ASH at 50: nearly eight million lives in the UK lost due to tobacco since 1971

02 December 2021
5 min read

A new analysis to mark the 50th anniversary of Action on Smoking and Health (ASH) finds that smoking killed nearly eight million people in the UK over the last 50 years, with an estimated two million more expected to die in the next 20 years without radical changes to smoking rates.[1]

The modelling was by Professor Sir Richard Peto, world renowned epidemiologist and statistician, who worked with Sir Richard Doll on the health risks of smoking. In the 1950s Doll and Sir Austin Bradford Hill had established the full impact of smoking on the health of the population, and following Hill’s retirement Peto joined Doll to continue this research. Their work showed that in the 1970s the UK had the worst death rate from smoking in the world, with half of male deaths in middle age and a quarter of those among women caused by smoking.

If the same proportion of adults smoked today as in 1971, there would be an additional 18 million smokers in the UK today, losing on average 10 years life expectancy because of their addiction.[2]

The charity was established by the Royal College of Physicians in 1971 following their landmark 1962 report recommending urgent government action to curb the harms from smoking.[3] When no action was taken, the College set up ASH with a mission to campaign for change. Five decades on, the calls to action, which once appeared radical, have largely been implemented thanks to the work of ASH working with the RCP and others to transform British society. In addition, the current government has pledged to make smoking obsolete and England ‘smokefree’ by 2030.[4]

However, given current trends in smoking, we are on course to miss the 2030 target by seven years, and more than twice that for the most deprived smokers.[5]

Deborah Arnott, chief executive of ASH since 2003, said, “[The] government knew about the terrible harms from smoking in the 1950s, but it took the tireless efforts of campaigners to bring about change. Today, we have a government with a vision to make smoking obsolete, but vision alone is not enough. Two years ago the government committed to ‘bold action’ to ‘finish the job’, including the option of a ‘polluter pays’ levy on the tobacco industry, when will it deliver on this promise?”

To mark their 50th anniversary, ASH has launched an online commemoration of those who have lost their lives to smoking. People can add their tributes to loved ones here. 

Cllr Alison Griffiths, Surrey county councilor and former smoker, shared, “This year I was diagnosed with terminal lung cancer. I started smoking at 12 and I was 45 when I was diagnosed and finally stopped. Finding out my life is coming to an end has been unbelievably tough, not just for me but my family too.

“I share our government’s vision of a country without smoking and I urge them from the bottom of my heart to take the action needed to make it happen. Every day we wait, more children are starting – and I know how hard it is to stop, once you’ve started. My grandchildren deserve a future without smoking.

“I urge all smokers to seriously consider quitting before it’s just too late, you think it will never happen to you, but it can and it does, unfortunately I am living proof.”

Dr Andrew Goddard, president of the Royal College of Physicians, added, “When the RCP had the vision to set up ASH 50 years ago, my predecessors knew the scale of the challenge to reduce death and disease from smoking, against the all-pervasive influence of the tobacco industry and its cosy relationship with government at the time. 

“ASH has proved itself over and over again as an effective organisation, not just for its own work, but its vital role in supporting and maintaining the wider tobacco alliances of like-minded bodies, coordinating campaigning efforts to make us all work better together. 

“There is still much work to do, particularly in the field of health inequalities, and it is time for the government, the NHS and the new public health structures to intensify their efforts in this area to speed up the pace of change.  Until we have a smokefree society, we will still need ASH, and I am proud to work alongside them to campaign until that day.”



[1] Peto R and Pan L. Mortality the UK from smoking 1971 to 2019. University of Oxford. November 2021

[2] Analysis undertaken by ASH using ONS data on smoking rates for 16+ for GB population for 1971 and 2019 and UK 16+ population data for 2020

[3] Royal College of Physicians. Smoking and Health. 1962

[4] Department of Health and Social Care. Advancing our health: Prevention in the 2020s. July 2019

[5] Cancer Intelligence Team, Cancer Research UK. Smoking prevalence projections for England, Scotland, Wales, and Northern Ireland, based on data to 2018/19. Published February 2020.

