million) and unemployment (£33.5 million) contribute substantially to economic losses.

• Illicit tobacco and illegal vaping products continue to undermine tobacco control efforts in Wirral, increasing access to cheap, unregulated products and contributing to health inequalities. Since December  2025, Wirral Trading Standards and Merseyside Police have strengthened enforcement activity, securing multiple Closure Orders against premises involved in the sale of illicit tobacco and illegal vaping products and underage sales [4].

•  In 2024/25, 8.6% of Wirral's smoking population were referred to specialist smoking cessation support.  Of those setting a quit date, 52.0% successfully quit smoking.[5]

• Additional investment through the government’s Smokefree Generation ('Stopping the Start') programme is supporting the expansion of local stop smoking services and targeted support for priority populations. This additional funding has enabled the continued development of stop smoking services in Wirral, supporting increased referrals and targeted interventions for priority groups with higher smoking prevalence, including routine and manual workers, people with mental health conditions and substance misuse.

• Wirral Smoking Profile (provided by DHSC via Fingertips)
  The aim of the profile is to assess the effect of smoking on local populations. Local government and health services can use this information to inform commissioning and planning decisions to tackle smoking and improve the health of local communities. The profile allows users to compare a local authority against other local authorities in the region and benchmark a local authority against the England or regional average. Link to Wirral Smoking Profile page.
  

• Key Tobacco Control information & data for Wirral (produced by Public Health England for 2019/20). This pack aims to signpost you to available tools and datasets to support your work in making the case for local tobacco control interventions.

• The Office for Health Improvement and Disparities(OHOD) Smoking Profile for England, including the Smoking Profile for Wirral, provides a comprehensive overview of smoking prevalence, smoking-related harm, health inequalities and the measures being taken to reduce tobacco-related harm at national and local levels. The profile is updated regularly and supports local assessment, commissioning and planning to reduce smoking and improve population health.

•  Qualitative research with young people and youth professionals in Wirral found that vaping is perceived to be common and socially acceptable among adolescents, with concerns around accessibility, knowledge of harms and nicotine addiction, and challenges in preventing under-age use - Vaping: Insights from young people and professionals in 2022–2023 - Wirral Health and Wellbeing Knowledge Hub

• The most effective approach to quitting smoking is a combination of behavioural support delivered by trained stop smoking advisors and evidence-based pharmacotherapy (Nicotine Replacement Therapy, varenicline, cytisine or other licensed medications [1] [2] and vapes). Most smokers try to quit without support, but unaided quit attempts have relatively low long-term success rates, whereas structured support and medication significantly improve outcomes.

• Smoking Profile: Statistical Commentary (OHID, July 2026) provides the latest national overview of smoking prevalence, smoking-attributable mortality and smoking-related harm, including updated mortality estimates for 2022-24 and local authority comparisons. Smoking profile: statistical commentary, July 2026 - GOV.UK

• Economic Impact of Smoking (ASH, 2026) Action on Smoking and Health (ASH) provides up-to-date estimates of the economic burden of smoking nationally and locally, including the ASH Ready Reckoner, which estimates healthcare, social care and productivity costs attributable to smoking. Economic impact of smoking - ASH

• Local Stop Smoking Services and Support Funding (DHSC, 2025/26) This guidance outlines the government's additional investment in local stop smoking services as part of the Smokefree Generation programme, including the £70 million annual funding available to local authorities. Local stop smoking services and support: funding allocations and methodology for 2025 to 2026 - GOV.UK

• Smoking, Drinking and Drug Use Among Young People in England (NHS England). This national survey provides the principal source of evidence on smoking, vaping, alcohol and substance use among children and young people aged 11-16 years. [digital.nhs.uk]

• NICE guidance provides evidence-based recommendations covering smoking prevention, smoking cessation, tobacco dependence treatment, vaping and harm reduction approaches. This guideline covers support to stop smoking for everyone aged 12 and over, and help to reduce people's harm from smoking if they are not ready to stop in one go. It also covers ways to prevent children, young people and young adults aged 24 and under from taking up smoking.  Overview | Tobacco: preventing uptake, promoting quitting and treating dependence | Guidance | NICE

• Electronic cigarettes for smoking cessation (Cochrane Review, 2025 update) This high-quality systematic review found that nicotine-containing e-cigarettes are more effective for smoking cessation than nicotine replacement therapy (NRT) and behavioural support alone. The evidence supports the use of e-cigarettes as an effective aid to help smokers quit, while continuing to monitor their long-term safety and use among children and young people. Electronic cigarettes for smoking cessation - Lindson, N - 2026 | Cochrane Library

• National Centre for Smoking Cessation and Training (NCSCT) - provides the national evidence base, treatment standards and professional training resources for smoking cessation services in England. NCSCT guidance informs the delivery of effective stop smoking interventions, including behavioural support, pharmacotherapy and the use of e-cigarettes for smoking cessation.NCSCT - National Centre for Smoking Cessation and Training

• Wirral participated in a CLeaR tobacco control peer review in 2018, providing an independent assessment of local tobacco control strengths and opportunities for improvement. The report remains a useful historical reference but should be considered alongside more recent tobacco control data and policy developments.

