Smoking and vaping

Smoking remains the single greatest preventable cause of disease and premature death in Wales

Between 2020 and 2022, an average of 3,845 deaths each year among adults aged 35 and over were attributable to smoking, more than one in ten deaths in this age group. More than 17,000 hospital admissions per year are caused by smoking related conditions.

Smoking is also a major cause of inequalities in Wales

Adults living in the most deprived areas are almost three times as likely to smoke as those living in the least deprived areas, and these differences are reflected in health outcomes, mortality and healthcare use.

Smoking is a major driver of poverty and economic inequality

The average adult smoker in the most deprived fifth of areas of Wales spends £38.70 per week on smoking, 42% of the maximum weekly Jobseeker’s Allowance and more than a fifth of the maximum Personal Independence Payment. Smokers living in poverty are estimated to spend 10-12% of their entire income on smoking.

Smoking also harms communities, with an estimated £1,776 per smoker per year leaving locally economies annually. At UK level, modelling suggests a 10% drop in spending on tobacco would boost the economy by £1.86 billion and create over 31,000 full-time jobs.

Smoking places a huge burden on healthcare services in Wales

Treatment and support for conditions caused by smoking cost more than £650 million per year, more than 5% of Wales’s entire budget for Health and Social Care. Taking into account other costs, such as loss of productivity through illness, the figure for Wales rises to £1.56 billion annually.

Smoking Prevalence

Smoking policy, prevention and cessation has been extremely successful. Smoking rates have fallen by a third over the past decade and are now comparable to those in England, with the most recent National Survey for Wales estimating 10% of adults smoke in Wales. If smoking rates had not changed in this time, there would be more than 150,000 more smokers. However, prevalence projection show that Wales is not on track to achieve the strategic target of 5% or less of adults smoking by 2030.

There is an enormous opportunity for Wales to lead the way on achieving a generational reduction in smoking prevalence

Welsh Government has set a Smokefree Wales target for less than 5% of adults in Wales smoking by 2030 with both smoking cessation and prevention activities key to its achievement. The Tobacco and Vapes Act enables an ambitious government and public health system to introduce world leading policies to denormalise smoking and reduce accessibility to products that will kill the majority of their users if they do not quit. Further ‘endgame’ policies are well scoped and modelled and gaining momentum in Wales and the UK.

Help Me Quit

Help Me Quit, Wales’s smoking cessation service reached 7.1% of estimated smokers in 2024-25 (i.e. at least one cessation session and set a quit date) with comparable outcomes for smokers living in the most and least deprived fifth of areas; for England the figure was 4.9%. This success has led Welsh Government to raise the target for annual treated smoker numbers to 7.5% of the smoking population. The smoking cessation system provides a mechanism for targeted investment in effective and cost-effective prevention, with a proven evidence-based intervention, an integrated system to identify, engage with and support smokers in settings across Wales and an increasing number of digital options.

Vaping in Wales

The increases in vaping prevalence, and the changing technology, social and commercial landscape that have enabled these rises are of increasing concern especially in relation to young people, where prevalence is highest. Although vaping is substantially less harmful than smoking, and there is evidence that vapes can support some smokers to quit, the risk of a newly nicotine dependant generation is a real public health concern. The Tobacco and Vapes Act provides a policy framework for managing these tensions, with the development of effective and cost-effective vaping cessation pathways also a priority for the TVNAP.

The work of the Tobacco, Vapes and Nicotine Addiction Programme

We reduce tobacco and nicotine use through a comprehensive approach, combining prevention, cessation support and system leadership. We work across the life course, with an emphasis on protecting future generations from nicotine addiction while continuing to support people who smoke to quit.

The programme aligns with national policy and legislative change, including maximising the opportunities created by the Tobacco and Vapes Act, and works in partnership with Welsh Government, NHS Wales, local authorities, education, workplaces, community organisations and the voluntary sector. Delivery combines policy influence, service improvement, social marketing and digital innovation to support action at scale and reduce inequalities.

Prevention and Smokefree Generation
Prevention of initiation is a major plank of our work to reduce prevalence and related harms and achieve the ambition to create a Smokefree Wales by 2030. This includes working with the Wales Healthy Schools programme to produce guidance and tools for schools and working with further and higher education settings and workplaces to develop targeted approaches for young people aged 16 to 24. We aim to maximise the opportunities created by the Tobacco and Vapes Act (2026) to further restrict the sale and promotion of tobacco and vapes, and to create a Smokefree Generation.

Denormalisation

We are synthesising the evidence to support Welsh Government policy on expanding the range of smokefree outdoor public spaces and extending to vapefree indoor and outdoor public spaces, using powers granted by the Tobacco and Vapes Act. In addition, we are developing a programme of work to promote smokefree households, to protect babies, children and other vulnerable groups including pregnant women.

Help Me Quit

We work closely with Help Me Quit teams based in Health Boards and community pharmacies across Wales to enhance smoking cessation support. We have developed high quality digital tools, including online quit plans and the HMQ app to reach more of the smoking population earlier. Further development of pathways within the wider cessation system include developing interventions to reduce inequalities and to more effectively support vaping cessation.

The Help Me Quit in Hospital programme has accelerated the uptake of smoking cessation amongst the most vulnerable populations over the past 3 years. The current focus of work includes further developing training, support for staff and system integration along pre-admission and discharge pathways to improve early identification and engagement, reduce attrition and maximise quits.

Reducing Smoking in Pregnancy

Working jointly with maternity and public health teams in Health Boards, this programme strengthens smoking cessation pathways within maternity services and supports pregnant women who smoke to become smokefree. The work focuses on improving service delivery, embedding best practice and working in partnership to increase quit rates during pregnancy.

Social Marketing and Digital Support

Targeted mass media social marketing campaigns promote smoking prevention, cessation support and encourage quit attempts, including campaigns such as Break Its Hold using TV advertising, social media channels and real‑life case studies, plus campaigns targeting young adults through influencers. Digital support for smokers and vapers is being expanded through online tools, interactive support on the Help Me Quit website, and a smoking cessation app. Work is also underway to scope a national adult vaping cessation service and a vaping cessation pathway for children and young people.

Data and research

Help Me Quit represents a unique resource as both a platform for supporting innovation and a repository for detailed information on smokers in Wales and their needs. We have an ambitious programme of research and evaluation to understand and support smokers by identifying, piloting and scaling effective interventions.