UCL News


Cost increasingly important motive for quitting smoking in England

22 April 2024

Health concerns are still the primary motive for more than half of those who say they want to stop smoking in England, but cost is now a key factor for more than one in four, finds a new study led by UCL researchers.


The researchers said that, given this shift in thinking, making much more of the potential savings to be had might encourage more people to stub out for good.

The study, published in the open access journal BMJ Public Health and funded by Cancer Research UK, looked at survey responses from 101,919 people in England between 2018 and 2023, analysing reasons that respondents gave for recent attempts to stop smoking.

Health concerns were the most frequently cited motives, reported by more than half the sample (52%) across the entire period – especially concerns about future health, reported by more than one in three (35.5%) compared with one in five (19%) who were motivated by current health problems.

Cost was the next most frequently cited motive, reported by nearly one in four (23%).

While there was little overall change in the proportion of quit attempts motivated by health concerns across the study period, the proportion of quit attempts motivated by cost increased significantly, rising from just over 19% in March 2018 to just under 25.5% in May 2023.

Lead author Dr Sarah Jackson, of the UCL Tobacco & Alcohol Research Group, said: “The harmful effects of smoking on health have always been a strong motivator for people wanting to stop smoking. Our data show that cost is another increasingly important influence on people’s quit attempts. This is not surprising, given the pandemic and cost-of-living crisis have put considerable pressure on household budgets over the last few years.

“The average smoker spends around £20 a week on cigarettes, so quitting smoking offers considerable potential to reduce their outgoings – even if they switch to other nicotine products like e-cigarettes, which are not only less harmful but more affordable.”

For the study, the researchers looked at responses to the ongoing Smoking Toolkit Study, a monthly survey of a representative sample of around 1,700 adults in England.

The responses were limited to those who were either current smokers and or who had stopped smoking in the past year and had made at least one serious attempt to quit during that time.

Out of the 101,919 survey respondents between 2018 and 2023, 17,812 reported smoking in the past year. Of these, 17,031 (96%) provided data on quit attempts over the past 12 months, 5777 (34%) of whom reported having made at least one serious attempt to do so: they formed the sample for analysis.

The proportion of quit attempts motivated by health professional advice fell significantly over the study period, dropping from just over 14% in March 2018 to 8.5% in May 2023.

The Covid-19 pandemic, which began to affect England in March 2020, is likely to have influenced the proportion of respondents reporting health concerns, social factors, and cost as motives for trying to stop smoking, the researchers suggested. 

The proportion of quit attempts motivated by future health concerns increased during 2020 and 2021. The researchers said: “It is likely the pandemic made health concerns (an already prevalent motive) even more salient, particularly during its first year when the virus was spreading rapidly and vaccinations were not yet available.”

Once the immediate threat of the virus had subsided thanks to the vaccination programme, the proportion of health-related attempts to quit returned to pre-pandemic levels.

The pandemic probably influenced other motives, the researchers suggested, as it led to loss of income and jobs for many people.

The researchers said: “These economic pressures probably contributed to the rise in cost-motivated attempts to quit around this time. But while the pandemic’s acute risks to health—and, as a result, attempts to quit motivated by concern for health or social factors—waned over time, its economic impacts have been compounded by a cost-of- living crisis.”

The pandemic’s impact on access to and availability of healthcare services may also have contributed to the decline in the proportion of respondents citing healthcare professional advice as a motivating factor, they said.

The researchers acknowledged various caveats to their findings, including that all the study data were self-reported and relied on personal recall, and may not apply to other countries with different attitudes to smoking, tobacco control policies, and provision of smoking cessation services.

They concluded: “These findings have implications for smoking cessation interventions and clinical practice ...They indicate that cost is an increasingly important factor motivating people to try to stop smoking. Communicating the potential savings people can make by stopping smoking (even if they switch to alternative nicotine products) could therefore be an effective means for motivating attempts to quit.” 



Media contact

Mark Greaves

m.greaves [at] ucl.ac.uk

+44 (0)20 3108 9485