Health matters: smoking and mental health

This edition of Health Matters focuses on smoking among people living with a broad range of mental health conditions. Click here to read government guidance

Many Ex-Smokers Crave Lost Social Identity

Many ex-smokers begin smoking again because they want to recapture a sense of lost social identity, according to new British research published in the Journal of Substance Use. In fact, according to the findings, many smokers experience quitting as a “loss." Click here for PsychCentral article

PHE publishes independent expert e-cigarettes evidence review

A new Public Health England (PHE) e-cigarette evidence review, undertaken by leading independent tobacco experts, provides an update on PHE’s 2015 review.  The main findings of PHE’s evidence review are that:

• vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits
• e-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more
• e-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country
• many thousands of smokers incorrectly believe that vaping is as harmful as smoking; around 40% of smokers have not even tried an e-cigarette
• there is much public misunderstanding about nicotine (less than 10% of adults understand that most of the harms to health from smoking are not caused by nicotine)
• the use of e-cigarettes in the UK has plateaued over the last few years at just under 3 million
• the evidence does not support the concern that e-cigarettes are a route into smoking among young people (youth smoking rates in the UK continue to decline, regular use is rare and is almost entirely confined to those who have smoked)

NIHR Signal National tobacco control policies linked to improvements in children’s health

National smoke-free legislation in advanced economies is linked to reduced rates of preterm birth, asthma hospitalisations and serious throat and chest infections in children. Comprehensive smoke-free policies appear to be more effective than policies with only partial or selective introduction.


Smoking increases health risks for the smoker and others through second-hand exposure. Although the number of people smoking in the UK is falling, eight million UK adults still smoke, and an estimated five million children are exposed to second-hand smoke. Children are vulnerable to smoke due to their small, developing lungs and immune systems.


From the NIHR Dissemination Centre

Poisons from cigarettes reach major body organs in seconds

Public Health England (PHE) releases a new TV advert highlighting the dangers of tar in cigarettes, as England’s 7 million smokers are urged to make a quit attempt with help from Smokefree this New Year. The latest campaign shows how poisons from tar in cigarettes enter the bloodstream, spreading around the body within seconds and causing damage to major organs. Click here to read PHE press release

Noncommunicable Diseases Progress Monitor 2017

This WHO report outlines progress made by WHO member states against globally agreed targets to control long-term conditions and chronic diseases. It finds that whilst the United Kingdom has fully achieved on many targets in relation to smoking and unhealthy diets, there is still progress to be made on reduction measures on harmful use of alcohol.

Smoking cessation in secondary care: acute and maternity settings

Self-assessment framework from Public Health England for NHS acute trusts to develop local action to reduce smoking prevalence and the use of tobacco.

Aggression Disorder May Up Risk of Substance Abuse

A new study finds that people with intermittent explosive disorder (IED) are at five times greater risk of abusing substances such as alcohol, tobacco, and marijuana than those who don’t display frequent aggressive behavior.

IED is described as a condition marked by frequent physical or verbal outbursts.

Researchers from the University of Chicago analyzed data from more than 9,200 subjects in the National Comorbidity Survey, a national survey of mental health in the United States. They found that as the severity of aggressive behavior increased, so did levels of daily and weekly substance use.

Better Beginnings: Improving Health For Pregnancy

This themed review from the NIHR brings together NIHR research on different aspects of health before, during and after pregnancy. It features published studies, ongoing studies or interim results and questions for clinicians, commissioners, public health professionals and others.

Reward-Based Therapy Can Be Helpful for Alcohol Abuse

New research suggests that offering rewards can be an effective, low-cost treatment for alcohol abuse. The findings are important as alcohol abuse is the nation’s third leading preventable cause of death.

Researchers at Washington State University studied Seattle-area participants with serious mental illness — a population whose lifespan is estimated to be 20-25 years shorter than the average person’s.

The reward-based intervention provided simple prizes for addiction treatment attendance and negative urine test results for alcohol use.

A surprise benefit of the treatment was that it also decreased study participants’ tobacco and drug use.

Stop smoking services may boost mental health of people with depression

Smokers with depression who successfully quit smoking using stop smoking services may see an improvement in their mental health, according to new research (link is external),* funded by Cancer Research UK and published in Annals of Behavioural Medicine.

Smoking cessation in secondary care: mental health settings

Guidance and self-assessment framework for NHS mental health trusts to develop local action to reduce smoking prevalence and the use of tobacco.

New resources launched and webinar scheduled on e-cigarette use in pregnancy

Two new resources on the use of e-cigarettes during pregnancy have been launched to help midwives in their consultations with women. An infographic and a briefing has been produced by the Smoking in Pregnancy Challenge Group.

The RCM has also launched an online training module on i-learn entitled Very brief advice on smoking for pregnant women.

Smoking cessation policy and practice in NHS hospitals National Audit Period: 1 April – 31 May 2016

The 2016 national BTS Smoking Cessation Audit was the first comprehensive audit of smoking cessation activity using BTS and NICE standards for secondary care. 

The audit showed poor recording of smoking status in medical notes. Few people who smoked were asked if they would like to stop smoking or be referred to a specialist stop smoking service and only a tiny fraction of people addicted to tobacco were offered nicotine replacement or other pharmacotherapies in hospital to reduce the symptoms of nicotine withdrawal.

Behavioural and drug treatment together help those with lung disease stop smoking

Smokers with chronic obstructive pulmonary disorder (COPD) given drug treatment alongside behavioural therapy were more than twice as likely to stop smoking by six months as those given behavioural treatment alone. There was also some evidence that high intensity behavioural treatment is more effective than usual care or lower intensity therapy.

From the NIHR Dissemination Centre

Understanding The Basic Economics Of Tobacco Harm Reduction

Institute of Economic Affairs (IEA) -
This report examines the economics behind smoking cessation policies and argues that minimising taxes on low-risk tobacco products (e-cigarettes or smokeless tobacco) has the potential to improve public health.

Annual NHS stop smoking service figures published

NHS Digital has published the latest statistics on NHS stop smoking services. They are for April 2015 to March 2016, including some time series data for the last 10 years.

A healthier life for all: the case for cross-government action

The Health Foundation and the All-Party Parliamentary Health Group have jointly published a comprehensive, accessible collection of essays setting out the current and emerging threats to health and wellbeing and what we know about what works to address them.

The essay collection concludes that addressing the wider determinants of health is critical to ensuring the prosperity and wellbeing of British society as well as easing pressure on the NHS. The essays support the view that a more proactive approach to tackling poor health across all policy areas is urgently needed, to help ensure individuals, families and communities can thrive.