• Statistics on smoking, England 2017 Latest smoking compendium report signposting to all the up-to-date smoking data

• Towards a Smokefree Generation: Making it happen here! Public Health England - Birmingham (November 2017) Conference Report and Sources

• Wirral Smoking and Alcohol Prevalence Survey (April 2017) This local survey informs local commissioners and service providers of the smoking prevalence and patterns of alcohol consumption in the 20% most deprived areas of Wirral, with over 2,900 interviews providing essential local insight and information Stop smoking services (May 2016) Infographic that explains why you should use Wirral local stop smoking service.

• The Young Persons’ Alcohol and Tobacco Survey 2017. These two surveys (Wirral and North West) have been conducted in the North West every two years since 2005. Fieldwork for the latest survey took place between January and April 2017 and targeted 14 to 17 year olds in school/college settings.

• Aiming High: Why the UK should aim to be tobacco free ’Cancer Research UK’s tobacco modelling (February 2016) This report suggests that smoking could cause 1.35 million new cases of smoking related illnesses over the next 20 years.

• Health matters: a resource - first edition focusing on smoking and quitting in England (September 2015) Designed to support commissioning and delivering services across local areas, the resource brings together a package of additional local and national level data, policy and programme expertise, plus campaigning and social marketing help.

• Smoking: harm reduction (NICE Quality Standard, July 2015) This quality standard covers ways of reducing harm from smoking. In particular, this includes people who are highly dependent on nicotine and who may not be able (or want) to stop smoking in one step, who may want to stop smoking without giving up nicotine, who may want to reduce the amount they smoke without stopping, or who want to abstain temporarily from smoking

• Child Poverty and Smoking (BMC: Public Health Journal (June 2015) In 2011/12 approximately 2.3 million children (17% of UK children) were estimated to be in relative poverty. This research suggested that 1.1 million children - almost half of all children in poverty - were estimated to be living with at least one parent who smoked. The report highlights tobacco control interventions that effectively enable low income smokers to quit and reduce the financial burden of child poverty.

• Smoking in prisons: management of tobacco use and nicotine withdrawal (May 2015) Public Health England. This guidance brings together the research on smoking in prisons and outlines a joined-up care pathway for treatment.

• Cost effectiveness of smoking services in Wirral (May 2015) In 2013 there was a comprehensive cost effectiveness analysis of smoking services in Wirral looking initially at data for 2011/12 financial year (refreshed in 2014). The report aimed to use data to understand the current landscape around tobacco in Wirral.

• Wirral’s Smoking Cessation programme: stakeholders consultation (March 2015). From January 2015 to March 2015 the Public Health team carried out a 12 week consultation with stakeholders to gather ideas and opinions that would help shape Wirral’s Smoking Cessation programme. Methods of consultation included an online questionnaire advertised and made accessible to the public, paper versions of the online questionnaire completed by clients during their session with existing services and an engagement event for professionals who have an involvement and/or interest in either smoking cessation, prevention and/or other aspects of tobacco control.

• Analysis of Wirral Stop Smoking Service clients using Mosaic Public Sector (Wirral Public Health Intelligence Team, February 2015) Mosaic is a geo-demographic population classification tool used to segment the population according to the type of neighbourhood in which they live. This report provides analysis of Wirral stop smoking service clients.

• Profile of smoking in pregnancy in Wirral (MOSAIC) (2014) according to the type of neighbourhood in which they live. This report provides analysis of smoking in pregnancy of Wirral residents.

• Tobacco Control - CLear Report for Wirral (February 2014) CLeaR is a way for local public health organisations to assess, review and improve their tobacco control work. Wirral were visited by the CLeaR team and participated in an external peer assessment and this report summarises that involvement.

• Wirral Smokefree Hospitals: Evaluation Report (July 2013) This evaluation report describes the outcomes and outputs from a stop smoking social marketing project that took place across Wirral University Teaching Hospital sites; Arrowe Park and Clatterbridge.  The project took place from November 2012 to June 2013.

• Wirral Smoking Prevalence Report (October 2012) This prevalence report presents the results of telephone interviews with just under 3,500 Wirral residents carried out in September and October 2012, with an emphasis on the more deprived areas of Wirral.

Wirral Tobacco JSNA - March 2020