Further key statistics

Smoking deaths 1970-2019 (UK) 1

  • 79 million men 2.95 million women = 7.8 million
  • 33% of all male deaths and 20% of all female deaths from 1970 to 2019 were caused by smoking, amounting to 26% of all deaths during this time.

[1] R Peto, A Lopez, H Pan. Mortality from Smoking in United Kingdom 1950-2020.

Decline in smoking rates 1971-2019 (adults 16+Great Britain)

  • 1971 6% of men and 41.8% of women smoked cigarettes 2
  • 2019 9% of men and 13.8% of women smoked cigarettes 3
  • If smoking rates were still at 1971 levels there would be 18 million additional 16+ smokers in the UK in 2020.4

2 Wald, N. and Nicolaides-Bouman, A. (1991) UK Smoking Statistics. 2nd edition, Oxford University Press. Table 3.3 Percentages of men and women Tobacco Advisory Council (TAC) 1948-1987.

3 Office for National Statistics. Opinions and Lifestyle Survey, General Lifestyle Survey and General Household Survey. Table 1. Proportion of cigarette smokers, by sex and age, Great Britain, 1974 to 2019.

4 Action on Smoking and Health. Custom analysis calculation number of smoking related deaths. 2021

Economics of smoking today

  • UK smokers spent £15.6 billion on tobacco in 2020 (£14.3 billion legal and £1.3 billion on illicit) 5
  • More than half a million households are driven into poverty because of the cost of smoking, containing 330,000 children, 743,000 working age adults and 183,000 pensioners.  6
  • Tobacco excise tax duty raised £10 billion for the UK government in the tax year 2020/21. 7
  • Tobacco retailers make around 6.6% profit on tobacco compared to 24.1% for other products. 8
  • Tobacco manufacturers made an average of 50% profits in 2018 making a total of £900 million in UK profits in 2018 9 an average of 50% per manufacturer.
  • A ‘polluter pays’ levy capping manufacturer profits and setting cigarette prices could raise £700 million annually more than enough to pay for the measures needed to stop people smoking. 10 11

5 H Reed (2021) The economic impact of a smokefree United Kingdom: technical report. September 2021.

6 H Reed (2021) Estimates of poverty in the UK adjusted for expenditure on tobacco – 2021 update. July 2021

7 National Statistics. Tobacco Bulletin July 2021. Table 1 receipts- figures for cigarettes, cigars, hand rolled tobacco, other tobacco products, and overall receipts. 8 Anderson W; Hitchman S. Counter Arguments - How important is tobacco to small retailers? - Action on Smoking and Health, 2016.

9 Branston JR. Tobacco industry response to taxes: “what do we know and what can we anticipate?” 8th European Conference on Tobacco or Health (ECToH), Plenary 6. February 2020.

10 Delivering a Smokefree 2030: The All Party Parliamentary Group on Smoking and Health recommendations for the Tobacco Control Plan 2021. London: APPG on Smoking and Health. 2021

1[1] Featherstone, H J Establishing a Smoke-free 2030 Fund.

Cost of smoking to society in 2020

  • Lost productivity £14.1 billion 12
  • Cost to the NHS £2.4 billion
  • Cost to NHS UK figure= £2.81 billion 13 (using 2019 population)
  • UK Productivity Cost: £15.84 billion (£14.1 billion in lost income (2020), UK Cost of early deaths (£1.74 billion)5 12
  • Cost to social care: Smokers require social care on average 10 years younger than never-smokers costing local authorities £1.2 billion a year 14

5 H Reed (2021) The economic impact of a smokefree United Kingdom: technical report. September 2021.

12 H Reed (2020), The impact of smoking history on employment prospects, earnings and productivity: an analysis using UK panel data.

[1]3 Action on Smoking and Health. Custom analysis calculation of UK Healthcare costs. 2021

[1]4 H Reed (2021), The costs of smoking to the social care system and related costs for older people in England: 2021 revision.

Benefits to the economy of ending smoking

  • The net benefit to public finances after netting out taxes with benefits would be an increase of £600 million in government revenues. 5
  • UK job numbers would increase by half a million as smokers switched to other goods and services. 5

5 H Reed (2021) The economic impact of a smokefree United Kingdom: technical report. September 2021.