Impact of increased funding for Stop Smoking Services in England on quit attempts: population-based study 2021-2025

Background

The UK Government aims to reduce smoking rates by implementing new, and investing in existing, tobacco control strategies including increased funding for Stop Smoking Services (SSS) in England. This study examined whether the additional funding starting in April 2024 was associated with a detectable increase in quit attempts supported by SSS and whether it was cost-effective.

Methods

We used data from the Smoking Toolkit Study, a repeat cross-sectional survey conducted in 2021 to 2025. Adults aged ≥18 years who smoked cigarettes and had made a quit attempt in the past year were included (n _weighted =5,076). The outcome was monthly prevalence of past-year quit attempts supported by SSS. We fitted general additive models with a step change in April 2024 to represent the start of the increased funding. We adjusted for tobacco tax increases, the Swap-to-Stop scheme, age, gender, and a measure of socioeconomic position. In an unplanned analysis, we extended the time series back to 2006. For the cost-effectiveness, we estimated incremental cost-effectiveness ratios for the total population and age groups, accounting for future lifetime cessation.

Results

In the primary model, the April 2024 step change was not statistically significant (adjusted odds ratio: 1.13; 95% CI: 0.52, 2.49). The cost-effectiveness analysis ranged from cost-effective to extremely ineffective (incremental cost-effectiveness ratio (ICER): £104,126, 95% CI: £939,398 to £8,293). When using the extended time series, the adjusted odds ratio for the step change was 2.70 (95% CI: 2.03, 3.60) and the intervention was cost-effective (ICER: £13,857; £21,393 to £9,620).

Conclusions

Compared with the long-term trend, increased funding to SSS in England in 2024 appeared to lead to an increase in quit attempts supported by SSS at the population level. This result is somewhat uncertain because our primary pre-planned analyses assessing the impact relative to a more recent trend were insensitive.

KEY MESSAGES

• What is already known on this topic – SSS are effective in helping people quit smoking. However, until recently, substantial funding cuts in England by the UK Government had reduced service capacity and contributed to low usage during quit attempts.

• What this study adds – The renewed investment in SSS introduced in April 2024 may be associated with an increase in the number of quit attempts supported by these services in England, depending on the time horizon chosen.

• How this study might affect research, practice or policy – Together with existing evidence and reported increases in service throughput, these results strengthen the rationale for sustained funding in SSS as part of England’s comprehensive tobacco control strategy.